Sociodemographic Factors Research Articles

Navigating Disparities in Dental Health-A Transit-Based Investigation of Access to Dental Care in Virginia.

To identify vulnerable areas and populations with limited access to dental care in Virginia, the study aimed (1) to calculate travel time and accessibility scores to dental care in Virginia using a transit-based accessibility model for all dental clinics and dental clinics participating in the Medicaid dental program and (2) to estimate factors associated with accessibility to dental clinics participating in the Medicaid dental program in Virginia. The study used building footprints as origins of transit trips to dental care services (or destinations). The study then computed transit-based origin-destination travel time matrices based on the detailed trip information, including in-vehicle and out-of-vehicle travel time. Accessibility scores were calculated by counting the number of dental clinics that can be reached within 60 min. Regression analysis was used to measure factors associated with accessibility scores to dental clinics participating in Medicaid. Residents in smaller regions spent longer travel time to dental clinics by public transit compared with those who resided in larger regions. Medicaid participants also faced longer travel time compared with the general population. Residents spent more than three-fourths of the time waiting for public transit and walking to clinics regardless of where they live and what type of insurance they have. Associations between sociodemographic factors and accessibility scores to dental clinics participating in the Medicaid dental program varied across regions. Disparities in dental care accessibility exist depending on the size of regions and Medicaid participation in Virginia. The disparities in transit-based access to dental clinics and a disproportionate amount of time spent waiting for public transit and walking to dental clinics could be improved through tailored interventions taking into account the sociodemographic and geographic characteristics of each region.

Indicators of sarcopenia and purpose in life levels in older adults: the influence of sociodemographic factors

This study aimed to compare the indicators of sarcopenia and the level of purpose in life among older adults, considering sociodemographic factors. It is a quantitative, analytical, observational, and cross-sectional study conducted with 128 older adults (≥60 years old) of both sexes residing in Brazil's Midwest and South regions. The study employed a unique methodology, including a sociodemographic questionnaire, the Purpose in Life Scale, and the SARC-f, which were administered to the participants. Data collection took place online from January 2024 to April 2024. The study's data analysis included the Kolmogorov-Smirnov test, measures of skewness and kurtosis, bootstrapping procedures, independent t-test, one-way ANOVA, and Tukey's post-hoc test, with a significance level of p < 0.05. The older adults showed a low risk of sarcopenia (1.23±1.97) and a moderate level of purpose in life (3.77± 0.63). Younger older adults (p = 0.005), those with completed higher education (p = 0.018), and those with higher income (p = 0.007) had a lower risk of sarcopenia. Younger older adults (p = 0.035) and those with higher incomes (p = 0.007) also had higher levels of purpose in life. Purpose in life showed a significant negative weak correlation with age (r = -0.24) and sarcopenia risk (r = -0.33) (p < 0.05). In conclusion, younger older adults and those with higher monthly incomes demonstrated a lower risk of sarcopenia and a higher level of purpose in life.

Prescriber Adherence to Antihypertensive Prescription Guidelines and the Impact of Patient Socioeconomic Factors: A Cross-Sectional Study Using Data From the IrishLongitudinal Study on Ageing.

Uncontrolled hypertension causes significant morbidity and mortality worldwide. Several prescribing guidelines have been created to address this, however, prescriber adherence to guidelines is influenced by various sociodemographic patient factors. This study aims to determine the effects of these patient factors on prescriber adherence to antihypertensive prescription guidelines. A secondary analysis of data from the first wave of The Irish Longitudinal Study on Ageing (TILDA), was conducted. Participants were included if they reported previous hypertension diagnoses. Antihypertensive medication regimes were compared with the prescribing guidance in the 2011 NICE hypertension guidelines. The effects of patient sociodemographic factors on prescriber adherence to guidelines, and the effect of prescriber adherence on blood pressure control (≥ 140/90 mmHg), were determined using binomial logistic regression models. A total of 2992 participants were included in this analysis; 54.9% female with mean age 65.7 years (±9.23). Male sex and older age, and lower socioeconomic status were associated with increased prescriber guideline adherence. Prescribers were less likely to adhere to guidelines in female patients ≥ 55 years (Relative Risk [RR] 0.75 [0.62, 0.91]), and female patients across all age groups (RR 0.80 [0.67, 0.95]). Better blood pressure control was seen with medication regimes adherent to prescription guidelines (140.38 (±18.98)/83.09 (±11.02) mmHg adherent vs. 141.66 (±19.86)/84.77 (±11.71) mmHg non-adherent). This study highlights the effect of patient sex on prescriber adherence to antihypertensive prescription guidelines, emphasizing a larger issue of systemic undertreatment of females observed within healthcare. Further research is needed to determine the reasons for such differences in hypertensive care.

