Self-Rated Health among Older Adults: Longitudinal Analyses Examining Sex Differences across Different Birth Cohorts and Educational Levels.

INTRODUCTION: Given the known female disadvantage in physical and mental health, this study aimed to investigate sex differences in self-rated health (SRH) among older adults, considering the longitudinal course by age, birth cohort, and educational level. METHODS: Data from birth cohort 1911-1937 with baseline age 55-81 years (n = 3,107) and birth cohort 1938-1947 with baseline age 55-65 years (n = 1,002) from the Longitudinal Aging Study Amsterdam (LASA) were used. Mixed model analyses were used to examine sex differences in SRH (RAND General Health Perception Questionnaire [RAND-GHPQ], range 0-16) over the age course, testing for effect modification by the birth cohort and educational level (low, middle, high). RESULTS: For both sexes, a decline in SRH was seen with increasing age. Over the age course, there was no significant sex difference in SRH within the older (1911-1937) birth cohort (0.13 lower score on SRH for women compared to men, 95% CI: -0.35 to 0.09) and only a small sex difference in the more recent (1938-1947) birth cohort (0.35 lower score on SRH for women compared to men [95% CI: -0.69 to -0.02], p = 0.04). There was no significant cohort difference in the size of the sex difference (p = 0.279). Those with a higher level of education reported a higher SRH, but between educational levels, there was no significant difference in the size of the sex difference in SRH. DISCUSSION: In this study, no relevant sex difference in SRH over the age course was observed among older adults. Future research on SRH trajectories by sex during aging should take health-related, cognitive, psychosocial, and behavioral factors into account.

The sex difference in self-rated health among older Turkish and Moroccan migrants in the Netherlands: an exploratory study of contributing determinants.

BACKGROUND: Although being a woman and having a migration background are strong predictors of poor self-rated health among (older) adults, research on the sex difference in self-rated health among (older) migrants remains limited. This study therefore aims to investigate this topic and explore the contributing role of determinants of self-rated health. METHODS: Cross-sectional data from 360 Turkish-Dutch and Moroccan-Dutch adults aged 55-65 as part of the Longitudinal Aging Study Amsterdam (LASA) were used. Self-rated health (good versus poor) was measured by a single item question. Univariate age-adjusted logistic regression analysis was used to investigate the sex difference in self-rated health and the contribution of sex differences in sensitivity (strength of the association) and/or exposure (prevalence) to socio-demographic, social, lifestyle or health-related determinants of self-rated health. RESULTS: Women had a 0.53 times lower odds (95%CI:0.40-0.82, p = 0.004) on good self-rated health compared to men. Women more often having a lower education level, living alone and having a higher prevalence of depressive symptoms, chronic diseases and especially functional limitations contributed to the lower self-rated health among women. In contrast, men were more sensitive to the impact of memory complaints, depressive symptoms, visual difficulties and functional limitations. CONCLUSIONS: Older Turkish-Dutch and Moroccan-Dutch women have a significant lower self-rated health compared to men. Women having a higher exposure to both socio-demographic and health-related determinants of self-rated health, which contributed to the sex difference. Future research should take these differences in self-rated health and determinants between women and men into account when investigating health among older migrants.

A genderful research world: rapid review, design, and pilot study of an interactive platform for curated sex and gender health research resources.

BACKGROUND: Integration of sex and gender into health research is best practice for designing and conducting equitable, rigorous scientific research. Many evidence-based resources exist to support researchers in this endeavour, but such resources often remain underutilized as they are difficult to find, are not publicly accessible, or are specific to a particular research phase, context, or population. The development and evaluation of a repository of resources was deemed important to create an accessible platform for promoting sex- and gender-integration in health research. METHODS: A rapid review was conducted of critical resources for conducting sex and gender health research. These were integrated into a prototype website design (the Genderful Research World; GRW) that provided an interactive digital landscape for researchers to access these resources. A pilot study evaluated the GRW website for applicability, desirability, and usability with an international sample of 31 health researchers from various disciplines and career stages. Quantitative data from the pilot study was summarized with descriptive statistics. Qualitative data was summarized narratively and used to identify concrete elements for improvement in a second design iteration. RESULTS: Results of the pilot study revealed that the GRW was considered user friendly and desirable by health researchers and helped them access relevant information. Feedback suggested that providing these resources in a playful way may enhance the experience of the user, particularly given the high 'desirability' scores and that users emphasized the interactive layout as being key to their intention to integrate it into their teaching endeavors. Key feedback from the pilot study (e.g., addition of resources specific to research with transgender populations, revision of website layout) was integrated into the current version of the website: www.genderfulresearchworld.com . CONCLUSIONS: The present research suggests a utility for a repository of resources for integrating sex and gender considerations into research, and that providing a logical, intuitive means of cataloguing and navigating such resources is critical for usability. The results of this study may inform the development of other novel researcher-directed resource curation efforts to address health equity issues and encourage and support health researchers to integrate a sex and gender perspective in their work.

