Exploring Sex Differences in Adult Obesity Candidates for Bariatric Surgery.

INTRODUCTION: Obesity represents a global health crisis and results from complex interactions between psychological, environmental, and genetic factors. Any therapeutic approach should consider the social, personal, and psychological characteristics of the obese subject, as well as possible medical complications. This study investigates sex differences in candidates for bariatric surgery. SUBJECTS AND METHODS: This is a cross-sectional study including subjects who underwent psychiatric pre-surgical evaluation. The evaluation comprised a clinical interview and the administration of self-report questionnaires that assessed socio-demographic and clinical aspects. Descriptive and bivariate analyses and a multivariate logistic regression model were performed to evaluate variables significantly associated with sex in bariatric surgery candidates. RESULTS: The sample consisted of 173 subjects, of which 71.1% were women. Significant differences between men and women were detected in employment status, birth nationality, psychopathological history, organic comorbidities, and BMI value. There were no significant differences in clinical aspects. CONCLUSION: Obesity has a significant impact on global health. Women and men who are considering bariatric surgery represent two different populations in demographic, personal, and social characteristics. Therefore, a sex-tailored approach is essential to guarantee adequate support in the management of the various aspects of obesity.

Individual child factors affecting the diagnosis of attention deficit hyperactivity disorder (ADHD) in children and adolescents: a systematic review.

Attention deficit hyperactivity disorder (ADHD) is a prevalent condition characterised by patterns of inattention, hyperactivity, and impulsivity. This systematic literature review aims to identify the child clinical and sociodemographic factors related to the detection and diagnosis of ADHD in children and adolescents, given concerns about delays or failures in identifying ADHD as well as over-diagnosis, hindering appropriate and timely support for children and families. Through electronic and manual searches of peer-reviewed and grey literature, 5852 articles were identified and subjected to two stages of screening by independent reviewers. Due to the heterogeneity in study methods, a narrative approach was used to summarise study findings. Forty-one studies meeting eligibility criteria revealed sixteen child-related factors influencing the ADHD diagnostic process. These factors include ADHD subtype, ADHD symptom severity, comorbid mental disorders, behavior problems, internalizing symptoms, functional impairment, social and cognitive functioning, physical health, gender, age, relative age, race/ethnicity, socio-economic status, insurance coverage, residence urbanicity, and family structure. While the impact of many of these factors on ADHD diagnosis was inconsistent due to the substantial diversity in study designs and context, certain patterns emerged. Meeting the criteria for the inattentive subtype, lower functional impairment, female gender, Black or Latinx ethnicity, and being relatively young for their grade were consistently found to be associated with a delayed or absent ADHD diagnosis. Further research is needed to explore the intricate relationships between these child-level variables and their implications for ADHD recognition, referral, and evaluation, especially outside the USA.

Trends and socio-demographic determinants of suicide-related mortality in Türkiye: An epidemiological study from 2009 to 2022.

BACKGROUND: Suicide is a leading cause of death, particularly among the young age group, in Türkiye, a country with a high population of young people. AIM: The aim of this study is determine the suicide related mortality trend and some associated socio-demographic factors in Türkiye between 2009 and 2022. METHODS: The study includes an epidemiological trend on suicide. The Turkish Statistical Institute's data portal was used. The study population is 46,691 people (Male/female ratios = 74.6%/ 25.4%). Changes in mortality trends were evaluated using the Joinpoint Regression method with Annual Percentage Change (APC) and Average Percentage Change (AAPC) analysis. RESULTS: Over the past 14 years in Türkiye, there has been a statistically significant increase in the standardized mortality rate among males (2009-2022 APC = .76, p = .012) and a statistically non-significant decrease among females (2009-2022 APC = -1.62, p = .083). According to the Nomenclature of Territorial Units for Statistics (NUTS-1) classification, the highest increase is observed in the Central Anatolia region followed by the Western Black Sea region (APC = 3.0 and 2.7, respectively; p < .005). While the percentage of primary school and below has decreasing trends (2009-2022 APC = -7.11, p < .005), there is a significant increase in the percentage of university graduates (2009-2016 APC = 10.87, p < .001). Regarding the marital status, there is a significant decrease in the percentage of those who are married (2009-2013 APC = -3.36, p < .001; 2013-2016 APC = 2.42, p = .037; 2016-2022 APC = -2.31, p = .003) and a significant increase in those who have never been married (2009-2013 APC = 2.63, p < .001; 2013-2016 APC = -1.36, p = .002). CONCLUSION: Although suicide related mortality is below the global average, there has been an increasing trend in turkey in the last 14 years. Analytical and intervention studies on the socio-demographic determinants supporting the increasing trend are needed.

