Informação e prevenção não farmacológica da COVID-19 no território de uma unidade de saúde da família em Pernambuco / Information and non-pharmacological prevention of COVID-19 in the territory of a family health unit in Pernambuco / Información y prevención no farmacológica del COVID-19 en el territorio de una unidad de salud de la familia en Pernambuco

Introdução: O conhecimento da magnitude em que a população implementa medidas de proteção emitidas pelas autoridades de saúde pública é essencial na prevenção da doença do novo coronavírus (COVID-19). A eficácia de medidas não farmacológicas de prevenção e das políticas públicas destinadas a reduzir o contágio pela COVID-19 depende de quão bem os indivíduos são informados sobre as consequências da infecção e as medidas que devem adotar para reduzir sua propagação. O entendimento, as atitudes e as práticas das pessoas em relação à COVID-19 e sua prevenção são basilares para a compreensão da dinâmica epidemiológica, demandando a realização de pesquisas sobre o cumprimento de medidas não farmacológicas de prevenção do contágio em diversos territórios. Para isso, em 2020, medidas não farmacológicas contra a COVID-19 foram divulgadas por fontes diversas, estatais e privadas, para a maior parte da população brasileira, com a finalidade de orientar comportamentos para conter a crise sanitária. As equipes da Estratégia Saúde da Família têm um papel fundamental neste processo de educação em saúde, pois compreendem elementos socioculturais das suas comunidades, alcançando-as tanto em capilaridade quanto em adequação local da informação técnico-científica. Este artigo abrange uma pesquisa de campo, parte de um projeto multicêntrico nacional. Objetivo: Avaliar se a população do território de uma unidade da Estratégia Saúde da Família da cidade de Condado-PE entende e aplica as informações que recebeu sobre medidas não farmacológicas de prevenção em suas práticas de proteção contra a COVID-19. Mais especificamente, a pesquisa visou determinar que informações foram recebidas pelos respondentes, quais as suas fontes, o grau de confiabilidade atribuído a estas, além da adesão deles às medidas não farmacológicas e sua relação com variáveis sociodemográficas. Métodos: O modelo do estudo foi observacional e descritivo, com abordagem quantitativa, a partir da coleta de dados primários com 70 usuários por entrevista presencial com questionário estruturado. Resultados: Os resultados mostraram que a população recebeu vasta informação sobre prevenção da doença. Conclusão: Com níveis variados de confiabilidade das fontes, atribuindo importância relevante às medidas de prevenção e adotou a maioria delas, com exceção do isolamento social total.

Introduction: Knowledge of the magnitude to which the population implements protective measures issued by public health authorities is essential in preventing coronavirus disease 2019 (COVID-19). The effectiveness of non-pharmacological prevention measures (NPM) and public policies aimed at reducing the spread of COVID-19 depends on how well individuals are informed about the consequences of the infection and the measures they must adopt to reduce its spread. The understanding, attitudes, and practices of people in relation to COVID-19 and its prevention are fundamental for understanding the epidemiological dynamics, demanding research on compliance with NPM to prevent contagion in different territories. To this end, in 2020, NPM against COVID-19 were released by various sources, state and private, for most of the Brazilian population, with the aim of guiding behaviors to contain the health crisis. The Family Health Strategy (FHS) teams play a key role in this health education process, as they comprise sociocultural elements of their communities, reaching them both in capillarity and in local adequacy of technical-scientific information. This article covers field research, part of a national multicenter project. Objective: To evaluate whether the population of the territory of an FHS unit in the city of Condado, Pernambuco, understands and applies the information it received about NPM prevention in their practices to protect against COVID-19. More specifically, the research aimed to determine what information was received by the respondents, what are their sources, the degree of reliability attributed to these, in addition to their adherence to the NPM and their relationship with sociodemographic variables. Methods: The study model was observational and descriptive, with a quantitative approach, based on the collection of primary data with 70 users through face-to-face interviews with a structured questionnaire. Results: The results showed that the population received extensive information on disease prevention. Conclusion: With varying levels of reliability of the sources, attributing relevant importance to prevention measures and adopted most of them, with the exception of total social isolation.