MATHEMATICAL MODEL FOR PREDICTING FASTING BLOOD GLUCOSE LEVEL IN DIABETES MELLITUS PATIENTS.

OBJECTIVE: The aim: To substantiate the use of data on patients' lifestyle, parameters of blood glucose, heart rate, blood pressure and bread units to build a mathematical model for predicting fasting blood glucose level in diabetes mellitus patients to improve existing measures for diabetes prevention. PATIENTS AND METHODS: Materials and methods: An open database consisting of the studied parameters of 359 people was used in the research. The linear regression method was used to predict fasting blood glucose level in diabetes mellitus patients. The statistical software IBM SPSS Statistics Version 23 was chosen for calculations. RESULTS: Results: To calculate the coefficients of the linear regression equation, stepwise elimination of parameters was chosen. The analysis of the coefficients of influence of independent variables on dependent showed that the greatest effect on the change in glucose level had value of consumed bread units. The model for women diagnosed with type 2 diabetes showed the highest accuracy. CONCLUSION: Conclusions: Mathematical modeling made it clear that any malnutrition or health disorders can lead to a significant change in glucose levels. The obtained models consist of a number of parameters, some of which might depend on the presence of concomitant diseases. Further studies should focus on the optimal combination of various parameters taking into account methods of treating comorbidities.

Sex Differences in Cognitive Functioning with Aging in the Netherlands.

INTRODUCTION: Dementia prevalence in older women is higher than that in men. The purpose of the present study was to investigate whether there is a female disadvantage in cognitive functioning at adult age and/or whether a female disadvantage develops with age. METHODS: Data of 5,135 women and 4,756 men from the Longitudinal Aging Study Amsterdam (LASA) and the Doetinchem Cohort Study (DCS) were used. In the LASA, memory, processing speed, fluid intelligence, and global cognitive function were measured every 3-4 years since 1992 in persons aged 55+ years for up to 23 years. In the DCS, memory, processing speed, cognitive flexibility, and global cognitive function were measured every 5 years since 1995 in persons aged 45+ years for up to 20 years. Sex differences in cognitive aging were analyzed using linear mixed models and also examined by the 10-year birth cohort or level of education. RESULTS: Women had a better memory, processing speed, flexibility, and, in the DCS only, global cognitive function than men (p's < 0.01). However, women showed up to 10% faster decline in these cognitive domains, except for flexibility, where women showed 9% slower decline. In the LASA, women scored poorer on fluid intelligence (p < 0.01), but their decline was 10% slower than that in men. Female advantage was larger in later born cohorts; adjustment for the educational level increased the female advantage. CONCLUSION: Women have better memory and processing speed than men at middle age. This female advantage becomes smaller with aging and has increased in more recent birth cohorts.

The sex difference in gait speed among older adults: how do sociodemographic, lifestyle, social and health determinants contribute?

BACKGROUND: This study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among older women compared to men. METHODS: Data from the Longitudinal Aging Study Amsterdam (LASA) were used. In total 2407 men and women aged 55-81 years were included, with baseline measurements in 1992/2002 and follow-up measurements every 3-4 years for 15/25 years. Multivariable mixed model analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure to (change of the sex difference when adjusted) socio-demographic, lifestyle, social and health determinants of gait speed. RESULTS: Women had a 0.054 m/s (95 % CI: 0.076 - 0.033, adjusted for height and age) lower mean gait speed compared to men. In general, men and women had similar determinants of gait speed. However, higher BMI and lower physical activity were more strongly associated with lower gait speed in women compared to men (i.e. higher sensitivity). More often having a lower educational level, living alone and having more chronic diseases, pain and depressive symptoms among women compared to men also contributed to observed lower gait speed in women (i.e. higher exposure). In contrast, men more often being a smoker, having a lower physical activity and a smaller personal network size compared to women contributed to a lower gait speed among men (i.e. higher exposure). CONCLUSIONS: Both a higher sensitivity and higher exposure to determinants of gait speed among women compared to men contributes to the observed lower gait speed among older women. The identified (modifiable) contributing factors should be taken into account when developing prevention and/or treatment strategies aimed to enhance healthy physical aging. This might require a sex-specific approach in both research and clinical practice, which is currently often lacking.

