Socio-demographic Determinants Research Articles

Prevalence of adults with fatigue in Germany: results of the ‘German Health Update 2023’ study

Abstract Background Fatigue is a non-specific symptom complex associated with exhaustion, lack of motivation and concentration. It has high public health relevance due to impairments in quality of life and work ability and increased risk of accidents. Fatigue has increasingly gained attention as one of the most common post-acute consequences of SARS-CoV-2 infection. Fatigue is also common among non-infected people and there is a lack of population-based background data. Therefore, we investigated the prevalence and factors associated with fatigue in a population-based epidemiological study in Germany. Methods The analyses are part of the national population-based cross-sectional telephone survey ‘German Health Update’ (GEDA 2023) in adults (3/2023-2/2024). Fatigue was surveyed using the Fatigue Assessment Scale (FAS) and dichotomized into yes (at least mild/moderate) versus no fatigue. The FAS is an instrument for mild-to-moderate fatigue, which must be distinguished from chronic fatigue syndrome (CFS). Weighted analyses of the data from 9,766 adults were carried out descriptively and in multivariable Poisson models, considering sociodemographic and health-related determinants. Results The prevalence of fatigue in Germany was estimated to be 29.7% (95% CI 28.1-31.2) and was highest in 18- to 29-year-olds at 39.6% (35.0-44.4). The prevalence decreased up to 65- to 79- year-olds (20.6% (18.2-23.3)) and was again higher in people aged 80 and over (33.2% (28.9-37.7)). Women had a higher risk of fatigue than men (aRR 1.19 (1.08-1.32)). Lower education (aRR 1.29 (1.13-1.49)) and medium education (aRR 1.13 (1.01-1.27)) were associated with increased risk of fatigue. There were significant associations between fatigue and chronic illness, depressive symptoms and long COVID. Conclusions Fatigue is a common symptom among adults in Germany. Female gender, young and very old adulthood as well as lower education are associated with higher risk of fatigue. Key messages • The correlations between fatigue and socio-demographic variables as well as parameters of physical and mental health provide important indications of groups particularly affected by fatigue. • The fatigue survey in GEDA 2023 is one of the few current European studies that describe the frequency of fatigue in the general population and analyzes health and sociodemographic determinants.

Exploring the Relationship Between Health Literacy and Alcohol Consumption Patterns in Tuscany

Abstract Introduction Alcohol consumption is a prevalent aspect of social and cultural life worldwide. However, high and binge consumption has become a significant public health concern. Inadequate health literacy (HL) may contribute to poor awareness and/or knowledge regarding the risks of alcohol-related behaviors. However, to date, only a few studies have examined the relationship between HL and different types of alcohol consumption. This study aimed to investigate the relationship between HL, other sociodemographic determinants, and their influence on high and binge consumption among the general population aged 18-69 in Tuscany. Methods The study analyzed data from 2017 to 2022 from a Tuscan population subsample in the Italian Behavioral Risk Factor Surveillance System PASSI. HL was assessed using the Italian version of the six-item European Health Literacy Survey Questionnaire (HLS-EU-Q6). Results Among the 12,953 interviewees, binge drinking was reported by 8.3%, while high consumption by 3.6% of the entire sample. In the multivariate logistic regression, participants aged between 50 and 69 years with problematic or inadequate HL levels had an increased adjusted odds ratio for high alcohol consumption. Instead, females, individuals older than 34 years, and those of foreign nationality had a reduced odds ratio for binge drinking. Low HL was a predictor of high alcohol consumption but not of binge drinking. Discussion As expected, young males are more likely to engage in binge drinking, while older individuals are more likely to have high consumption. In a challenging period for healthcare system sustainability, it is mandatory to use economic resources efficiently and target the right population with tailored interventions: given that HL impacts on high consumption, research and policy should focus HL interventions specifically on high alcohol consumers. Conversely, educational campaigns aimed at increasing HL in binge drinkers risk to have a lesser impact. Key messages • Health literacy does not influence binge drinking. • Inadequate levels of health literacy predict high alcohol consumption.