Depression and stigma experience among patients with tuberculosis in urban and rural settings.

BACKGROUND: Tuberculosis is one of the leading causes of morbidity and mortality in the globe. The most common infectious disease-related death in the world is tuberculosis. In 2020, an estimated 9.9 million people became ill with tuberculosis (TB), translating to 127 cases per 100,000 people. The stigma associated with tuberculosis (TB) causes people to put off seeking treatment and adhering to their treatment regimen. India has the highest prevalence of tuberculosis in the world. Depression and stigma oftem co-exist in people with tuberculosis. OBJECTIVE: To estimate the prevalence of depression and stigma experience among patients with tuberculosis, and to determine the association of socio-demographic variables and stigma experience with depression in urban and rural field practice areas. METHODOLOGY: This is a cross-sectional study where purposive sampling method was adopted. A house-to-house and phone interview was conducted using a pre-designed, pre-tested questionnaire. Depression was assessed using the PHQ-9 and stigma experience was assessed using the Stigma Scale for Chronic Illness - 8 items (SSCI -8 Items). SPSS version 25 was used (licensed to the institution)for analysis. Descriptive statistics was used to calculate proportions, mean, standard deviation. Inferential statistics like Chi-square analysis/Fisher's exact analysis were used to find the association between various socio-demographic variables with the depression among patients with tuberculosis and association between stigma experience and depression. (Yates continuity Highlights correction applied wherever required) p < 0.5 was considered to be statistically significant. RESULTS: The overall prevalence of depression was 57.8%. The association between number of family members and type of tuberculosis with depression was statistically significant. 28.6% did not experience stigma, while 71.6% did. The association between depression score and stigma experience was not statistically significant. CONCLUSION: More than half of the study's participants had depression and had encountered stigma. There was significant association between depression scores with family size and type of tuberculosis.

Global burden of viral infectious diseases of poverty based on Global Burden of Diseases Study 2021.

BACKGROUND: Viral infectious diseases of poverty (vIDPs) remain a significant global health challenge. Despite their profound impact, the burden of these diseases is not comprehensively quantified. This study aims to analyze the global burden of six major vIDPs, including coronavirus disease 2019 (COVID-19), HIV/AIDS, acute hepatitis, dengue, rabies, and Ebola virus disease (EVD), using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021). METHODS: Following the GBD 2021 framework, we analyzed the incidence, mortality, and disability-adjusted life years (DALYs) of the six vIDPs across 204 countries and territories from 1990 to 2021. We examined the association between the Socio-Demographic Index (SDI) and the burden of vIDPs. All estimates were reported as numbers and rates per 100,000 population, calculated using the Bayesian statistical model employed by GBD 2021, with 95% uncertainty intervals (UI). RESULTS: In 2021, vIDPs caused approximately 8.7 million deaths and 259.2 million DALYs, accounting for 12.8% and 9.0% of the global all-cause totals, respectively. Globally, the burden of vIDPs varied significantly: COVID-19 caused around 7.9 million (95% UI: 7.5, 8.4) deaths and 212.0 million (95% UI 197.9, 234.7) DALYs in 2021. Acute hepatitis had the second-highest age-standardized incidence rate, with 3411.5 (95% UI: 3201.8, 3631.3) per 100,000 population, while HIV/AIDS had a high age-standardized prevalence rate, with 483.1 (95% UI: 459.0, 511.4) per 100,000 population. Dengue incidence cases rose from 26.5 million (95% UI: 3.9, 51.9) in 1990 to 59.0 million (95% UI: 15.5, 106.9) in 2021. Rabies, although reduced in prevalence, continued to pose a significant mortality risk. EVD had the lowest overall burden but significant outbreak impacts. Age-standardized DALY rates for vIDPs were significantly negatively correlated with SDI: acute hepatitis (r = -0.8, P < 0.0001), rabies (r = -0.7, P < 0.0001), HIV/AIDS (r = -0.6, P < 0.0001), COVID-19 (r = -0.5, P < 0.0001), dengue (r = -0.4, P < 0.0001), and EVD (r = -0.2, P < 0.005). CONCLUSIONS: VIDPs pose major public health challenges worldwide, with significant regional, age, and gender disparities. The results underscore the need for targeted interventions and international cooperation to mitigate the burden of these diseases. Policymakers can use these findings to implement cost-effective interventions and improve health outcomes, particularly in regions with high or increasing burdens.