El conocimiento de la magnitud con la que la población implementa las medidas de protección emitidas por las autoridades de salud pública es fundamental en la prevención de la enfermedad por coronavirus 2019 (COVID-19). La efectividad de las medidas de prevención no farmacológicas (MFN) y de las políticas públicas dirigidas a reducir la propagación de la COVID-19 depende de qué tan bien se informe a las personas sobre las consecuencias de la infección y las medidas que deben adoptar para reducir su propagación. La comprensión, actitudes y prácticas de las personas con relación al COVID-19 y su prevención son fundamentales para comprender la dinámica epidemiológica, exigiendo investigaciones sobre el cumplimiento de las MNF para prevenir el contagio en diferentes territorios. Con ese fin, en 2020, MNF contra el COVID-19 fueron divulgados por diversas fuentes, estatales y privadas, para la mayoría de la población brasileña, con el objetivo de orientar comportamientos para contener la crisis sanitaria. Los equipos de la Estrategia de Salud de la Familia (ESF) juegan un papel fundamental en este proceso de educación en salud, ya que integran elementos socioculturales de sus comunidades, alcanzándolas tanto en la capilaridad como en la adecuación local de la información técnico-científica. Este artículo aborda una investigación de campo, parte de un proyecto multicéntrico nacional, con el objetivo de evaluar si la población del territorio de una unidad de la ESF en la ciudad de Condado-PE comprende y aplica la información recibida sobre la prevención de MNF en sus prácticas de protección contra el COVID -19. Más específicamente, la investigación tuvo como objetivo determinar qué información recibieron los encuestados, cuáles son sus fuentes, el grado de confiabilidad atribuido a estas, además de su adherencia al MNF y su relación con variables sociodemográficas. El modelo de estudio fue observacional y descriptivo, con enfoque cuantitativo, basado en la recolección de datos primarios con 70 usuarios a través de entrevistas cara a cara con un cuestionario estructurado. Los resultados mostraron que la población recibió amplia información sobre prevención de la enfermedad, con diversos niveles de confiabilidad de las fuentes, atribuyendo importancia relevante a las medidas de prevención y adoptando la mayoría de ellas, con excepción del aislamiento social total.

Correlation Analysis of Traditional Chinese Medicine Constitution and Metabolic Indexes in General Physical Examination People.

OBJECTIVE: Analysis of Traditional Chinese Medicine (TCM) constitution type general medical patients and the relationship between the metabolic index. METHODS: A cohort of 1,029 general individuals who underwent a physical examination at the Affiliated Hospital of Changchun University of Chinese Medicine for identification of their TCM constitution between January 2021 and April 2023 were included in this study. Their data were sorted and analyzed using Microsoft Excel and SPSS26.0 statistical software. RESULTS: Among the 1029 study participants, the balanced constitution (BC) type was the most prevalent (33.24%), and the blood stasis constitution (BSC) type was the least prevalent (2.62%). Compared with BC, phlegm-dampness constitution (PDC) (P=0.000), yang-deficiency constitution (YADC) (P=0.000) and BSC (P=0.008) had significant differences in body mass index (BMI) (P<α). The systolic blood pressure (SBP) of PDC was different (P=0.042, P<α). There was a significant difference in diastolic blood pressure (P=0.001, P<α). The diastolic blood pressure (DBP) of YADC was significantly different (P=0.001, P<α). Yin-deficiency constitution (YIDC) (P = 0.007) and YADC differences between fasting blood glucose (FBG) (P = 0.025) were significantly (P<α). There were significant differences in uric acid (UA) of YADC (P=0.000), BSC (P=0.004), PDC (P=0.007) and qi-stagnation constitution (QSC) (P=0.012, P<α). The triglyceride (TG) of YADC (P=0.000) and PDC (P=0.005) were significantly different (P<α). There was a difference in total cholesterol (TC) between PDC (P=0.046) and BC (P<α). BSC (P = 0.028) and PDC (P = 0.023) of low-density lipoprotein cholesterol (LDL-C) also had a significant difference (P<α). CONCLUSION: People with PDC, YADC and BSC had more abnormal metabolic indexes than people with BC, and the metabolic indexes of people with YIDC constitution were different from those with BC. Individuals with these four TCM constitution types should pay attention to making appropriate changes in lifestyles and dietary habits and take required measures to prevent the incidence and development of metabolic diseases.

Non-communicable diseases prevention and control by government ministries in Guyana.

Background: Countries of the Caribbean Community signed the Declaration of Port of Spain in 2007 with the vision to stop the epidemic of non-communicable diseases (NCDs). The adoption of the Declaration by member states represented a regional effort, challenging governments, the private sector, and civil society to act together. Multisectoral actions in Guyana aimed at achieving this goal are the focus of this article, demonstrating the work of different actors in addressing the burden of NCDs in the country. Objective: To analyze multisectoral actions developed among five ministries for the implementation of the Declaration of Port of Spain 2007 in Guyana. Methods: This qualitative study was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist and conducted in five ministries (Agriculture, Education, Finance, Health, and Trade) in Georgetown, Guyana. The thematic analysis was guided by a framework consisting of four elements: context (why the policy is needed), content (what the policy is mainly about), process (how the policy was brought forward and implemented), and actors (who participates in and influences the formulation and implementation of the policy). The framework considers how these elements interconnect to shape policy development and implementation processes. Findings: Data analysis provided the researchers with insights into possible topic areas and codes for consideration during the analysis, hence a deductive approach to data analysis was used. The results highlighted the importance of coordination among government entities, national and international agencies, private actors, industry players, and civil society. Participants did not mention the use of responsibility metrics but cited mechanisms that facilitated collaboration. Conclusion: The results showed limitations in transforming multisectoral initiatives into intersectoral collaboration to achieve real integration among the different actors involved, considering the actual context and content. Actions could be more effectively implemented with significant outcomes for NCD control in Guyana.

