Sociodemographic Characteristics Research Articles

Acceptance of Digital Discharge Management Interventions Among Patients After Bariatric Surgery: A Cross-Sectional Study

Bariatric surgery is an effective long-term treatment for severe obesity, but relapse rates remain high. Digital interventions can enhance patient care, yet research on the intention to use digital discharge management interventions is lacking. This study aims to assess the behavioral intention to use digital discharge management interventions after bariatric surgery and to identify differences in sociodemographic and medical characteristics, as well as potential key drivers and barriers. A cross-sectional study with N = 514 patients was conducted using the Unified Theory of Acceptance and Use of Technology (UTAUT). Mean scores for behavioral intention and predictors were calculated. Group differences were analyzed with independent t-tests and analyses of variance with post hoc tests. Drivers and barriers were assessed through multiple hierarchical regression analysis. The behavioral intention to use digital discharge management interventions was high. Significant predictors included age (β = −0.17, p < 0.001), eHealth literacy (β = 0.10, p = 0.037), internet anxiety (β = −0.15, p = 0.003), and time since bariatric operation (β = −0.13, p = 0.005). The predictors performance expectancy (β = 0.23, p < 0.001), effort expectancy (β = 0.36, p < 0.001), and social influence (β = 0.26, p < 0.001) were significantly positive key factors. These results confirm the need for implementing digital discharge interventions after bariatric surgery, with various drivers and barriers identified for application usage.

Pregnancy Preparedness and Complication Preparedness of Pregnant Women in Prenatal Clinics of Tertiary Hospitals

This study assesses the level of Birth Preparedness and Complication Readiness (BPACR) among pregnant women attending antenatal clinics at a tertiary care center. Conducted through an analytical cross - sectional approach from August to October 2023 at Rajarajeswari Medical College Hospital, Bengaluru, it involved 194 participants who were 32 weeks gestation or more. The research utilized a questionnaire covering sociodemographic characteristics, knowledge of birth preparedness, and complication readiness, with data analyzed using descriptive statistics. Results indicated a low BPACR index with significant gaps in awareness and preparedness for childbirth and emergency situations. Only a fraction of participants had initiated antenatal care in the first trimester, and a majority were unaware of severe preeclampsia signs. The study underscores the need for enhanced education and awareness programs at both community and health center levels to improve birth preparedness and complication readiness among pregnant women.

A Tailored Postpartum eHealth Physical Activity Intervention for Individuals at High Risk of Postpartum Depression-the POstpartum Wellness Study (POW): Protocol and Data Overview for a Randomized Controlled Trial.

Postpartum depression (PPD) is associated with significant health consequences for the parent and child. Current recommendations for PPD prevention require intense health care system resources. Evidence-based interventions for PPD prevention that do not further burden the health care system are needed. Evidence suggests that physical activity (PA) can generally reduce depressive symptoms. Technology-based interventions may help decrease common barriers to PA. This study aims to report the protocol and provide a data overview of the POstpartum Wellness study (POW)-an effectiveness trial evaluating whether an eHealth PA intervention tailored for postpartum individuals increased PA and decreased depressive symptoms among individuals at high PPD risk. This remote parallel-group randomized controlled trial included postpartum individuals with a history of depression or at least moderate current depressive symptoms not meeting the PPD diagnostic threshold and with low PA levels from an integrated health care delivery system. Participants were randomized to an eHealth PA intervention or usual care. The intervention group received access to a library of web-based workout videos designed for postpartum individuals, which included interaction with their infants. At baseline and follow-up (3 and 6 months), PA was measured using questionnaires and a wrist-worn accelerometer. Depressive symptoms were measured using the Patient Health Questionnaire-8 (PHQ-8). Data were collected to assess exploratory outcomes of sleep, perceived stress, anxiety, parent-infant bonding, and infant development. The study was funded in January 2020. Participants were enrolled via REDCap (Research Electronic Data Capture) or telephonically between November 2020 and September 2022; data collection ended in April 2023. Randomized participants (N=99) were 4 months post partum at baseline with moderately severe depressive symptoms (mean PHQ-8 score 12.6, SD 2.2). Intervention (n=50) and usual care (n=49) groups had similar sociodemographic characteristics, months post partum, baseline depressive symptoms, number of children at home, and prepregnancy PA levels. Retention in assessments was ≥66% for questionnaires and ≥48% for accelerometry, with modest differences by group. At 3-month follow-up, 73 of 99 (74%) participants (intervention: 35/50, 70%; usual care: 38/49, 78%) completed questionnaires; 53 of 99 (54%) wore the accelerometer for 7 days (27 of 50 (54%) intervention, 26 of 49 (53%) usual care). At 6-month follow-up, 66 of 99 (67%) participants (30 of 50 (60%) intervention, 36 of 49 (73%) usual care) completed questionnaires and 43 of 99 (43%) wore the accelerometer for 7 days (21 of 50 (42%) intervention, 22 of 49 (45%) usual care). Data analysis is completed, and a manuscript with these findings is currently under review for publication. The POW trial evaluates the effectiveness of an eHealth PA intervention for improving depressive symptoms and increasing PA among postpartum individuals at high PPD risk. Results have implications for the design and delivery of behavioral interventions among vulnerable patients. ClinicalTrials.gov NCT04414696; https://clinicaltrials.gov/ct2/show/NCT04414696. DERR1-10.2196/56882.