Prevalent Adverse Childhood Experiences Among Young Adults Returning Home From Jail: The Need for Trauma-Informed Reentry Services.

Prevalence of adverse childhood experiences (ACEs) and the extent to which they relate to health among young adults (ages 18-25) returning home from jail is underexamined. To build on the growing literature examining associations between ACE exposure among young people involved with carceral systems and health, we (1) measured ACE prevalence and (2) explored associations between ACEs and health/well-being indicators among young adults experiencing reentry. Using a telephone survey on reentry experiences, participants completed an ACE screening, single-item responses on health and social indicators, and five-item responses on substance misuse. Fisher's exact tests and t tests compared sociodemographic and health-related factors by the levels of ACEs. Among the 85 participants, 66 (78%) reported four or more ACEs and 48 (56%) reported six or more ACEs, including divorced parents (n = 69, 81%), witnessing violence (n = 63, 74%), and household member incarceration (n = 60, 71%). Higher exposure to ACEs was associated with mental health diagnoses, psychiatric medication prescriptions, psychiatric hospitalizations, drug dependence, binge drinking, and cannabis misuse. High ACE exposure among young adults experiencing reentry portends worse mental health and high rates of substance use. Findings signify an opportunity to apply a trauma-focused developmental framework to support emerging adults during the crucial reentry period.

Incidence and factors associated with immediate adverse neonatal outcomes among emergency obstetric referrals in labor at a tertiary hospital in Uganda: a prospective cohort study

BackgroundHigh rates of adverse neonatal outcomes in resource-limited settings are multifactorial, varying by country, region, and institution. In sub-Saharan Africa, the majority of adverse neonatal outcomes are intrapartum related, and studies in Uganda have shown that referral in labor is a major determinant of adverse neonatal outcomes. This study aimed to assess the incidence and factors associated with immediate adverse neonatal outcomes among emergency obstetric referrals in labor at a tertiary hospital in Eastern Uganda.Materials and methodsThis was a prospective cohort study involving 265 women who were referred in labor to Jinja Regional Referral Hospital in Uganda with emergency obstetric complications. The exposure of interest was being referred with obstetrical emergency, and the outcome variable was adverse neonatal outcomes. The study was conducted between July 5, 2023, and October 5, 2023. Consecutive sampling was used, and data on sociodemographic and obstetric factors, referral related factors, as well as the primary outcome variable (adverse neonatal outcome) were collected via interviewer-administered questionnaires. The data were then cleaned, coded, and analyzed using STATA version 14. Log-binomial regression determined risk ratios and associations for factors related to adverse neonatal outcomes. Variables with p-values < 0.2 in bivariable analysis were included in the multivariable analysis, where significance was set at p < 0.05.ResultsOf the 265 women exposed to emergency obstetrical referrals, 40% experienced adverse neonatal outcomes, a composite measure including neonatal intensive care admission (27.6%), low Apgar score (23.8%), fresh stillbirth (11.3%), early-onset neonatal infection (6.8%), and early neonatal death (2.3%). Factors significantly associated with adverse neonatal outcomes were; maternal age ≥ 35 years (aRR = 1.72, CI:1.194–2.477, p value = 0.004), APH (aRR = 2.48, CI: 1.859–3.311, p-value < 0.001), and non-reassuring fetal status (aRR = 1.90, CI: 1.394–2.584, p-value < 0.001).ConclusionsThe study found a high rate of adverse neonatal outcomes among emergency obstetric referrals, with 40% of participants facing issues like ICU admissions, low Apgar scores and fresh stillbirth. Key factors included maternal age over 35, antepartum hemorrhage, and non-reassuring fetal status. These results highlight the urgent need for targeted interventions in emergency obstetric care. Strategies should enhance referral systems, improve facility preparedness, train healthcare providers, and educate communities on timely referrals and managing high-risk pregnancies.

