Educational Status Research Articles

Factors associated with zero vegetable and fruit consumption among Tanzanian children

BackgroundProper nutrition during early childhood is essential for healthy growth and development, yet many children, particularly in low and middle-income countries, fail to meet recommended intake levels of fruits and vegetables. This study aims to assess the factors associated with zero vegetable and fruit (ZVF) consumption among children aged 6–23 months in Tanzania, using data from the 2022 Tanzania Demographic and Health Survey (DHS).MethodsA weighted sample of 4582 children aged between 6 and 23 months were included in the study. Data cleaning, coding, and analysis were performed using STATA version 17 software. To address the hierarchical nature of the DHS data and the binary outcome variable, a multilevel mixed-effect binary logistic regression model was used. The deviance value served as a guide for determining the best-fitting model. In the subsequent multivariable multilevel binary logistic regression analysis, adjusted odds ratios were computed alongside their respective 95% confidence intervals to evaluate the strength of association, with statistical significance set at a p-value below 0.05.ResultThe overall proportion of ZVF consumption among children aged 6–23 months in Tanzania was 48.34% (95% CI: 46.87, 49.81). Current breastfeeding status, maternal educational status, household wealth index, sex of the household head, and community poverty level were associated with higher odds of ZVF consumption. Meanwhile, child age, maternal employment status, father’s educational status, and media exposure were associated with lower odds of ZVF consumption.ConclusionChild age, current breastfeeding status, maternal educational status, maternal employment status, father’s educational status, household wealth index, sex of household, media exposure, and community poverty level were significantly associated with ZVF consumption. Efforts should focus on educating mothers about the early introduction of fruits and vegetables in children’s diets, alongside supporting breastfeeding. Tailored economic empowerment initiatives are needed in impoverished communities to improve access to nutritious foods.

Influence of Family Financial Education and Socioeconomic Status on Financial Literacy with Well-Being as Mediator

Influence of Family Financial Education and Socioeconomic Status on Financial Literacy with Well-Being as Mediator

Predictors of Fertility Desire During COVID-19 Pandemic: A Cross Sectional Study

Background: Fertility, the most important factor in population growth, is affected by various factors, including pandemics. COVID-19 (CV) was a global challenge that spread rapidly around the world. Objective: This study aimed to investigate predictors of fertility desire during the covid virus pandemic. Methods: In this cross-sectional study, 315 women who visited health centers in northern Iran for vaccination against covid virus were recruited using convenient sampling. The participants completed the sociodemographic information, Fertility Desire Scale, and Fear of covid virus scale. Logistic regression analysis was employed to assess the predictive factors of fertility desire. Results: The participants' mean age and marriage duration were 34.4 ± 6.7, and 7.3±11.5 years, respectively. It showed fertility desire among household women was about twofold more compared to employed ones [Odds Ratio (OR) = 1.96, p = 0.009)]. The fertility desire was decreased among more educated women (OR = 0.43, p= 0.035), women with one child (OR = 0.44, p= 0.030), and women with no infant gender preferences (OR = 0.53, p= 0.032). Fear of covid virus and any history of covid virus infection in the participants or their close relatives did not change fertility desire (P > 0.05). Conclusion: In conclusion, health policymakers should pay more attention to the potential effects of women's employment, their educational status, and their attitude toward infant gender preferences on fertility desire during the development of programs. Further research is needed to examine this empirical association on a global scale and its effect on trying to conceive.

Knowledge Management Status in Russian Higher Education

Abstract: Though the issue of knowledge management (KM) education is not new in the KM literature, there is not much research on KM education in Russia. There is only one thorough study, published in 2018, that represented what KM education was in this country by that year. There is a lack of case studies on KM courses taught in Russian universities. This paper reviews the current situation with KM education in Russia and focuses primarily on KM as a bachelor’s and master’s course in Russian universities. It demonstrates the way KM has developed since the late 1990s when Russian research began to increase in a variety of fields. The Russian database eLIBRARY. ru and the internet were searched for KM courses and courses that included KM as a topic. This paper presents a range of KM courses that were taught from 2011 to 2022 and the fields of studies that included these courses.