Sex differences in mental health among older adults: investigating time trends and possible risk groups with regard to age, educational level and ethnicity.

OBJECTIVES: Older women report lower mental health compared to men, yet little is known about the nature of this sex difference. Therefore, this study investigates time trends and possible risk groups. METHOD: Data from the Doetinchem Cohort Study (DCS) and the Longitudinal Aging Study Amsterdam (LASA) were used. General mental health was assessed every 5 years, from 1995 to 1998 onwards (DCS, n = 1412, 20-year follow-up, baseline age 55-64 years). Depressive and anxiety symptoms were assessed for two birth cohorts, from 1992/1993 onwards (LASA cohort 1, n = 967, 24-year follow-up, age 55-65 years,) and 2002/2003 onwards (LASA cohort 2, n = 1002, 12-year follow-up, age 55-65 years) with follow-up measurements every 3-4 years. RESULTS: Mixed model analyses showed that older women had a worse general mental health (-6.95; -8.36 to 5.53; range 0-100, ∼10% lower), more depressive symptoms (2.09; 1.53-2.63; range 0-60, ∼30% more) and more anxiety symptoms (0.86; 0.54-1.18; range 0-11, ∼30% more) compared to men. These sex differences remained stable until the age of 75 years, where after they decreased due to an accelerated decline in mental health for men compared to women. Sex differences and their course by age were consistent over successive birth cohorts, educational levels and ethnic groups (Caucasian vs. Turkish/Moroccan). CONCLUSION: There is a consistent female disadvantage in mental health across different sociodemographic groups and over decennia (1992 vs. 2002) with no specific risk groups.

Influence of geographic conditions on body length of male newborns in Kyrgyzstan.

Newborn length has been reported by many researchers to be reduced at high altitudes. However, many of these studies lacked adequate control of the ethnic group which may be confounding the altitude differences. In addition, few studies have examined the sources of variation in birth weight at high altitudes that may be related to ethnic group adaptation to the stresses of this hypoxic environment. In our study, we tested the hypotheses that the effect of altitude differences in newborn length depends on ethnic variation. Samples of 3359 healthy male newborns from different areas in Kyrgyzstan between the years 2003 and 2011 were analyzed for altitude and ethnic variation on male newborn length. Our results indicate significant decrease in male newborn length as a latitude increase. It is concluded that ethnic group difference in pregnancy outcome reflects a better state of adaptation to high altitude in this healthy indigenous population and that long-term genetic selection may be the most plausible explanation for these ethnic differences.

APPROACHES TO DEVELOPING AND IMPLEMENTING CLINICAL AND ORGANIZATIONAL REGULATIONS ENSURING INFECTIOUS SAFETY AND EPIDEMIOLOGICAL RESPONSE IN THE WORK PROCESS (THE CASE OF COVID-19).

OBJECTIVE: The aim: Of the work was to develop clinical and organizational regulations ensuring infectious safety and epidemiological response in the work process (the case of COVID-19) based on the current legislative acts of Ukraine to combat the spread of coronavirus disease (COVID-19), as well as on the data from international practices. PATIENTS AND METHODS: Materials and methods: The research objective was carried out in accordance with the Methodology for the development of medical and technological documents for the standardization of medical care. RESULTS: Results: The Protocol includes organizational elements to prevent the spread of coronavirus disease, such as "The development of general provisions on infectious safety and antiepidemic measures during the COVID-19 pandemic in the company's workplaces, taking into account the legislative acts of Ukraine and international practices", which include: the development of "Health Questionnaire" (epidemiological data questionnaire) for daily monitoring of the company employee health; the development of "Checklist for self-assessment of the workplace", "Checklist for self-assessment of the public space"; the development of "Analytical report on compliance with the infectious safety rules in the workplace and in the public space on the basis of self-assessment", thirteen Appendices. CONCLUSION: Conclusions: "The Protocol for infectious safety and antiepidemic measures in the work process" is a detailed instruction that provides a balance of compliance with medical standards and reasonable needs of employees and employers through the implementation of scientific evidence base in antiepidemic and infectious safety measures in the workplace.