Work Environment and Socio-Demographic Factors of Psychiatric Nurses: A Cross-Sectional Study in Hospitals of Eastern Saudi Arabia.

The work environment in healthcare institutions, especially in psychiatric hospitals, plays a crucial role in shaping the experiences and efficacy of nurses' performance. This environment is influenced by various factors such as facility design, resource availability, workplace culture, support systems, and interpersonal dynamics. Understanding the intricate dynamics of the work environment in psychiatric hospitals is essential for ensuring the provision of high-quality mental healthcare services and enhancing the overall quality of life for both patients and healthcare providers, including nurses. However, the work environment of psychiatric nurses in the eastern region of Saudi Arabia is still inadequately understood. Objective: This study aimed to examine the work environment of nurses working in psychiatric hospitals in the eastern region of Saudi Arabia. Method: A cross-sectional research design was employed on a sample of 346 nurses using a non-probability convenience sampling technique. The survey method was adopted with the Practice Environment Scale of the Nursing Work Index (revised, Arabic version). Results: The study found a significant association between psychiatric nurses' work environment and their socio-demographic characteristics. Demographic factors, such as age and years of experience, were identified as influencing factors of nurses' perceptions of their work environment. Younger nurses and those with fewer years of experience reported greater job satisfaction when their work environment was positive. Conclusions: This study underscores the critical importance of maintaining a supportive work environment for psychiatric nurses due to its possible direct influence on their job satisfaction, work performance, quality of life, and overall well-being. Tailoring interventions to address demographic variations in perceptions of the work environment can enhance the well-being of nurses and improve the quality of care provided to psychiatric patients. These findings contribute to the body of knowledge on psychiatric nursing and have clinical implications for healthcare institutions that aim to optimize their work environments and retain a skilled and satisfied nursing workforce.

Cannabis use and sleep problems among young adults by mental health status: A prospective cohort study.

Young adult cannabis use is common; while cannabis is often marketed as a product that can improve sleep, evidence supporting these claims is limited, and effects may differ for individuals with underlying mental health issues. This study measured the association between cannabis use and sleep problems among young adults and determined whether associations differ by mental health status. Using two waves of a young adult cohort study (baseline: March-September 2020; follow-up: January-June 2021), we measured the association of cannabis use frequency with subsequent sleep problems overall and stratified by baseline sleep quality and mental health status in separate moderation analyses. This study was conducted in Southern California, USA, and included 1926 participants aged 20-23 years (mean age = 21; 61% female, 46% Hispanic). Exposure was baseline cannabis use frequency (never use, prior use, 1-5 days/month, 6-19 days/month, ≥ 20 days/month). The outcome was sleep problems at follow-up (range = 4-24, higher score indicating worse sleep). Models were adjusted for socio-demographic factors, baseline sleep problems, mental health symptoms (depression and/or anxiety versus neither) and past 30-day nicotine or alcohol use. In moderation analyses, models were additionally stratified by mental health symptoms and baseline sleep quality (excellent versus imperfect sleep). Among the young adult sample, 11% used cannabis ≥ 20 days/month at baseline. For participants without baseline anxiety or depression symptoms, using cannabis ≥ 20 days/month (versus never use) was associated with greater sleep problems at follow-up [mean difference (MD) = 1.66, 95% confidence interval (CI) = 0.59-2.74]. Among participants with anxiety and/or depression and pre-existing sleep problems at baseline, using cannabis ≥ 20 days/month (versus never use) was associated with fewer sleep problems at follow-up (MD = -1.42, 95% CI = -2.81 to -0.02). The effects of cannabis use on sleep appear to differ by underlying mental health symptoms. Frequent cannabis use may improve sleep for young adults with depression and/or anxiety who have pre-existing sleep problems, but worsen sleep for young adults without depression and/or anxiety.

Health literacy and loneliness among physically inactive Danes aged 18-65: a cross-sectional study.

