Unmasking caries risk: a multi-regional study in Saudi Arabia.

BACKGROUND: Dental caries are common and troublesome and may affect individuals' health conditions. It is crucial to comprehend the caries experience for prevention, management, and enhancing oral health. Techniques such as CAMBRA can help assess an individual's risk factors for caries lesions. This study aims to assess the caries risk in five distinct regions of Saudi Arabia, utilizing the CAMBRA methodology. METHODS: This multiregional cross-sectional study was conducted at university dental clinics across the five regions of Saudi Arabia, using a Caries Management by Risk Assessment (CAMBRA) tool. This study used binary logistic regression analysis, the Pearson Chi-square test, and descriptive analysis as statistical methods. RESULTS: A total of 551 respondents participated in the study, with 59.7% being male and 40.3% being female. The age group with the highest proportion was 20-29, making up 31.6% of the participants. All participants exhibited at least one caries lesion (100%), with white spots (66.4%) and enamel lesions (56.1%) being the most prevalent. The moderate-risk category encompassed the largest proportion of participants, accounting for 60% of the total. High caries risk had a significant association with age group (P < 0.001), education (P < 0.001), profession (P < 0.001), and socio-economic status (P < 0.001). Furthermore, only age and socio-economic status showed a significant relationship with high caries risk in the multiple logistic regression. CONCLUSION: The CAMBRA tool indicates a high prevalence of moderate risk across the five regions of Saudi Arabia, identifying age and socio-economic status as significant predictors of caries risk.

Exploring the impact of maternal marital status on child health: insights from the 2022 Tanzanian Demographic and Health Survey.

The SDG 2.2 targets the end of all forms of malnutrition by 2030. Despite the efforts by the Tanzania government to attain this goal, over 30 percent of children under-five are stunted. This study explored the relationship between maternal marital status and child health outcomes in Tanzania using the Tanzania Demographic and Health Survey data set of 2022. A multiple logistic regression was conducted with the binary outcome variable "Stunted," using predictors such as the mother's age and education level, the child's birth size, birth order, and gender, as well as other household characteristics. The study findings highlight a significant association between maternal marital status and child stuntedness. The mothers in a marriage relationship are 30% less likely to have stunted children (OR=0.70, 95%CI, 0.56-0.86) compared to the mothers outside the marriage relationship. Mothers with primary and secondary education or higher, show a lower likelihood of having stunted children (OR=0.90, 95%CI 0.70-1.17) and (OR=0.68, 95%CI 0.44- 1.03) respectively compared to their uneducated counterparts. In other words, a mother being married or educated reduces the odds of her children being stunted. The probability of child stuntedness reduces as the wealth quintile of the household increases. This study contributes to the understanding of the factors influencing child health outcomes in Tanzania especially the role of marriage.

L'ODD 2.2 vise à mettre fin à toutes les formes de malnutrition d'ici 2030. Malgré les efforts du gouvernement tanzanien pour atteindre cet objectif, plus de 30 % des enfants de moins de cinq ans sont atteints de retard de croissance. Cette étude explore la relation entre le statut matrimonial des mères et les résultats de santé des enfants en Tanzanie en utilisant l'ensemble de données de l'Enquête Démographique et de Santé de Tanzanie de 2022. Une régression logistique multiple a été réalisée avec la variable de résultat binaire "retard de croissance", en utilisant des prédicteurs tels que l'âge et le niveau d'éducation de la mère, la taille à la naissance de l'enfant, l'ordre de naissance, le sexe, ainsi que d'autres caractéristiques du ménage. Les résultats de l'étude mettent en lumière une association significative entre le statut matrimonial des mères et le retard de croissance des enfants. Les mères mariées sont 30 % moins susceptibles d'avoir des enfants atteints de retard de croissance (OR = 0,70, IC à 95 %, 0,56-0,86) par rapport aux mères vivant hors d'une relation matrimoniale. Les mères ayant suivi des études primaires et secondaires ou supérieures présentent une probabilité moindre d'avoir des enfants atteints de retard de croissance (OR = 0,90, IC à 95 %, 0,70-1,17) et (OR = 0,68, IC à 95 %, 0,44-1,03) respectivement, par rapport à leurs homologues non éduquées. En d'autres termes, le fait que la mère soit mariée ou éduquée réduit les chances que ses enfants soient atteints de retard de croissance. La probabilité de retard de croissance infantile diminue à mesure que le quintile de richesse du ménage augmente. Cette étude contribue à la compréhension des facteurs influençant les résultats de santé des enfants en Tanzanie, en particulier le rôle du mariage.