Determinants of animal source food consumption among children aged 6–23 months in sub-Saharan Africa: multilevel mixed effect model

A diversified diet in early childhood that comprises plant and animal source foods contributes to better health outcomes throughout the life course. However, inadequate infant and young child-feeding practices are serious public health problems in Africa. Evidence on the magnitude and determinants of inadequate animal source food consumption (ASF) in sub-Saharan Africa (SSA) is not yet well established. Hence, this study aimed to estimate the pooled magnitude and determinants of ASF consumption in SSA. A total weighted sample of 92,309 children aged 6–23 months from the Demographic and Health Survey dataset of 35 SSA countries was used for this study. A multilevel mixed-effect model was fitted. The intra-class correlation coefficient (ICC) and likelihood ratio (LR) tests were used to assess the presence of the clustering effect. The model comparison was made using deviance information criteria (DIC). A p-value of p < 0.05 was used to declare statistical significance. The pooled magnitude of ASF consumption among children aged 6–23 months in SSA was 23.7% (95% CI: 23.4, 23.9). Across the SSA regions, the Southern Africa region had the highest consumption of ASF (51.35%), and the lowest was from the Eastern Africa region (21.41%). Younger children aged 6–9 months (AOR = 3.39; 95% CI: 3.14, 3.65), mothers who had no formal education (AOR = 1.46; 95% CI: 1.37, 1.56), children from mothers with no media exposure (AOR = 1.17; 95% CI: 1.11, 1.24), children from the poorest households (AOR = 2.59; 95% CI: 2.36, 2.84), rural residence (AOR = 1.20; 95% CI: 1.12, 1.28), living in low-income countries (AOR = 2.43; 95% CI: 2.03, 2.90), and children from the East Africa region (AOR = 1.24; 95% CI: 1.14, 1.35) were among the significant predictors for not consuming ASF. In this study, ASF consumption was markedly low. Almost three-fourths of children aged 6–23 months in SSA did not consume ASF in the previous day. Age of the child, ANC visits, maternal educational status, maternal marital status, media exposure, and household wealth index were significant individual-level predictors of ASF consumption, whereas the place of residence, country’s income level, and regions of SSA were found to be significant community-level predictors of ASF consumption. Thus, the study highlighted that policymakers, governments, and their partners should demonstrate rigorous efforts to improve dietary diversification with due consideration to the identified predictors of ASF.

Tracing the educational journey of Indian women across generations: A study of multigenerational education mobility in India

This study investigates intergenerational mobility and socioeconomic disparities in women's education in India, utilizing data from the Longitudinal Ageing Study in India (LASI) Wave 1. It uniquely examines three generations of women: the second generation (G2), aged 45–75, who reported on their own education, their mother's education (G1), and their daughter's education (G3). Despite India's economic growth over the past three decades, women's educational status remains poor, influenced by enduring gender discrimination. The study constructs educational transition matrices and measures two mobility indices: M1, which represents the expected proportion of daughters transitioning from their mother's educational level, and M2, which measures the extent of transitions between educational categories. M1 is further broken down into upward and downward mobility. The findings highlight significant progress in educational mobility across generations, with notable increases in upward mobility from the grandmother-mother to the mother-daughter generations, indicating a positive trend. Urban women show significantly higher levels of educational mobility compared to their rural counterparts. However, the study also identifies a decline in multigenerational educational mobility among Muslim women. Persistent caste-based disparities in education are observed, although there is a promising trend of narrowing gaps in recent years. Additionally, the study reveals substantial progress in educational attainment among the most economically disadvantaged groups compared to previous generations.

Determinants of self-reported sexually transmitted infections among reproductive age women in Senegal: evidenced by Senegal demographic and health survey.