MORPHOMETRIC FEATURES OF THE STRUCTURAL COMPONENTS OF THE HEMOMICROCIRCULATORY BED IN THE PERIVULNAR REGION OF THE CAECUM IN WOUND DEFECT SUTURED WITH POLYFILAMENT SUTURE MATERIAL.

OBJECTIVE: The aim: The study focuses on the morphometric features specification concerning the structural components of the hemomicrocirculatory bed of the perivulnar region of the cecum in rabbits when suturing a wound defect with synthetic polyfilament surgical suture Vicryl. PATIENTS AND METHODS: Materials and methods: The research was carried out on rabbits (n = 30: 5 animals made up the control group and 25 animals made up the experimental group) and included surgery based on the method of surgical intervention on the large intestine patented by the authors, which was performed in the conditions of the operating room at the Department of Clinical Anatomy and Operative Surgery. When determining the main morphometric parameters, we took biopsy specimens of the cecum and used paraffin and epoxy resin embedding considering the generally accepted methods. RESULTS: Results: The study determined that the implantation of Vicryl surgical suture material in the tissues of the cecum became a trigger for the formation of active inflammatory focus and occurrence of leukocyte infiltrate in the perivulnar region. CONCLUSION: Conclusions: Arterioles, as a resistive link, capillaries, as an exchange link and venules, as a capacitive link in the hemomicrocirculatory bed, actively participate in response to the inflammatory process and formation of a connective tissue scar. The process of structural organization of microvessels begins in the formed granulation tissue in the perivulnar region of the cecum starting from the 14th day of the experiment.

#Testathome: Implementing 2 Phases of a HIV Self-Testing Program Through Community-Based Organization Partnerships in New York City.

BACKGROUND: Access to human immnodeficiency virus (HIV) testing in New York City (NYC) has increased, but disparities in testing rates still exist among most communities impacted by HIV. HIV self-tests (HIVSTs) present an opportunity to address testing barriers, but HIV-affected communities experience difficulties accessing HIVSTs, including lack of awareness and cost. To support increased access to HIVSTs, the NYC Health Department launched a partnership with select organizations to pilot distribution of free HIVSTs in 2 phases among priority populations across NYC. METHODS: Organizations that were diverse in their missions, experiences, capacities and populations served were recruited through a formal application process. The program initially launched with 10 organization partners (phase 1); as the pilot continued, partners identified necessary revisions to the program and launched a second phase in year 2. Both phases included outreach to NYC priority populations, HIVST distribution/redemption, and a follow-up survey. RESULTS: From March 2017 to August 2019, organizations distributed 75 HIVSTs during phase 1 and 252 during phase 2. All intended priority populations were reached, notably, those who had never tested before: 35% in phase 1 and 12% in phase 2. Over half of the follow-up survey respondents reported testing sooner. Respondents reported liking the HIVST because it did not require a visit to a clinic (84%) and preferred an HIVST to testing in a clinic (92%). CONCLUSIONS: Through 2 phases of implementation, this innovative partnership was able to reach and offer HIVSTs to priority populations across NYC. This program supports the feasibility of distributing HIVSTs through close partnerships with diverse organizations.

An evaluation of SecondBite® 's FoodMate® , a nutrition education and skill-building program aimed at reducing food insecurity.

ISSUE ADDRESSED: Enhancing food skills and nutrition knowledge may help promote healthy eating among people who are food insecure. FoodMate® by SecondBite® , an 8-week nutrition education and food hamper program, focuses on developing food skills and independence among Australians at risk of/experiencing food insecurity. This study aimed to explore participants' perceptions of and experiences with FoodMate® over a long-term (up to 2 years) follow-up. METHODS: For evaluation purposes, SecondBite® previously collected data from participants prior to (T1) and following completion (T2) of FoodMate® . This paper reports results from semi-structured telephone interviews conducted in a follow-up study (2016/2017, T3) among 19 adults enrolled in FoodMate® programs delivered in Victoria and New South Wales within the previous two years. Data were analysed using inductive thematic analysis of responses to T3 open-ended questions, and descriptive analysis of closed-ended question responses (T1 vs T2 vs T3). RESULTS: Major qualitative themes included program enjoyment; perceived positive long-term program impact on participants' eating and related attitudes and skills; barriers to cooking; suggested program modifications; and impact on others. In descriptive quantitative analyses, participants' diet; confidence to cook using basic ingredients, follow simple recipes and try new foods; cooking and food-related skills; social engagement and life satisfaction all improved between T1 and T3. CONCLUSIONS: Overall, FoodMate® was well-received and associated with long-term positive changes in a range of outcomes. Wider implementation among vulnerable groups should be considered. SO WHAT?: Future health promotion initiatives could adopt FoodMate® to increase food skills and knowledge among adults experiencing food insecurity.

