A sociodemographic index identifies sex-related effects on insomnia in the Hispanic Community Health Study/Study of Latinos.

Study Objectives: Sex differences are related to both biological factors and the gendered environment. We constructed measures to model sex-related differences beyond binary sex. Methods: Data came from the baseline visit of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We applied the least absolute shrinkage and selection operator penalized logistic regression of male versus female sex over sociodemographic, acculturation, and psychological factors jointly. Two "gendered indices," the gendered index of sociodemographic environment (GISE) and gendered index of psychological and sociodemographic environment, summarizing the sociodemographic environment (GISE) and psychosocial and sociodemographic environment (GIPSE) associated with sex, were calculated by summing these variables, weighted by their regression coefficients. We examined the association of these indices with insomnia, a phenotype with strong sex differences, in sex-adjusted and sex-stratified analyses. Results: The distribution of GISE and GIPSE differed by sex with higher values in male individuals. In an association model with insomnia, male sex was associated with a lower likelihood of insomnia (odds ratio [OR] = 0.60, 95% CI [0.53, 0.67]). Including GISE in the model, the association was slightly weaker (OR = 0.63, 95% CI [0.56, 0.70]), and weaker when including instead GIPSE in the association model (OR = 0.78, 95% CI [0.69, 0.88]). Higher values of GISE and of GIPSE, more common in the male sex, were associated with a lower likelihood of insomnia, in analyses adjusted for sex (per 1 standard deviation of the index, GISE OR = 0.92, 95% CI [0.87, 0.99], GIPSE OR = 0.65, 95% CI [0.61, 0.70]). Conclusions: New measures such as GISE and GIPSE capture sex-related differences beyond binary sex and have the potential to better model and inform research studies of sleep health.

Amyotrophic lateral sclerosis caused by the C9orf72 expansion in Norway - prevalence, ancestry, clinical characteristics and sociodemographic status.

OBJECTIVE: The most common genetic cause of amyotrophic lateral sclerosis (ALS) is the C9orf72 expansion. A high incidence of this expansion has been detected in Sweden and Finland. This Norwegian population-based study aimed to identify the prevalence, geographic distribution, ancestry, and relatedness of ALS patients with a C9orf72 expansion (C9pos). Further, we compared C9pos and C9neg patients' clinical presentation, family history of ALS and other neurodegenerative disorders, and sociodemographic status. METHODS: We recruited ALS patients from all 17 Departments of neurology in Norway. Blood samples and questionnaires regarding clinical characteristics, sociodemographic status and family history of ALS, and other neurodegenerative disorders were collected. The C9orf72 expansion was examined for all patients. RESULTS: The study enrolled 500 ALS patients, 8.8% of whom were C9pos, with half being sporadic ALS cases. The proportion of C9pos cases differed between regions, ranging from 17.9% in the Northern region to 1.9% in the Western region. The majority of C9pos patients had non-Finnish European descent and were not closely related. C9pos patients exhibited a significantly shorter mean survival time, had a higher frequency of relatives with ALS or dementia, and were more often unmarried/single and childless than C9neg patients. CONCLUSION: C9pos patients constitute a large portion of the Norwegian ALS population. Ancestry and relatedness do not adequately explain regional differences. Relying on clinical information to identify C9pos patients has proven to be challenging. Half of C9pos patients were reported as having sporadic ALS, underlining the importance of carefully assessing family history and the need for genetic testing.

Tracking multidrug resistant tuberculosis: a 30-year analysis of global, regional, and national trends.

