Two-stage Sampling Method Research Articles

Differences in Physical Activity and Self-Rated Health Levels Based on Satisfaction with Physical Environment of Local Communities: From School to Lifelong Physical Education

Background: In Korea, substantial disparities exist in physical environments across regions, exacerbating the polarization between metropolitan and provincial areas and urban and rural regions. Objectives: This study examines the differences in the physical activity and self-rated health of local communities in relation to satisfaction with the physical environment. By identifying and addressing these underlying causes of health disparities, the study provides foundational data to inform policy efforts. Methods: The study utilized data from the 2023 Community Health Survey conducted by the Korea Disease Control and Prevention Agency. It included 231,752 individuals aged 19 and older (105,754 men and 125,998 women) selected through a two-stage probability proportional systematic sampling method. One-on-one online interviews were conducted from 16 May to 31 July 2023. The physical environment was assessed based on public satisfaction with safety, natural and living environments, public transportation, and medical services. Study variables included subjective health status and physical activity, with subvariables for physical activity encompassing the duration of vigorous and moderate physical activity, walking, and flexibility exercises. For data analysis, MANOVA and ANOVA were conducted, with Bonferroni correction for multiple comparisons. Results: Considerable variations in physical activity were observed based on satisfaction with the local community environment. Regarding self-rated health, significant differences were found in safety levels, living environment, and medical services. Satisfaction with the physical environment positively influenced physical activity and self-rated health. Conclusion: Therefore, it is imperative to reduce disparities in the physical environment between regions and enhance residents’ satisfaction.

Gambling-specific metacognitions, depression, and responsible gambling in Macao, China

The Self-regulatory Executive Function model elucidates how metacognitions link to the development and maintenance of gambling disorder, however whether, and how, metacognitions explain responsible gambling remains unknown. This study is the first to address this knowledge gap by: (a) examining whether both generic and gambling-specific metacognitions explain variances in responsible gambling; and (b) testing the mediating role of depression between generic/gambling-specific metacognitions and responsible gambling. A two-stage cluster random sampling method was used to obtain a probability sample of 837 Chinese adult gamblers (48.5 % men, mean age = 41.11, SD = 14.31) in Macao, China. Hierarchical regression analysis indicated that gambling-specific metacognitions contributed to an additional 23 % variance explained in responsible gambling after considering generic metacognitions and demographics. Path analysis further showed that the direct paths from generic, positive and negative gambling-specific metacognitions to responsible gambling were all significant while the positive type showing a stronger effect. Moreover, depression partially mediated the effects of both generic and gambling-specific metacognitions on responsible gambling. Findings suggest that responsible gambling campaigns should consider improving the awareness of metacognitions and emotion regulation in depression among Chinese adult gamblers.

Assessment Beliefs, Practices and Competence Vis-À-Vis Demographic Characteristics of Senior High School Social Studies Teachers in Ghana

This study examined the impact of demographic factors on the assessment beliefs, practices and competence of Social Studies teachers in selected Senior High / Technical Schools in the Volta and Oti Regions of Ghana. The study was guided by the Human Capital Theory (HCT). It utilized a quantitative research approach and a cross-sectional research design. Employing a two-stage simple random sampling method, 196 Social Studies teachers were randomly selected from 80 Senior High Schools (SHS) and Senior High Technical Schools (SHTS) in the Regions. Data was collected through a questionnaire, covering the participants’ demographic information and assessment beliefs, practices and competence. Statistical data treatment was done through frequency distributions. It was displayed using a contingency table and Cramer's V analysis. Findings indicated no significant correlation between the teachers’ gender, educational background, teaching experience, assessment beliefs, practices and competence. The study concludes that the demographic did not influence the teachers’ assessment beliefs. Based on the conclusions, it is recommended that professional development should focus on individualized training that targets specific needs of teachers in assessment literacy rather than generalizing based on demographic factors. This could help foster more robust and consistent assessment beliefs across the teaching population. In addition, teacher education programs should prioritize skills-based training on contemporary assessment methodologies and address competency gaps regardless of demographic factors.