A questionnaire to assess ecoanxiety and its sociodemographic determinants among Italian adolescents

Abstract Background Climate change poses serious challenges to Public Health, including mental health impacts. In Italy, few studies investigated the rise of eco-anxiety, especially among adolescents, who are the main group affected by this feeling. Specific measurement tools for this population are needed to fill this gap. The aim is to adapt the Italian version of the Climate Change Anxiety Scale (CCAS) to adolescents, and pair it with a socioeconomic and demographic questionnaire (SDQ) to assess determinants. Methods The Italian CCAS was modified for adolescents through a process involving a literature review, expert discussions, and a pretest. This adapted version (a-CCAS) was tested with individuals aged 14-18 years old, maintaining an ideal ratio of 10 respondents per item. Extant psychometric scales were utilized to assess its validity. The SDQ was developed from results of a systematic review of known associations between socioeconomic and demographic factors and eco-anxiety in youth, and expert discussions, and validated by piloting the SDQ with another sample of adolescents. Internal consistency of the a-CCAS and SDQ was assessed by Cronbach’s alpha (Cα). Results The a-CCAS kept most of its original content, comprising 13 items and 2 subscales: cognitive and functional impairment. Pilot respondents were 162; Cα coefficient was >0.7 for both subscales. Convergent and concurrent validity showed positive correlations with the extant scales. The SDQ comprised 12 items in 3 domains: family, social and political-environmental determinants. Respondents were 47 and Cα coefficient was >0.7. Conclusions The a-CCAS and SDQ are valid tools for assessing baseline eco-anxiety and its determinants in Italian adolescents and can contribute to Public Health efforts to reduce the climate-related mental health burden, by measuring the impact of specific educational interventions about climate change targeted at the young. This questionnaire was created as part of the PRIN P2022JJ3LB project. Key messages • These results contribute to filling an evidence gap on eco-anxiety and its socioeconomic and demographic determinants among Italian adolescents by providing researchers with a valid measurement tool. • This tool holds promise for assessing the impact of psychologically-informed educational interventions about climate change and adaptive coping strategies on adolescents’ eco-anxiety levels.

The practice of defensive medicine among Italian physicians: a cross sectional study in Rome

Abstract Background To identify the perception and the reason of defensive medicine among Italian physicians, and identify the socio-demographic and work-related determinants of the increased practice of defensive medicine. Methods This study is a cross sectional web survey. A questionnaire was sent by e-mail to all the physicians registered to the Order of Physicians and Dentists of the Province of Rome. The collection period was from mar 2024 to may 2024. Descriptive analysis and multivariable linear regression models were conducted to describe differences between groups and to estimate the relationships between variables. Results A total of 291 physicians completed the survey and were included in this analysis. Almost 60% of respondents feel under pressure due to the possibility of legal disputes. 73,8% adopted defensive medicine behaviours during the last year. More than 80% are aware that defensive medicine represents a limitation for their profession and a unfavourable factor for patients. Who answered that they practice defensive medicine think that it is a factor limiting their professional activity (OR: 2.3) and an unfavourable factor for the patient’s health (OR: 1.1). Conclusions Defensive medicine is an important factor in health care costs without increasing the benefits to the patient. The study contributes to a deeper understanding of the perception of defensive medicine among physicians. Defensive medicine practice is common among physicians with concerns about increasing pattern in the future. Key messages • Our study highlights physicians’ awareness of adopting defensive medicine behaviors in their clinical practice. • The study contributes to a deeper understanding of the perception of defensive medicine among physicians.

Determinants of the consumption of ultra-processed foods in the Brazilian population.

This article aims to evaluate the sociodemographic determinants of ultra-processed foods (UPF) consumption in the Brazilian population ≥ 10 years of age. The study used data from the personal and resident food consumption module of the Family Budget Surveys, grouping foods according to the NOVA classification of food processing. The classification and regression tree (CART) was used to identify the factors determining the lowest to highest percentage participation of UPF in the Brazilian population. UPF accounted for 37·0 % of energy content in 2017-2018. In the end, eight nodes of UPF consumption were identified, with household situation, education in years, age in years and per capita family income being the determining factors identified in the CART. The lowest consumption of UPF occurred among individuals living in rural areas with less than 4 years of education (23·78 %), while the highest consumption occurred among individuals living in urban areas, < 30 years of age and with per capita income ≥ US$257 (46·27 %). The determining factors identified in CART expose the diverse pattern of UPF consumption in the Brazilian population, especially conditions directly associated with access to these products, such as penetration in urban/rural regions. Through the results of this study, it may be possible to identify focal points for action in policies and actions to mitigate UPF consumption.