Assessment of knowledge, attitude and practice regarding hygiene among meat handlers in Vijayapura city, North Karnataka

Background: Food-borne diseases are a significant health concern globally, particularly in meat-related cases, due to unhygienic handling and inadequate sanitation. Challenges such as inadequate food safety regulations, weak regulatory frameworks and insufficient awareness among food handlers contribute in exacerbating the issue. The aim of this study was to evaluate knowledge, attitudes, and practices of hygiene among slaughterhouse workers in Vijayapura, north Karnataka. Objective was to evaluate the sociodemographic characteristics of meat handlers and their correlation with knowledge, attitudes, and practices related to meat hygiene in in Vijayapura, north Karnataka. Methods: This descriptive, cross-sectional study was conducted in Vijayapura city from July to September 2023, involving meat handlers from various shops. 79 participants were selected from 200 shops using a lottery method, anticipating a 71% knowledge level of meat hygiene. Informed consent was taken, and data collection was done using a pretested, semi-structured questionnaire. Results: Among the 79 participants, 86.1% were male and 13.9% female, with 64.5% having over five years of experience. Most (96.2%) had good knowledge of meat hygiene, while 3.8% had poor knowledge. Significant associations were found between gender (p=0.00), religion (p=0.00), educational status (p=0.013), and meat hygiene practices. Conclusions: The study reveals satisfactory knowledge, attitudes, and practices regarding meat hygiene among meat handlers in Vijayapura. It is highly advisable to emphasize public health education, develop policies, and implement consistent training programs for meat handlers focused on safe meat handling practices, as well as maintaining high standards of personal and general hygiene.

Economic disadvantage during childhood, obesity, and diabetes across three birth cohorts of older Mexicans.

Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in three cohorts of Mexican adults. Data on those 60-69 years old from the 1930-39, 1940-49, and 1950-59 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent reports. Supplementary analyses using HbA1c as a criterion for diabetes were conducted. A regression-decomposition approach was implemented. Logistic regression models included adjustments for sociodemographic characteristics and access to medical care. Diabetes prevalence was 23% overall and 11%, 25%, and 26% in the 1930-39, 1940-49, and 1950-59 cohorts, respectively. EDDC declined across successive cohorts, while the prevalence of overweight/obesity at age 50 increased. EDDC and overweight/obesity were associated with higher odds of reporting diabetes. A scenario that eliminates disadvantaged EDDC reduced diabetes prevalence by 11% in a pooled sample, while eliminating overweight/obesity reduced it by 30%. Overweight/obesity explained 42% of the rise in diabetes prevalence between the 1930-39 and 1950-59 cohorts. Improvement in EDDC explained 18% of the rise in diabetes prevalence between 1930-39 and 1950-59 cohorts. High body weight across Mexican birth cohorts seemed to offset the potential benefits from improvements in childhood conditions on adult diabetes risk.

Trust in the science behind COVID-19 vaccines as a driver of vaccine acceptance in the United States, 2021–2023

ObjectivesTo evaluate changes in public trust in the science behind COVID-19 vaccines in the United States (US) from 2021 to 2023, and to assess how loss of a family member or close friend to COVID-19, influences this trust and vaccine acceptance. MethodsUsing stratified random sampling for key demographic variables, including age, gender, race/ethnicity, region, and education level, the study analyzes data from a series of cross-sectional surveys conducted in 2021, 2022 and 2023. Descriptive statistics were employed to summarize the socio-demographic characteristics of the respondents and their levels of trust in science and vaccine acceptance. Weighted logistic regression models were applied to assess the relationships between trust in science, vaccine acceptance, and socio-demographic factors. These models controlled for potential confounding variables and allowed for the estimation of adjusted odds ratios (aOR) and 95% confidence intervals (CI), highlighting the key predictors of vaccine acceptance and willingness to receive future recommended boosters. ResultsThe results indicate that trust in science remained relatively stable over the study period and continued to be a strong predictor of vaccine acceptance, which was higher among male respondents, those with university degrees, and those with higher than median income. Notably, the experience of personal loss was significantly related to an individual’s trust in science and vaccine acceptance. ConclusionsTrust in the science behind COVID-19 vaccines appears to have been a crucial factor in US vaccine acceptance, with respondents who expressed higher trust being significantly more likely to accept the vaccine and express willingness to take future boosters. To maintain and enhance public trust in vaccination programs, trust in health communication from public sources, particularly the CDC, must be strengthened, as trust in the CDC was also found to be significantly correlated with both vaccine acceptance and future booster uptake. Personal experiences of loss due to COVID-19 were important predictors of trust in science and vaccine acceptance, highlighting the need for public health communications to be sensitive to the emotional impact of loss and grief along with the diverse socio-economic and educational backgrounds of the US population.