The effect of season and agro-ecology on physicochemical properties of cow's raw milk in Central and North-Western Zone of Tigray, Ethiopia

Milk at a normal state has unique physical, chemical, and biological characteristics that are used as quality indicators. The quality of milk is influenced by many factors and the components of milk are very sensitive indicators for milk production practices. Season and agro-ecologies have influences on physicochemical properties of cow milk. Therefore, this research aimed to investigate the effect of season and agro-ecology on the physicochemical properties of cow's raw milk in Central and North-Western Zone of Tigray. The study was conducted in Aksum, Shire-Indaselassie, and Sheraro administrative towns. A two-stage sampling method was used to select both the study area and respondents. All towns in the Central and North-Western zones of Tigray were categorized into three agro-ecologies, and sample towns were purposively selected from each category based on accessibility and milk production potential. Sample respondents were then randomly selected from each agro-ecology. Agro-ecology categorization was based on altitude, temperature, and feeding practices, while seasons were classified according to rainfall and temperature. A total of 210 samples, comprising 35 samples from dairy farms and 35 samples from cafeterias within each agro-ecology, were analyzed to assess the physicochemical properties of cow milk across two different seasons. Physicochemical analysis including determination of fat, crude protein, solids not fat, density, lactose, salt, water added and freezing point was conducted in the laboratory of Mekelle University using Lacto scan, Bulgaria. The overall mean values of milk fat, solids-not-fat (SNF), protein, and lactose were 3.72 ± 0.12 %, 6.72 ± 0.17 %, 2.6 ± 0.08 %, and 3.72 ± 0.09 %, respectively. Specific gravity, salt content, water added, and freezing point exhibited mean values of 1.026 ± 0.001 g/ml, 0.53 ± 0.01 %, 19.33 ± 1.8 %, and −0.42 ± 0.01oC, respectively. Significant differences (p < 0.05) were observed in protein, solids-not-fat, lactose, and salt content among agro-ecologies, seasons, and sources of milk. Correlation analysis revealed positive correlations between specific gravity and solids-not-fat, protein, lactose, and total salt, while negative correlations were observed with water added and freezing point (p ≤ 0.01). In conclusion, the physical and chemical properties of cow's raw milk are influenced by agro-ecology, season, and the source of milk. Notably, milk adulteration, particularly with the addition of water, was more prevalent among cafeteria owners. Given the absence of established milk quality standards in Ethiopian conditions, it is imperative for the government to introduce quality standard measures, rules, and regulations to effectively control milk quality.

Dietary practices of children and adolescents residing in an area of Chakdaha Block, Nadia district, West Bengal

ABSTRACT Background: Childhood and adolescence are crucial developmental stages during the life course. They develop and establish lifelong dietary and lifestyle habits. Unhealthy food environments that influence the risk of obesity and other nutrition-related NCDs by affecting the dietary patterns. Assessment of dietary patterns and factors affecting them will help to provide targeted interventions to improve the same. Methods: A community-based cross-sectional study was conducted among children aged more than 6 months and adolescents by interviewing their mothers regarding the dietary patterns. A two-stage sampling method was followed for selection of the participants. Results: A total of 325 participants were interviewed. Dietary diversity (DD) was present in 55.4% of the participants. Children of mothers who were educated beyond middle school (aOR = 3.81 (1.87-7.73), P = 0.000) and children who stayed in a joint family (aOR = 1.73 (1.11-2.72) P &lt; 0.05) had higher odds of having dietary diversity in their diet, after adjusting for age and sex. Fast food shop location (aOR = 0.14 (0.05-0.38), P value = 0.000) was found to have a significant association with fast food intake among participants. Conclusion: Children and adolescents residing in the study area have a distinct dietary pattern compared to prevalent dietary practices in India. To improve dietary diversity of children and adolescents, maternal education, family dynamics, and community food environment, which include fast food and market locations, can be points of targeted interventions

Examining the expansion of agroforestry practices and their management practices in the central highlands of Ethiopia