Social patterning of health misinformation in two Eastern Mediterranean populations

Abstract Background Health misinformation, the spread of false or misleading information relevant to health, has been proposed as a major global public health thread by the WHO. We aimed to identify the major social determinants of health misinformation in the general Greek and Cypriot populations. Methods Following proportional quota sampling we recruited a nationwide sample of 585 adults from Greece and Cyprus between January 2022 and May 2023. A newly developed, culturally adopted questionnaire comprising 48 items, was used to assess misinformation on COVID-19 vaccines and the pandemic. Sociodemographic determinants of interest included gender, age, marital status, area of residence, educational attainment, and income. Multiple linear regression was used to determine associations between the aforementioned social factors and the two dimensions of health misinformation, applying mutual adjustment. Results Misinformation about both vaccination and the pandemic was higher in younger age groups (p-trend 0.026 and 0.007, respectively), among those separated, divorced, or widowed (mean difference, 95% CI compared to those single: 9.73, 0.45, 19.01), and among those living in semi-urban compared to urban areas (11.14, 1.32; 20.97 and 9.44, 1.96; 16.92, respectively). We also detected strong inverse socioeconomic gradients in health misinformation based on educational attainment and income (p-trend &amp;lt;0.001, for both). Conclusions Younger individuals, those living alone, those residing in semi-urban areas, and those with lower educational attainment and income are particularly prone to health misinformation. Our adjusted models show that this social phenomenon is not simply explained by differences in education, hence more complex, cultural, political, perceptual, and psychosocial dynamics might be in place. Addressing the social patterning of health misinformation would help manage the issue more effectively and also reduce health inequalities. Key messages • Health misinformation is strongly socially patterned in two Eastern Mediterranean European populations. • Targeting efforts to tackle health misinformation to those more vulnerable, would render such programmes more effective, also helping reduce social inequalities in health.

Trends and predictors of full immunization coverage in Nigeria

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

Socio-Demographic Determinants of Premature Child Mortality among Kumal Women in Gandaki Province, Nepal

Socio-Demographic Determinants of Premature Child Mortality among Kumal Women in Gandaki Province, Nepal

Adherence to Mediterranean diet in Moroccan school-age adolescents: sociodemographic, socioeconomic and lifestyle determinants

BackgroundDespite its benefits, the Mediterranean diet (MD) is abandoned or not adopted by the younger generations in most Mediterranean countries.ObjectiveThe aim here was to examine some factors determining adherence to MD in Moroccan school-age adolescents.Material and methodsA cross-sectional survey was conducted in a school setting among 386 students (148 boys and 238 girls), aged 14 to 18 years, randomly selected and from different socioeconomic strata. A structured questionnaire was used to collect sociodemographic, socioeconomic and lifestyle data. Physical activity was assessed using the short French version of the IPAQ questionnaire. The KIDMED test was used to assess adherence to the Mediterranean diet. Weight, height and waist circumference were measured according to WHO standards. Body mass index (BMI) and waist�to-height ratio (WHtR) were calculated. Statistical ANOVA test was used for to compare multiple means, Student’s t-test for independent samples, &lt;i&gt;Chi&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test for categorical variables and multinomial logistic regression analysis to identify factors associated with adherence to the MD amongst adolescents sample.ResultsAdherence to the MD in this population was very low, with nearly 53% having poor adherence and only 7.7% reporting optimal adherence. Multinomial regression analyses showed that poor adherence is correlated with female gender (p=0.042), low paternal education (p=0.004), limited number of meals (p=0.006), advanced age (p=0.005) and inadequate sleep duration (p=0.027). In contrast, better adherence appears to be correlated with a high number of meals per day (p&lt;0.001) and a better socio-professional class of the father (p&lt;0.001).ConclusionsThis study revealed a low prevalence of good adherence to MD confirming a transition of the study adolescents towards a Westernized diet. Targeted nutritional intervention programs should be implemented to improve adherence to the MD among Moroccan adolescents, by promoting healthy eating habits.