Understanding Ixodes ricinus occurrence in private yards: influence of yard and landscape features.

BACKGROUND: Lyme borreliosis is the most frequent zoonotic disease in the northern hemisphere and is transmitted by ticks of the genus Ixodes. Although many people are bitten by ticks in private yards, our understanding of the factors associated with their presence in these areas remains limited. To address this gap, we used a citizen science approach to identify the local and landscape features associated with tick presence in yards. METHODS: This study was conducted near Nancy, a city in northeastern France, from 2020 to 2022. Citizen scientists collected ticks in their yard on a single event (n = 185) and measured 13 yard features. Additionally, we computed 11 features related to the landscape composition and spatial configuration surrounding these yards. Using generalized linear mixed models, we determined the yard and landscape features associated with the presence of ticks and nymphal Ixodes ricinus (hereafter nymphs), the life stage, and species that mostly bite humans. RESULTS: Despite a low density, ticks were found in 32% of the yards, including yards in urbanized areas. At the transect level, the likelihood of finding a nymph was nearly three times higher in transects shaded by vegetation compared to those in open areas, with no relationship between nymph occurrence and transect location or grass height. At the yard level, the occurrence of ticks and nymphs was related to both yard and landscape characteristics. Nymph and tick occurrence were more than twice as high in yards with signs of deer and a wood/brush pile compared to those without these characteristics, and increased with the connectivity of vegetation areas and the percentage of forest areas in the landscape. CONCLUSIONS: Our study reveals that private yards across an urbanization gradient are locations of tick exposure with tick presence linked to both yard and landscape factors. These findings emphasize the importance of public awareness regarding tick exposure in yards and provide crucial insights for future public health prevention campaigns.

The Role of Visualization in Estimating Cardiovascular Disease Risk: Scoping Review.

BACKGROUND: Supporting and understanding the health of patients with chronic diseases and cardiovascular disease (CVD) risk is often a major challenge. Health data are often used in providing feedback to patients, and visualization plays an important role in facilitating the interpretation and understanding of data and, thus, influencing patients' behavior. Visual analytics enable efficient analysis and understanding of large datasets in real time. Digital health technologies can promote healthy lifestyle choices and assist in estimating CVD risk. OBJECTIVE: This review aims to present the most-used visualization techniques to estimate CVD risk. METHODS: In this scoping review, we followed the Joanna Briggs Institute PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The search strategy involved searching databases, including PubMed, CINAHL Ultimate, MEDLINE, and Web of Science, and gray literature from Google Scholar. This review included English-language articles on digital health, mobile health, mobile apps, images, charts, and decision support systems for estimating CVD risk, as well as empirical studies, excluding irrelevant studies and commentaries, editorials, and systematic reviews. RESULTS: We found 774 articles and screened them against the inclusion and exclusion criteria. The final scoping review included 17 studies that used different methodologies, including descriptive, quantitative, and population-based studies. Some prognostic models, such as the Framingham Risk Profile, World Health Organization and International Society of Hypertension risk prediction charts, Cardiovascular Risk Score, and a simplified Persian atherosclerotic CVD risk stratification, were simpler and did not require laboratory tests, whereas others, including the Joint British Societies recommendations on the prevention of CVD, Systematic Coronary Risk Evaluation, and Framingham-Registre Gironí del COR, were more complex and required laboratory testing-related results. The most frequently used prognostic risk factors were age, sex, and blood pressure (16/17, 94% of the studies); smoking status (14/17, 82%); diabetes status (11/17, 65%); family history (10/17, 59%); high-density lipoprotein and total cholesterol (9/17, 53%); and triglycerides and low-density lipoprotein cholesterol (6/17, 35%). The most frequently used visualization techniques in the studies were visual cues (10/17, 59%), followed by bar charts (5/17, 29%) and graphs (4/17, 24%). CONCLUSIONS: On the basis of the scoping review, we found that visualization is very rarely included in the prognostic models themselves even though technology-based interventions improve health care worker performance, knowledge, motivation, and compliance by integrating machine learning and visual analytics into applications to identify and respond to estimation of CVD risk. Visualization aids in understanding risk factors and disease outcomes, improving bioinformatics and biomedicine. However, evidence on mobile health's effectiveness in improving CVD outcomes is limited.

Musculoskeletal disorders, associated factors, and literature review for intervention according to gender.