Objectives: To provide valuable insights for targeted interventions and resource allocation, our analysis delved into the multifaceted burden, trends, risks, and projections of multi drug resistant tuberculosis (MDR-TB). Methods: This research employed data from the Global Burden of Disease (GBD) 2019 dataset, which used a comparative risk assessment to quantify the disease burden resulting from risk factors. Initially, this database was utilized to extract details concerning the disability-adjusted life years (DALYs), mortality, incidence, and the number of individuals afflicted by MDR-TB. Subsequently, regression analyses were conducted using the Joinpoint program to figure average annual percent change (AAPC) to ascertain the trend. Thirdly, the age-period-cohort model (APCM) was adopted to analyze evolutions in incidence and mortality. Finally, utilizing the Nordpred model within R software, we projected the incidence and mortality of MDR-TB from 2020 to 2030. Results: MDR-TB remained a pressing global health concern in regions with lower socio-demographic indexes (SDI), where the AAPC in DALYs topped 7% from 1990 to 2019. In 2019, the cumulative DALYs attributed to MDR-TB tallied up to 4.2 million, with India, the Russian Federation, and China bearing the brunt. Notably, the incidence rates have shown a steadfast presence over the past decade, and a troubling forecast predicts an uptick in these areas from 2020 to 2030. Additionally, the risk of contracting MDR-TB grew with advancing age, manifesting most acutely among men aged 40+ in lower SDI regions. Strikingly, alcohol consumption had been identified as a significant contributor, surpassing the impacts of smoking and high fasting plasma glucose, leading to 0.7 million DALYs in 2019. Conclusions: A robust strategy is needed to end tuberculosis (TB) by 2030, especially in lower SDI areas.

Association of sociodemographic characteristics with the timeliness of surgery for patients with open tibial fractures.

BACKGROUND: The American College of Surgeons recommends operative debridement of open tibial fractures within 24 h of presentation. It is unknown what the compliance rates are with this recommendation and what factors contribute to delays to operation. METHODS: To determine the characteristics associated with delays to operation for open tibial fractures, we conducted a retrospective cohort study utilizing American College of Surgeons Trauma Quality Improvement Program data from 2017 to 2021. Individuals aged 18 and older presenting to a trauma center with an open tibial fracture were included. Associations were determined with a hierarchal regression model nesting patients within facilities. RESULTS: Of the 24,102 patients presenting to 491 trauma centers, 66.3 % identified as White, 21.7 % as Black, 1.5 % as Asian, 1.1 % as American Indian, and 10.6 % as Other race. In total, 15.8 % identified as Hispanic. Patients were most often men (75.9 %) and privately insured (47.6 %). The median time to OR was 10.2 h (IQR 4.4-17.7) with 84.6 % receiving surgery within 24 h. In adjusted analyses, Black and American Indian patients had 5.5 % (CI 1.3 %-9.9 %) and 17.8 % (CI 2.2 %-35.8 %) longer wait times, respectively, and a decreased odds of receiving surgery within 24 h (AOR 0.85, CI 0.8-0.9; AOR 0.69, CI 0.5-0.9) when compared to White patients. Female patients had 6.5 % (CI 3.0 %-10.2 %) longer wait times than men. Patients with Medicaid had 5.5 % (CI 1.2 %-9.9 %) longer wait times than those with private insurance. Greater time to OR was associated with increasing age (p < 0.001), increasing injury severity (p < 0.001), and the presence of altered mentation (p < 0.001). CONCLUSION: We identified longer wait times to operative irrigation and debridement of open tibial fractures for Black and American Indian patients, women, and those with Medicaid. The implementation of health equity focused quality metrics may be necessary to achieve equity in trauma care.

Comparative analysis of stress levels among working and non-working Indian women in rural Gujarat.

Stress is derived from the Latin word "stringers" manifests as the body's response to various demands and pressures, affecting individuals' health and well-being. Therefore, it is of interest to evaluate stress levels in employed and unemployed women, recognizing the differential stress experiences in various life domains. A quantitative non-experimental comparative research design was employed, with data collected through structured questionnaires from 120 women in Visnagar, Gujarat. Results: Non-working women demonstrated lower stress levels compared to working women in pre-test measures. Post-intervention, non-working women experienced a reduction in stress, while working women showed no change. Demographic factors like age, education, and family structure did not significantly influence stress levels, except for monthly income, which correlated with lower stress across both groups. The study underscores significant disparities in stress levels between employed and unemployed women in rural Visnagar. Tailored interventions effectively reduced stress among non-working women but showed limited efficacy for working women. Financial stability emerged as a crucial factor in mitigating stress. Younger working women reported higher stress levels, suggesting the need for targeted interventions addressing career and familial pressures.