Both physical inactivity and loneliness are public health threats bringing huge costs to society and quality of life. The two health challenges often co-exist, suggesting physically inactive and lonely individuals to be a high-risk group. Health literacy as a concept is understood as a modifiable health determinant, and it has been proposed for promoting equity in future health promotion. The aim of this study was to examine the association between health literacy and loneliness among physically inactive adults. A representative sample of 6,196 Danish adults, aged 18-65 years, was invited to a screening on a set of health outcomes for physical inactivity, which was based on the International Physical Activity Questionnaire-Short Form. A total of 1,033 adults were classified as physically inactive and therefore received the full questionnaire screening on a set of different health outcomes including the Health Literacy Questionnaire (HLQ) and the Three-Item Loneliness Scale (T-ILS). Two statistical approaches were applied: (1) health literacy expressed as nine different continuous variables corresponding to the domains of HLQ using logistic regressions analyses to examine the association between health literacy and loneliness; (2) health literacy expressed as nine different binary variables showing proportions of low literacy among lonely versus non-lonely participants. Statistical analyses were performed using Stata/IC version 16.1. Among a sample of 1,010 physically inactive adults, 23.7% felt lonely with a T-ILS score below ≥7. Regression analyses predicted a negative association between health literacy and loneliness in all HLQ domains, after adjusting for gender, age, education, and occupation. Adjusted ORs ranged from 0.21 (95% CI: 0.16; 0.27) to 0.69 (95% CI: 0.57; 0.83) in domains 1-5 and 0.50 (95% CI: 0.41; 0.61) to 0.70 (95% CI: 0.55; 0.89) in domains 6-9. A similar pattern was found in the analysis with health literacy as a binary variable as the proportions of low health literacy were the highest among persons with loneliness in all HLQ domains. Even after adjusting for sociodemographic factors, a negative association was predicted between health literacy and loneliness in physically inactive adults. This suggests that strategies for improving physical activity among inactive individuals might be more effective if they include a focus on enhancing health literacy and addressing loneliness.

Socio-demographic Factors Influencing the Adoption of Digital Health Tools for Public Health Emergencies in Northern Nigeria

Socio-demographic Factors Influencing the Adoption of Digital Health Tools for Public Health Emergencies in Northern Nigeria

DOMESTIC ENERGY DEMAND AND CONSUMPTION BETWEEN TWO CONTRASTING COMMUNITIES IN GEREI LOCAL GOVERNMENT AREA, ADAMAWA STATE, NIGERIA: IMPLICATIONS FOR SUSTAINABLE ENVIRONMENTAL MANAGEMENT

The problem of domestic energy demand and consumption between two contrasting communities, Sangere Village and Modibbo Adama University of Technology Yola (MAUTECH) Campus, in Gerei Local Government has been examined. The study aims to investigate whether the rate and choice of energy utilization of the two different communities will impact sound environmental management. Thus, they highlighted some of the socio-demographic factors that informed the choice of domestic energy types and the volume used as well as some environmental repercussions between these contrasting communities. Data was gathered using a questionnaire survey of 120 adult residents and was complemented by personal observation. The result indicates fuelwood was the highest energy utilized (30%) in the Sangere community, while the highest energy choice in MAUTECH community was cooking gas (27%). The implication of this perpetual fuelwood utilization, especially among Sengere residents will exacerbate deforestation, soil erosion, and air pollution, thereby undermining sustainable environmental management. Thus, a serious awareness campaign is urgently needed among Sangere residents where the literacy rate is low and population growth is visible. The study finally recommends government policies/legislation and public enlightenment/education as a panacea to attitudinal change for sound environmental management in the area.

Handwashing practices and associated socio-demographic factors among primary school students in Cox's Bazar, Bangladesh: A cross-sectional study

Handwashing practices and associated socio-demographic factors among primary school students in Cox's Bazar, Bangladesh: A cross-sectional study

Factors influencing surgical treatment of De Quervain's tendinopathy: A retrospective cross-sectional observational study