PREVALENCE AND DETERMINANTS OF HYSTERECTOMY IN THE GYNECOLOGY UNIT OF AYUB TEACHING HOSPITAL, ABBOTTABAD

Hysterectomy is one of the most common obstetric surgery performed on women. It provides symptomatic relief, reduces morbidity and enhances the quality of life but can also lead to complications like mental stress, infertility, fractures and cardiovascular insults. To the best of our knowledge, no studies have provided information regarding the prevalence and risk factors of hysterectomies in Pakistani females. Objective: The goal of this study is to investigate the prevalence and socio-demographic determinants of hysterectomy in a teaching hospital in Pakistan, Methods: This descriptive cross-sectional study was done in the Gynecology C unit of Ayub Teaching Hospital, Abbottabad from 25th July 2024 to 10th Oct, 2024 after taking approval from ethical committee. 246 patients who underwent major gynaecological procedures were included in this study. Basic demographics, type of procedure and indication for hysterectomy were noted after obtaining consent from the patient. Results: The overall prevalence of hysterectomy was around 36.9% in our study. Heavy menstrual bleeding (43.95%) was found to be the leading cause of hysterectomy followed by fibroid uterus and adenomyosis in 25.27% and 16.48% cases respectively. Additionally, age group 45-49 (OR: 1.04, 95% CI: 0.5-2.1), urban residence (OR: 1.08, 95% CI: 0.64-1.8), more gravida (OR: 2.08, 95% CI: 0.88-4.92) and higher socioeconomic levels (OR: 1.28, 95% CI: 0.62-2.64) were found to increase odds of hysterectomy, whereas having a job (OR: 0.83, 95% CI: 0.47-1.44) and getting college education (OR: 0.83, 95% CI: 0.4- 1.7) were found to decrease the risk of hysterectomy. Conclusion: The prevalence of hysterectomy was found to be higher than in other countries. Urban residence, multigravida, higher socioeconomic levels and older age groups tend to increase the odds of hysterectomy.

Physical Inactivity and its Sociodemographic Determinants among Adults: A Community-Based Study

Introduction: Physical inactivity (PI) is the fourth leading risk factor for global mortality and is potentially modifiable. Understanding its sociodemographic correlates can contribute in planning preventive measures to reduce the same. Aims and Objectives: 1) To estimate the prevalence of PI among adults aged 20–60 years and 2) to identify the sociodemographic determinants of PI among adults. Material and Methods: A community-based cross-sectional study was done in district Aligarh, Uttar Pradesh. 304 adults aged 20–60 years, giving informed consent were selected by simple random sampling. Pregnant women and those with febrile disease and physical defect were excluded. Predesigned structured proforma and Global Physical Activity Questionnaire were used. Chi-square test and logistic regression analysis were applied using IBM SPSS 23.0. Results: Prevalence of PI was 47.7% (95% CI: 42.0–52.6). It was significantly higher in urban (55.3% vs 41.1%) than in rural area and among females than in males (68.7% vs 34.9%). PI during work was 74.3%, during travel 78.9%, and during recreation 88.5%. Being female increased odds of PI by almost ten times (adjusted odds atio (AOR) =9.7, 95% CI: 1.6–58.5). Unskilled workers/laborers and farmers (those involved in active occupational work) were found to have lesser odds of PI (AOR = 0.2, 95% CI: 0.1–0.5 and AOR = 0.2, 95% CI: 0.01–0.6, respectively). Conclusion: PI is highly prevalent among adults. Targeted interventions to increase physical activity in recreational domain are recommended, specially in urban areas and among women. Further studies to explore barriers to physical activity are needed to address this problem.