Agroforestry is an emerging livelihood strategy for meeting the fundamental requirements of millions of rural households, yet quantifying its expansion and management practices in Ethiopia remains limited. This study investigated the trends, extents and drivers of agroforestry expansion and related management practices in the central highlands of Ethiopia. A two-stage sampling method was employed to select 160 rural households that engaged in home garden and woodlot agroforestry practices. The data were collected via semi-structured questionnaires, key informant interviews, and focus group discussions and analyzed using descriptive statistics, content analysis, the Kruskal-Wallis test, and the Mann‒Whitney U test. The results demonstrated that there was a significant difference in the mean size (in hectares) of home gardens and woodlot agroforestry practices (p<0.05). There has been an increasing trend in the adoption and expansion of agroforestry practices, both in home gardens and woodlots. The rate of agroforestry expansion increased from 0.23 % before the 1980s to 3.95 % between 2011 and 2022. The expansion of agroforestry practices, particularly the increase in home garden size and woodlot establishment, was positively influenced by increased market demand, increased seedling availability, increased availability of labor, improved knowledge of agroforestry benefits, and increased proximity to homes and roads. Furthermore, the findings demonstrated that rural households implemented weeding, pruning, thinning, looping, pollarding, fertilizer application, watering, coppicing, fencing, and mulching to maintain and optimize the productivity of their agroforestry systems. Policymakers and stakeholders should consider developing targeted programs and incentives to further encourage the expansion of both home gardens and woodlot agroforestry practices.

Cultural and social factors associated with generalized anxiety disorder among adolescent mothers during the postpartum period in Malawi: a cross-sectional survey

BackgroundThe postnatal period is an important time for adolescent mothers to regain their health as they adjust to life with their infants. However, it is also a time when mothers are vulnerable to mental health problems. Generalized anxiety disorders (GADs) are among the common mental disorders that can impact mothers. Anxiety disorders can have adverse effects on a child’s cognitive development. However, there is a scarcity of studies pertaining to anxiety disorders among adolescent mothers in Malawi.MethodsA cross-sectional survey was conducted among adolescent postnatal mothers aged ≤ 19 years to establish the prevalence of probable GAD and identify cultural and social factors that influence anxiety in this population. Adolescent mothers were recruited from the Mitundu Rural Hospital catchment area in Lilongwe district, Malawi. A two-stage random sampling method was employed: clinics were randomly selected, and participants were recruited via systematic random sampling. The Generalized Anxiety Disorder (GAD-7) scale was used to assess anxiety. Data were analyzed using SPSS version 27.ResultsOf the 395 adolescent mothers who participated, 34% were aged 14–17. The prevalence of probable GAD (GAD-7 ≥ 10) was 31.9%. Increased social support decreased the odds of probable GAD (aOR 0.95, 95% CI: 0.91–0.98, p < 0.001). Experiencing intimate partner violence (IPV) increased the likelihood of probable GAD (aOR 4.80, 95% CI: 1.23–18.82, p = 0.02), while those who had contact with a health worker postnatally (aOR 0.38, 95% CI: 0.17–0.83, p = 0.02) and those who were “not prayerful” (aOR, 0.43, 95% CI: 0.21–0.87, p = 0.02) were less likely to report probable GAD.ConclusionsGiven that the prevalence of probable GAD among adolescent mothers in Malawi is higher compared to the global estimates of their peers, policies and guidelines that prioritize the maternal mental health of adolescent mothers in Malawi are required. The findings also highlight the importance of enhancing social support among family and community. Co-designed mental health promotion, prevention, and early interventions to involve health workers and religious leaders are recommended.

Differences in Associated Factors of Underweight and Overweight According to Rural-Urban Residence Strata among Ever-Married Non-Pregnant Women of Reproductive Age in Bangladesh.

This study sought to compare the prevalence of underweight and overweight among ever-married, non-pregnant women of reproductive age in Bangladesh by urban or rural residency status. This study used Bangladesh Demographic and Health Survey (BDHS), 2017 data. Cross-sectional study design with two-stage stratified sampling method was employed. A sample of ever-married non-pregnant women of reproductive age was selected and multinomial logistic regression was utilised in analysis. It was found that around half of rural women (45.0%, N = 4,934) and more than half of urban women (60.3%, n = 3,913) were overweight. Nearly one in seven rural women (14.0%, n = 1,537) and 1 in 12 urban women (9.0%, n = 564) were reported as underweight. Our analyses revealed that being overweight was substantially connected with age, husband's occupation, economic status, television access, and division for both urban and rural areas. Women from poor households were significantly more likely to be underweight than women from middle- income households for both urban (P < 0.05; OR: 1.41; 95% CI: 1.03, 1.94) and rural (P < 0.05; OR: 1.23; 95% CI: 1.04, 1.46) areas. Interestingly, women without television access both in urban (P < 0.001; OR = 0.78; 95% CI: 0.67, 0.91) and rural (P < 0.001; OR = 0.75; 95% CI: 0.68, 0.84) areas had an inverse association with overweight/obesity compared to women with television access. In both areas, women in Sylhet and Mymensingh had higher likelihood of being underweight than Barisal division. Additionally, in both residential zones, women in Sylhet had lower likelihood of being overweight than Barisal division. This study reveals that multiple characteristics are linked to both overweight and underweight among ever-married, non-pregnant women of reproductive age in Bangladesh. Addressing these variables should be a priority in public health efforts to combat the dual challenge of malnutrition in Bangladesh.