Assessing the prevalence, risk factors, and socio-demographic predictors of malaria among pregnant women in the Bono East Region of Ghana: a multicentre hospital-based mixed-method cross-sectional study.

BACKGROUND: Malaria is one of the world's most lethal vector-borne diseases, causing significant health burdens in endemic countries. Several studies on the prevalence of malaria among pregnant women in Ghana have been conducted in various parts of the country, yielding evidence pointing to intra- and inter-regional variations. The current study assessed the prevalence, risk factors, and sociodemographic predictors of malaria among pregnant women in the Bono East Region of Ghana. METHODS: This multicentre hospital-based study employed a mixed-method cross-sectional design. A multistage sampling technique was used to select seven health facilities and recruited 1452 pregnant women who attended ANC at seven selected health facilities. Haematological examination, a structured closed-ended questionnaire, in-depth interviews (IDIs), and focus group discussions (FGDs) were used to obtain relevant data. Quantitative data were analysed with STATA 14 (StataCorp, College Station, USA). Likewise, the four-step thematic analysis was used to analyse qualitative data. A significant level was set at (p < 0.05) at a 95% confidence interval (CI). RESULTS: The ages of the pregnant women at enrolment ranged between 17 and 40 years, with a mean (SD) of 28.8 ± 3.73 (95% C.I: 28.63-29.02). The overall prevalence of malaria infection among pregnant women was 10.8% (95% CI: 9.32-12.56). Presence of farm or domestic animals, living close to drainage tunnels, living near overgrown vegetation, not married, not having formal education, living in extended-type households, living in compound-type households, mud and thatch households, mud and iron sheet households, primigravidae, multiparity, first-time pregnant women, second-time, third-time, fourth-time, and fifth-time ANC visits, blood groups A, B, and AB were independent factors or predictors significantly associated with increased risk of malaria. CONCLUSION: The current study revealed an approximately 10.8% prevalence of malaria among pregnant women. The prevalence revealed, was, however, higher than the national prevalence of 8.6%. The high prevalence of malaria, associated risk factors, and sociodemographic and maternal predictors highlight the need to strengthen screening for malaria, administer treatments, monitor maternal and foetal health, and provide education and counselling.

Contribution of socio-demographic factors in prevalence of soil-transmitted helminth infections among newly arrived laborers in Jeddah, Saudi Arabia.

Background: Soil-transmitted diseases are caused by intestinal worms transmitted via various routes into the human body resulting in various clinical manifestations. This study aimed to investigate the socio-demographic factors contributing mainly to the prevalence of soil-transmitted helminths (STHs) among newly arrived laborers in Jeddah, Saudi Arabia. Methods: A total of 188 stool specimens were collected and examined macroscopically and microscopically using different techniques. In addition, real-time PCR was used as a molecular tool to detect several STHs. The descriptive analysis was used to evaluate demographic data and categorical variables in association with STHs infection. Results: Of all participants, the mean age was 26.08 ± 2.67 years, including 103 females and 85 males. A total of 86 (45.70%) were illiterate, followed by 60 (31.90%) of participants belonging to elementary level. STHs and other intestinal parasites were detected among 35 newly arrived laborers (18.61%). Nineteen cases (10.11%) were infected with STHs, including 15 cases with one STHs (four A. lumbricoides, four N. americanus, four T. trichiura, two S. stercoralis, one A. duodenale) and four cases with two STHs (two T. trichiura and N. americanus; one S. stercoralis and A. duodenale; one T. trichiura and S. stercoralis). High rates of STHs infection were detected among drivers (11.70%) followed by housemaids (11.20%), but with no significant association to occupation. Higher rates of STHs infection were detected among those used to walk on soil barefoot in their home countries before arriving in Jeddah. Conclusion: This study found that none of the newly arrived expatriate laborers in Jeddah was aware of STHs. About 10% of them had infection with one or two STHs, mainly among newly arrived laborers from Asian countries. There is a need for awareness programs and regular screening for STHs and other intestinal parasites among newly arrived expatriate laborers.

Understanding menstrual factors associated with poor mental health among female secondary school students in Uganda: a cross-sectional analysis.