Residential relocation and changes in patterns of environmental exposures by health determinants among children and adolescents in Catalonia, Spain

Residential relocation leads to environmental changes, besides being likely to be influenced by sociodemographic characteristics. The relationship between them is, however, still not well described. We aimed to investigate changes in patterns of urban, natural and physical environmental exposures due to relocation and related sociodemographic determinants in a population-based cohort study of children and adolescents. We included individuals between 0 and 17 years of age, registered in primary healthcare records in Catalonia, Spain from 2006 to 2018 and categorized them as non-movers and movers (first residential change). Hierarchical clustering identified groups of individuals based on their exposure to air pollution, green spaces and built environment. Low, medium and high environmental hazard exposure clusters were identified, which were used to identify changes in environmental exposure patterns due to relocation, namely same, worse, and better environment. Multinomial logistic regression determined whether sex, age, nationality and area-level deprivation influenced these changes. From 1,316,138 individuals, 221,058 were movers. Compared to non-movers, movers were more frequently with foreign nationality (12.1% vs. 21.3%, respectively) and more likely to live in the most deprived areas at baseline (19.2% vs. 24.4%). Younger children had higher risk of moving to better or worse environments. Individuals living in areas with the highest levels of deprivation were least likely to move within the same environments (i.e., either moving to better (Odds Ratio [95% Confidence Interval] 1.39[1.34–1.44]) or worse environment (1.56[1.49–1.63])). Compared to people from Spain, those from Africa moved to similar environments (OR of moving to a better environment 0.90 (0.87–0.94) with respect to move to the same environment, and OR of moving to a worse environment 0.82 (0.78–0.85)), those from America tended to move to other environments (1.17 (1.12–1.23) better and 1.09 (1.03–1.15) worse), while those from Asia and Europe moved to better environments (1.22 (1.12–1.33) and 1.20 (1.14–1.27) respectively). No associations were found for sex. Changes in patterns of environmental exposures due to residential mobility are complex and may be determined by age, deprivation and nationality.

Predictive model for the risk of paediatric intensive care utilization in children with medical complexity: A longitudinal retrospective cohort study.

Children with medical complexity (CMC) are at increased risk of admission in intensive care. Despite improvements in mortality rates, there remains a burden of morbidity, long-term health care needs and hospital readmissions. Beyond clinical factors, socio-demographic determinants could impact utilization of acute services. To identify risk factors that can differentiate CMC who are admitted to the paediatric intensive care unit (PICU). A 6-year longitudinal retrospective cohort study evaluated clinical, socio-demographic and health care utilization. A total of 248 CMC were included, with a median age of 13 years (9.75-17.00). Intensive care admission rate was 47.2%. The risk of PICU admission was higher for children undergoing surgical interventions (HR = 1.58, 95% CI 1.34-1.86, p < .001) and those using medical devices (HR = 1.81, 95% CI 1.54-2.13, p < .001). Mother's higher educational level was a protective factor (HR = 0.66, 95% CI 0.55-0.79, p < .001). Multivariable analysis revealed significant associations between risk of admission and the presence of malignancy, comorbidities, home medical devices, surgical procedures and higher health care utilization. Children's age and higher maternal educational level acted as protective factors. Socio-demographic factors should be considered in the provision of care to CMC. Individualized assessments to guide supportive interventions adapted to socio-economic factors may prevent PICU admissions. This study highlights the importance of integrating individualized assessments of socio-demographic risk factors, such as maternal educational level, into the clinical practice of paediatric nurses. Moreover, targeted interventions, including educational resources and community support programmes, may optimize care.

Sociodemographic and Health Determinants of Loneliness in Older Immigrants in Canada: A Cross-Sectional Study.

The COVID pandemic brought to light the pressing issues of social isolation and loneliness for older adults. Immigrant older adults' experience of loneliness is even more exacerbated by factors, such as, language barriers, and the loss of cultural community. Key determinants of loneliness in older immigrants are not clear in the literature. A cross-sectional study was conducted in nine cities across Canada to: describe the experience of emotional, social and overall loneliness; and examine the determinants of loneliness among Punjabi, Mandarin, and Arabic-speaking older immigrants. A total of 647 older immigrants participated in the study. Descriptive statistics were used to describe their experience of loneliness, and multiple regression analysis was performed to examine the determinants of loneliness. Most participants had a post-secondary education, were married, and had been in Canada for about 16 years. On average, the participants reported good physical and mental health, and moderate levels of emotional, social, and overall loneliness. Ethnocultural group, emotional wellbeing, and depression were associated with emotional loneliness. Social loneliness was associated with education, depression, psychological distress, age, and ethnocultural group. Determinants of overall loneliness were age, gender, ethnocultural group, self-rated mental health, emotional wellbeing, depression, and psychological distress. Community based interventions that target these key factors must be designed to address loneliness experienced by older immigrants.