Comparative Analysis of Stress Levels Among Undergraduate Students at St. John's College, Agra.

Background Stress is prevalent among college students, impacting their mental health and academic performance. Understanding the distribution and determinants of stress levels in students is crucial for developing effective interventions. This study aims to assess the prevalence of stress and its association with sociodemographic factors among undergraduate students at St. John's College, Agra, India. Materials and methods A descriptive cross-sectional study was conducted between August 1, 2023, and December 31, 2023, involving 160 undergraduate students from B.A., B. Com., and B.Sc. programs. Students were selected using a stratified random sampling technique. Stress levels were measured using the Perceived Stress Scale (PSS), which classifies low, moderate, and high levels. Data were collected through a validated, semi-structured questionnaire administered via Google Forms. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York), with descriptive statistics and chi-square tests used to examine associations between stress levels and sociodemographic variables. Results The study found that 103 (64.4%) of students experienced moderate stress, 34 (21.3%) reported high perceived stress, and 23 (14.4%) had low stress. A significant association was observed between stress levels and gender (p = 0.022), with female students more likely to experience high stress. Additionally, urban students reported higher stress levels than their rural counterparts (p = 0.012). However, no significant differences in stress levels were found across different courses. Conclusion The study reveals a substantial prevalence of moderate to high stress among college students, particularly among females and those from urban areas. These findings suggest the need for targeted stress management interventions to support student well-being. Further research is recommended to explore the underlying causes of stress and develop comprehensive stress reduction strategies in the student population.

Energy drink consumption among Korean adolescents: prevalence and associated factors.

Background: Energy drinks are gaining popularity among young people worldwide. However, little is known about their consumption among Korean adolescents. Purpose: : To examine the prevalence and factors asso-ciated with energy drink consumption among Korean adolescents. Methods: : This study used data from the Korea Youth Risk Behavior Surveys conducted in 2014-2017 and in 2019. A total of 325,210 participants aged 12-18 years were included. The prevalence of energy drink consumption (with 95% confidence intervals) was estimated. Multivari-able logistic regression analyses examined the association between energy drink consumption and sociodemographic and individual factors. Results: : The prevalence of consuming energy drinks 3 or more times during the previous 7 days increased signifi-cantly from 3.2% in 2014 to 12.2% in 2019 (P for trend<0.001). This increasing trend was observed in all subgroups regardless of sex, school grade, region of residence, subjec-tive economic status, family cohabitation status, and academic achievement. Data from the 2014-2017 and 2019 surveys revealed that boys, high schoolers, city-dwelling adolescents, adolescents with low economic status, those not living with their families, and those with low academic achievement were more likely to consume energy drinks. However, the relationship between energy drink consump-tion and the associated factors differed by survey year and school grade. In 2019, higher energy drink consumption among middle schoolers was associated with sex (male), low economic status, not living with family, and low academic achievement; however, higher energy drink con-sumption among high schoolers was associated with city-dwelling, high economic status, not living with family, and high academic achievement. Conclusion: : Energy drink consumption is common, has recently increased among Korean adolescents, and varies according to sociodemographic and individual factors. Further research to monitor the energy drink consumption of adolescents and understand their attitudes toward and factors influencing energy drink consumption is needed to develop policies and educational strategies for energy drink consumption.

The prevalence of psychological distress and its associated sociodemographic factors in the Australian adults aged 18-64 years during COVID-19: Data from the Australian National Health Survey.