BACKGROUND: There is growing global concern about poor mental health among adolescents in sub-Saharan Africa. In particular, adolescent girls face multiple challenges in managing menstruation which can impact both their health and wellbeing. In this study we address an evidence gap on the association of a broad range of menstrual-related factors with mental health problems amongst secondary school female adolescents in Uganda. METHODS: We used baseline data from a cluster-randomised menstrual health intervention trial conducted in 60 secondary schools in two districts in Uganda. Baseline data were collected between March and July 2022, including socio-demographic characteristics, menstrual knowledge and attitudes, menstrual practices and self-efficacy, and mental health problems measured using the Strengths and Difficulties Questionnaire Total Difficulties score (SDQ-25). We used random-effects linear regression to estimate the adjusted mean difference (aMD) for the association between mental health problems (SDQ Total Difficulties Score) and menstrual-related factors, including the Menstrual Practice Needs Scale (MPNS) and the Self-Efficacy in Addressing Menstrual Needs scale (SAMNS)), accounting for school-level clustering and adjusting for prior confounders. RESULTS: Among the 3841 female participants, there was strong and consistent evidence of associations between mental health problems and menstrual-related factors. Mental health problems were associated with poor knowledge about menstruation (aMD = 1.17, 95%CI 0.50, 1.84 <0.001), using disposable and reusable menstrual products compared to using just disposable products (aMD = 1.42, 95%CI 0.92, 1.92, p <0.001), and experiencing menstrual pain even when using an effective management method at last menstrual period (LMP) compared to those experiencing no pain (aMD = 1.60, 95%CI 1.19, 2.01, p <0.001). Mental health problems were also associated with greater unmet menstrual needs according to the MPNS (aMD = 4.40 95%CI 3.96, 4.84, p <0.001), and with lower menstrual self-efficacy measured by the SAMNS (aMD = 0.94 95% CI 0.51, 1.37, p <0.001). CONCLUSION: This study shows strong evidence that mental health problems reported by adolescent girls in Uganda are associated with poor menstrual health. The association between menstrual health and mental health provides evidence as to why menstrual health should be a public health priority. TRIAL REGISTRATION: Trial registration: ISRCTN 45461276. Registered on 16 September 2021.

Spatiotemporal patterns of rheumatic heart disease burden attributable to high systolic blood pressure, high sodium diet, and lead exposure (1990 to 2019): a longitudinal observational study.

Background: Rheumatic heart disease (RHD) continues to be a significant global health concern, exhibiting unique regional disparities. Although there is a noted decline in the burden of RHD, the specific causatives for this decrease remain unclear. This study aims to identify and quantify the spatiotemporal patterns related to the RHD-attributable risk burden. Methods: The data pertaining to deaths and disability-adjusted life years (DALYs) attributable to RHD risk were drawn from the Global Burden of Disease (GBD) study conducted from 1990 to 2019. These data, categorized by age, gender, and geographical location, highlighted risk factors including diets high in sodium, elevated systolic blood pressure (SBP), and lead exposure. To examine the long-term trends in RHD changes due to these specific risk factors, the average annual percentage change (AAPC) method was used. Results: During the past 30 years, the highest decrease in RHD burden was attributed to high SBP. An AAPC of -2.73 [95% confidence interval (CI): -2.82 to -2.65] and - 2.45 (95% CI: -2.55 to -2.36) in deaths and DALYs was attributable to high SBP, while an AAPC of -3.99 (95% CI: -4.14 to -3.85) and - 3.74 (95% CI: -3.89 to -3.6) in deaths and DALYs was attributed to a diet high in sodium. Moreover, the trends in deaths and DALYs due to lead exposure also showed decreases with an AAPC of -2.94 (95% CI: -3 to -2.89) and - 3.46 (95% CI: -3.58 to -3.34) from 1990 to 2019. Oceania showed an upward trend of the RHD DALYs due to high SBP, with an AAPC of 0.23 (95% CI: 0.13 to 0.33). In general, countries in Oceania, East Asia, and South Asia had higher age-standard deaths and DALY rates of RHD due to diets high in sodium. Conclusion: Our study has revealed that high SBP remains the prime risk factor contributing to the RHD burden. There are decreasing spatiotemporal patterns in RHD-related deaths and burdens. Gaining this knowledge is fundamental to making informed public health strategies and clinical decisions, especially concerning risk assessment, screening, and prevention initiatives.

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.

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.

Food insecurity and its association with socio-demographic characteristics in Cyprus.