Understanding healthy ageing in India: insights from multivariate regression trees.

BACKGROUND: Population ageing represents a significant global challenge, particularly pronounced in countries like India. AIMS: This study aims to explore how factors such as socio-economic status, behaviour, and health influence healthy ageing across the Indian older population. METHODS: In this study, we utilized the Longitudinal Ageing Study in India - wave 1 dataset for analysis purposes. Scores were generated for five dimensions of healthy aging, including physical, functional, mental, cognitive, and social aspects and these scores were treated as the target variables. Multivariate Regression Trees analysis was employed to identify the behavioural and socio-demographic factors associated with each dimension of healthy ageing. RESULTS: Years of education emerge as crucial across all dimensions, positively impacting cognitive health and mitigating age-related decline in healthy ageing. Marital status, engagement in household activities, spiritual practices, and living arrangements impacts the scores of different aspects of healthy ageing. Gender disparities in healthy aging are noticeable in the 60-74 age group, with women generally having lower scores. Safety of the living environment is a crucial determinant of the mental health of the elderly across all age groups.These findings highlight the complex interplay of factors in healthy ageing outcomes. CONCLUSION: Our study emphasizes the pivotal role of education in fostering healthy ageing in India. Factors such as environmental safety and social participation also influence well-being. Targeted interventions addressing education, gender equality, safety, and healthcare access are vital for enhancing the ageing experience and overall well-being of older adults.

Public perception and acceptance of coypu Myocastor coypus removal in urban areas: influences of age and education.

Monitoring and management of alien coypu (Myocastor coypus) is a key issue in Europe since this species has been included in the EU Invasive Alien Species Regulation 1143/2014. Thus, controlling the population of this rodent is considered as imperative by wildlife managers. Coypu management in urban areas is crucial considering potential conflicts with human activities. The aim of this study is to investigate citizens' knowledge, perceptions and opinions towards the presence and management of coypu in a case study in Central Italy (the Serravalle urban park, Tuscany). The survey was administered to a subset of municipal residents and garnered responses from 281 park visitors. The outcomes showed a high level of knowledge of respondents: 99.3% of total respondents had heard of coypu before this survey, and 93.9% were able to distinguish the coypu from the Eurasian beaver (Castor fiber). Despite the importance of coypu control in invaded countries, our results highlight that most respondents are against the removal of coypu, with the exception of most young, highly-educated and upperclass men, but favouring sterilization over capture and population control. Findings of this study could assist managers in enhancing the efficacy of management efforts via an information initiative involving the general public. Achieving this goal may entail improved communication by wildlife managers, which is imperative for optimizing management strategies regarding alien species.

Health literacy and its associated factors among the population in two schistosomiasis-endemic villages in Jiangxi Province, China.

This cross-sectional study aimed to assess the levels of health literacy and the associated factors among the general population living in 2 schistosomiasis-endemic villages in Jiangxi Province, China. Multistage stratified random sampling was used to select participants, and a face-to-face survey was conducted from July to August 2021 to collect participants' socio-demographic characteristics and levels of overall health literacy (HL) and its 3 subscales: health literacy of basic knowledge and concepts (HL-BKC), health literacy of behavior and lifestyle (HL-BAL), and health literacy of health-related skills (HL-HRS). The Chi-square test and logistic regression models were used to assess the association between socio-demographic characteristics and low HL levels. The prevalence rates of low overall HL, HL-BKC, HL-BAL, and HL-HRS were 84.3%, 61.8%, 82.6%, and 86%, respectively. In addition, no significant differences (P > .05) were noted between the 2 villages regarding overall HL scores and the 3 subscales of health literacy scores. Older age (P < .001), occupation (P < .001), lower educational level (P < .001), and lower annual household income (P < .05) were associated with an increased risk of low HL. Multivariate logistic regression revealed that occupation as a student (OR = 32.289, 95% CI:1.965-530.462, P < .05) and fishermen (OR = 27.902, 95%CI:1.91-407.642, P < .05), lower education level (OR = 0.384, 95%CI:0.149-0.99, P < .05), older age (OR = 5.228, 95%CI:1.458-18.75, P < .001), and lower annual household income (OR = 0.452, 95%CI:0.24-0.851, P < .05) were independently associated with low HL. The prevalence of low HL is high among the population in the schistosomiasis-endemic villages of Jiangxi Province, China. Age, education level, occupation, and annual household income were all independent factors associated with HL levels. Health educational interventions to improve HL should be simultaneously conducted in health promotion work to reduce risky habits.