BackgroundThe literature surrounding how different patient, sociodemographic, and anatomical factors influence surgical treatment of De Quervain's tendinopathy (DQT) is limited. PurposeWe hypothesised that different patient, anatomical, or sociodemographic factors influence the management of DQT with regard to non-operative vs. surgical management. MethodsThis retrospective cross-sectional study reviewed 155 cases of patients with DQT seen over a 10 year period. Patient-specific factors included age, gender, hand affected, dominant hand, steroid injection given and mean number of injections. Sociodemographic factors included ethnicity, employment, and deprivation, were measured using deprivation quintiles through The Index of Multiple Deprivation. Anatomical factors included the presence of subcompartmentalization, number of APL and EPB tendon slips, tendon thickening, exudative tenosynovitis, hypervascularization, and the presence of a sheath ganglion Patients were categorized into either non-operative or surgical cohort. Bivariate analysis was used to compare factors between the cohorts, and significant factors (p < 0.05) were included in the logistic regression model, used to predict factors influencing surgical management. ResultsBivariate analysis detected a significant difference in the mean number of steroids given between the non-operative and surgical cohort (p = 0.001) patient factors. For sociodemographic factors, a significant difference was found between deprivation quintiles (p = 0.02). From the anatomical factors, the surgical cohort had more patients with multiple APL tendon slips (p = 0.02) and the presence of a tendon ganglion sheath ganglion (p = 0.02). For patient and sociodemographic factors, logistic regression identified that the number of steroids (per patient) and being in deprivation quintile 4 were associated with surgical treatment. For anatomical factors, multiple APL tendon slips and the presence of a tendon sheath ganglion were associated with the surgical treatment. ConclusionThis study suggests that several factors are associated with the need for surgical treatment of DQT, including the number of steroid injections received, social deprivation, and anatomical factors, such as the presence of multiple tendon slips and a tendon sheath ganglion. Our findings add to the growing body of literature exploring factors that may influence treatment pathways for patients with DQT.

Sociodemographic Disparities in 1-Year Outcomes of Children With Community-Acquired Acute Kidney Injury

Racial disparities have been identified in pediatric community-acquired acute kidney injury (CA-AKI), and they are associated with increased risk of child mortality, morbidity, and progression of kidney disease. To assess clinical outcomes at 1 year among children with CA-AKI, stratified by age, race, and ethnicity. This retrospective cohort study is a population-based analysis of deidentified, aggregated electronic health record data collected by 61 large health care organizations from 2003 to 2023 and accessed through the TriNetX platform. Outcomes were assessed at 1 year after a CA-AKI episode. Participants included pediatric patients (aged <18 years) with AKI. Data were accessed in January 2024. A diagnosis of CA-AKI and sociodemographic factors such as race, ethnicity, and age, as reported in electronic health records. The primary end point of this study was to assess differences in clinical outcomes within 1 year of an episode of CA-AKI, including all-cause emergency department (ED) visits, intensive care unit (ICU) admissions, mechanical intubation and ventilation, and mortality. Risk was compared between White children and Asian (including Asian, Native Hawaiian, and Other Pacific Islander), Black, and Hispanic children, stratified by age group. Measures of association, Cox proportional hazard analyses, and Kaplan-Meier survival curves were performed within the TriNetX Advanced Analytics Platform between racial and ethnic groups for each analysis. From the total sample of 18 152 children, those with hospital-acquired AKI, chronic kidney disease, end-stage kidney failure, or dialysis dependence were excluded, leaving a final cohort of 17 125 children (mean [SD] age, 11.2 [5.2] years; 9424 male [55.3%]). Eligible patients were divided into racial and ethnic groups as follows: non-Hispanic Asian, 1169 children (6.5%); non-Hispanic Black, 4636 children (27.3%); Hispanic, 1786 children (10.2%); and non-Hispanic White, 9534 children (55.9%). Patients were further subdivided into groups aged 0 to 9 years (546 Asian children, 1675 Black children, 689 Hispanic children, and 3340 White children) and 10 to 18 years (623 Asian children, 2961 Black children, 1091 Hispanic children, and 6104 White children). Within 1 year of CA-AKI diagnosis, compared with White children, Black children experienced greater rates of ED visits (hazard ratio [HR], 1.53; 95% CI, 1.40-1.67), ICU admissions (HR, 1.31; 95% CI, 1.16-1.47), mechanical ventilation (HR, 1.33; 95% CI, 1.13-1.56), and all-cause mortality (HR, 1.27; 95% CI, 1.09-1.48), as well as the greatest risk for composite outcomes (HR, 1.43; 95% CI, 1.33-1.53). Hispanic children experienced greater rates of ED visits (HR, 1.40; 95% CI, 1.21-1.62) and the greatest risk of all-cause mortality (HR, 1.66; 95% CI, 1.31-2.09), whereas Asian children experienced greater rates of mechanical ventilation (HR, 1.69; 95% CI, 1.26-2.27), compared with White children. Black and Hispanic children aged 0 to 9 years were at greatest risk of experiencing poor clinical outcomes. Black children had a 11.41% lower survival probability and Hispanic children had a 7.14% lower survival probability compared with White children after an initial ED encounter. Among children with an identified episode of CA-AKI diagnosed in an ED, within 1 year, Black and Hispanic children had a poorer survival probability compared with White children. Future studies are needed to understand these disparities and improve awareness and follow-up after emergency care.