The moderating role of work environment in the relationship between proactive personality and personal growth initiative among nurses: a cross-sectional study

BackgroundsPersonal growth initiative (PGI) is regarded as a meaningful concept with potential value at both the individual and organizational levels, but little is known about the factors that contribute to nurses’ PGI. This study aimed to explore how proactive personality and hospital work environment affect PGI of clinical nurses.MethodsA cross-sectional study was conducted between September and October 2022 among 4414 nurses from 10 tertiary general hospitals in 10 cities in Sichuan, China, using a two-stage sampling method. Self-reported anonymous online questionnaires, such as sociodemographic information survey, personal growth initiative scale II, the 10-item proactive personality scale, and practice environment scale-nursing work index were used to collect data. Multiple hierarchical regression analyses were performed to examine research hypotheses.ResultsAmong the control variables in this study, nurses’ self-perceptions of general health status and professional title positively predicted PGI (β = 0.462, 95%CI = 0.272–0.653; β = 1.078, 95%CI = 0.508–1.648). After adding control variables, both proactive personality (β = 1.143, 95%CI = 1.096–1.190) and work environment (β = 3.391, 95%CI = 2.904–3.879) positively predicted PGI. The work environment positively moderated the association between proactive personality and PGI (β = 0.108, 95%CI = 0.025–0.191). These predictors jointly explained 50.3% of the variance in PGI.ConclusionsNurses with a greater tendency to have a typical proactive personality have higher levels of personal growth initiative, and this positive effect will be better highlighted in a healthier work environment. Nursing managers should prioritize the employment of people with proactive personality traits, focus on the development and stimulation of proactive personality traits in nurses, and establish a supportive work environment to maximize the personal growth initiative of nurses.

Desire Thinking About Gambling: Assessment and Associations With Gambling Disorder and Responsible Gambling Among Chinese Gamblers.

Desire thinking, within the metacognitive model of addictive behaviors, is conceptualized as a transdiagnostic process linked to the escalation and maintenance of craving for various addictive disorders; however, its application to the understanding of gambling and the Chinese community remains at an early stage. The present study aimed to introduce desire thinking into gambling research in the Chinese context by: (1) testing the applicability of its two-factor conceptualization and assessment tool, the Desire Thinking Questionnaire (DTQ), and (2) exploring its association with dysregulated and regulated engagements in gambling (i.e., Gambling Disorder [GD] and responsible gambling [RG], respectively). We conducted a telephone survey in Macao, China, and obtained a probability sample of 837 Chinese adult past-year gamblers (48.5% men; age:M = 41.11,SD = 14.31) with a two-stage cluster random sampling method. Our data indicated the psychometric adequacy of the two-factor DTQ (i.e., verbal perseveration and imaginal prefiguration) for measuring Chinese gamblers' desire thinking about gambling. After controlling for craving and demographics, desire thinking contributed to an additional 12.1% and 18.9% variance explained in GD tendency and RG behaviors, respectively. This study provides the first empirical evidence of the utility of desire thinking and the DTQ in facilitating gambling research on Chinese gamblers. Our findings also suggest the value of incorporating desire thinking in detecting and treating GD and in promoting RG.

Climate change adaptation strategies among smallholder farmers in Senegal’s semi-arid zone: role of socio-economic factors and institutional supports