Globally, access to sexual and reproductive health is a significant public health issue for women of the reproductive age group. Senegal is a low-income country with limited access to reproductive health services, such as in the prevention and treatment of STIs. The prevention and treatment of STIs is one of the goals set by the government to decrease reproductive health-related morbidity and mortality among women. So, the main objective of this research was to evaluate the prevalence's and determinant of self-reported sexually transmitted infections among reproductive-age women. Data from the 2023 Senegal Demographic and Health Survey datasets were used for secondary data analysis. A total of 16,583 women of reproductive age participated in the study. Bivariate analysis was employed in order to select the factors for multivariate analysis. In the multivariate analysis, variables with p < 0.05 significance levels were considered to be significant predictors of sexually transmitted infections among reproductive-age women. Finally, the percentage and odd ratio, together with their 95% confidence intervals, were reported. The prevalence of sexually transmitted infection among women was 3.21% with a 95 CI. [2.95-3.49] in the last 12 months. Being between the age range of 20 and 44 years old; attending higher education [AOR: 2.70, 95% CI (1.74, 4.19); P = 0.0001]; women who were never in union [AOR: 0.09, 95% CI (0.046, 0.17); P = 0.001] were positively associated with sexually transmitted infections among women. In contrast to this, living in Louga [AOR: 0.41, 95% CI (0.23,0.69); P = 0.001]; Fatick [AOR: 0.33, 95% CI (0.18,0.61); P = 0.0001]; Kolda [AOR: 0.23, 95% CI (0.11,0.49); P = 0.0001]; Kedougou [AOR: 0.34, 95% CI (0.17,0.68); P = 0.002]; and Sedhiou [AOR: 0.43, 95% CI (0.23,0.79); P = 0.007] and women who had history terminated pregnancy [AOR: 1.27, 95% CI (1.03,1.58); P = 0.023] were negatively associated with sexually transmitted infections among women. Women's sexually transmitted infection has been associated with sociodemographic and geographic determinants such as the age of the woman, region, educational status, marital status, and history of terminated pregnancy. Therefore, to prevent the spread of sexually transmitted infections among women, the governments of Senegal and other concerned stakeholders should give special attention to women by addressing sociodemographic and geographic determinants.

The Awareness of Antimicrobial Resistance Among Adult Population in an Urban Setting of Rawalpindi

O Objective: To determine the association of various aspects of antimicrobial resistance awareness and socio-demographic determinants among residents of Rawalpindi. Study Design: Cross-sectional analytical study. Place and Duration of Study: Rawalpindi Cantonment, Pakistan, from Jan to Dec 2021. Methodology: A validated (World Health Organization) multi-country questionnaire was completed by a total of 400 participants, aged 16 years and older, by using two-stage sampling technique. The relationship between social and dependent variables was analyzed using chi-square test of significance. Results: Study results showed that 53.8% of participants were aware of the term ‘antibiotic resistance’ whereas only 29.5% understood what antimicrobial resistance meant. In comparison to males, more females (65.3%) knew the term antibiotic resistance. Antibiotic resistance awareness was higher among young adults aged 16-24 years (67.8%) than among older age groups (p=0.001). Antibiotic resistance awareness in relation to gender (p&lt;0.001), education level (p&lt;0.001), occupation (p&lt;0.001) and monthly household income (p&lt;0.001) was found statistically significant. Antibiotic resistance, according to nearly one-third of respondents (31.8%), was a problem in other countries but not in Pakistan. Conclusion: Awareness and level of understanding regarding spread of antimicrobial resistance and antibiotic resistance itself were found to be low. The study findings revealed that older adults, those with lower education and lower socioeconomic status had the least knowledge and attitudes regarding antibiotic resistance and antimicrobial resistance as compared to other groups.

Factors Influencing the Personal Recovery in Outpatients With Schizophrenia

Objectives: This study aims to quantitatively investigate factors influencing personal recovery in patients with schizophrenia.Methods: This study included 168 outpatients treated for schizophrenia. Patients’ sociodemographic factors (sex, age, education, and marital status), clinical factors (duration of illness, number of hospitalizations, and dose of drug), symptoms, behavior and symptoms, physical and mental health, family attitude, social support, attitude toward drug therapy, insight, self-esteem, hopelessness, and self-stigma were analyzed. The analysis included these 17 factors as explanatory variables for personal recovery to perform regression analysis.Results: Backward elimination was used to select variables, and multiple regression analysis was performed. The five factors (symptoms, self-esteem, insight, physical, and mental health, and social support) accounted for 75.8% of the variance in patients’ perceived willingness for personal recovery.Conclusion: Personal recovery in schizophrenic patients is very important because it means subjective satisfaction and quality of life in society. In this study, social support was the most important variable in predicting personal recovery. These results imply that not only symptoms but also various factors including social support should be emphasized when establishing a recovery strategy for schizophrenic patients.