ICARUS registry: findings from the first 1595 cases of acute decompensated heart failure in a single center in a latin american country

Abstract Introduction Institutional aCute decompensAted HeaRt FailUre RegiStry (ICARUS) will provide information on clinical characteristics, medical practice, patterns of treatment, and outcomes of patients hospitalized with Acute Decompensated Heart Failure (ADHF) in a hospital in a middle-income country. Objective Describe the methodological aspects, sociodemographic, and clinical characteristics of patients hospitalized with ADHF and their short-term outcomes. Method Prospective cohort of patients with ADHF from the emergency service of a cardiovascular center. Descriptive statistics were used to synthesize sociodemographic characteristics, clinical characteristics during hospitalization, and outcomes. Results 1595 patients with ADHF. The median age was 68 years (Q1=58; Q3=76), and 69.28% were men. The median hospital stay was six days (Q1=4; Q3=11), with an accumulative incidence (AI) for rehospitalization at 30 days of 8.70 % (95% CI 7.18 to 10.40%), in-hospital mortality AI of 4.33% (95% CI 3.38 to 5.44%), and a median change in the quality-of-life score like Minnesota Living with Heart Failure Questionnaire (MLHFQ) at 30 days of -20 points (Q1=-37; Q3=-5). At discharge, all patients had a percentage greater than 70% of the use of quadruple neurohormonal blockade therapy. Conclusions ICARUS is one of the first registries in Latin America since the indication of the use of SGLT2 inhibitors, evaluating the clinical and sociodemographic characteristics, treatment patterns, and outcomes of a preliminary cohort of 1595 patients hospitalized for ADHF. The results indicate that, at discharge, up to 82.79% of patients were receiving quadruple neurohormonal blockade therapy, which is considerably challenging to achieve in Latin America. Considering the results of the Safety, tolerability and efficacy of up-titration of Guideline-Directed Medical therapies for acute heart failure (STRONG-HF study), our study reinforces the benefit of discharge with Guideline-Directed Medical Therapy (GDMT) for heart failure from hospitalization. The use of GDMT for heart failure may have influenced our positive outcomes in terms of in-hospital mortality, improvement in quality of life, and the percentage of short-term rehospitalizations compared to similar cohorts.Proportion of HF drug group

Digital health literacy and associated socio-demographic characteristics in the French population

Abstract Background With the development of digital devices in the health field, digital health literacy has become an important issue in promoting and protecting people’s health. Digital health literacy was measured in a representative sample of the French adult population in order to assess its level and to identify the socio-demographic characteristics of individuals with the lowest literacy levels. Comparisons with works carried out in other European countries as well as implications for the implementation of digital interventions will be discussed. Methods Digital health literacy was assed using the HLS19-DIGI-HI Instrument. This 8-item scale measuring the skills related to dealing with digital health information was introduced in the 2023 Health Barometer survey, conducted by the French national public health agency. The survey included French-speaking individuals living in France, aged 18-85, selected through randomly generated phone numbers. 3007 persons were interviewed using a computer assisted telephone interview. A continuous score and categories were calculated to determine the level of Digital Health Literacy. Their associations with sociodemographic characteristics were studied using univariate and multivariate analysis. Results 1902 persons declared they used internet to search information or advice on health on internet in the last 12 months and completed the Digital health literacy questionnaire. 61 % of these individuals have a low level of digital health literacy (29 % “inadequate” and 32% “problematic”). Multiple sociodemographic characteristics were associated with lower levels of literacy in univariate and multivariate analysis. Conclusions These results are useful to better understand and assess the digital health literacy of the population according to their socio-demographic characteristics. They will provide a knowledge base to implement web-based interventions for promoting targeted digital health interventions, according to targeted audiences. Key messages • This study in large random sample of the French population showed frequent difficulties to deal with online health information. • Multiple sociodemographic characteristics were associated with digital health literacy and can help to support implementation of targeted digital health interventions.