Introduction: The relationship of risk factors with musculoskeletal disorders and their intervention is a topic of interest, given their prevalence among workers. Thus, analyzing risk factors from approaches such as the gender perspective may be an alternative. Objectives: To analyze risk factors in a health entity with a high prevalence of musculoskeletal disorders in upper limbs and to describe possible intervention measures according to scientific evidence, from a gender perspective. Methods: This is an analytical study. A questionnaire was applied to 93 workers on demographic aspects, presence of factors related to the environment, the task, and the organization, extra-work activities related to musculoskeletal disorders in the upper limbs. Chi-square was used to identify significant relationships between the sex variable and individual, occupational, and non-occupational factors, corroborated by Fisher's test and prevalence ratio. According to the associations identified, a literature review was carried out to establish possible strategies. Results: Significant relationships were found between the sex variable and task-related factors such as the presence of repetitive or sudden movements (p < 0.05), supporting postulates of labor segregation. According to the literature consulted, the effectiveness of activities such as physical preparation and adaptation of the workplace under professional guidance, training activities, and breaks is discussed. It is important to review organizational factors. Conclusions: By identifying significant relationships between the sex variable and task-related factors, the present study contributes to the postulate of labor segregation, in terms of concentration of female labor in activities with particular working conditions. Regarding literature and actions, it is important to generate more studies from this perspective.

Introducción: La relación de factores de riesgo con desordenes musculoesqueléticos y su intervención es tema de interés, dada su prevalencia entre trabajadores. Así, analizar los factores de riesgo desde enfoques como la perspectiva de género puede ser una alternativa. Objetivos: Analizar factores de riesgo en una entidad sanitaria con alta prevalencia de desordenes musculoesqueléticos en miembros superiores y describir posibles medidas de intervención según evidencia científica, desde la perspectiva de género. Métodos: Éste es un estudio de tipo analítico. Se aplicó un cuestionario a 93 trabajadores sobre aspectos demográficos, presencia de factores relacionados con ambiente, tarea y organización, y actividades extralaborales vinculadas con desórdenes musculoesqueléticos en miembros superiores. Mediante chi cuadrado, se realizó la identificación de relaciones significativas entre la variable sexo y factores individuales, intralaborales y extralaborales, corroboradas por prueba de Fisher y razón de prevalencias. Según las asociaciones identificadas, se efectuó revisión de literatura para establecer posibles estrategias. Resultados: Se encontraron relaciones significativas entre la variable sexo y factores de la tarea como la presencia de movimientos repetitivos o súbitos (p < 0,05), apoyando postulados de segregación laboral. Según la bibliografia consultada, se discute la eficacia de actividades como preparación física y adecuación del puesto de trabajo bajo orientación profesional, actividades de capacitación y pausas. Es importante revisar factores organizacionales. Conclusiones: Al identificarse relaciones significativas entre la variable sexo y factores de la tarea, se aporta al postulado de segregación laboral en cuanto a concentración de mano de obra femenina en actividades con condiciones de trabajo particulares. Sobre la literatura y las acciones, es importante generar más estudios desde esta perspectiva.

Strategies for Cardiovascular Disease Prevention in Type 1 Diabetes: A Comprehensive Review.

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among individuals with type 1 diabetes (T1D), necessitating effective prevention strategies. This comprehensive review consolidates current knowledge and evidence on preventing CVD in T1D patients. It begins by exploring the pathophysiological mechanisms that link T1D to an increased risk of CVD, highlighting factors such as chronic hyperglycemia, hypertension, dyslipidemia, and inflammation. The review also examines the epidemiology and specific risk factors for CVD in this population, emphasizing the need for rigorous risk assessment and screening. Lifestyle modifications, including dietary interventions, regular physical activity, and smoking cessation, are evaluated for their effectiveness in reducing CVD risk. Additionally, the review discusses pharmacological interventions, such as insulin therapy for glycemic control, antihypertensive medications, lipid-lowering agents, and antiplatelet therapy, underscoring their critical role in CVD prevention. Emerging therapies and future research directions are explored, focusing on novel pharmacological agents, advances in insulin delivery systems, and personalized medicine approaches. The importance of integrated care models involving multidisciplinary teams and the use of technology is highlighted as essential for comprehensive management. Challenges and barriers to implementing these strategies, including healthcare system limitations, patient adherence, and socioeconomic factors, are also addressed. This review provides a detailed synthesis of current strategies and future directions for preventing CVD in individuals with T1D, serving as a valuable resource for clinicians, researchers, and policymakers dedicated to improving cardiovascular outcomes in this high-risk population.

Integrating cardiovascular risk assessment into mobile low-dose CT lung screenings in rural Appalachia: A comprehensive analysis of the relationship between lung cancer risk, coronary artery calcium burden, and cardiovascular risk reduction strategies.