In dryland agricultural systems, developing appropriate climate-smart technology (CST) options is important to adapt agriculture to climate change and transition toward sustainability, as well as increasing productivity and incomes. This study examines the impact of socio-economic and institutional support on community responses to climate change and the impact of changes in three selected regions of Senegal (Meouane, Thiel, and Daga Birame), which fall within different rainfall gradients. It captures community perceptions of climate change, compares them to long-term meteorological data, and identifies site-specific response strategies. Communities are randomly selected from a list of communities within the target sites. We used a two-stage stratified sampling method to select sample households. First, purposive sampling was conducted to select at least six (6) villages as a cluster within each rainfall gradient. Likewise, the selection of households in each cluster was based on the main value chains of crops grown in the study area, namely groundnut, millet, black pea, and livestock. A total of 145 households participated in this study. Data from surveys conducted during the 2022 post-harvest season were analyzed using descriptive statistics and logit models. The analysis found that smallholders have a comprehensive understanding of climate indicators, including annual rainfall, shortened crop seasons, and rising temperatures, compared to historical data trends. Additionally, the results highlight how farmers view the negative impacts of seasonal rainfall deficiencies (72%), delayed start of the growing season (88%), frequent dry spells (68%), and longer dry spells (76%), which ultimately lead to decreased grain and fodder yields. The logit model also highlights the importance of socio-economic and institutional factors such as access to credit, extension services, agricultural experience, frequency of interaction with extension workers, and access to government subsidies. These factors play a crucial role in farmers’ decision to adopt CST. Given the specificity of community contexts, these insights have important implications for guiding policymakers and making it easier to reduce climate risk among smallholder farmers.

Association between Gestational Weight Gain and Maternal and Birth Outcomes in Northern Ghana.

Although inappropriate gestational weight gain is considered closely related to adverse maternal and birth outcomes globally, little evidence was found in low- and middle-income countries. Study Objectives. This study is aimed at identifying the determinants of gestational weight gain and examine the association between gestational weight gain and maternal and birth outcomes in the Northern Region of Ghana. Study Methods. The study used a facility-based cross-sectional study design involving 611 antenatal and delivery records in Tatale district, Tamale west, and Gushegu municipal hospitals. A two-stage sampling method involving cluster and simple random sampling was employed. Descriptive statistical analysis and measures of central tendency were used to describe the sample. The multinomial logistic regression model was used to determine the determinants of gestational weight gain and its association with maternal and birth outcomes. Among the 611 women included in the study, 516 (84.45%) had inadequate gestational weight gain, and 19 (3.11%) had excessive gestational weight gain. The gestational weight gain ranged from 2 kg to 25 kg with a mean of 7.26 ± 3.70 kg. The risk factor for inadequate gestational weight gain was low prepregnancy BMI (adjusted odds ratio (AOR) = 1.33, 95% CI = 1.18 - 2.57, P = 0.002). Pregnant women who had inadequate gestational weight gain were significantly less likely to deliver through caesarean section (AOR = 0.27, 95% CI = 0.12 - 0.61, P = 0.002), and those who had excessive weight gain were more likely to undergo caesarean section (AOR = 19.81, 95% CI = 5.38 - 72.91, P = 0.001). The odds of premature delivery (birth < 37 weeks) among pregnant women with inadequate weight gain were 2.88 (95% CI = 1.27 - 6.50, P = 0.011). Furthermore, subjects who had excessive weight gain were 43.80 times more likely to give birth to babies with macrosomia (95% CI = 7.07 - 271.23, P = 0.001). Inappropriate gestational weight gain is prevalent in Ghana, which is associated with caesarean section, preterm delivery, delivery complications, and macrosomia. Urgent policy interventions are needed to improve on the frequent monitoring and management of gestational weight gain of pregnant women till term.

Prevalence, Patterns and Peculiarities of Depression among Tuberculosis Patients Attending Directly Observed Treatment Short-course (DOTS) Centers in Lagos State Nigeria

Tuberculosis (TB) is an infectious disease that is life-threatening to vulnerable populations, and has been reported to be associated with depression. Nigeria is one of the countries with a high TB burden, and with the current economic hardship in Nigeria, people are becoming poorer suggesting more TB patients are more likely to elapse into depression. The aim of this research was to assess the prevalence, patterns and peculiarities of depression among TB patients attending Directly Observed Treatment Short course (DOTS) centers in Lagos State, Nigeria. A descriptive, cross-sectional survey was conducted among 301 TB patients at 8 DOTS centers in Lagos State, Nigeria using a two-stage sampling method. Data was collected using interviewer-administered questionnaires to elicit responses from the TB patients. Patient Health Questionnaire-9 (PHQ-9) was used to determine and assess depression. Data was analyzed using SPSS version 23.0, with the Chi-square test being used to check for the association between socio-demographic characteristics and depression among the respondents. Mean age of the respondents was 35.1±11.7 years. A majority (71.8%) of the respondents were males, 69.1% were Christians, Yorubas were most (52.2%), 88.4% earned ≤N150,000 monthly, and only 1 respondent had no formal education. The prevalence rate of depression among the TB patients was 51.8%. Socio-demographic characteristics like gender (females were more affected), low financial status, and low educational level were associated with depression (p&lt;0.05); unlike age, marital status, ethnicity, employment status, and family setting (p&gt;0.05). Depression among TB patients is real as one in every two TB patients is depressed. Therefore, healthcare workers at DOTS centers should pay adequate attention to signs of depression among their patients.