Eating habits of students of health colleges and non-health colleges at the Northern Border University in the Kingdom of Saudi Arabia.

Eating habits are important determinants of health. Young adults who have recently transitioned to university life experience stress and lack of time, which are major risk factors for poor eating habits. This study's objectives were to identify and compare eating habits between students at health and non-health colleges at Northern Border University (NBU), Saudi Arabia and to determine the relationship between students' eating habits and their sociodemographic, lifestyle, and psychological factors. This comparative cross-section study was conducted on 480 students equally from health and non-health colleges at NBU from March to April 2023. A pre-designed electronic questionnaire was used to collect data on students' sociodemographic characteristics, eating habits, and diet-related psychological factors. Statistical analyses were carried out using STATA/SE version 11.2 for Windows. Unhealthy eating habits were reported by 44.6% and 41.3% of students at health and non-health colleges, respectively. Most students had irregular meals, skipped breakfast, ate fast food frequently, and consumed insufficient amounts of vegetables, fruits, and water. Parental separation, living away from family predisposed to unhealthy eating habits. Being 21-23 years old, playing sports, and high body mass index were linked to healthy eating habits. Psychological factors such as overeating until the stomach hurts and eating to feel happy were associated with unhealthy eating habits. Unhealthy eating habits were prevalent among students at NBU irrespective of the type of study. Thus, implementing initiatives to promote nutrition and healthy eating habits within the university environment is crucial for health promotion and well-being among students.

Are answers affected by data collection on paper or online? The case of Belgian adolescents

Abstract Background In the early 2000s, the prevalence estimations were compared in relation with the mode of data collection, i.e. paper or online. Following the widely spread routine use of connected devices, especially in adolescents, such a monitoring is of interest. Within the 2022 “Health Behaviour in school-aged children” survey in French-speaking primary and secondary schools of Belgium, those participating could choose between paper and online collection. Our objective was to compare a large set of indicators between the two modes after adjusting for the students’ characteristics. Methods After a two-stage random selection of schools and classes, 11,751 10-to-20-year-old adolescents completed the questionnaire either on paper or online. Descriptive analysis and comparisons were conducted using chi2 and multiple logistic regressions adjusted for the students’ sociodemographic characteristics that may vary according to the questionnaire mode. Results Overall, 54.9% of the questionnaires were completed online. The choice of the collection mode provided to the schools’ headteachers was associated with the adolescents’ characteristics. Those who completed the questionnaire online were more likely to be in secondary schools, in Wallonia, and of a more favourable socioeconomic profile. After adjustments, no difference in the indicators regarding health, well-being, substance use, or sleep duration was observed. Conversely, a difference was observed for screen time (internet ≥2h/weekday: 70.4% on paper vs. 72.3% online; adjusted P-value: 0.02), some food groups (daily vegetables: 51.2% vs. 58.0%; P-value<0.001) and body weight status (overweight including obesity: 16.7% vs. 14.0%; P-value<0.001). Conclusions In some circumstances such as data collection in the school setting, mixed modes are still necessary due to operational issues. While most indicators did not show a difference between online and paper collection, potential implications for others need to be further understood. Key messages • Collecting data through online or paper questionnaires does not lead to major differences in prevalence estimates. • With the rise of online surveys, further assessment is required to understand the potential declaration biases.

Maternal pre-pregnancy weight and infant spontaneous movement: is there an association?

Abstract Introduction Maternal pre-pregnancy overweight status might create a chronic systemic inflammatory environment for the foetus, impairing neurons development. The Motor Optimality Score-Revised (MOS-R) is an established tool to assess infant spontaneous movement at 3-5 months helping predict later neurodevelopmental outcomes in infants, including language, minor neurological dysfunction or learning difficulties at school age. The aim of our study was to investigate if maternal BMI together with other characteristics were potentially associated with MOS-R score at 3-5 months in a sample of newborns representative of physiologic full-term pregnancies. Methods 128 mother-children couples were enrolled in the Hospital of Modena, Italy. Mothers’ socio-demographic characteristics and BMI pre and during pregnancy were collected. MOS-R was assessed in infants within 9-18 weeks post term age (Median 13, IQR 12-14). Descriptive statistics, bivariate associations and multivariate analysis were performed. Results In our sample, 94.5% of infants (44% females) had a MOS-R≥25 (optimal score), 3.9% a MOS-R between 23-24 and 1.6% a MOS-R<23. In bivariate analyses pre-pregnancy BMI≥25 and weight gain higher than recommended during pregnancy were associated with MOS-R<25 (p < 0.05); being unemployed before and during pregnancy and having pregnancy during COVID lockdown were associated with reduced “age adequate movement repertoire” subcategory (p < 0.05). In multivariate analysis, pre-pregnancy BMI≥25 remained the only factor significantly associated with lower scores (p < 0.05). Discussion Our sample of healthy infants showed a typical range of spontaneous movements reflecting neural integrity. However, lower MOS-R scores were associated with pre-pregnancy overweight. This finding reinforce the importance of enhancing public health actions targeted at keeping a weight in the normal range to protect from a large number of unhealthy conditions both the mother and the offspring. Key messages • Pre-pregnancy weight appears associated with infant spontaneous movement in 3-5 months infants. • Public health actions targeted at keeping female weight in the normal range must be strengthen.