Objective: Mobile low-dose computed tomography (LDCT) lung screenings are part of an outreach program in rural Appalachia to detect early lung cancer. Coronary artery calcium (CAC) scoring on LDCT can identify calcium deposits in coronary arteries and can prompt consideration of risk modification for prevention of cardiovascular disease (CVD) events. It is not known if Lung CT Screening Reporting & Data System (Lung-RADS) scoring correlates with CAC scores. There is no clear guidance for patients undergoing LDCT screenings to receive follow-up regarding CAC or prevention of associated CVD risk. Methods: This was a retrospective review of mobile LDCT LCS in adults with no known history of CVD. CT images were obtained at 100 kVp with a slice thickness of 3 mm. Agatston CAC scoring was performed retroactively. Lung-RADS scores were categorized as: Negative (1), Benign (2), Probably Benign (3), and Suspicious (4). CAC scoring was grouped as 0, 1-100, 101-399, and ≥400. Descriptive statistics and chi-square analyses were utilized. Results: A total of 526 LDCT screenings were included. Over 54 % of patients had coronary calcification on LDCT LCS. 161 patients (30.6 %) had a CAC score of ≥100 and 75 patients (14.3 %) had a CAC score ≥400. Of patients with a CAC score ≥100, 7.5 % received referrals for follow-up after the LDCT screen and 9.3 % had additional cardiac testing. Of those with a CAC score ≥100 not already on a statin (45.3 %) and not already on aspirin (63.3 %), few were started within 3 months of LDCT for prevention (8.2 % and 5.9 % respectively). Among patients with a Lung-RADS score of 4, 17 % had a CAC score >400, whereas only 12 % with a Lung-RADS score of 1 fell into the same CAC category. Higher Lung-RADS scores correlated with fewer patients with CAC of 0. A significant correlation was observed between higher Lung-RADS scores and elevated CAC scores (p = 0.02). Conclusion: In patients with no CVD history, coronary artery calcification was frequently identified on mobile LDCT lung screenings in rural communities. Patients with higher probabilities of malignant lung nodules may also be at increased risk for significant coronary artery disease. Calcium scoring from LDCT screenings allowed for simultaneous assessment of lung cancer and CVD risk. Unfortunately, few referrals or CVD prevention medications were initiated. Awareness of CAC score utility, follow-up for identified coronary calcifications, and consideration of primary prevention medications when indicated, would be beneficial in patients undergoing LDCT lung screenings, especially in rural areas with limited healthcare access.

The evolution and diversity of porcine reproductive and respiratory syndrome virus in China.

The porcine reproductive and respiratory syndrome virus (PRRSV) has emerged as a significant pathogen in the global pork industry since the late 1980s, causing substantial economic losses due to its high contagiousness and genetic variability. China, with its complex epidemiological landscape, has witnessed the emergence of four distinct lineages of PRRSV-2 (Lineages 1, 3, 5, and 8) and occasional occurrences of PRRSV-1. This review summarizes the historical context and epidemiological trends that have led to the diversification of PRRSV in China, discusses the evolutionary dynamics behind the establishment of diverse genetic variants, as well as the impact of recombination and modified live vaccines (MLVs) on the virus's rapid evolution. The implications for disease management, including strategies to reduce the complexity of PRRSV epidemics and improve prevention and control measures, are also suggested. Understanding the evolutionary pattern and factors contributing to PRRSV diversity is crucial for enhancing our knowledge, control capabilities, and prevention strategies, which could be integrated into swine health management practices.

Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION): Study protocol for a randomized controlled trial of a web-based platform integrating nutrition, physical activity, and mindfulness for individuals with obesity.

Excess body weight, suboptimal diet, physical inactivity, alcohol consumption, sleep disruption, and elevated stress are modifiable risk factors associated with the development of chronic diseases. Digital behavioural interventions targeting these factors have shown promise in improving health and reducing chronic disease risk. The Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION) study is a parallel group, two-arm, randomized controlled trial evaluating the effects of adding healthcare professional guidance and peer support via group-based sessions to a web-based wellness platform (experimental group, n = 90) compared to a self-guided use of the platform (active control group, n = 90) among individuals with a body mass index (BMI) of 30 to <35 kg/m2 and aged 40-65 years. Obesity is defined by a high BMI. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which holistically integrates nutrition, physical activity, and mindfulness programs. Over 16 weeks, the experimental group uses the web-based wellness platform daily and engages in weekly online support group sessions. The active control group exclusively uses the web-based wellness platform daily. Assessments are conducted at baseline and weeks 8 and 16. The primary outcome is between-group difference in weight loss (kg) at week 16, and secondary outcomes are BMI, percent weight change, proportion of participants achieving 5% or more weight loss, dietary intake, physical activity, alcohol consumption, sleep, and stress across the study. A web-based wellness platform may be a scalable approach to promote behavioural changes that positively impact health. This study will inform the development and implementation of interventions using web-based wellness platforms and personalized digital interventions to improve health outcomes and reduce chronic disease risk among individuals with obesity.

Aortic arterial stiffness associates with carotid intima-media thickness and carotid plaques in younger middle-aged healthy people.