Influence of maternal and neonatal continuum of care on the risk of intergenerational cycle of stunting: a cross-sectional study

ObjectivesThis study aimed to analyse the influence of the continuum of care during pregnancy and neonatal periods on the risk of intergenerational cycle of stunting.DesignThis study was a cross-sectional study,...

Two-stage sampling with predicted distribution changes in federated semi-supervised learning

Federated semi-supervised learning (FSSL) involves training a model in a federated environment using a few labeled samples and many unlabeled samples. Compared with semi-supervised learning, FSSL faces more complex data situations, especially when data are non-independently and identically distributed (non-IID), adding more challenges to the learning process. The previous method addresses the aforementioned issues by enlarging the training sample space through multiple client random sampling and reweighting the parameters. Although it achieves high accuracy, it sacrifices communication efficiency. In this study, we propose PDCFed, a two-stage sampling method that uses the Predicted Distribution Changes of samples after different data augmentations. We evaluate the credibility of the samples based on the maximum probability predicted by weak augmentation. When the samples are in a less reliable space, they are further sampled after adjusting the predicted distribution changes using a Gaussian function. To enhance the model’s generalization ability, an entropy penalty term is incorporated after unsupervised training loss. Extensive experiments demonstrate that this method outperforms existing methods on three datasets with non-IID data and significantly improves communication efficiency.

The Knowledge and Practice of Family Planning Among Muslim Women in Rural Karnataka, India.

Introduction Women's health is significantly impacted by undesirable pregnancies and unsafe abortions, leading to the deaths of thousands of women and causing many others to suffer from infertility and long-term reproductive health issues. To address this problem, the use of modern contraception methods is increasing, regardless of economic status and dwelling, allowing women to exercise their rights and access reproductive health services. Objective The objective of this study is to examine the knowledge and practiceof family planning and the factors associated with it. Settingand design A cross-sectional study was conducted among Muslim women (n=461) using a two-stage stratified random sampling method with a semi-structured questionnaire in the five taluks of Dakshina Kannada district in Karnataka. Methods and materials The required study sample was drawn by adopting the two-stage stratified random sampling technique. The study population was divided into different strata consisting of panchayats and wards. The number of households was selected from these panchayats/wards. Statistical analysis The association between faith in family planningand the knowledge and practice of family planning is studied using a chi-squared test. The factors associated with the practice of family planningare identified using a univariable and multivariable logistic regression analysis. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS)version 27 (IBM SPSS Statistics, Armonk, NY). Results There is a significant association between faith in family planning and its practice, with a p-value of less than 0.0001. Age was also found to be a significant factor associated with the practice of family planning. Specifically, women aged 31-40 were less likely to practice family planning compared to women aged 21-30, with a p-value of 0.012. The majority of individuals indicated the preferred child (23.9%) and going against the custom (16.5%) as their reasons for not using family planning. Conclusions Muslim women are reasonably well-informed about modern methods of contraception, but their usage remains relatively low. Outreach initiatives, health worker mobilization from within the community, and health education and information sharing are examples of program interventions that could help address this issue.

Rural and urban differences in the prevalence and determinants of Type-2 diabetes in Bangladesh.

To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location. We conducted this study using data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes. The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55-64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension. Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings.

Role of handgrip strength in predicting the quality of life in older adults: A cross-sectional study.