Investigation of Global Climate Change Awareness Levels Among Faculty of Medicine Students

Abstract Background According to the WHO, climate change is the biggest threat to global health in the 21st century. Thus, it is important to understand medicine faculty students’-who are future doctors-awareness of climate change and its effects on human health. The aim of this study is to determine the level of awareness of Inonu University Faculty of Medicine students about global climate change. Methods This descriptive cross-sectional study was conducted between February and March 2024. The target population consisted of 1692 students studying in a medical university. The sample size was calculated as 260 students based on a percentage of awareness of global climate change of 32.3%, and 283 respondents were included in the study. A questionnaire was used that included questions about the respondents’ sociodemographic characteristics and global climate change awareness. In addition, they answered the items of the Awareness Scale of University Students About Global Climate Change (GCCAS). The dependent variable was total GCCAS scores, and the independent variables included age, concern about climate change, and knowledge status. A Student’s t-test was used in the statistical analysis. Results Of the students, 50.2% were female, 51.6% were older than 22 years of age, 82% were worried about the negative effects of climate change, 79.5% said they received no education about climate change during their medical education. The mean total GCCAS score in the study group was 71.74 +/-13.81. Women, students who were concerned about climate change, and those who had knowledge about climate change had significantly higher mean GCCAS scores (p < 0.05). Conclusions More than 75% of study group said that they had received no education about climate change. However, the percentage of students who were aware of and concerned about climate change and who had information about climate change was even higher. Key messages • Due to the potential for medical students to encounter the health effects of climate change, these issues should be included in education programs to increase their awareness of this important issue. • Medical students need to take conscious and informative steps regarding climate change to help protect the health of future generations.

Characteristics of users of oral nicotine products according to smoking status in Denmark

Abstract Background Oral nicotine products e.g., snus, chewing tobacco, and tobacco-free nicotine pouches gain increasing popularity. The aim of the study was to estimate the prevalence of use of oral nicotine products in the Capital Region of Denmark in 2021, to describe associations with socio-demographic characteristics and to explore if smoking status moderated these associations. Methods The study was based on the Danish Capital Region Health Survey 2021 including 56,245 persons aged ≥16 years old (response rate 54.9%) which included self-reported information on use of oral nicotine products and smoking status. Information on socio-demographic characteristics were assessed in national registries. Descriptive analyses and multivariate logistic regression models including interaction terms with smoking status and weighted for survey-sampling and non-response were performed. Results In total, 3.5% used oral nicotine products. Men showed higher odds of using oral nicotine products compared with woman (OR = 3.70) while there were no associations with education and occupational affiliation when adjusted for sex and age. The associations with age and place of residence were moderated by smoking status. Among smoking participants, young persons aged 16-19 years showed the strongest association with use of oral nicotine products (sex-adjusted OR = 21.71) while persons aged 20-24 years showed the strongest association in non-smoking participants (OR = 11.08). Conclusions Especially men and young age were strongly associated with use of oral nicotine products. For age, the association was moderated by smoking status. Interventions should address these high-risk groups and pay attention to smoking status. Key messages • Sex and age play a siginificant role in use of oral nicotine products. • Interventions and public health campagins should adress high-risk groups

Deep learning modeling to assess surface temperature and greenery impact on emergency room access