The association between sedentary behaviour and indicators of stress: a systematic review.

BACKGROUND: Emerging evidence shows sedentary behaviour may be associated with mental health outcomes. Yet, the strength of the evidence linking sedentary behaviour and stress is still unclear. This study aimed to synthesise evidence regarding associations between time spent in sedentary behaviour and stress in adults. METHODS: A systematic search was conducted (January 1990 - September 2019). Following PRISMA guidelines, an evaluation of methodological quality, and best-evidence synthesis of associations between time in sedentary behaviour (including sitting time, TV viewing, computer use) and stress were presented. Twenty-six studies reporting on data from n = 72,795 people (age 18-98y, 62.7% women) were included. RESULTS: Across the studies (n = 2 strong-, n = 10 moderate- and n = 14 weak-quality), there was insufficient evidence that overall time spent in sedentary behaviour and sitting time were associated with stress, particularly when using self-report measures of sedentary behaviour or stress. There was strong evidence of no association between TV viewing, or computer use and stress. Amongst studies using objective measures of sedentary behaviour and/or stress there was also strong evidence of no association. CONCLUSION: Although previous research suggested sedentary behaviour may be linked to mental health outcomes such as depression and anxiety, the evidence for an association between various types of sedentary behaviour and stress is limited in quality, and associations are either inconsistent or null. High-quality longitudinal/interventional research is required to confirm findings and determine the direction of associations between different contexts (i.e. purpose) and domains (i.e. leisure, occupational, transport) of sedentary behaviour and stress.

Prognostic model of skin cancer risk assessment.

OBJECTIVE: Introduction: Early detection of people at risk of skin cancer will reduce the incidence of disease, lower the cost of health technologies and decrease anxiety level in patients. The aim of the work is to create a prognostic model for identifying people at increased risk of skin cancer development. PATIENTS AND METHODS: Material and methods: We used the results of our previous research on identifying risk factors in patients with actinic keratosis (AK), squamous cell carcinoma in situ (SCCis) and cutaneous squamous cell carcinoma (cSCC), who were under dynamic observation at the State Institution of Science "Research and Practical Centre of Preventive and Clinical Medicine" State Administrative Department (hereinafter SIS) in 2014-2017. RESULTS: Results: The prognostic model is valid, AUC = 0.97 (95% CI 0.96 - 0.99) showing a significant association of the risk of skin cancer development with the following factors: patient's age, sunburns, using skin sunscreens, exposure to the sun in recent times, exposure to radiological materials, drug administration (antiarrhythmic drugs, antihypertensive medications, hormonal contraceptives, antibiotics), burdened family history (melanoma, squamous cell cancer). Model sensitivity was 95.1% (95% CI 91.6% - 97.4%), specificity - 88.5% (95% CI 84.6% - 91.8%). CONCLUSION: Conclusions: The developed and analysed mathematical risk prediction system made it possible to identify 11 factors which are significantly associated with risk of skin cancer development. The prognostic model might be offered for specialists in taking decision at the stage of primary and secondary prevention of skin cancer.

A qualitative study of the drivers of socioeconomic inequalities in men's eating behaviours.