OBJECTIVE: COVID-19 significantly contributed to an increase in psychological distress and may have disproportionally impacted certain sociodemographic groups. This study aimed to assess the prevalence of psychological distress among Australian adults aged 18-64 years and identify sociodemographic factors associated with psychological distress during the COVID-19 pandemic. METHODS: Secondary analyses were conducted using data from the National Health Survey 2020-21 to calculate weighted national estimates of the prevalence of psychological distress using the Kessler Psychological Distress scale (K10). The association between sociodemographic factors and psychological distress was analysed using multivariable logistic regression, with adjustments for complex survey design. RESULTS: The average of K10 score was 16.94, with a prevalence of combined high/very high distress reported at 21.13 % among Australian adults. Young women aged 18-25 reported the highest average scores (M = 20.44) across all sex and age groups. Risk factors associated with psychological distress included lower personal income, marital status (never married; widowed/divorced/separated) and being 'born in Australia'. Protective factors included homeownership and having children in the household. Additionally, among women, being aged ≥56 was significantly associated with lower odds of psychological distress. LIMITATIONS: Data collection relied on self-completed online form, and a cross-sectional design limits the inference of a causal relationship. DISCUSSION: During COVID-19 pandemic, lower personal income and being female have consistently been identified as risk factors for psychological distress. Targeted and tailored interventions based on age, sex and disadvantage are warranted, particularly focusing on younger women, to alleviate the adverse effect of the pandemic on the population's mental health.

Characteristics of high-dose benzodiazepine use: nationwide cohort study on new benzodiazepine users with 5-year follow-up.

BACKGROUND: A nationwide register-based cohort study from Finland including 48 124 incident benzodiazepines and related drug (BZDR) users aged 18-65 years who initiated use in 2006 and were not dispensed BZDRs during 2004-2005. The follow-up was 5 years or until death, whichever occurred first. AIMS: To investigate sociodemographic and clinical factors associated with high-dose use of BZDRs (i.e. Z-drugs) among new BZDR users. METHOD: The temporal BZDR dose was calculated as a point estimate every 6 months after initiation as defined daily doses (DDDs) per day, based on the PRE2DUP method (an approach based on mathematical modelling of personal drug purchasing behaviours). Sociodemographic and clinical factors associated with dose categories were studied using multinomial logistic regression. RESULTS: During the 5-year follow-up, very high-dose BZDR use was observed in 7.4% (n = 3557) and medium high-dose use in 25.5% (n = 12 266) of the users (corresponding to ≥30 mg and 10-29 mg in diazepam equivalents, respectively). Very high-dose use was more common among men compared with women (10.9% versus 4.6%). Very high-dose use patterns were especially observed in younger age groups (18- to 25-year-olds). Compared with oxazepam, initiating BZDR use with clonazepam (adjusted odds ratio 3.86, 95% CI 3.24-4.60), diazepam (2.05, 1.78-2.36) or alprazolam (1.76, 1.52-2.03) was associated with increased odds for very high-dose use. Both medium high-dose and very high-dose BZDR use were associated with a lower level of education. In all, 58% of very high-dose use occurred in BZDR users who received their first prescription from general practitioners. CONCLUSIONS: Clinicians should be aware of the dose escalation risk especially when prescribing diazepam, alprazolam or clonazepam for psychiatric indications. If BZDRs are needed, our findings suggest favouring oxazepam.

Affective symptoms in pregnancy are associated with the vaginal microbiome.

BACKGROUND: Composition of the vaginal microbiome in pregnancy is associated with adverse maternal, obstetric, and child health outcomes. Therefore, identifying sources of individual differences in the vaginal microbiome is of considerable clinical and public health interest. The current study tested the hypothesis that vaginal microbiome composition during pregnancy is associated with an individual's experience of affective symptoms and stress exposure. METHODS: Data were based on a prospective longitudinal study of a medically healthy community sample of 275 mother-infant pairs. Affective symptoms and stress exposure and select measures of associated biomarkers (diurnal salivary cortisol, serum measures of sex hormones) were collected at each trimester; self-report, clinical, and medical records were used to collect detailed data on socio-demographic factors and health behavior, including diet and sleep. Vaginal microbiome samples were collected in the third trimester (34-40 weeks) and characterized by 16S rRNA sequencing. Identified taxa were clustered into three community clusters (CC1-3) based on dissimilarity of vaginal microbiota composition. RESULTS: Results indicate that depressive symptoms during pregnancy were reliably associated with individual taxa and CC3 in the third trimester. Prediction of functional potential from 16S taxonomy revealed a differential abundance of metabolic pathways in CC1-3 and individual taxa, including biosynthetic pathways for serotonin and dopamine. We did not find robust evidence linking symptom- and stress-related biomarkers and CCs. CONCLUSIONS: Our results provide further evidence of how prenatal psychological distress during pregnancy alters the maternal-fetal microbiome ecosystem that may be important for understanding maternal and child health outcomes.