Total life expectancy and disability-free life expectancy and differences attributable to cigarettes' smoking among Chinese middle-aged and older adults.

OBJECTIVES: Middle-aged and older adults smoking for years are afflicted by smoking-related diseases and functional limitations; however, little is known about the effect of smoking on nonfatal conditions in middle and later life. This study aims to investigate the impact of smoking on both total life expectancy (TLE) and disability-free life expectancy (DFLE) and the variations in such effects by educational level in China. METHODS: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), 2011-2018, with a total sample of 16,859 individuals aged 45 years or older involved in the final analysis. The Activities of Daily Living (ADL) scale was used to measure disability, and the population-based multistate life table method was used to estimate the differences in TLE and DFLE by smoking status and educational attainment. RESULTS: At baseline, 28.9% of participants were current smokers, 8.5% were former smokers, and 62.6% never smoked. Approximately 5.6% were identified with ADL disability. Both current smokers and former smokers experienced lower TLE and DFLE than never smokers, and such differences were particularly prominent among men. Intriguingly, former smokers manifested a lower DFLE for both sexes and a lower TLE among women, though a longer TLE among men, compared with current smokers. Similar differences in TLE and DFLE by smoking status were observed for groups with different levels of education. CONCLUSION: Never smokers live longer and healthier than current smokers and persons who quit smoking. Smoking was associated with greater reductions in TLE and DFLE among men. However, educational attainment might not moderate the adverse effect of smoking on both fatal and nonfatal conditions in the context of China. These findings have implications for disability prevention, aged care provision and informing policies of healthy aging for China and elsewhere.

Edentulism and quality of life in the Salvadoran population: a cross-sectional study.

INTRODUCTION: Edentulism is the partial or total loss of teeth, it is irreversible and disabling due to its sequelae in the masticatory, phonetic and aesthetic function that affect the quality of life. OBJECTIVE: To establish the impact of edentulism and sociodemographic factors on the quality of life of the Salvadoran population. MATERIALS AND METHODS: Secondary cross-sectional analysis of data in 3322 users of the Public Health System of El Salvador, aged 15 to > 60 years. The variables under study were sociodemographic, edentulismo and quality of life. Edentulism was determined by clinical examination using the Oral Impact on Daily Performance scale. The statistical analysis was performed using χ2, OR, multiple regression analysis and set the significance threshold at p < 0.05. RESULTS: Partial edentulism in the upper jaw was present in 68.24% people, partial edentulism in the lower jaw was present in 72.42% people and complete edentulism was observed in 2.02% people. There were significant sex differences and a relationship between sex and quality of life (p < 0.004); the self-perception of severe/very severe impacts was greater in women. People without education or with primary or secondary education only were the most affected (p < 0.05). Tooth loss increases with age, affecting quality of life in a severe/very severe manner. Complete edentulism had greater impacts on quality of life in terms of eating (25.64%), speaking (21.15%), and socializing/enjoying contact with people (10.90%). A severe/very severe impact on quality of life of teeth lost was reported mainly by those over 60 years of age, with an average of 11 missing posterior teeth, 6 missing anterior teeth and 13 missing teeth per patient. Those missing up to 6 anterior teeth were times more likely to perceive severe/very severe impacts on quality of life than those without any missing teeth (OR:5.788). Edentulism affected the quality of life of those examined, especially the loss of upper anterior teeth.

Where have I got to? Associations of age at marriage with marital household assets in educated and uneducated women in lowland Nepal.