BACKGROUND: Men of low socioeconomic position (SEP) are less likely than those of higher SEP to consume fruits and vegetables, and more likely to eat processed discretionary foods. Education level is a widely used marker of SEP. Few studies have explored determinants of socioeconomic inequalities in men's eating behaviours. The present study aimed to explore intrapersonal, social and environmental factors potentially contributing to educational inequalities in men's eating behaviour. METHODS: Thirty Australian men aged 18-60 years (15 each with tertiary or non-tertiary education) from two large metropolitan sites (Melbourne, Victoria; and Newcastle, New South Wales) participated in qualitative, semi-structured, one-on-one telephone interviews about their perceptions of influences on their and other men's eating behaviours. The social ecological model informed interview question development, and data were examined using abductive thematic analysis. RESULTS: Themes equally salient across tertiary and non-tertiary educated groups included attitudes about masculinity; nutrition knowledge and awareness; 'moralising' consumption of certain foods; the influence of children on eating; availability of healthy foods; convenience; and the interplay between cost, convenience, taste and healthfulness when choosing foods. More prominent influences among tertiary educated men included using advanced cooking skills but having relatively infrequent involvement in other food-related tasks; the influence of partner/spouse support on eating; access to healthy food; and cost. More predominant influences among non-tertiary educated men included having fewer cooking skills but frequent involvement in food-related tasks; identifying that 'no-one' influenced their diet; having mobile worksites; and adhering to food budgets. CONCLUSIONS: This study identified key similarities and differences in perceived influences on eating behaviours among men with lower and higher education levels. Further research is needed to determine the extent to which such influences explain socioeconomic variations in men's dietary intakes, and to identify feasible strategies that might support healthy eating among men in different socioeconomic groups.

Features of vascular dermatoscopic component in various morphological types of epidermal dysplasia.

OBJECTIVE: Introduction: Dermatologists of many foreign countries have been successfully using and developing dermatoscopy as a method of early diagnosis of skin tumors for three decades. It is believed that the vascular dermatoscopiccomponent is a promising criterion for the diagnosis of epidermal dysplasia of the skin and can be used for differential diagnosis. The aim of the work was to study the features of the vascular dermatoscopic component in actinic keratosis (AK), non-invasive (squamous cell carcinoma in situ-SCCis) and invasive forms of squamous cell carcinoma (cSCC). PATIENTS AND METHODS: Material and methods: 68 dermatological images were studied, including 33 cases of AK, 22 cases of SCCis and 13 cases of cSCC of different localization. Pathology of the skin is confirmed by pathologic studies in 100% of cases. The dermatoscopic examination was performed by the Heine Delta 20 dermatoscope. The evaluation of the vascular component was performed using the DermaVisionPro software. RESULTS: Results: In the analysis of dermatoscopic signs, the following vascular components were revealed: red pseudo-net (64.7%), strawberry pattern (36.8%), dotted vessels (26.5%), linear vessels (11.8%), polymorphic vessels (16.2%), blood vessels of the type of glomeruli (11.8%) and red globules (5.9%). The morphological type of dysplasia AK correlated with red pseudo-network (r =0.99) and strawberry pattern (r =0.92). The SCCis correlated with blood vessels of the type of glomeruli (r =0.82) and dotted vessels (r =0.75), the cSCC correlated with polymorphic (r =0.91) and linear (r =0.68) vessels. CONCLUSION: Conclusions: The study confirms the existing opinion on the possible effective use of the vascular dermatoscopic component as a differential diagnostic criterion for non-invasive diagnosis of epidermal dysplasia of the skin. Typical combinations of vascular dermatoscopic components for morphological types of epidermal dysplasia - AK I-III, SCCis and cSCC were determined.

Can an incentive-based intervention increase physical activity and reduce sitting among adults? the ACHIEVE (Active Choices IncEntiVE) feasibility study.