Abstract The escalating land surface temperature is a key environmental indicator with potential repercussions on human health. An artificial NN model was built to predict the number of ER accesses as a dependent variable, to establish the predictive power and interactions of land surface temperature and normalized differential vegetation index(NDVI), which is used to measure urban greenery.A map of Taranto was built by vector files on the Apulia region website and processed using R Studio 2023.06.2.The vector file containing the mapping of the city of Taranto was processed to obtain a 200mx200m grid of the entire surface.The Local Health Authority of Taranto provided indications of the residences of ER accesses, and coordinates were merged to gridded vector file to obtain the average of ER accesses and the socio demographic features per single grid unit. NDVI and surface temperature were averaged for July 2023 using images from Landsat 8(30m) and merged to the vector providing an average value of temperature and NDVI index per single quadrant. The dataset was divided into two db according to an 80/20 ratio respectively for the training and test dataset.A NN model was built on dichotomous value (above/below median) for each quadrant (6513 units) with hyperparameter tuning technique using the accuracy to select the best model.A MOC model was built to reduce the probability of NN detection by at least 40% in a randomly selected subject.A MOC model was built considering sociodemographic variables as fixed features and an epsilon of 0 for 175 generations and an ICE curves population initialization strategy. NNET accuracy value was 0.849 and 0.841 in training and testing, suggesting a good fitting of the model.Relative change plots were adopted to show the amount and the direction of generated counterfactuals, to reduce grid unit prediction to be over median.LST decreasing and NDVI score increasing were associated with a reduction of classification probability of grid unit. Key messages • Rising land surface temperature is a critical environmental indicator with potential impacts on human health. • Artificial neural network models perform well in predicting the number of ER accesses with respect to land surface temperature and NDVI, which is used to measure urban greenery.

Heterogeneity of postpartum bonding and maternity blues among mothers three days after delivery

Abstract Background Findings about risk factors for postpartum depression (PPD) are often inconsistent. The variability could be due to the heterogeneity of characteristics of mothers at risk for PPD in certain populations, which has important mental health implications. We examined the heterogeneity of sociodemographic, pregnancy and labor characteristics in postpartum women referred to follow-up care on the third day after delivery. Methods We performed a nested cross-sectional latent profile analysis (LPA) on a convenience sample of women in a tertiary community hospital in Split, Croatia in 2020. Participants completed the first subscales of Postpartum Bonding and Maternity Blues questionnaires, as well as five subscales of the Questionnaire of Family Functioning According to Parents and 12 sociodemographic, pregnancy and childbirth-related variables. LPA identified profiles of mother-infant bonding and postnatal blues, and multinomial regression analysis was used to determine the influence of different profiles. Results Of the 318 participants, the best-fitting model had three latent profiles. First (n = 76, 24% of participants) and second (n = 216, 68% of participants) latent profiles showed good postpartum bonding, while second profile showed higher primary blues. Third profile (n = 80, 25% of participants) was characterized by poorer postpartum bonding and elevated primary blues. Only good youth experiences of mothers with their parents (relative risk [RR] 0.26; 95% CI 0.12-0.57; p = 0.001) and good present-day relationships with partners (RR 0.26; 95% CI 0.13-0.52; p < 0.001), significantly decreased the risk for third latent profile classification. Conclusions Postpartum bonding and primary blues of women who gave birth three days prior were heterogeneous. This heterogeneity could result in the well-documented heterogeneity of postpartum depression in women, and therefore, be the focus of mental health interventions in similar settings. Key messages • We found heterogeneity of sociodemographic, pregnancy, and labor characteristics in postpartum women after delivery, highlighting the variability in risk factors for postpartum depression. • This heterogeneity could result in the well-documented heterogeneity of postpartum depression in women, and therefore, be the focus of mental health interventions in similar settings.

Characteristics of sick-listed employees diagnosed with a mental disorder in Germany

Abstract Purpose Employees with mental disorders (MDs) are more likely to exit the labour market prematurely. In Western European countries, characteristics of employees diagnosed with a MD have not been reported comprehensively, hampering targeting the risk group and developing preventive interventions. The aim was to describe the socio-demographic, health, treatment, organisation, job and labour market characteristics of employees diagnosed with a MD in Germany and their gender differences. Methods This cross-sectional study uses baseline data from sick-listed (≥6 weeks) employees diagnosed with a MD, aged 20-60 years, who were patients in the German mental health care, and recruited in the context of a return to work (RTW) intervention evaluation trial (RTW-PIA study). Descriptive T-tests/Chi-2 tests were applied. Results 484 individuals (58.5% female; 31% highly educated, average age 42.6) were included, of which 88.4% had affective disorders. Most were salaried employees working full-time, employed in large companies and having permanent contracts. 65.5% reported moderate depressions and the average work ability was 3.9 on a 0-10 scale. 74.2% had a positive RTW prognosis; 15.3% scored high levels of RTW self-efficacy. Gradual RTW (GRTW) was perceived the most important requirement for RTW (76.9%). More than 60% had discussed various work-related topics during therapy; further RTW-measures were prepared among 47.7%. Almost 60% received a recommendation for GRTW. Significant gender differences were found among the socio-demographic, health, job and labour market characteristics. Conclusions This study gives insights into a hardly investigated group. Almost two thirds had moderate depressions, 84.7% had low RTW self-efficacy and a very low average work ability. This highlights the vulnerability of persons with MDs in the labour market and suggest an urgent need for more work-related (health-)care. Gender differences need to be better addressed in mental health research. Key messages • Comprehensive knowledge of the characteristics of sick-listed employees diagnosed with MDs is crucial for targeting interventions to promote RTW. • Moderate depression scores, low RTW self-efficacy and very low work ability highlight the vulnerability of persons with MDs in the labour market, suggesting an urgent need for more work-related care.