Physical and psychological aspects of multiple sclerosis: Revisiting the Multiple Sclerosis Impact Scale (MSIS-29).

The MSIS-29 measures the physical and psychological impact of MS. The associations between MSIS-29 domains and demographic/clinical aspects were examined and trajectories analysed over time. Data were collected in the Trajectories of Outcome in Neurological Conditions study for a diverse population of people with MS, with follow-up for up to 5 years. Following Rasch analysis, minimal important change (MIC) was computed for ensuing total, physical and psychological domains. Fit to the Rasch model using data from 5921 participants validated physical, psychological and total domains, and the conversion table transforms raw scores to interval-level metric equivalents. These domains showed significant differences across demographic (age, gender, employment, education, and marital status) and clinical (subtype, treatment, and duration) factors with large effect sizes. The MIC scores were physical: 9.1, total: 14.1, which were both above measurement error, and psychological: 5.5 which was not, so 1.6% of participants reported psychological change which was clinically important but not statistically significant. Trajectory analysis showed three groups, one stable and two with significant slopes, improving and deteriorating. The MSIS-29 has shown adequate fit to the Rasch model after accommodating problems with local item dependency, through a bi-factor solution. The domains showed good discrimination across key factors.

Association of periodontal disease with stress levels and drinking frequency in adults: analysis using data from the 7th National Health and Nutrition Examination Survey

Objectives: This study aimed to investigate the association of stress level and alcohol consumption with periodontal disease in adults. Methods: Data from the 7th Korean National Health and Nutrition Examination Survey were used for this study, which included 13,199 Korean adults aged &gt;19 years. The variables analyzed included demographic characteristics (sex and age) and socioeconomic factors (income, education, and marital status). Multiple logistic regression analysis was performed to evaluate the association between periodontal disease, stress level, and drinking frequency after considering confounding factors such as income quartile and marital status. Results: After correcting for all confounding factors, the analysis showed that the group that drank more than four times a week had a 1.541 times higher risk of developing periodontal disease than the group that drank less than once a month (odds ratio [OR]=1.541, 95% confidence interval [CI]=1.245-1.906, p&lt;0.001). The prevalence of periodontal disease was higher in men, in those over 60 years of age, and in those with lower levels of education and income. Interestingly, those with lower perceived stress had a significantly higher disease prevalence (31.5%) than those with higher stress levels (28.0%; p&lt;0.001). Conclusions: The results of this study suggested that the higher the frequency of drinking, the higher the prevalence of periodontal disease.

Rural-urban differentials in undernutrition among women in India: Evidence from a decomposition approach.

Background: Global healthcare and nutrition policies have not eliminated the pressing public health issue of undernutrition, which remains a paramount public health concern in countries like India, coinciding with overweight and obesity, in the form of dual burden of malnutrition. Aim: This study delves into the rural-urban differential in undernutrition among reproductive-aged women in India for targeted policy interventions and to achieve universal health coverage. Methods: Data from the recent iteration of the National Family Health Survey (NFHS-5; 2019-21) were utilized to examine the factors influencing rural-urban differentials in women's undernutrition. A set of logistic regression and Fairlie's decomposition analysis are employed to identify the associated covariates and understand the factors driving these differentials. Results: The analysis reveals that rural women are significantly more vulnerable to undernutrition compared to urban counterparts, with factors such as education, wealth status, age, and dietary diversity playing key roles. The decomposition analysis of the rural-urban gap revealed that the variables considered in the study accounted for approximately 75% of the disparity. The difference in household wealth between rural and urban areas contributed about 63% of the explained gap, followed by educational status (16%), age group (11%), dietary diversity (8%), religion (5%), and media exposure (4%). Conclusion: The findings underscore the importance of targeted interventions addressing socio-economic inequalities to mitigate undernutrition among women in India. Enhancing access to education, improving economic opportunities, promoting dietary diversity, and challenging cultural norms are crucial steps towards achieving equitable nutritional outcomes and reducing the existing rural-urban disparity.

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.

Association of Transient Global Amnesia (TGA) With Dietary Intake of Vitamin B12.