Background: Women's underage marriage (<18 years) is associated with adverse maternal and child health outcomes. Poverty in the natal household has been widely considered to be a key risk factor for underage marriage, but the evidence base is unreliable. When investigating this issue, most studies use marital wealth inappropriately, as a proxy for wealth in the natal household. In contrast, we investigated whether the timing of women's marriage was associated with the wealth of the households they marry into, and how this may vary by women's education level. This approach allows us to explore a different set of research questions which help to understand the economic value placed on the timing of women's marriage. Methods: We used data on 3,102 women aged 12-34 years, surveyed within 1 year of marriage, from the cluster-randomized Low Birth Weight South Asia Trial in lowland rural Nepal. Linear mixed-effects regression models investigated independent associations of women's marriage age and education level with marital household wealth, and their interactive effects. Models adjusted for marital household traits. We analysed the full sample, and then only the uneducated women, who comprised a substantial proportion in our sample. Results: In the full sample, we found that each later year of women's marriage was associated with 1.5% lower asset score for those with primary education, and with 0.3% and 1.3% higher asset score for those with lower secondary or secondary/higher education, respectively. For uneducated women, relative to marrying ≤14 years, marrying at 15, 16, 17 and ≥18 years was associated with 1.5%, 4.4%, 2.4% and 6.2% greater marital asset score respectively. Conclusion: On average, marrying ≥18 years was associated with greater marital assets for secondary-educated women. There were only very modest benefits in terms of marital household wealth for delaying marriage beyond 16 years for uneducated women or those with low education. These findings elucidate potential trade-offs faced by families, including decisions over how much education, if any, to provide to daughters. They may help to understand the economic rationale underpinning the timing of marriage, and why early marriage remains common despite efforts to delay it.

Caesarean section and associated factors in Nigeria: assessing inequalities between rural and urban areas-insights from the Nigeria Demographic and Health Survey 2018.

INTRODUCTION: When medically indicated, caesarean section (CS) can be a life-saving intervention for mothers and their newborns. This study assesses the prevalence of CS and its associated factors, focussing on inequalities between rural and urban areas in Nigeria. METHODS: We disaggregated the Nigeria Demographic and Health Survey 2018 and performed analyses separately for Nigeria's overall, rural, and urban residences. We summarised data using frequency tabulations and identified factors associated with CS through multivariable logistic regression analysis. RESULTS: CS prevalence was 2.7% in Nigeria (overall), 5.2% in urban and 1.2% in rural areas. The North-West region had the lowest prevalence of 0.7%, 1.5% and 0.4% for the overall, urban and rural areas, respectively. Mothers with higher education demonstrated a greater CS prevalence of 14.0% overall, 15.3% in urban and 9.7% in rural residences. Frequent internet use increased CS prevalence nationally (14.3%) and in urban (15.1%) and rural (10.1%) residences. The southern regions showed higher CS prevalence, with the South-West leading overall (7.0%) and in rural areas (3.3%), and the South-South highest in urban areas (8.5%). Across all residences, rich wealth index, maternal age ≥ 35, lower birth order, and ≥ eight antenatal (ANC) contacts increased the odds of a CS. In rural Nigeria, husbands' education, spouses' joint healthcare decisions, birth size, and unplanned pregnancy increased CS odds. In urban Nigeria, multiple births, Christianity, frequent internet use, and ease of getting permission to visit healthcare facilities were associated with higher likelihood of CS. CONCLUSION: CS utilisation remains low in Nigeria and varies across rural-urban, regional, and socioeconomic divides. Targeted interventions are imperative for uneducated and socioeconomically disadvantaged mothers across all regions, as well as for mothers in urban areas who adhere to Islam, traditional, or 'other' religions. Comprehensive intervention measures should prioritise educational opportunities and resources, especially for rural areas, awareness campaigns on the benefits of medically indicated CS, and engagement with community and religious leaders to promote acceptance using culturally and religiously sensitive approaches. Other practical strategies include promoting optimal ANC contacts, expanding internet access and digital literacy, especially for rural women (e.g., through community Wi-Fi programs), improving healthcare infrastructure and accessibility in regions with low CS prevalence, particularly in the North-West, and implementing socioeconomic empowerment programs, especially for women in rural areas.

Grandparents' educational attainment is associated with grandchildren's epigenetic-based age acceleration in the National Growth and Health Study.

We examined three generations (grandparents, mothers, and grandchildren) to assess the association between grandparents' educational attainment and their grandchildren's epigenetic-based age acceleration and whether the association was mediated by parental educational attainment and mothers' life course health-related factors. Mothers were recruited to the NHLBI Growth and Health Study at 9-10 years and followed for 10 years (1987-1998). Mothers were then re-contacted three decades later (ages 37-42) to participate in the National Growth and Health Study (NGHS), and health information from their youngest child (i.e., grandchildren; N = 241, ages 2-17) was collected, including their saliva samples to calculate epigenetic age. Five epigenetic-based age acceleration measures were included in this analysis, including four epigenetic clock age accelerations (Horvath, Hannum, GrimAge, and PhenoAge) and DunedinPACE. Grandparents reported their highest education during the initial enrollment interviews. Parental educational attainment and mothers' life course health-related factors (childhood BMI trajectories, adult cardiovascular health behavioral risk score, and adult c-reactive protein) are included as mediators. Grandparents' education was significantly associated with Horvath age acceleration (b = -0.32, SE = 0.14, p = 0.021). Grandchildren with college-degree grandparents showed significantly slower Horvath age accelerations than those without college degrees. This association was partially mediated by parental education and mothers' health-related factors, especially adult cardiovascular health behavioral risk score and CRP, but not mothers' childhood BMI trajectory. This ability to conserve the speed of biological aging may have considerable consequences in shaping health trajectories across the lifespan.