Global, regional, and national burden of intracerebral hemorrhage and its attributable risk factors from 1990 to 2021: results from the 2021 Global Burden of Disease Study.

BACKGROUND: Intracerebral hemorrhage (ICH) results from the rupture of blood vessels causing bleeding within the brain and is one of the major causes of death and long-term disability globally, particularly in low- and middle-income countries. Despite having a lower incidence than ischemic stroke, ICH imposes a greater social and economic burden. To our knowledge, since the release of the 2021 Global Burden of Disease (GBD) report, there has been no comprehensive update on the epidemiology and trends of ICH. This study aims to analyze the impact of gender, age, and the Sociodemographic Index (SDI) on the burden of ICH at global, regional, and national levels. METHODS: Data on the incidence, deaths, and disability-adjusted life years (DALYs) of ICH and its related risk factors from 1990 to 2021 were extracted from the GBD 2021 project, encompassing 203 countries and regions. Furthermore, temporal trends of the global intracerebral hemorrhage burden were assessed through Joinpoint analysis. RESULTS: In 2021, there were 3.444 million new cases of ICH worldwide, with an age-standardized prevalence rate of 40.8 per 100,000 people, representing a 31.4% decrease compared to 1990. In 2021, ICH caused 3.308 million deaths, with an age-standardized mortality rate of 39.1 per 100,000 people, a reduction of 36.6% since 1990. Globally, ICH accounted for 79.457 million DALYs, with an age-standardized DALY rate of 92.4 per 100,000 people, representing a 39.1% decrease since 1990. Regionally, Central Asia, Oceania, and Southeast Asia had the highest age-standardized prevalence rates of ICH, whereas Australasia, high-income North America, and Western Europe had the lowest rates. Nationally, the Solomon Islands, Mongolia, and Kiribati had the highest age-standardized prevalence rates, whereas Switzerland, New Zealand, and Australia had the lowest. Hypertension, smoking, and environmental pollution were identified as the primary risk factors for ICH. This study also validated the significant association between SDI and the burden of ICH, with the age-standardized DALY rate of ICH decreasing significantly as SDI increased. CONCLUSION: Despite the decreasing burden of intracerebral hemorrhage, it remains a significant public health issue in countries with a lower SDI. Prevention strategies should prioritize hypertension management, air quality improvement, and smoking control to further mitigate the impact of intracerebral hemorrhage.

Moderating effects of socioeconomic status and geographical location on the Health4Life school-based intervention.

Objective: This study evaluated the moderating effects of socioeconomic status (SES) and geographical location on the efficacy of an eHealth school-based multiple health behaviour change intervention - Health4Life - in targeting alcohol and tobacco use, dietary intake, knowledge, behavioural intentions, and psychological distress over 24-months. Methods: Data from the Health4Life cluster-randomised controlled trial conducted from 2019 to 2021 in 71 Australian secondary schools were analysed (N=6639; baseline age 11-14yrs). Schools were from metropolitan (89%) and regional (11%) areas, and participants' SES was classified as low (15%), mid (37%), and high (48%) relative to the study population. Primary outcomes included alcohol and tobacco use, and a composite indicator of poor diet. Secondary outcomes were knowledge, behavioural intentions, and psychological distress. Latent growth models assessed moderating effects of SES and geographical location on between-group change over 24-months. Results: Geographical location moderated the intervention's effect on odds of reporting a poor diet (OR = 1.79, 95% CI = 1.32-2.43, p < 0.001) and diet-related behavioural intentions (OR = 0.71, 95% CI = 0.56-0.89, p = 0.024) over time. Subset analyses indicated that intervention participants in regional areas had higher odds of reporting a poor diet (OR = 1.61, 95% CI = 1.13-2.29, p = 0.008), while those in metropolitan areas had higher odds of improving diet-related behavioural intentions (OR = 1.13, 95% CI = 1.01-1.27, p = 0.041), compared to the control group. No other significant moderation effects were observed. Conclusions: While significant disparities were generally not observed, the geographical differences in intervention effects on diet and diet-related intentions suggest that co-designed and tailored approaches may benefit disadvantaged adolescents to address the disproportionately high rates of lifestyle risk behaviours among these priority populations.