Transient global amnesia (TGA), which is described as short-term amnesia, may be influenced by some dietary components involved in brain function. The aim of the present study was to assess the connection between TGA and dietary intake of vitamin B12. This cross-sectional study was conducted on 258 people with TGA and 520 people without TGA in Sabzevar, Iran. All participants were screened for TGA (ICD-10 code: G45.4). A validated Food Frequency Questionnaire (FFQ) was utilized to estimate the dietary intake of vitamin B12. Different models of logistic regression were used to determine the association between TGA and dietary intake of vitamin B12 after adjusting the confounders. There was an inverse association between the risk of TGA and the intake of vitamin B12 (OR = 0.94, CI 95%: 0.89-0.99, p= .02, effect size: -0.04). The result did not change after adjustment for age, gender, education, job, and marital status (OR = 0.93, CI 95%: 0.88-0.98, p= .01, effect size: -0.03). The result remained significant after additional adjustments for body mass index (BMI) and physical activity (OR = 0.94, CI 95%: 0.89-0.99, p= .03, effect size: -0.04), and after further adjustments for the underlying diseases, including diabetes, hypertension, and stroke (OR = 0.86, CI 95%: 0.81-0.92, p< .01, effect size: -0.10). Vitamin B12 deficiency may increase the risk of TGA and should be considered as a potential concern for people at risk for TGA. Further studies are needed to validate these findings and to discover the underlying mechanisms of the effects of vitamin B12 on TGA.

An Eye on the Future: Student Plans for Higher Education in Qatar

Education is identified as very critical to the achievement of the goals that were specified as strategic to Qatar’s socio-economic progress and development. At the core of the country’s policy plans is the need to develop human capacity as is highlighted in the Qatar National Vision (QNV) 2030. Not surprisingly, education has been identified as a strategic key to achieving the goals outlined in the QNV 2030. The present exploratory study employed a quantitative research design in order to investigate the factors that are likely to influence the educational aspirations of Qatari students. Drawing on Social Cognitive Theory (SCT) and Attribution Theory (AT), this study sought to examine students’ aspirations for post-secondary education in Qatar. Data for this study were collected using the Qatar Education Study (QES) survey, which is a nationally representative survey involving K-12 students in the State of Qatar. The analysis of this study’s data revealed that personal and household characteristics play an important role in shaping post-secondary educational aspirations of student participants, including age, nationality, education and employment status, as well as parental influence. Based on the study’s results, statistically significant associations were observed between personal and household variables and students’ aspirations for higher education. This study concludes with relevant recommendations and proposes future studies to explore the potential impact of individual aptitude and contextual factors on student future academic plans.

Unequal cannabis use among European adolescents: the mediating role of perceived access and risk

Abstract Introduction Cannabis use among adolescents is a public health concern, because of its association with the use of other illicit drugs, mental health disorders, and social problems. Most studies show that adolescents from low socioeconomic status (SE) background are more likely to use cannabis, but the causes of SE inequalities remain to be understood. We test whether access and risk perceptions of cannabis use among disadvantaged adolescents explain the SE gradient. Objectives The aim of this study was to measure the mediating effect of access perception and risk perception on the association between SE status and cannabis use among European adolescents in 2019. Methods A cross-sectional, observational, analytical study was conducted, among 16-year-old students, based on data from the European School Survey Project on Alcohol and Drugs (ESPAD) in 2019. The outcome was cannabis use (experimental, regular, and problematic) and the exposure was SE status (parental education and subjective social status). Mediating variables were perceived accessibility and perceived risk of cannabis use. We used logistic regressions, where the odds ratio (OR) reduction measures the part of the association explained by the mediators. Results Regular and problematic cannabis use was significantly more prevalent among adolescents with a lower SE background (low parental education and low subjective social status, p &amp;lt; 0,001). This relationship remained significant after adjustment for perceived access and risk, and the modification of ORs was of a small magnitude (a non-significant reduction of the association). Conclusions Perceived accessibility and risk showed a weak mediating effect of the association between SE background and cannabis use. Consequently, these factors cannot be considered as major explanations for the higher use among worse-off adolescents. Reinforcing information or imposing stronger barriers in access may not help reduces SE inequalities in cannabis consumption. Key messages • Perceived accessibility and risk hardly explain the association between socioeconomic background and cannabis use among European adolescents. • Reinforcing information or imposing stronger barriers in access may not help reduces socioeconomic inequalities in cannabis use.