BACKGROUND: Despite recent interest in the potential of incentivisation as a strategy for motivating healthier behaviors, little remains known about the effectiveness of incentives in promoting physical activity and reducing sedentary behavior, and improving associated health outcomes. This pre-post-test design study investigated the feasibility, appeal and effects of providing non-financial incentives for promoting increased physical activity, reduced sedentary time, and reduced body mass index (BMI) and blood pressure among inactive middle-aged adults. METHODS: Inactive men (n = 36) and women (n = 46) aged 40-65 years were recruited via a not-for-profit insurance fund and participated in a 4 month pre-post design intervention. Baseline and post-intervention data were collected on self-reported physical activity and sitting time (IPAQ-Long), BMI and blood pressure. Participants were encouraged to increase physical activity to 150 mins/week and reduce sedentary behavior by 150 mins/week in progressive increments. Incentives included clothing, recipe books, store gift vouchers, and a chance to win one of four Apple iPad Mini devices. The incentive component of the intervention was supported by an initial motivational interview and text messaging to encourage participants and provide strategies to increase physical activity and reduce sedentary behaviors. RESULTS: Only two participants withdrew during the program, demonstrating the feasibility of recruiting and retaining inactive middle-aged participants. While two-thirds of the sample qualified for the easiest physical activity incentive (by demonstrating 100 mins physical activity/week or 100 mins reduced sitting time/week), only one third qualified for the most challenging incentive. Goals to reduce sitting appeared more challenging, with 43% of participants qualifying for the first incentive, but only 20% for the last incentive. More men than women qualified for most incentives. Mean leisure-time physical activity increased by 252 mins/week (leisure-time), with 65% of the sample achieving at least 150 mins/week; and sitting time decreased by 3.1 h/day (both p < 0.001) between baseline and follow-up. BMI, systolic and diastolic (men only) blood pressure all significantly decreased. Most participants (50-85%) reported finding the incentives and other program components helpful/motivating. CONCLUSIONS: Acknowledging the uncontrolled design, the large pre-post changes in behavioral and health-related outcomes suggest that the ACHIEVE incentives-based behavior change program represents a promising approach for promoting physical activity and reducing sitting, and should be tested in a randomized controlled trial. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry IDACTRN12616000158460 , registered 10/2/16.

Studying risk factors for skin cancer development.

INTRODUCTION: In most countries with a population of mainly European origin, non-melanoma skin carcinoma incidence rate has increased over the last decade. Understanding of what is the best way to identify people at high risk for skin cancer development will help to optimize the strategy for prevention and treatment tactics. Aim of the research involves studying risk factors for skin cancer development in patients with cutaneous squamous cell carcinoma and squamous cell carcinoma in situ (cSCC and SCCis correspondingly) and patients with actinic keratosis (AK). MATERIALS AND METHODS: we conducted a survey of patients with cSCC, SCCis and AK who had been under case follow-up at the State Scientific Institution "Scientific and Practical Centre of Preventive and Clinical Medicine" of the State Administration (hereinafter SIS) during 2014-2016.Clinical diagnosis in 100% of cases was confirmed by pathomorphological study. Statistical processing of the obtained data was performed using STATISTICA 7.0 programme. RESULTS: The questionnaire involved 129 patients, including 21(16.3%) patient with cSCC, 40 (31%) patients with SCCis, 57 (44.2%) patients with AK and 11 (8.5%) patients who had mentioned above combined pathology i.e. cSCC, SCCis and АК at the same time. Only two studied risk factors for skin cancer development were found to have influence on the skin pathology: "Not using sun-protection preparation for the skin" and "Burdened family history of thefirst level of relationship". CONCLUSIONS: In forming the risk groups for skin cancer development it is advisable to consider burdened family history and using sun-protection preparation for the skin.

Cutaneous squamous cell carcinoma: epidemiological aspects among the population of Ukraine.

INTRODUCTION: In the structure of malignant skin neoplasms, the tumours of epithelial origin take the first place, among them the prevalence of cutaneous squamous cell carcinoma (cSCC) is about 20%. The aim of the work involves the analysis of cSCC epidemiological features among the contingent of the State Scientific Institution "Scientific and Practical Centre of Preventive and Clinical Medicine" of the State Administration (SIS) over 2005-2014 (Ukraine, Kyiv). MATERIAL AND METHODS: For retrospective epidemiological analysis there was used identifying information of patients with cSCC of the contingent of SIS over 2005-2014 in comparison with the data on patients with cSCC of Kyiv city and Kyiv region over the same period of time. RESULTS: The morbidity rate of cSCC among the contingent of SIS in 2005-2014 increased from 6.7 per 100,000people to 37.1 per 100,000 people. Among men it increased from 8.2 per 100,000 people to 59.2 per 100,000 people, and among women - from 6.6 per 100,000 people to 19.2 per 100,000people. Among the contingent of SIS the highest incidence both in men and women was observed in the age group of 85 and upwards; among men it was 115.2 per 100,000 people, and among women - 112.0 per 100,000 people. CONCLUSIONS: The morbidity rate of cSCC among the contingent of SIS in 2005-2014 was significantly higher (p<0.05) than the morbidity rate among the population of Kyiv city and Kyiv region over the same period of time, with the prevalence of patients aged 85 and upwards, both men and women.