The prevalence of food insecurity in Cyprus and the socio-demographic factors that are related to this public health problem are unknown. Data used in this cross-sectional study were collected between 1 June 2022 and 21 May 2023 using a self-reported method. Food insecurity was evaluated using the Greek version of Adult Food Security Survey Module. The data regarding socio-demographic and socio-economic characteristics along with body weight and height measurements were collected through self-administered questionnaire. A representative sample of n=1255 adults, ≥18 years old living in the five different districts of the Republic of Cyprus, was recruited. Prevalence of food insecurity in Cypriot population was 12.6%. Prevalence was higher in females, in older adults, in adults living in Paphos, in individuals who were separated, divorced, or widowed, in retired people, in people living with children, and in people with low income and education. Based on multivariable analysis, income was the strongest socio-demographic factor independently associated with food security (€ 6,500-€ 19,500: AOR: 0.49, 95% CI 0.28, 0.86 and >€ 19,500: AOR: 0.15, 95% CI 0.73, 0.31). Food insecurity is a global problem that need further examination. The association between food insecurity and socio-demographic characteristics needs to be highlighted in order for each country to develop specific public health policies (e.g. financial support to low income people) to decrease food insecurity and improve people's overall health and quality of life.

Socio-demographic predictors of the time interval between successive hospitalizations among patients with borderline personality disorder.

Background: Borderline personality disorder (BPD) affects 0.7 to 2.7% of the adult population and higher rates are reported in inpatient care. Hospitalizations of BPD patients are a complex and controversial challenge for mental health professionals. Recurrent hospitalizations are common and it is essential to identify risk factors that characterize patients who benefit from their hospitalization and those who return to the ward shortly after discharge. Aim: To investigate the potential link between BPD patients' socio-demographic factors and the expected time interval between their successive hospitalizations. Methods: A retrospective analysis of 1051 hospitalization records from 174 BPD patients. Through univariate, bivariate, and multivariate analyses, we investigated the possible relationship between patients' primary socio-demographic factors and the time between their successive hospitalizations. Results: Patients' age, marital status, and living arrangement were found to be statistically connected with the time interval between successive hospitalizations. Specifically, being older, married and/or patients to live with one's spouse/partner seem to be linked with a longer time interval between successive hospitalizations compared to patients who are young, single/divorced and/or those who live with their parents. Conclusions: The expected time interval between successive hospitalization of BPD patients can be partly explained by their socio-demographic characteristics.

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.

Socio-demographic correlates of ultra-processed food consumption in Canada.

OBJECTIVE: To characterise consumption of ultra-processed foods and drinks (UPF) across a range of socio-demographic characteristics of Canadians. DESIGN: Cross-sectional study. The national-level 2015 Canadian Community Health Survey-Nutrition provided data on all foods and drinks consumed on the previous day via a 24-hour dietary recall. All food items were classified according to the type of industrial processing using the NOVA system. Multivariable linear regression models examined associations between a range of socio-demographic characteristics and the mean energy contribution (% of total daily energy intake) from total UPF and UPF subgroups. SETTING: The ten Canadian provinces. PARTICIPANTS: Canadians aged 2 or older (n 20 103). RESULTS: UPF contributed, on average, nearly half (44·9 %) of total daily energy intake of Canadians. Children aged 6-12 and adolescents aged 13-18 consumed over half of total daily energy from UPF (adjusted means of 51·9 % and 50·7 %, respectively). Recent and long-term immigrants consumed a significantly lower share of energy from UPF (adjusted means of 42·2 % and 45·1 %, respectively) compared with non-immigrants (54·4 %), as did the food secure (42·8 %) v. those in moderately (48·1 %) or severely food-insecure households (50·8 %). More modest differences were observed for intake of total UPF and UPF subgroups by sex, education, income adequacy and region of residence. CONCLUSION: Levels of UPF consumption in 2015 in Canada were pervasive in all socio-demographic groups and highest among children and adolescents, non-immigrants and those living in food-insecure households. These findings can inform public health interventions to reduce UPF consumption and promote healthier diets in various socio-demographic groups.

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.

Socio-demographic analysis of destination selection factors for Himalayan Hill destinations.