PURPOSE: Aortic stiffness, assessed as estimated aortic pulse wave velocity (aPWV), and carotid intima-media thickness (cIMT) are markers of vascular age, and carotid plaques are a marker of early atherosclerosis. In this cross-sectional study we aimed to investigate the association between aPWV, cIMT and plaques across different age groups and in women and men, in a middle-aged healthy population. MATERIALS AND METHODS: Participants in the 6.5-year follow-up of the VIPVIZA trial who were aged 47, 57 and 67 underwent an oscillometric measurement which estimates aPWV between 2020 and 2023. Carotid ultrasound examinations were also performed. Linear and ordinal regression models were used to investigate how aPWV associates with cIMT and with carotid plaques, for the overall study group and stratified for age groups and sex. RESULTS: A total of 1046 subjects were included in the analyses. Linear associations between aPWV and cIMT (ß = 0.018, 95% CI: 0.006-0.030, p = 0.003), and between aPWV and plaques (OR: 1.19, 95% CI: 1.03-1.38, p = 0.018), were seen in the 57-year-olds. In the 47-year-olds a significant association was seen between aPWV and plaques (OR: 2.98 95% CI: 1.44-6.14, p = 0.003). No significant associations were seen in the 67-year-olds. For women, a significant association between aPWV and cIMT (ß = 0.011, 95% CI: 0.004-0.017, p = 0.002) was shown. CONCLUSION: Estimated aPWV was positively associated with increasing cIMT and the presence of carotid plaques in younger middle-aged individuals, and with cIMT in women, suggesting that measurement of estimated aPWV may improve cardiovascular risk assessment in younger middle-aged individuals and women.Clinical Trial Registration date 8 May 2013: URL: www.clinicaltrials.gov. Unique identifier: NCT01849575.

What is the context? Vascular ageing is a process where the arteries become stiff, leading to impaired function and organ damage. Stiff arteries increase the risk of cardiovascular disease. Aortic pulse wave velocity is a measurement of arterial stiffness and a marker of vascular age. Carotid intima-media thickness and carotid plaque presence are other markers of vascular age and early atherosclerosis. There are limited data on the association between aortic pulse wave velocity, carotid intima-media thickness and carotid plaques.What is new? We measured estimated aortic pulse wave velocity using an oscillometric device and performed carotid ultrasound examinations for assessment of carotid intima-media thickness and carotid plaques in healthy middle-aged individuals across three different age groups. The association between aortic pulse wave velocity, carotid intima-media thickness and carotid plaques was examined in the different age groups and in women and men separately.What is the impact? Estimated aortic pulse wave velocity was associated with carotid intima-media thickness and carotid plaques in younger middle-aged individuals and with carotid intima-media thickness in women. Suggesting that for these groups ­ healthy younger middle-aged people, and especially women ­ measurement of estimated aortic pulse wave velocity could improve evaluation of cardiovascular risk.

Attitudes of general and specialist French practitioners toward stage III-IV grade C periodontitis with familial aggregation.

The aim of this cross-sectional convenience sample survey was to assess attitudes of French dentists regarding stage III-IV grade C periodontitis in systemically healthy individuals. Among 225 dentists, 85.1% informed patients of the familial nature of periodontitis including 27.3% that recommended a consultation for the family. When dealing with a child who presented with severe periodontitis, 42.2% of the respondents did not advise examination of the parents. In addition, 39.1% of practitioners did not consider it possible to establish a family consultation. Finally, family factors are not often considered by French practitioners in the management of grade C periodontitis.

Reliability Issues of Mobile Nutrition Apps for Cardiovascular Disease Prevention: Comparative Study.

Background: Controlling saturated fat and cholesterol intake is important for the prevention of cardiovascular diseases. Although the use of mobile diet-tracking apps has been increasing, the reliability of nutrition apps in tracking saturated fats and cholesterol across different nations remains underexplored. Objective: This study aimed to examine the reliability and consistency of nutrition apps focusing on saturated fat and cholesterol intake across different national contexts. The study focused on 3 key concerns: data omission, inconsistency (variability) of saturated fat and cholesterol values within an app, and the reliability of commercial apps across different national contexts. Methods: Nutrient data from 4 consumer-grade apps (COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!) and an academic app (Formosa FoodApp) were compared against 2 national reference databases (US Department of Agriculture [USDA]-Food and Nutrient Database for Dietary Studies [FNDDS] and Taiwan Food Composition Database [FCD]). Percentages of missing nutrients were recorded, and coefficients of variation were used to compute data inconsistencies. One-way ANOVAs were used to examine differences among apps, and paired 2-tailed t tests were used to compare the apps to national reference data. The reliability across different national contexts was investigated by comparing the Chinese and English versions of MyFitnessPal with the USDA-FNDDS and Taiwan FCD. Results: Across the 5 apps, 836 food codes from 42 items were analyzed. Four apps, including COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, significantly underestimated saturated fats, with errors ranging from -13.8% to -40.3% (all P<.05). All apps underestimated cholesterol, with errors ranging from -26.3% to -60.3% (all P<.05). COFIT omitted 47% of saturated fat data, and MyFitnessPal-Chinese missed 62% of cholesterol data. The coefficients of variation of beef, chicken, and seafood ranged from 78% to 145%, from 74% to 112%, and from 97% to 124% across MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, respectively, indicating a high variability in saturated fats across different food groups. Similarly, cholesterol variability was consistently high in dairy (71%-118%) and prepackaged foods (84%-118%) across all selected apps. When examining the reliability of MyFitnessPal across different national contexts, errors in MyFitnessPal were consistent across different national FCDs (USDA-FNDSS and Taiwan FCD). Regardless of the FCDs used as a reference, these errors persisted to be statistically significant, indicating that the app's core database is the source of the problems rather than just mismatches or variances in external FCDs. Conclusions: The findings reveal substantial inaccuracies and inconsistencies in diet-tracking apps' reporting of saturated fats and cholesterol. These issues raise concerns for the effectiveness of using consumer-grade nutrition apps in cardiovascular disease prevention across different national contexts and within the apps themselves.