Trends and socio-demographic determinants of suicide-related mortality in Türkiye: An epidemiological study from 2009 to 2022.

Suicide is a leading cause of death, particularly among the young age group, in Türkiye, a country with a high population of young people. The aim of this study is determine the suicide related mortality trend and some associated socio-demographic factors in Türkiye between 2009 and 2022. The study includes an epidemiological trend on suicide. The Turkish Statistical Institute's data portal was used. The study population is 46,691 people (Male/female ratios = 74.6%/ 25.4%). Changes in mortality trends were evaluated using the Joinpoint Regression method with Annual Percentage Change (APC) and Average Percentage Change (AAPC) analysis. Over the past 14 years in Türkiye, there has been a statistically significant increase in the standardized mortality rate among males (2009-2022 APC = .76, p = .012) and a statistically non-significant decrease among females (2009-2022 APC = -1.62, p = .083). According to the Nomenclature of Territorial Units for Statistics (NUTS-1) classification, the highest increase is observed in the Central Anatolia region followed by the Western Black Sea region (APC = 3.0 and 2.7, respectively; p < .005). While the percentage of primary school and below has decreasing trends (2009-2022 APC = -7.11, p < .005), there is a significant increase in the percentage of university graduates (2009-2016 APC = 10.87, p < .001). Regarding the marital status, there is a significant decrease in the percentage of those who are married (2009-2013 APC = -3.36, p < .001; 2013-2016 APC = 2.42, p = .037; 2016-2022 APC = -2.31, p = .003) and a significant increase in those who have never been married (2009-2013 APC = 2.63, p < .001; 2013-2016 APC = -1.36, p = .002). Although suicide related mortality is below the global average, there has been an increasing trend in turkey in the last 14 years. Analytical and intervention studies on the socio-demographic determinants supporting the increasing trend are needed.

Sociodemographic and dietary determinants of glyphosate exposure in a NYC-based pregnancy cohort

Previous studies have provided evidence for associations between glyphosate and aminomethylphosphonic acid (AMPA) exposure and adverse birth outcomes. However, few pregnancy cohort studies have investigated dietary and other determinants of glyphosate and AMPA exposure. We aimed to identify dietary and sociodemographic factors that predict glyphosate and AMPA exposure in a contemporary, urban pregnancy cohort in the US. The study included 725 pregnant participants from the New York University Children's Health and Environment Study (NYU CHES) in New York City. Urinary concentrations of glyphosate and AMPA, determined by high-performance liquid chromatography and tandem mass spectrometry, were analyzed in urine collected from NYU CHES participants across three prenatal time points. The Diet Health Questionnaire II was completed to capture dietary intake during the prenatal period. Descriptive statistics and bivariate linear models were used to assess determinants of urinary glyphosate and AMPA concentrations. Median urinary glyphosate and AMPA levels were 0.36 ng/mL and 0.37 ng/mL, respectively. Lower glyphosate levels were associated with younger age, obesity, public insurance, being single, and lower educational attainment. Nuts, seeds and whole grain intake was associated with increased urinary glyphosate concentrations. Urinary glyphosate concentrations were lower in summer than in winter. The study findings highlight widespread exposure to glyphosate and AMPA in this pregnancy cohort, with nuts/seeds and whole grains identified as possible dietary sources of exposure. High detection rates in the study population necessitate further research on dietary exposure patterns and perinatal outcomes to inform targeted interventions and reduce exposure in vulnerable populations.