Attitudes and Related Factors of Women in Turkey Towards Cancer Screening: Analytical Cross-Sectional Study

Objective: This study aimed to examine women's attitudes and related factors towards cancer screening in Turkey. Methods: This analytical-cross-sectional study was conducted between June and September 2022. The universe of the study consisted of all women between the ages of 30-70 in Turkey, and the sample included 335 women. The data of the study were collected online with the “Personal Information Form’’ and “Attitude Scale for Cancer Screening”. Results: The average Attitude Scale for Cancer Screening total score of the women participating in the study was 84.36±14.55. Of the women who participated in the study, 33.1% did not perform breast self-examination, 63.1% did not perform clinical breast examination, 49.5% did not perform Pap smear and HPV-DNA testing, 60.9% did not perform mammography, 76.1% did not perform fecal occult blood testing and 93.8% did not perform colonoscopy. It was determined that education status, breast self-examination, clinical breast examination, Pap Smear and HPV-DNA test frequencies, and knowing the places where cancer screening was performed affected the Attitude Scale for Cancer Screening score averages (F = 8.729, p = 0.000). Conclusion: It was determined that the attitudes of the women participating in the study towards cancer screening were moderate. Several factors are done affect attitudes towards cancer screening.

Large sample size MRI measurements to assess the relation between cardiac function and structure and white matter hyperintensity volumes

Abstract Background People with established cardiovascular disease (CVD) are at risk of early cognitive decline, and neurological diseases such as dementia. CVD and neurological diseases share common risk factors, such as blood pressure, sedentary lifestyle, as well as genomic risk factors such as mutations in APOE4 [1]. It's unclear to what extent the co-occurrence of CVD and neurological diseases is explained by these risk factors, or whether there is a direct association where CVD is a first step towards poorer neurological health. White matter hyperintensities (WMH) of presumed vascular origin are damaged areas in the brain observed through magnetic resonance imaging (MRI). These lesions are associated with progressive neurological disease such as vascular dementia, as well with risk factors for CVD [2]. Purpose We set out to determine to what extent CMR measurements associated with WMH independent of known cerebrovascular risk factors. Methods Cardiac and brain MRI images were analysed for 23,963 UK biobank (UKB) participants. WMH analysis included 5 brain regions (Frontal[F], Parietal[P], Temporal[T], Occipital[O], Basal Ganglia and Thalami [BGT]) and total brain WMH volume. Cardiac traits included stroke volumes, atrial volumes, ejection fractions of right and left chambers, left ventricular (LV) strain, LV wall thickness and aortic areas. Multivariable regression analysis was carried out, where each cardiac trait was regressed on each brain region and adjusted for: age, difference between age at initial visit and imaging visit, sex, systolic and diastolic blood pressure, Hba1c, household income, educational status, Townsend score and family history of disease (Alzheimer’s, Parkinson's, high blood pressure, stroke, heart disease) . Results were evaluated against a multiple testing correct p-value threshold of 0.05, reflecting the number of principle components(n=10) necessary to explain 90% of the cardiac trait variability. Results For 5 cardiac traits (right ventricular stroke volume, left atrial stroke volume, left ventricular stroke volume, left ventricular ejection fraction and right ventricular end diastolic volume) higher values were associated with lower WMH volumes in all brain regions. Additionally, some cardiac traits such as LV cardiac output associated with specific brain regions (T, O, BGT). Additionally, APOE- ε4 stratified analyses indicated, homozygous carriers show a greater association between higher minimum LA and RA volumes and higher WMH volumes in the occipital lobe. Conclusions This study gives an insight into the WMH burden in a large population of adults. It highlights the associations of cardiac traits with white matter hyperintensity volumes in different brain regions independent of known risk factors. Using cardiac traits as surrogate markers of different cardiac disease could explain how cardiac functionality defines WMH volume distribution and subsequently the wider relationship between CVD and cerebrovascular disease.Figure 1Graphical Abstract

Disparities in diabetes-related outcomes in prostate cancer patients - role of social determinants of health and race