Protective effects of spermidine levels against cardiovascular risk factors: An exploration of causality based on a bi-directional Mendelian randomization analysis.

The study investigated the causal relationships between spermidine levels and CVD risk factors using a bi-directional MR approach. Employing genetic variants from extensive GWAS datasets as IVs, the study aimed to determine whether spermidine levels can influence CVD risk factors such as blood pressure, blood glucose, and lipid profiles, and vice versa. The findings suggest a protective role of elevated spermidine levels against hypertension, elevated blood glucose, and lipid profiles (LDL-C and HDL-C). Specifically, increased spermidine levels were significantly associated with lower risk of hypertension (IVW beta = -0.0013453913, p = 0.01597648) and suppression risk of elevated blood glucose (IVW beta = -0.08061330, p = 0.02450205). Additionally, there was a notable association with lipid modulation, showing a decrease in LDL-C (IVW beta = -0.01849161, p = 0.01086728) and an increase in HDL-C (IVW beta = 0.0044608332, P = 0.01760051). Conversely, the influence of CVD risk factors on spermidine levels was minimal, with the exception that elevated blood glucose levels resulted in reduced spermidine levels. (IVW beta = -0.06714391, P = 0.01096123). These results underline the potential of spermidine as a modifiable dietary target for the prevention and management of cardiovascular diseases. Further investigations are warranted to explore the underlying biological mechanisms and the applicability of these findings in broader and diverse populations.

Knowledge, Attitudes, and Practices of Patients with Knee Osteoarthritis Regarding Osteoporosis and Its Prevention: A Cross-Sectional Study in China.

Background: Older age and female sex are risk factors for osteoarthritis and osteoporosis (OP). This study evaluated the knowledge, attitudes, and practices of patients with knee osteoarthritis (KOA) in China regarding OP and its prevention. This cross-sectional, questionnaire-based study enrolled patients with KOA at four grade-A tertiary hospitals in Shandong Province between 1st September and 20th November 2022. Methods: The administered questionnaire contained 55 items across four dimensions (demographic information, knowledge, attitude, and practice). Logistic regression analyses were performed to identify factors associated with an overall questionnaire score ≥70% of the maximum possible score. SPSS 26.0 was used for the analyses; P<0.05 was considered significant. Results: The analysis included 434 participants (261 females). The median knowledge, attitude, and practice scores were 7 (interquartile range: 5-10) (possible range, 0-17 points), 44 (interquartile range: 42-49) (possible range, 11-55 points), and 43 (interquartile range: 38-47) (possible range, 13-65 points), respectively. Multivariable logistic regression indicated that female sex (odds ratio [OR], 2.421; 95% confidence interval [95% CI] 1.558-3.762; P<0.001), age 56-65 years-old (OR, 4.222; 95% CI, 1.763-10.109; P=0.001 vs ≤55 years-old), age >65 years-old (OR, 4.358; 95% CI, 1.863-10.195; P=0.001 vs ≤55 years-old), middle/high/technical secondary school education (OR, 1.853; 95% CI, 1.002-3.428; P=0.049 vs primary school or below), and having KOA for 4-5 years (OR, 2.682; 95% CI, 1.412-5.094; P=0.003 vs ≤3 years) were independently associated with a high KAP score. Conclusion: There is room for improvement in the knowledge and practices of patients with osteoarthritis in China regarding OP. The findings of this study may facilitate the design and implementation of education programs to increase awareness about OP prevention among patients with KOA.

Perceptions of the role of dentists in human papillomavirus and COVID-19 vaccinations: Results of a cross-sectional validated survey of adults.