A person-reported cumulative social risk measure does not show bias by income and education.

BACKGROUND: Social risk such as housing instability, trouble affording medical care and food insecurity are a downstream effect of social determinants of health (SDOHs) and are frequently associated with worse health. SDOHs include experiences of racism, sexism and other discrimination as well as differences in income and education. The collective effects of each social risk a person reports are called cumulative social risk. Cumulative social risk has traditionally been measured through counts or sum scores that treat each social risk as equivalent. We have proposed to use item response theory (IRT) as an alternative measure of person-reported cumulative social risk as IRT accounts for the severity in each risk and allows for more efficient screening with computerized adaptive testing. METHODS: We conducted a differential item functioning (DIF) analysis comparing IRT-based person-reported cumulative social risk scores by income and education in a population-based sample (n = 2122). Six social risk items were analyzed using the two-parameter logistic model and graded response model. RESULTS: Analyses showed no DIF on an IRT-based cumulative social risk score by education level for the six items examined. Statistically significant DIF was found on three items by income level but the ultimate effect on the scores was negligible. CONCLUSIONS: Results suggest an IRT-based cumulative social risk score is not biased by education and income level and can be used for comparisons between groups. An IRT-based cumulative social risk score will be useful for combining datasets to examine policy factors affecting social risk and for more efficient screening of patients for social risk using computerized adaptive testing.

Is educational attainment associated with the onset and outcomes of low back pain? a systematic review and meta-analysis.

BACKGROUND: Low back pain (LBP) is the leading global cause of years lived with disability. Of the biopsychosocial domains of health, social determinants of LBP remain under-researched. Socioeconomic status (SES) may be associated with the onset of new LBP or outcomes of acute LBP, with educational attainment (EA) being a key component of SES. The association between EA and LBP has yet to be the subject of a dedicated review and meta-analysis. PURPOSE: To review evidence of the association between EA and a) onset or b) outcomes of acute and subacute LBP in the adult general population and to conduct statistical pooling of data where possible. METHODS: An electronic search was conducted in MEDLINE, Embase, CINAHL, and ProQuest from inception to 2nd November 2023 including reference lists to identify relevant prospective studies. Risk of bias (RoB) was assessed using the Quality in Prognostic Studies (QUIPS) tool. Where adequate data were available, estimates were pooled using a random-effects meta-analysis. Overall evidence for each outcome was graded using an adapted GRADE. RESULTS: After screening 8498 studies, 29 were included in the review. Study confounding and attrition were common biases. Data from 19 studies were statistically pooled to explore EA as a predictor of new LBP onset or as prognostic for outcomes of acute or subacute LBP. Pooled results showed no association between EA and the onset of new LBP (OR: 0.927, 95%CI: 0.747 to 1.150; I2 = 0%). For predicting outcomes of acute LBP, compared to those with no more than secondary-level education, post-secondary education or higher was associated with better outcomes of pain (OR: 0.538, 95%CI: 0.432 to 0.671; I2 = 35%) or disability (OR: 0.565, 95%CI: 0.420 to 0.759; I2 = 44%). High heterogeneity (I2>80%) prevented meaningful pooling of estimates for subacute LBP outcomes. CONCLUSION: We found no consistent evidence that lower EA increases the risk of LBP onset. Lower EA shows a consistent association with worse LBP outcomes measured at least 3 months later after acute onset with inconclusive findings in subacute LBP. Causation cannot be supported owing to study designs. High-quality research is needed on potential mechanisms to explain these effects.

Rising premature menopause and variations by education level in India.