Quality of life (QOL) is a vital component in assessing the standard of living for seniors. Hand grip strength (HGS) is a widely used measure to diagnose muscle strength decline that often occurs due to age-related loss of skeletal muscle mass and function. This study focuses on the HGS in predicting the QOL of older adults who are referred to retirement centers in Guilan Province. In 2021, a cross-sectional analytical study was conducted among 115 older adults who were residing in retirement centers located in Guilan Province, Northern Iran. The participants were selected using a two-stage sampling method, where three retirement centers were randomly chosen followed by convenience sampling from each center. The selected retirement centers were situated in Langrod, Sowme'eh Sara, and Rasht cities in the east, west, and center of the province, respectively. The data were collected through a demographic information questionnaire, QOL scale (CASP-19), and HGS measurement using a dynamometer. Of the participants, 57.4% were male, 51.3% had middle income, and 96.5% were categorized as young elderly. The mean overall QOL score was found to be 37.026 ± 6.123, while the mean HGS level was 31.74 ± 7.45 and 18.48 ± 5.13 among males and females, respectively. There was a significant association between the level of education and QOL (P = 0.002). Moreover, there was a positive and significant correlation between HGS and QOL (r = 0.54, P = 0.001). The results of the multiple linear regression identified HGS as a predictor of QOL (Adj R2 = 0.44, βHGS = 0.79). Given that HGS has been identified as a predictor of QOL in older adults, improving this factor through exercise can lead to enhancement in their QOL. Therefore, regular sports exercises can be recommended as a means of improving HGS and subsequently enhancing the QOL of older adults.

Vision problems and positive youth development: The mediating role of vision-related quality of life and the moderating role of self-control

BackgroundVision problems are still widespread among children and adolescents in rural areas of China. Previous studies on the effects of vision problems on adolescent development have mostly focused on the effects of vision problems from a negative and problematic perspective, but the associations of vision problems with adolescent development potential and resources and potential mediating and moderating mechanisms are unclear. In this study, we investigated thepotentialmediating effects of vision-related quality of life (VR-QoL) and the potential moderating effects of self-control in the relationship between vision problems and positive youth development (PYD). MethodsUsing a two-stage sampling method, 2,837 students in grades 7–9 at five middle schools in four townships in Zhenping County, Henan Province, completed self-report questionnaires that included measurements of vision problems, PYD, VR-QoL and self-control as well as covariates such as sex. The relationships among variables were analysed with a moderated mediation model using the PROCESS macro of SPSS. ResultsThe total effect and direct effect of vision problems on PYD were not significant, but PYD was predicted negatively by the emotional dimension of VR-QoL. VR-QoL may fully mediate the association between visual problems and PYD. The moderated mediation analysis results showed that self-control enhanced the positive effect of the emotional dimension on PYD. Simple slope analyses indicated that the emotional dimension positively predicted PYD at a high level of self-control, while the emotional dimension did not significantly predict PYD at a low level of self-control. ConclusionThe present study revealed the relationship between vision problems and PYD and related mechanisms. Vision problems affected PYD through VR-QoL, and the mediating effect was greater in adolescents with high levels of self-control.

Low birth weight, household socio-economic status, water and sanitation are associated with stunting and wasting among children aged 6-23 months: Results from a national survey in Ghana.

Stunting and wasting are key public health problems in Ghana that are significantly linked with mortality and morbidity risk among children. However, information on their associated factors using nationally representative data is scanty in Ghana. This study investigated the influence of Infant and Young Child Feeding (IYCF) indicators, socio-demographic and economic related factors, and water and sanitation on stunting and wasting, using nationally representative data in Ghana. This is a secondary data analysis of the most recent (2017/2018) Ghana Multi-Indicator Cluster Survey (MICS) datasets. The multi-indicator cluster survey is a national cross-sectional household survey with rich data on women of reproductive age and children under the age of five. The survey used a two-stage sampling method in the selection of respondents and a computer-assisted personal interviewing technique to administer structured questionnaires from October 2017 to January 2018. The present study involved 2529 mother-child pairs, with their children aged 6 to 23 months. We used the Complex Sample procedures in SPSS, adjusting for clustering and stratification effects. In a bivariate logistic regression, variables with P-values ≤ 0.05 were included in a backward multivariate logistic regression to identify the significant factors associated with stunting and wasting. The mean age of children was 14.32 ± 0.14 months, with slightly more being males (50.4%). About 12% and 16% of the children were wasted and stunted, respectively. There were 39.4%, 25.9%, and 13.7% of children who, respectively, satisfied the minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). None of the IYCF indicators was significantly associated with stunting or wasting in the multivariate analysis but low socio-economic status, low birth weight, being a male child and unimproved toilet facilities were significantly associated with both wasting and stunting. Our findings suggest that aside from the pre-natal period, in certain contexts, household factors such as low socio-economic status and poor water and sanitation, may be stronger predictors of undernutrition. A combination of nutrition-specific and nutrition-sensitive interventions including the pre-natal period to simultaneously address the multiple determinants of undernutrition need strengthening.