BACKGROUND: Human papillomavirus (HPV) and COVID-19 are contagious diseases for which effective vaccines exist. Dental care professionals' involvement in vaccination campaigns for these conditions has been proposed, but there is a lack of understanding of dentists' roles in vaccination, specifically assessing patients' attitudes around dentists as vaccinators for HPV and COVID-19. METHODS: Using a cross-sectional design and convenience sampling, a 12-item validated survey was distributed to community members to determine perceptions about dentists' roles in vaccination for HPV and COVID-19. Demographic characteristics, vaccination status, knowledge of the diseases, vaccination intentions, and willingness to receive education about, recommendations for, and administration of vaccine from a dentist were assessed. Responses were analyzed using bivariate and multivariate analysis. RESULTS: Of 618 participants, most were vaccinated previously against HPV and COVID-19 (n = 462 [75.6%] and n = 371 [61.0%], respectively). Participants responded more favorably to dentist involvement in educating, discussing, and administering COVID-19 vaccines than HPV vaccines (P < .05). Participants' knowledge of HPV was found to be low compared with that of COVID-19. There were significant differences across demographic groups, with race most frequently associated with differences in responses to COVID-19 and HPV-related questions. CONCLUSIONS: Formative data to develop interventions to support dentists' participation in vaccination campaigns are provided. Participants' acceptance of COVID-19 vaccination over HPV vaccination may reflect the public awareness of COVID-19 vs HPV due to daily relevance of this disease, or the lack of knowledge about HPV, particularly its oropharyngeal impacts. PRACTICAL IMPLICATIONS: The authors provide evidence to support dentists' involvement in vaccine education and distribution, expanding previous literature into evaluation of a new disease context (COVID-19). Lack of knowledge of HPV may affect willingness to receive the HPV vaccine, presenting an opportunity for education.

Drunk in China? The Imperative for Effective Interventions Against Alcohol Abuse.

BACKGROUND: Alcohol use and abuse remain prevalent in China, though mounting evidence shows that even drinking in moderation is detrimental to health. While many countries' intake is on the decline, China's alcohol consumption is rising fast and is on the path to overtaking countries like the United States, even on a per capita level. OBJECTIVES: This paper aims to analyze the danger of lax enforcement of laws and regulations against alcohol use and abuse and underscores the imperative for effective health interventions to curb problematic alcohol consumption in China. RESULTS: Different from their Western counterparts, Chinese drinkers often consume more spirit with a high percentage of alcohol in social settings that encourage the "ganbei culture"-making toasts with alcohol filled to the brim and downed in one go to show respect-which perpetuates excessive drinking at a fast pace. Though the country has various laws and regulations in place to curb problematic alcohol consumption, like workplace drinking, their impacts are dismal. Considering that China has 1.4 billion people, the country's uncurbed alcohol consumption trend could have a detrimental effect on national strategic objectives like "Healthy China 2030" and international ones like the Sustainable Development Goals. To further compound the situation, prevalent campaigns promoted by liquor companies-like alcohol-infused coffee, chocolate, and ice cream-may groom young people to develop alcohol consumption habits, if not addictions, for generations to come. CONCLUSIONS: We developed the Framework of 5Vs of China's "Ganbei Culture to shed light on the issue, with the hope that it, along with the overarching insights of this paper, can assist health professionals and policymakers in better guarding and improving public health against the harms of alcohol use and abuse in China and beyond.

Effect of a structured health promotional program using the self-support groups on lifestyle behavior: The Ath Waas Interventional Trial.

BACKGROUND: Ath Waas is a one-of-a-kind health promotion intervention that focuses on chronic disease prevention behaviors through peer support and social support network development. The goal of the study was to see how effective Ath Waas was in a city setting in India. MATERIALS AND METHODS: From July 2018 to July 2019, we used a mixed-methods intervention research design including many sites. At 0, 2, 3, 5, 7, 9, and 12 months, data were collected using participant surveys and in-person interviews. Throughout the research period, participants met in groups at least once a month to self-monitor health indicators, prepare and share a healthy snack, engage in physical activity, create a healthy lifestyle goal, and socialize. Data were analyzed using a paired t-test, and inferences were drawn thereof. RESULTS: There were statistically significant improvements in the majority of the domains of health from pre- to post-program, and 59% of participants reported specific behavioral changes as a result of their participation in the Ath Waas. Peer support, obtaining particular health knowledge, inspiration, motivation, or accountability, the empowering effect of monitoring one's own health indicators, overcoming social isolation, and knowing how to better access resources were all positive health outcomes. The mean knowledge scores for diabetes, hypertension, and nutrition in the first survey were 20.3 ± 2.1 and 5.2 ± 1.9 and in the last survey were 22.6 ± 3.1 (P < 0.05), 5.8 ± 2.4 (<.05), and 44.3 ± 3.9 (<0.001) after the intervention, respectively. CONCLUSION: The necessity to find novel approaches to chronic illness prevention and management drove the implementation and evaluation of Ath Waas. While more research is needed to confirm the current findings, it looks like Ath Waas could be a useful tool for empowering community members to support one another while promoting healthy lifestyle choices and recognizing early changes.Clinical Trial Registry of India: CTRI/2019/01/017028 (registered on 10/01/2019).