The proportion of women experiencing premature menopause is on the rise in India, particularly in the age groups of 30-39 years. Consequently, there is a need to understand the factors influencing the prevalence of premature menopausal status among women. Our study uses the data from 180,743 women gathered during the latest Indian version of the Demography Health Survey (National Family Health Survey-5). Our results suggest that close to 5% of women in rural areas and 3% of women in urban areas experience premature menopause, and this figure varies across Indian States. The regression results show that surgical menopause, lower levels of education, poorer wealth index, rural residence, female sterilization, and insurance coverage are key drivers of premature menopause. One of the striking factors is that the prevalence of premature menopause among those with the lowest levels of education (6.85%) is around seven times higher than those with the highest level of education (0.94%). We conducted a decomposition analysis to delve into the factors contributing to this inequality. The results show that undergoing a hysterectomy (surgical menopause) account for 73% of the gap in premature menopausal rates between women with the lowest and highest levels of education. This indicates that women with poor education are more likely to undergo hysterectomy at a younger age. This finding warrants further exploration as we would expect that women from lower socio-economic background would have limited access to surgical care, however, our results suggest otherwise. This perhaps indicates a lack of awareness, lack of alternative treatment options, and over-reliance on surgical care while neglecting conservative management. Our results have implications for addressing the diverse needs of the increasing number of women in their post-menopause phase and for focusing on conservative treatment options for these women.

The effect of socio-economic status on children's dental health.

The aim of the present study was to record the oral health status of children from different socioeconomic backgrounds and correlate these findings with parent-associated factors. It comprised a cross-sectional study of healthy children, aged 6-12 years, attending either the Reception and Solidarity Center of the Municipality of Athens or the Postgraduate Paediatric Dentistry Department (NKUA) for dental care. Data regarding the demographics of both parents-guardians, as well as the children, and oral hygiene and dietary habits were collected through a structured questionnaire. This was followed by a thorough clinical examination evaluating oral hygiene status, gingival inflammation and caries experience. Analysis was based on the socioeconomic status (SES) of the parents which was according to the family income. Families with a monthly income of <1400 euros were considered as being of a low SES and families with incomes of >1400 euros as medium. Data were presented in frequency tables and significance of calculated differences was tested using chi-square and Fisher's exact tests. Multivariate regression analysis was used to detect possible risk factors for development of poor dental health. The sample consisted of 216 children (146 from a low and 70 from a medium SES) with a mean chronological age of 9.19 years. Parents from low SES were younger, of lower education, had lived abroad most of their lives and were unemployed or worked in the private sector. Children from low SES backgrounds reported infrequent dental visits, consumed more meals and had more sugary snacks. This was reflected in their worse dental health with significantly higher values for oral hygiene and caries indices. Despite the above differences, none of the parent-associated factors were significantly correlated to worse dental health. In conclusion, SES of parents is reflected in the oral health of children, although it is not a significant predictor of dental health.

Analysis of the current situation and demand for perinatal education in pregnant women in general grade A tertiary hospitals in China: a cross-sectional survey.

OBJECTIVES: This study aimed to assess the factors influencing pregnant women's participation in perinatal education and their demand for educational courses. DESIGN: A cross-sectional study. SETTING: Tertiary hospital in Suzhou, China, July-September 2022. PARTICIPANTS: Pregnant women from a general grade A tertiary hospital in Suzhou were recruited via online survey invitations during the specified period. MEASURES: A self-designed scale was used to evaluate pregnant women's demand for perinatal education. Multiple response sets were employed for the assessment of multiple-choice items and analyses included frequency and cross-tabulation. Logistic regression analysis was conducted to assess the factors influencing pregnant women's participation in perinatal education. OUTCOME: The primary outcome measured was the demand for perinatal education among pregnant women. RESULTS: A majority (53.8%) of pregnant women expressed a preference for a mixed teaching mode combining online and offline formats. Logistic regression analysis showed that education level significantly influenced pregnant women's participation in online learning. Specifically, women with higher education levels were more likely to participate actively in online courses. Additionally, compared with those with first-born children, pregnant women with second-born children participated less actively in online learning. Pregnant women in their second and third trimesters showed greater engagement in online learning compared with those in their first trimester. CONCLUSIONS: These findings indicate that Chinese pregnant women's preferences for perinatal education are influenced by their educational background, pregnancy history and the mode of teaching employed. The variability in educational needs underscores the importance of regularly updating course content based on participant feedback.

Exploring the state and influential factors of dental caries in preschool children aged 3-6 years in Xingtai City.