Traditional medicine use to manage hypercholesterolemia, hyperglycaemia and hypertension in Ecuador

Abstract Background Although the use of traditional medicine (TM) to manage health issues is frequently reported, clinical guidelines often overlook this practice. This study aimed to describe the frequency of TM use to control 3 cardiometabolic risk factors for non-communicable diseases (arterial hypertension, hypercholesterolemia, and hyperglycaemia, collectively referred to as CMRF here); and associated sociodemographic, economic, and clinical characteristics. Methods Descriptive cross-sectional study with a representative population of two health districts in Ecuador, one urban in southern Quito and one in a forested rural area with diverse ethnic groups in Esmeraldas. We included 602 individuals with at least one CMRF and calculated the proportion of those who reported regular use of TM (herbal or traditional remedies) to control their CMRF. We used a multivariable logistic regression model to calculate Odds Ratios for TM use according to sociodemographic, economic, and clinical characteristics. Results TM was commonly used to control CMRF in both sociocultural contexts (39.4% Esmeraldas, 31.1% Quito), often in combination with conventional medicine (CM). A notable percentage of people (33.9% Esmeraldas, 39.0% Quito) did not take any treatment for their CMRF, and the rest used CM alone. In both settings, education was significantly associated with TM use. While in Quito people with higher education were more likely to use TM (aOR 2.04, 95%CI 1.03-3.90), in Esmeraldas, it was more common among people without formal schooling (aOR 3.76; 95%CI 1.59-8.88) as well as those of younger age (aOR per year 0.97; 95%CI 0.95-0.99) and from Afro-Ecudorian ethnicity (aOR 2.13; 95%CI 1.02-4.45). Conclusions Traditional medicine is used by a significant portion of Ecuador’s population, highlighting the need for a more accessible and intercultural approach to healthcare. Key messages • The use of traditional medicine to address hypertension, hypercholesterolemia, and hyperglycaemia appears to be widespread in different sociocultural and economic contexts of Ecuador. • To promote intercultural health, understanding the diverse sociocultural patterns associated with the use of traditional medicine, often combined with conventional medicine, is crucial.

Evolution of online health-related information seeking in France from 2010 to 2023

Abstract Background Given the rapid ongoing progression of the internet and increase in health information available online since 2010, it is important to understand how these changes impact online health information-seeking behaviour of the population and the way of managing one’s health. This study aims to describe the evolution of the use of internet to seek health-related information as well as the characteristics of online health information seekers. Methods We used data from the French nationally representative surveys Health Barometers. It is a cross-sectional repeated survey of random representative samples of the French population conducted by the French national public health agency since 1992 using computer-assisted telephone interviewing. It serves to measure the evolution of key indicators regarding health-related behaviors, attitudes, and opinions in the general population and includes individuals aged 18-75 years old selected through randomly generated phone numbers. In the 2010, 2014, 2017 and 2023 editions, the same question was asked about the internet use as a source of health information. Evolutions over time were assessed using chi-square tests. Associations with sociodemographic characteristics and health status were evaluated using logistic regression models. Results Although internet access increased steadily during this period, from 72.8% in 2010 to 95.2% in 2023, the use of the internet as a source of health information rose between 2010 and 2014 (from 37.3% to 67.9%), decreased significantly in 2017 (60.3%) and rose again in 2023 at 65.3 %. The study describes the characteristics of the online health information-seekers trough time. Conclusions The past decade was marked by a breakthrough of the use of internet in the general population and the use of internet to seek health information. The analysis of the digital health information-seekers serves the public health authorities in their mission to provide accessible information on public health. Key messages • This study aims to describe the evolution of Online Health-Related Information Seeking in France from 2010 to 2023 and the characteristics of digital health information-seekers. • The analysis of the digital health information-seekers serves the public health authorities in their mission to provide accessible information on public health.