Kenya: Socio-Demographic Determinants of Intractable Communal Land Use Conflicts in the Squatter Enclaves of Mount Elgon Region

In the post-Cold War world order, the African Continent has been a stage for some of the most violent intra-state conflicts arising from natural resources and land distribution. These contes tations have often been inter-communal and take the violent extremism route. The consequences of these devastating contestations have been apocalyptic in most of these conflicts. In Kenya’s Mount Elgon Region, the emergence of extremism Sabaot Land Defence Forces and counter-extremist groups is rooted in a long historical struggle for equitable distribution of land rights. Despite efforts by state and non-state actors, sustainable peace remains a distant mirage. Socio-economic deter minants have emerged as fundamental determinants in these extremist contestations, yet, extant literature has been silent on this subject matter. This paper sought to interrogate socio-demographic determinants as pathways for homegrown extremism in the Mount Elgon Region. Study findings revealed strong support for the interplay between ownership of land, source of income, level of education, and sustenance of homegrown extremism over land-use conflicts in the study area. The paper recommends the need for the Ministry of Lands to expedite the management of the historical land question to contain the socio-demographic determinants as pathways for homegrown ex tremism in the study area. The findings under score the importance of land tenure security in pursuit of peaceful, just, and inclusive societies as advocated for in the Sustainable Development Agenda 2030. Keywords: Demographic, extremism, home grown, land-use, Mt. Elgon.

Socio-Demographic Determinants of Resilience and Psychological Preparedness for Floods in Assam

Socio-Demographic Determinants of Resilience and Psychological Preparedness for Floods in Assam

Clinical and sociodemographic determinants of older breast cancer survivors' reports of receiving advice about exercise.

Exercise offers various clinical benefits to older breast cancer survivors. However, studies report that healthcare providers may not regularly discuss exercise with their patients. We evaluated clinical and sociodemographic determinants of receiving advice about exercise from healthcare providers among older breast cancer survivors (aged ≥65years). We used data from the Surveillance, Epidemiology, and End Results cancer registries linked to the Medicare Health Outcomes Survey (MHOS) from 2008 to 2015. We included female breast cancer survivors, aged ≥65years, who completed the MHOS survey ≥2years after a breast cancer diagnosis in a modified Poisson regression to identify clinical and sociodemographic determinants of reportedly receiving advice about exercise from healthcare providers. The sample included 1,836 breast cancer survivors. The median age of the sample was 76years (range:72-81). Overall, 10.7% of the survivors were non-Hispanic Black, 10.1% were Hispanic, and 69.3% were non-Hispanic White. Only 52.3% reported receiving advice about exercise from a healthcare provider. Higher body mass index (BMI) and comorbid medical history that included diabetes, cardiovascular, or musculoskeletal disease were eachassociated with a higher likelihood of receiving exercise advice. Lower education levels, lower BMI, and never having been married wereeach associated with a lower likelihood of receiving exercise advice. Nearly half of breast cancer survivors aged ≥65 years did not report receiving exercise advice from a healthcare provider, suggesting interventions are needed to improve exercise counseling between providers and survivors, especially with women with lower educational attainment who have never been married.

Sociodemographic, mental, and physical health determinants of incident depressive symptoms among ageing men and women in rural South Africa: A longitudinal study from 2015 to 2022

We aimed to assess the associations between sociodemographic, mental, and physical health factors and incident depressive symptoms (IDS) among ageing men and women in rural South Africa over time. Data from the 7-year South African longitudinal Health and Ageing in Africa INDEPTH Community study (HAALSI: 2015–2022) were used in the analysis (study sample: n = 3 122, aged 40 and older). The proportion of IDS was in 28.2% in 2019 and 30.0% in 2022 among men, and 30.3% in 2019 and 2022 among women. Among men, the adjusted model indicated that older age, food insecurity, poor life satisfaction, physical pain, functional disability, diabetes, kidney disease, anaemia, and obesity were positively associated, and hypertension was negatively associated with IDS. Among women, food insecurity, poor life satisfaction, physical pain, and diabetes were positively associated, and current smokeless tobacco use was negatively associated with IDS. By sex, a high proportion of IDS were found, as was the prevalence of food insecurity, poor life satisfaction, physical pain, and diabetes associated with IDS. Among older men only, older age, functional disability, kidney disease, anaemia, and obesity, but not hypertension were associated with higher odds for IDS. Among older women, only current smokeless tobacco use was negatively associated with IDS. Interventions addressing the risk for depression should consider specific sex differences.