OBJECTIVE: To explore the main factors affecting early dental caries among preschool children aged 3-6 years in Xingtai City to formulate effective preventive measures. METHODS: A cross-sectional study was conducted on 570 preschool children aged 3-6 years in Xingtai City through questionnaire surveys and oral examinations to understand their dental caries situation. Multifactorial logistic regression analysis was used to analyse the main influencing factors for the occurrence of dental caries in preschool children. RESULTS: Univariate analysis showed statistically significant differences in age (χ2 = 2.636, p = 0.008), father's education level (χ2 = 4.207, p < 0.001), mother's education level (χ2 = 4.217, p < 0.001), daily tooth brushing frequency (χ2 = 3.160, p = 0.002), age of starting tooth brushing (χ2 = 8.756, p < 0.001), mouth rinsing after meals (χ2 = 89.401, p < 0.001), Streptococcus mutans positivity (χ2 = 133.503, p < 0.001), non-sweet snack consumption frequency (χ2 = 5.962, p < 0.001), snack flavour preference (χ2 = 116.119, p < 0.001), use of fluoridated toothpaste (χ2 = 75.639, p < 0.001), regular oral examinations (χ2 = 98.711, p < 0.001), sugary drink consumption frequency (χ2 = 10.370, p < 0.001) and sweet food consumption frequency (χ2 = 9.261, p < 0.001) between the caries and non-caries groups. Multifactorial analysis revealed that older age (odds ratio [OR] = 5.342, 95% confidence interval [CI]: 1.434-6.631), later initiation of tooth brushing (OR = 3.244, 95% CI: 2.413-5.424), S. mutans positivity (OR = 5.357, 95% CI: 4.529-8.563), high snack consumption frequency (OR = 3.452, 95% CI: 2.634-5.442), high sugary drink consumption frequency (OR = 4.414, 95% CI: 2.534-6.451) and high sweet food consumption frequency (OR = 4.531, 95% CI: 3.421-6.354) were risk factors for dental caries. Higher father's educational level (OR = 0.724, 95% CI: 0.564-0.891), higher mother's educational level (OR = 0.641, 95% CI: 0.601-0.813), high daily tooth brushing frequency (OR = 0.572, 95% CI: 0.423-0.864), mouth rinsing after meals (OR = 0.743, 95% CI: 0.643-0.813), use of fluoridated toothpaste (OR = 0.657, 95% CI: 0.553-0.931) and regular oral examinations (OR = 0.443, 95% CI: 0.352-0.747) were protective factors against dental caries (all p < 0.05). CONCLUSION: Multiple factors result in early dental caries in preschool children aged 3-6 years; however, the most influential factors are older age and high snack consumption, as well as high sugary and sweet food/drink consumption.

Factors related to early weaning in babies born at term in a public maternity. / Fatores relacionados ao desmame precoce em bebês nascidos a termo em uma maternidade pública.

PURPOSE: to analyze how socioeconomic, pregnancy and childbirth factors relate to the feeding situation in the sixth month of life of full-term babies. METHODS: longitudinal observational study, with 98 mothers of full-term babies. Data collection was structured by capturing information regarding the clinical history and moment of birth in the babies' medical records, followed by the application of two questionnaires to the postpartum women, with questions regarding sociodemographic data, pre- and post-pregnancy data and the baby's nutrition. baby, the first being answered during hospital stay and the second, by telephone, in the 6th month of life. A descriptive analysis of the data was performed, using the frequency distribution of categorical variables, inferential analysis using Pearson's Chi-square test and multivariate analysis using binary logistic regression, adopting, for inclusion in the final model, the significance level of 5%. RESULTS: there was an association between exclusive breastfeeding in the 6th month and maternal education and between the period of food introduction and family income. Mothers with higher education were 4.82 times more likely to breastfeed their children exclusively until the sixth month. Families with lower income (up to one minimum wage) were 2.54 times more likely to start food introduction before the sixth month than families with higher income. CONCLUSION: higher maternal education was a predictive factor for exclusive breastfeeding at the 6th month and higher military income was a predictive factor for introducing food after the 6th month.