Comparative Study of Risk Factors Associated with Normal Cognition and Cognitive Impairment in Rural West Elderly Texans.

Background: Alzheimer's disease (AD) is related to one or more chronic illnesses, which may develop cognitive decline and dementia. Cognitive impairment is increasing, and public health officials must address risk factors for AD to improve the health of rural West Texas communities. Objective: The purpose of this study was to explore the sociodemographic and chronic disease risk factors related to cognitive impairment among elderly adults living in Cochran, Parmer, and Bailey counties in rural West Texas. Methods: Statistical methods such as Pearson's chi-squared, proportion tests, univariate binary logistic regression, and a multivariable logistic regression were utilized to analyze data. SPSS software was used to detect the significant relationship between cognitive impairment and risk factors. Results: Summary statistics were obtained for sociodemographic and chronic diseases by using cross-tabulation analysis and comparing the county respondents with proportion tests. A univariate binary logistic regression method was utilized and found that age group 60-69, anxiety, depression, diabetes, hypertension, and cardiovascular disease were significantly associated with cognitive impairment. Using a multivariable logistic regression approach, it was found that Bailey County (age group 60-69) had a higher likelihood (p = 0.002) of cognitive impairment than Parmer (p = 0.067) and Cochran counties (p = 0.064). The risk of females (p = 0.033) in Parmer County was 78.3% lower compared to males in developing AD. Conclusions: Identifying significant risk factors for cognitive impairment are important in addressing issues of geographic variations and integrating such factors may guide relevant policy interventions to reduce cognitive impairment incidence in rural communities within West Texas.

The impact of overweight and obesity on health outcomes in the United States from 1990 to 2021.

AIM: Elevated body mass index (BMI) presents a significant public health challenge in the United States, contributing to considerable morbidity, mortality and economic burden. This study investigates the health burden of overweight and obesity in the United States from 1990 to 2021, leveraging the Global Burden of Disease data set to analyse trends, disparities and potential determinants of high BMI-related health outcomes. MATERIALS AND METHODS: Our study focused on the United States, analysing trends in disability-adjusted life years (DALY) and deaths attributable to high BMI, defined as a BMI of 25 kg/m2 or higher for adults. Statistical analyses included estimated annual percentage change (EAPC) in age-standardized DALY rates and age-standardized death rates. Pearson correlation was performed between EAPCs and the socio-demographic index (SDI), with significance set at p < 0.05. RESULTS: From 1990 to 2021, age-standardized DALY rates attributable to high BMI increased by 24.9%, whereas the age-standardized death rates increased by 5.2%. Age disparities showed DALYs peaking at 60-64 years for males and 65-69 years for females, with deaths peaking at 65-69 years for males and 90-94 years for females. A strong negative correlation was found between the EAPC in age-standardized DALY and death rates and the SDI. CONCLUSIONS: Overweight and obesity significantly impact public health in the United States, especially among older adults and lower socio-demographic regions. Comprehensive public health strategies integrating behavioural, technological and environmental interventions are crucial. Future research should focus on longitudinal studies, personalized interventions and policy-driven approaches to address the multifaceted influences on high BMI.

Presence of Anxiety or Depression Feelings and Its Associated Risk Factors among Immigrants in Korea: A Nationwide Cross-Sectional Study.