Abstract Background Prostate cancer (PC) patients on androgen deprivation therapy (ADT) with diabetes mellitus (DM) are at increased risk of cardiovascular events (CVE) and all-cause mortality (ACM), with metformin use linked to lower ACM. Purpose To analyze the impact of low socioeconomic status (SES), low educational levels, and Non-Hispanic Black (NHB) race on the relationship between DM, and its treatments, and CVE, cardiovascular mortality (CVm), prostate cancer-specific mortality (PCsm), and ACM within 2 years of PC diagnosis in patients ± ADT. Methods We utilized SEER-Medicare (national database for individuals 65 or older covered under US federal health insurance program merged with multiple state cancer registries with ~50% US cancers covered) to study a cohort of PC patients diagnosed from 2009 to 2017, identifying PC cases with ICD-10 - C61 and DM via the Medicare chronic condition file. CVE included Afib, AMI, peripheral artery disease, ischemic stroke, and heart failure. Two patient cohorts were analyzed: those enrolled in Medicare Parts A and B with PC (cohort 1), and those exclusively on ADT (± diabetic medications) and enrolled in Medicare Part D (cohort 2). Outcomes were evaluated using Fine-Gray and Cox models, with further analysis by subgroups: NHB, SES, and education. Results We analyzed 74,052 PC patients, with 6,682 having comprehensive Part D data. Of these, 35% in cohort 1 and 16% in cohort 2 had DM, with median ages of 73 and 72, respectively. Diabetes was more prevalent among NHB men than Non-Hispanic White (NHW), 49% vs 33% in cohort 1 and 25% vs 15% in cohort 2. In cohort 1, 9% and 8.5% of overall and DM individuals were on ADT. Risk factor details are in Table 1, and CVE, CVm, PCsm, and ACM are included in Table 2, showing higher risks of various cardiovascular outcomes for DM patients, particularly for those with low-education levels. In cohort 1, we demonstrated a higher risk of all outcomes across all subgroups with DM (p&amp;lt;0.001). No significant interaction with race was present except in those with lower education levels, where NHW men with lower education showed an increased risk of CVE (sHR 1.15, 95%CI 1.10-1.21, P&amp;lt;0.001). In cohort 2, compared to metformin, the use of all other DM medications was associated with higher ACM. Additionally, those on other DM medications with lower education levels had higher CVE rates. Non-DM individuals with low SES had lower CVE rates, while NHB non-DM individuals had higher PCsm. Conclusion Our study highlights disparities in PC patients with DM in relation to cardiovascular and ACM, with NHB men and those with lower SES and educational status having worse outcomes. Metformin use in patients with low education levels was associated with reduced ACM and CVE risk, indicating its potential protective effect. These findings emphasize the need for further research on the disparities in PC and effects of diabetes medications across different subpopulations.

Missed opportunities of method information index plus (MII+) counseling among current modern contraceptive users. multi-level analysis from the Ethiopian PMA 2021 data set

IntroductionIn Ethiopia, there is a decrease in percentage of women who receive method information index counseling service from 39% (95%CI: 33%, 44%) in 2015 to 12% in 2019 (95% CI: 10%, 14%) nationally, and less than 40% of these services provided are high quality. Therefore, the aim of this study was to identify modern contraceptive users-related factors at individual level and community level associated with missed opportunities of method information index plus counseling.MethodsThis study used the datasets from the 2019 Performance Monitoring for Action Ethiopia Survey, which comprised a total of 8,365 households (98.9%) and 7,988 women (98.8%). The data analysis was done with Stata version 14. Using multilevel mixed effect logistics regression, both individual and community-level factors were found to be associated with missed opportunities of method information index plus counseling. a P-value of less than 0.05 was used to declare statistical significance. The association was presented using an adjusted odds ratio with a 95% confidence interval.ResultsThe study shows that the prevalence of missed opportunity MII + family planning counseling among current modern contraceptive users was 81% (79.15, 82.66) and factors significantly associated with missed opportunities of method information index plus counselling are educational status, low level of media exposure, religion, receiving the service in health centers and health posts, never heard of any other methods, number of children at first contraceptive use and region.ConclusionsIn Ethiopia 81% of women had a missed opportunities of MII + counseling service. In order to address this, we recommend policy makers to focus on training of health care workers and pharmacists about MII + counseling, and establishing ways to improve access to media exposure.