OBJETIVO: analisar como os fatores socioeconômicos, da gestação e do parto se relacionam com a situação da alimentação no sexto mês de vida de bebês nascidos a termo. MÉTODO: estudo observacional longitudinal, com 98 mães de bebês termos. A coleta de dados foi estruturada pela captação das informações referentes à história clínica e ao momento do parto nos prontuários dos bebês, seguida da aplicação de dois questionários, com questões referentes a dados sociodemográficos, dados pré e pós-gestacionais e da alimentação do bebê, sendo o primeiro respondido durante a internação hospitalar e o segundo, por contato telefônico, no 6° mês de vida. Foi realizada análise descritiva dos dados, por meio da distribuição de frequência das variáveis categóricas, análise inferencial utilizando o teste Qui-quadrado de Pearson e análise multivariada por regressão logística binária, adotando-se, para inclusão no modelo final, o nível de significância de 5%. RESULTADOS: houve associação entre aleitamento materno exclusivo no 6º mês e escolaridade materna e entre o início da introdução alimentar e a renda familiar. Mães com ensino superior apresentaram 4,82 vezes mais chances de amamentarem os filhos de forma exclusiva até o sexto mês. Famílias de menor renda (até um salário mínimo) tiveram 2,54 vezes mais chances de iniciarem a introdução alimentar antes do sexto mês do que as famílias de maior renda. CONCLUSÃO: maior escolaridade materna foi fator preditor para o aleitamento materno exclusivo ao 6º mês e maior renda familiar foi fator preditor para introdução alimentar após o 6º mês.

Risk factors for breast cancer among women in Freetown, Sierra Leone, 2017: a case-control study.

Introduction: breast cancer is the most commonly diagnosed malignancy and an important cause of cancer death among females worldwide. The disease accounted for 25% (1.67 million) of new cancer cases and the fifth cause of cancer deaths. Incidence of all types of cancers is approximately 25% in Sierra Leone. However, there was no documented evidence on risk factors for breast cancer among women in the country. The main aim of this study was to assess risk factors associated with breast cancer among women screened for breast cancer in Freetown Sierra Leone. Methods: we conducted a case-control study on breast cancer involving 116 confirmed breast cancer cases and 116 controls. Questionnaire was designed to collect data on socio-demographic, reproductive and behavioral risk factors. Analysis was carried using logistic regression to assess the associations between breast cancer and the risk factors. Results: in the final multiple logistic regression, had formal educational level, (aOR 0.1, 0.03-0.26, p= 0.001) physical activity for more than 30 minutes per week (aOR 0.5 (0.9- 0.7, p=0.001). Cigarette smoking (aOR 4.8, 1.2-18.5, p=0.023) and family history of breast cancer (aOR 9.9 cigarette smoking (OR 4.4, 1.2-18.5, p=0.023) and family history of breast cancer (OR 9.9, 2.7-36.45, p=0.040) were identified as the main risk factors for breast cancer. This study did not find any statistically significant associations between reproductive risk factors and breast cancer. Conclusion: risk factors for breast cancer among women in Sierra Leone include educational level, physical activity, cigarette smoking and family history of breast cancer. We recommended screening program for women above 40 years and had history of breast cancer. Also, to establish breast cancer registry.

Prevalence of Dental Erosive Wear and Possible Risk Factors among Adolescents and Adults in Poland - A National Survey.

PURPOSE: To investigate the prevalence and severity of erosive tooth wear (ETW) and evaluate the determinants of ETW among adolescents and adults in Poland. MATERIALS AND METHODS: The study covered three age groups of patients: 15 years old, 18 years old, and adults aged 35-44 years. Calibrated examiners measured ETW according to the Basic Erosive Wear Examination (BEWE) scoring system in 6091 patients. The clinical examination of patients was preceded by a socio-medical study based on a questionnaire consisting of items identifying potential risk factors for ETW. RESULTS: In all age groups, erosive lesions were most common in the form of initial enamel damage; more advanced lesions (BEWE 2 and 3) were rarely observed among 15-year-olds, while in the group of older adolescents and adults, the percentages were 13% and 20%, respectively. Acidic diet, gender, level of education, and medical conditions were statistically significantly associated with ETW in the examined population. The analysis showed that, depending on age, multiple and statistically significant risk factors for ETW become most apparent in the 35-44 age group, especially with regard to general health. This suggests that the long-term impact of factors and their cumulative effects are critical to the development of ETW. CONCLUSIONS: This is the first large, representative study of ETW in Central and Eastern Europe among adolescents and adults, which indicates the relatively rare occurrence and severity of erosive lesions. The present findings support other longitudinal studies supporting the use of the BEWE system as a valuable standard for assessing erosive lesions and related risk factors among different populations at different ages.