Perception of food quality among Saudi consumers

Consumers’ perceptions of quality of food products increase their purchasing likelihood. This study provides a framework for exploring consumers’ perceptions of food quality for food product development and food market-ing strategies by providing vital information related to consumer behavior and food choice. It establishes a method for measuring food quality perceptions through a validated questionnaire. It was found that adult consumers in Riyadh City, Saudi Arabia, perceive intrinsic food characteristics higher than of extrinsic food characteristics. Characteristics related to product safety, nutritional value, and sensory attributes were the most highly valued aspects. Sociodemographic factors such as age, marital status, education, occupation, income, and work/study in the food field were found to affect Saudi consumers’ perceptions of food quality. Furthermore, marital status, education, occupation, and income were the major classification factors for perception trends. Food identity and processing, food health prosperity, food safety and presentation, and food sensory attributes were the major qual-ities perceived by Saudi consumers.

Assessment of adherence to antihypertensive medication and its associated factors: a cross-sectional study

Background: Hypertension is a silent killer. India is home to approximately 220 million hypertensive individuals. Poor adherence to medication may lead to complications and add to the burden of disease. So, this study aims to assess medication adherence and its associated factors. Methods: This hospital based cross sectional study was conducted at Urban Health Training center. Patients who attended Out Patient Department over the period of three months were enrolled in the study. Morisky Medication Adherence four-point scale (MMAS-4) was used to study compliance, while JAMOVI software was used for data analysis. Results: Around half (45%) of the patients had high adherence to anti-hypertensive medication. Various sociodemographic factors like age, gender, education, occupation, family history, personal history and duration of hypertension were considered. A significant association was observed between age and duration with adherence. Conclusions: There was significant association between age and poor adherence. Timely interventions are necessary to reinforce good compliance to antihypertensive drugs.

Examining Sociodemographic Variability in the Amount and Type of Interventions for Children With Autism.

Various intervention usage is associated with positive outcomes for children with autism. However, the intensity of these interventions tends to be below recommendations, especially for minoritized children. This study aimed to examine how average weekly intervention hours among children vary by sociodemographic factors. Regression analyses were conducted using data from 2,857 participants with autism included in the Simons Simplex Collection. Findings indicated the amount and type of intervention received varied by race, ethnicity, family income, and maternal education. This study marks an important step in documenting the extent of sociodemographic intervention disparities; and, helps to elucidate which therapy types are most readily underused and by which groups to help inform approaches to increase more equitable access.

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.

Comparison of Breast Sensibility Following Breast Reconstruction with Two Different Techniques: Deep Inferior Epigastric Perforator Flap and Implant

Introduction: Breast sensibility following reconstruction surgery, though often overlooked, holds significant importance due to its widespread occurrence and profound effects on patients’ well-being and safety. The author’s objective is to compare the sensory outcomes between deep inferior epigastric perforator (DIEP) flap microsurgery reconstruction and implant-based reconstruction. Additionally, the potential influence of sociodemographic and clinical factors on sensory recovery is explored, along with assessing temperature discrimination abilities and evaluating quality of life. Material and methods: An ambispective descriptive-analytical study was conducted involving women who underwent mastectomy with reconstruction using either DIEP flap and implants at the author’s hospital between 1990–2021. Data were collected from medical records, patient histories, physical examinations, and validated quality of life questionnaires (BREAST-Q). Spearman’s or Pearson’s correlation coefficients were employed for the analysis of quantitative variables, while the Student’s T test or Mann-Whitney U test were used to compare quantitative and qualitative variables. Results: A total of 99 women with breast reconstruction were included, 47 with DIEP flap and 52 with implants. Sensory recovery in implant-based reconstruction was found to be superior to DIEP flap reconstruction (5.03 and 5.18, respectively; p&lt;0.005). A direct correlation was observed between sensory improvement and thermal discrimination (Spearman coefficient 0.9; p&lt;0.001). Factors such as radiotherapy, delayed reconstruction with DIEP flap, and height with implants were associated with poorer sensory recovery in the breast. Women experiencing better breast sensibility reported higher satisfaction with their surgeon, medical team, and psychosocial quality of life. Conclusion: Women reconstructed with implants or DIEP abdominal flap exhibit suboptimal overall sensory recovery of the reconstructed breast, with slightly better outcomes observed in women reconstructed with implants. The development of novel surgical techniques aimed at enhancing sensibility after breast reconstruction could significantly benefit these patients.