Association between infant feeding behavior and maternal choice of breastfeeding type

Abstract Introduction Feeding in infants is a fundamental process influenced by the mother-child relationship during the early months of life. The regulation of feeding behavior, and hunger and satiety cues may be interpreted by the mother, potentially relating to the type of feeding chosen. Objectives To determine the association between infant feeding behavior and the type of breastfeeding chosen by the mother. Methods A cross-sectional and prospective study was conducted, including mothers with children aged between 6 and 18 months. Those with medical contraindications for immediate postpartum breastfeeding or with suspension of exclusive breastfeeding during the first 6 months of life due to medical prescription were excluded. The Baby Eating Behavior Questionnaire was used to evaluate the baby’s enjoyment of food, appetite response, eating speed, and satiety response. Results 108 mothers were included, with 87% in agreement with exclusive breastfeeding (EBF), 43.3% using breastfeeding as the primary feeding method, and only 33.3% practicing EBF during the first 6 months. Food response (FR) scored 19.6 (±4.3), enjoyment of food (EF) 17.6 (±2.1), satiety response (SR) 7.1 (±2.0), eating speed (ES) 8.8 (±2.3), and appetite (AP) 4.2 (±0.7). Comparing FR, EF, SR, ES, and AP scores between those who practiced EBF and those who did not showed p > 0.05. sociodemographic characteristics, perinatal factors, stance on EBF, number of hours per day with the child, feeding location, poor technique, breastfeeding pain and lack of medical guidance, all showed p > 0.05 when comparing between those who practiced EBF and those who did not; in contrast to perceiving that the baby wanted to breastfeed (2.5/1.0-6.2), having time to feed (3/1.2-7.2) and having no health problems (10/1.2-78.7) all with p-value <0.05. Conclusions The mother’s perception identifying the baby’s desire to breastfeed, having time to feed the baby and not having health problems favor exclusive breastfeeding. Key messages • Maternal perception plays an important role in deciding to give SCI, so it is the physician’s job to educate the mother so that she has additional arguments for choosing SCI. • The infant’s feeding behavior does not have a significant impact on the mother’s behavior in choosing SCI feeding.

Awareness of personal cardiovascular risk among the adults with an elevated body mass index in a very high-risk country

Abstract Background An elevated body mass index (BMI) is a risk factor for cardiovascular diseases (CVD). The awareness of personal cardiovascular risk (pCVR) may vary in different populations, thus influencing health behaviours and cardiovascular prevention. Purpose To analyse the awareness of pCVR among the adults with an elevated BMI, along with sociodemographic characteristics and cardiovascular risk factors (CRF) possibly associated with the lack of pCVR awareness in a very high-risk country. Methods The pilot study included a convenient sample of 1054 adults. Those with an elevated BMI (≥25 kg/m2) were divided into two groups depending on their awareness of pCVR. The groups were compared according to the sociodemographic characteristics (age, gender, and education) and CRF (BMI, hypertension, dyslipidaemia, diabetes mellitus, smoking, physical inactivity, feeling of frequent exposure to stress, previous myocardial infarction (MI), and family history for CVD). The data were collected by voluntary filling out a survey with multiple-choice questions from April 1st to June 30th, 2022. Results Out of the total number, about half of the participants had an elevated BMI (N=549, 52%). Most of them were aware of their pCVR (69% vs 31%, p<0.01). Those unaware of pCVR were younger (44±13 vs 51±14, p<0.05), mostly females (56% vs 47%, p<0.05), with high education (61% vs 51% with more than high school, p<0.05). The groups had similar average BMI (28±3 kg/m2 vs 29±3 kg/m2, p>0.05), but the participants unaware of pCVR were more frequently overweight than obese (82% vs 64% with BMI ≥25 kg/m2 and <30 kg/m2, p<0.01). They had significantly lower frequencies of hypertension (15% vs 53%, p<0.01), dyslipidaemia (23% vs 46%, p<0.01), diabetes mellitus (2% vs 14%, p<0.01), smoking (50% vs 59%, p<0.05), previous MI (3% vs 26%, p<0.01), and family history for CVD (62% vs 82%, p<0.01). However, the majority in both groups reported physical inactivity (60% vs 64%, p>0.05) and a feeling of frequent stress exposure (70% vs 71%, p>0.05). The participants unaware of pCVR less frequently had over three modifiable CRF (12% vs 37%, p<0.01). Conclusion Most of the adults with an elevated BMI in a very high-risk country are aware of pCVR, usually because of obesity, multiple additional modifiable CRF, previous MI, or family history of CVD. Still, a notable proportion of the adults with an elevated BMI in a very high-risk country is unaware of pCVR, which is associated with younger age, female gender, high education, overweight, fewer additional modifiable CRF, and the absence of previous MI or family history for CVD. This subpopulation should be considered as a target for timely health education to raise the awareness of pCVR. Increasing physical activity through motivational campaigns and developing programmes for stress relief would be important for CVD prevention among the adults with an elevated BMI, independently of pCVR awareness.