Background: The influx of immigrants into Korea has increased in recent years, affecting Korean society and the healthcare system. This study analyzed the frequency of anxiety and depression in immigrants, which negatively affects their quality of life. Methods: We analyzed data from a 2020 survey on the Health Rights of Migrants and the Improvement of the Medical Security System. Bivariate analyses and a multiple logistic regression model were used to identify the risk factors associated with the presence of anxiety or depression among immigrants. Results: We included 746 immigrants, 55.9% of whom were female. The overall rate of anxiety or depression was 31.77%, with 38.3% in females, which was significantly higher than the 26.62% in males. The frequency of anxiety and depression was also strongly associated with certain immigrant groups, including immigrants of African or Western Asian origin (over 64%); those with student visas (60.53%); those who self-reported poor health (52%), physical or mental disabilities (69.23%), or chronic diseases (58.43%); and those facing difficulties accessing medical services (59.47%). Conclusion: This study showed the frequency of feelings of anxiety or depression and associated risk factors among immigrants. These findings may have implications for policymakers in reducing the likelihood of developing anxiety or depression in the future and improving the quality of life of immigrants in Korea.

The impact of exclusive breastfeeding on breastfeeding duration.

BACKGROUND: While breastfeeding is globally recommended, its duration still represents a public health issue. AIM: To examine the association between the period of exclusive breastfeeding (EBF) and the duration of overall human milk nutrition, and to identify determinants associated with the duration of EBF and overall human milk nutrition length. STUDY DESIGN: The presented study is a cross-sectional study. A total of 209 healthy Polish women of Caucasian origin, aged 19-42 years, who were the mother of a child aged 3-12 months, were enrolled in the study. Data were collected from 2018 to 2020 using an anonymous questionnaire. Statistical analyses included one way ANOVA and liner regression. RESULTS: After birth almost all newborns were exclusively breastfed (96.7 %), but the supply of mother's milk declined as the children's ages increased. The duration of breastfeeding is strongly associated with EBF, especially until the child is six months old (p < 0.001). Mother's breastfeeding self-efficiency and her will for breastfeeding, comfortable latch, younger infant age, avoiding of a pacifier and excluding additional food may explain 36 % of variation of EBF duration (p < 0.001) and could be useful information for exclusive breastfeeding support. CONCLUSIONS: The practice of exclusive breastfeeding strongly affects overall breastfeeding duration. The promotion of exclusive breastfeeding, rather than of overall breast milk supply, is crucial.

Associations between rural/urban status, duration of untreated psychosis and mode of onset of psychosis: a mental health electronic clinical records analysis in the East of England, UK.

PURPOSE: The influence of rurality on the duration of untreated psychosis (DUP) in first-episode psychosis (FEP) is poorly understood. We investigated factors associated with FEP in rural/urban settings and whether there are rural/urban differences in DUP and the mode (speed) of onset of psychosis. METHODS: We used the Cambridgeshire and Peterborough NHS Foundation Trust Research Database (CPFTRD) to identify all persons presenting to an early intervention for psychosis service with FEP between 2013 and 2015. We performed descriptive statistics and multivariable linear and multinomial regression to assess the relationships between the study outcomes and the independent variables. RESULTS: One hundred and fifty-five FEP patients were identified, with a mean age of 23.4 (SD, 5.3) years. The median DUP was 129.0 (IQR: 27.5-524.0) days. In rural areas, FEP patients were more likely to be employed and live with family than those in urban areas. A longer DUP was observed among patients with an insidious onset of psychosis compared with an acute onset (619.5 (IQR: 333.5-945.0)) vs. (17.0 (IQR: 8.0-30.5)) days respectively, p < 0.0001. We found evidence that the mode of onset of psychosis differed by employment status and living circumstances. There was insufficient evidence of rural/urban differences in DUP and mode of onset of psychosis. CONCLUSIONS: Our results suggest that the mode of onset of psychosis is an important indicator of treatment delay and could provide vital information for service planning and delivery. Sociodemographic variations in FEP exist in rural populations, and our findings are similar to those observed in urban settings.

Unraveling the Tapestry of Depression: A Cross-Sectional Study.