Sleep Quality Assessment and Its Predictors Among Saudi Adults with Type 1 and Type 2 Diabetes: A Cross-Sectional Study

Background: Poor sleep quality is prevalent among adults with diabetes, impacting their physical, psychological, and functional well-being. Our goals were to assess the prevalence of poor sleep quality and its association with glycemic control and to identify predictors of poor sleep quality among adults with diabetes mellitus. Methods: This cross-sectional study took place at a tertiary hospital, from October 2022 to March 2023, including 192 adults with type 1 and type 2 diabetes. We collected demographic and clinical data and utilized the Pittsburgh Sleep Quality Index (PSQI) scale to evaluate sleep quality. Results: A total of 65.9% of the participants experienced poor sleep quality (PSQI score &gt; 5), with an average global sleep quality score of 7.36 ± 3.53 for all patients. Poor sleep quality was higher among older and married patients, those with lower education levels, housewives, and those with type 2 diabetes mellitus and associated comorbidities, such as hypertension and dyslipidemia. None of these factors were significantly associated with sleep quality in a multiple linear regression analysis. The mean glycated hemoglobin was 8.68 ± 1.91% and did not correlate with the overall PSQI score and its components. Conclusions: This study revealed a notably high prevalence of poor sleep quality among Saudi adults with diabetes, potentially associated with specific sociodemographic and clinical factors. These findings emphasize the importance of integrating sleep quality education into diabetes management strategies.

Associations of periconception dietary glycemic index and load with fertility in women and men: a study among couples in the general population

BackgroundThe dietary glycemic index (GI) and load (GL) reflect carbohydrate quality and quantity, potentially impacting fertility through modulation of insulin sensitivity and generation of oxidative stress. While fertility is influenced by both women and men, reproductive research often emphasizes maternal factors. We first examined periconception dietary intake in both women and male partners, and subsequent associations of dietary GI and GL with fecundability and subfertility.MethodsAmong 830 women and 651 male partners, participating in a population-based prospective cohort study from preconception onwards, we assessed periconception dietary intake and calculated GI and GL, using a food frequency questionnaire (FFQ) at median 12.4 weeks gestation (95% range 10.9, 18.4). Information on time to pregnancy was obtained through questionnaires, with subfertility defined as a time to pregnancy ≥ 12 months or use of assisted reproductive technology.ResultsIn the periconception period, mean energy intake in women was 1870 kcal (SD: 500; 46% carbohydrates, 16% protein, 33% fat; dietary GI 56.2 (SD: 3.5) and GL 141.4 (SD: 67.4)). Mean energy intake in men was 2350 kcal (SD: 591; 43% carbohydrates, 16% protein, 33% fat; dietary GI 56.8 (SD: 3.2) and GL 156.7 (SD: 75.4)). Median time to pregnancy was 4.8 months (IQR: 1.2, 16.4), with 30.6% of 830 women experiencing subfertility. Dietary GI and GL were not associated with fertility outcomes in women. In men, higher dietary GI and GL across the full range were associated with decreased fecundability, after adjusting for socio-demographic and lifestyle factors, as well as dietary GI or GL of female partners [FR: 0.91, 95% CI 0.83, 0.99; FR: 0.90, 95% CI 0.81, 0.99, per SDS increase in dietary GI and GL, respectively]. When assessing the combined influence of dietary GI clinical categories in women and men, both partners adhering to a low GI diet tended to be associated with increased fecundability, but not with subfertility risk.ConclusionsSuboptimal periconception carbohydrate intake may be negatively associated with male fertility, but not with fertility outcomes in women. Further studies are needed to assess whether a lower GI and GL diet is a feasible lifestyle intervention to improve couples fertility.