Background: The towering peaks of the Himalayas lie in troves of captivating hill destinations, especially in India. Each destination aims to provide tourists with unique experiences and breath-taking landscapes. Understanding the tapestry of factors that weave the allure of these destinations and draw visitors from diverse backgrounds remains intriguing. Method: This study delves into the socio-demographic tapestry of Himalayan hill destination selection, unraveling the complex interplay of demographic characteristics, social influences, and individual motivations that shape tourists' choices. Results: This study aims to answer why different tourists have different travel choices and what factors are the drivers behind such choices. The results show that destination selection factors are similar irrespective of respondents' socio-demographic variabilities; however, for a few factors, the results are reversed. Conclusion: The study has implications for policymakers and the limitations of the research discussed at the end.

Trends in deaths and disability-adjusted life-years of ischemic heart disease attributable to high body-mass index worldwide, 1990-2019.

BACKGROUND: The objective of this study is to evaluate the global burden of ischemic heart disease (IHD) attributable to High body mass index (HBMI) by utilizing data from Global Burden of Disease (GBD) 2019. METHODS: This study utilized data from the GBD 2019 to examine the impact of HBMI on deaths and disability-adjusted life years (DALYs). The analysis focused on age-standardized rates and considered a 30-year time frame. Trends were assessed using estimated annual percentage changes (EAPCs). RESULTS: Since 1990, a significant global increase in IHD attributable to HBMI has been observed. This increase is particularly notable among elderly males and in regions with low-middle Socio-Demographic Index (SDI), such as Central Asia and Eastern Europe. In 2019, IHD globally resulted in 1,662,339 deaths and 41,369,773 DALYs. Despite the high age-standardized death rate (20.73 per 100,000) and DALY rate (499.41 per 100,000), a declining trend was noted. This trend is reflected by the EAPCs of -0.35 for DALYs and - 0.67 for deaths. Notably, males and middle SDI countries exhibited higher rates of IHD, whereas high SDI regions such as High-income Asia Pacific and Western Europe showed decreasing trends in IHD. CONCLUSION: Over the past three decades, there has been a significant increase in IHD caused by HBMI, especially in low-middle and low SDI regions. This highlights the importance of targeted interventions in addressing this issue. Notably, regions including Central Asia, Eastern Europe, North Africa, and the Middle East have been heavily affected.

Exploring the Determinants of Tobacco Usage Among Adolescents: A Cross-Sectional Study in Western Maharashtra.

Introduction The widespread use of tobacco is a major global health threat, causing significant morbidity and mortality. The World Health Organization (WHO) estimates that annually, millions of people die prematurely due to tobacco use, with this number projected to increase significantly in the future. Developing countries, including India, bear a substantial burden of tobacco-related deaths, often beginning during adolescence. This study estimated the prevalence of tobacco use among adolescents in the 13-19 years age group, identified the types of tobacco products used, explored the reasons for initiation, and examined the influence of family, peers, and socio-demographic factors on tobacco use. Methods A community-based cross-sectional study was conducted from August 2022 to June 2024 in a medical college's urban and rural field practice areas in Pune district, Maharashtra. A total of 310 adolescents were surveyed using convenience sampling. Data were collected using a pre-designed, pre-tested questionnaire, and statistical analysis was performed using Jamovi software version 2.3.28. Chi-square and Fisher's exact tests were applied to assess associations between variables. Results Out of 310 participants, 94 (30.32%, 95% CI: 25.25%-35.77%) reported using tobacco. Among these 94 participants, 82 (87.23%) used smokeless tobacco, 19 (20.21%) used the smoked form of tobacco, and seven (7.45%) used both forms. The mean age of initiation was 15.94 years for smoking and 15.59 years for smokeless tobacco. The data indicate a higher percentage of tobacco use among females (50%) compared to males (24.8%). However, in terms of absolute numbers, more males (60) than females (34) reported using tobacco due to the larger number of males in the study sample. The most common reasons for initiation included curiosity (43.74%) and peer pressure (53.99%). Specifically, 49 individuals (42.6%) aged 13-15 were using tobacco, compared to 23 individuals (30.3%) aged 16-17, and only 22 individuals (18.5%) aged 18-19. Participants from urban areas reported higher tobacco use (48%) compared to those from rural areas (46.7%). Among those from joint families, about 24 (31.6%) reported tobacco use, while in nuclear families, it was slightly lower at about 70 (29.9%). Conclusion Factors such as peer pressure and curiosity played significant roles in the initiation of tobacco use, with more than half of the participants citing peer influence as the primary reason for starting. This study revealed differences in tobacco usage patterns across age groups, with younger participants showing higher usage rates. The findings highlight the need for targeted interventions, such as health education and anti-tobacco media campaigns, to reduce tobacco use among adolescents.

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.