BACKGROUND: An often-occurring and severely disabling mental illness that mostly affects older people living in urban slums is depression. Developing successful therapies requires an understanding of the complex interactions between the different factors that contribute to depression in this susceptible population. OBJECTIVES: This study aimed to find the prevalence of depression and identify the factors associated with depression in the geriatric population aged ≥60 years in the study area during the study period in Gujarat, India. METHODS: This study was carried out among 450 participants aged ≥60 years. Face-to-face interviews and standardized assessment tools, including the Geriatric Depression Scale (GDS) for depression and the Mini-Cog test for cognitive impairment, were used to collect data on depression levels, sociodemographic characteristics, behavioral factors, medical conditions, life events, and psychiatric history. Statistical analyses, including chi-squared tests, were performed to assess the associations. RESULTS: Significant associations were found between various factors and depression levels, which were lower education (11.11% severe depression among non-literate vs. 2.11% among literate, p<0.001) and widowhood (11.56% severe depression among widowed vs. 4.53% among married, p<0.001), which were linked to higher depression severity. Behavioral risk factors like short sleep duration (<6 hours at night: 21.71% severe depression, p<0.001), tobacco snuffing (16.24% severe depression, p<0.001), and lack of physical activity (28.71% severe depression, p<0.001) were strongly associated with increased depression. Medical conditions such as hypertension (10.36% severe depression, p<0.001) and stressful life events like family conflicts (16.67% severe depression, p<0.001) exhibited strong associations. A personal history of depression (38.82% severe depression, p<0.001) was a potent predictor. CONCLUSIONS: The study highlights the multifaceted nature of depression in the geriatric population of the study area, underscoring the necessity of all-encompassing measures to tackle the recognized possible risk factors. The results provide valuable insights for developing targeted prevention strategies, healthcare policies, and support systems to enhance the mental well-being of this vulnerable population.

Determinants of High HIV Infection Prevalence in Vijayapura, Bagalkot, and Belagavi Districts in Karnataka, India.

Introduction India has the second-highest number of people living with human immunodeficiency virus (PLHIV). Despite the national decline in the prevalence of the human immunodeficiency virus (HIV) from 2000 to 2021, regional variations persist, particularly in the northeastern and southern states. High-risk populations, including female sex workers (FSW), men who have sex with men (MSM), and injecting drug users (IDU), significantly contribute to these dynamics. This study focuses on high-prevalence districts in Karnataka. Objectives This study aims to identify socioeconomic and behavioral factors associated with high HIV prevalence in high-burden districts of South Indian states. Methodology A cross-sectional study was conducted using data from Integrated Counseling and Testing Centers (ICTCs) and Designated STI/RTI (sexually transmitted infections/reproductive tract infections) Clinics (DSRCs) across 24 centers in the three districts. The centers were determined using a simple random sampling method. Data from 2501 HIV-positive individuals were analyzed, focusing on demographics, risk behaviors, and treatment history. Results Males constituted the majority of HIV cases, accounting for 448 (56.0%) in Vijayapura, 334 (51.4%) in Bagalkot, and 644 (61.1%) in Belagavi districts, with a significant portion referred by government hospitals. High HIV prevalence was linked to adults aged 25-49 years of age; the number of people with HIV was high among daily wage workers and individuals with multiple sexual partners compared to married and educated people. Newly diagnosed discordant couples ranged from 129 (12.2%) in Belagavi to 133 (18.4%) in Vijayapura districts. Most patients were on first-line antiretroviral therapy (ART), with loss to follow-up attributed to system negligence and poor compliance. Conclusion Key determinants of high HIV prevalence include gender, age, marital status, socioeconomic status, and sexual behavior. Effective interventions require targeted education, improved healthcare services, robust surveillance, and strengthened collaboration among stakeholders.

A Cross-sectional Study for Examining Catastrophic Healthcare Expenditure Across Socio-demographic Variables among Employees in a Sedentary Occupation.

Health expenditure above a certain threshold level can result in a financial catastrophe by reducing the expenses on necessities. Certain socio-demographic variables have been observed to play a role in influencing catastrophic healthcare expenditure, guiding the present study to examine this scenario for employees in sedentary occupations. A cross-sectional study has been conducted among 370 employees recruited through a random sampling technique. Multinomial logistic regression was used to test the main objective of the study. The factors associated with a higher probability of catastrophic healthcare expenditure were males with increasing age. Years of work experience tend to be associated with a lower likelihood of catastrophic healthcare expenditure. No conclusive evidence could be drawn for BMI, income, marital status and education.