ABSTRACT
Hypertension is a very common comorbidity in type 2 diabetes patients, which leads to important health and treatment challenges. The present study was conducted with the aim of determining the prevalence of hypertension and its risk factors in type 2 diabetes patients. This study was conducted using cross-sectional data from 1245 participants aged between 35 and 70 years and diagnosed with type 2 diabetes at baseline in the Fasa cohort study. The prevalence hypertension was determined and multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between various risk factors and hypertension prevalence. The average age of the participants was 53.5 ± 8.7 years and 71.7% (n = 893) were female and 28.3% (n = 352) were male. The prevalence of hypertension in people with type 2 diabetes was 45.5% (n = 566). Higher age (AOR, 95% CI: 8.1, 4.6-14.3), female gender (OR, 95% CI: 1.8, 1.2-2.5), Fars (AOR, 95% CI: 1.6, 1.1-2.4) and Turk (AOR, 95% CI: 1.6, 1.1-2.5) vs. other ethnicity, and overweight (AOR, 95% CI: 1.8, 1.38-2.38) and obesity (AOR, 95% CI: 2.7, 2.0-3.8) vs. BMI < 25 was associated with a higher prevalence of hypertension, while higher physical activity (AOR, 95% CI: 0.57, 0.42-0.78) was associated with lower prevalence of hypertension in the multivariable model. The prevalence of hypertension in persons with type 2 diabetes was high and increased with greater age, in some ethnic groups, and with higher BMI and low physical activity. Further prospective studies are needed to investigate these associations in this population.
Subject(s)
Diabetes Mellitus, Type 2 , Hypertension , Life Style , Humans , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/complications , Male , Female , Middle Aged , Hypertension/epidemiology , Hypertension/complications , Aged , Adult , Prevalence , Risk Factors , Cross-Sectional Studies , Socioeconomic Factors , Cohort StudiesABSTRACT
Introduction: Loneliness and cognitive decline are pressing concerns among older adults, yet little research has explored cognition as a predictor of loneliness. This study investigates the dynamic relationship between loneliness and cognitive function in older adults using the random intercept cross-lagged panel model (RI-CLPM). Methods: Data were drawn from Waves 9-14 of the Health and Retirement Study (HRS), encompassing 8,473 individuals aged 65 years and older. Loneliness was assessed using the UCLA Loneliness Scale, and cognitive function was measured using immediate and delayed word recall and serial 7s from the HRS RAND file. Age, gender, education, marital status, self-health report, and depression were included as covariates. Using Mplus, we computed RI-CLPMs. The first three models were conducted on loneliness and cognitive functions. Then unconditional RI-CLPMs with no exogenous predictors were computed. Results: Three conditional model results showed that age, gender, marital status, self-health report, and depression were significantly associated with loneliness in the first wave, but only age and self-health report were significantly associated with immediate and delayed word recall at the first wave, not with serial 7s. For carry-over effects, loneliness showed significant positive associations across consecutive waves, but cognitive functions showed significant positive associations just in the last two waves. Some spill-over effects were found between loneliness and cognitive functions. For within-person effects, although initially non-significant, a negative association between loneliness and immediate and delayed word recall emerged in later waves (11-12 and 13-14). The conditional models indicated that older age, not being married, male gender, low self-reported health, and high depression levels were positively associated with loneliness. However, only older age and lower self-reported health were positively linked to cognitive functions. Discussion: This study underscores the link between loneliness and cognitive function decline in older adults, emphasizing the need to address loneliness to potentially reduce cognitive decline. Insights into demographic predictors of loneliness and cognitive function could inform targeted interventions for promoting successful aging.
Subject(s)
Cognition , Loneliness , Humans , Loneliness/psychology , Male , Female , Aged , Aged, 80 and over , Depression/psychology , Depression/epidemiology , Cognitive Dysfunction/psychology , Longitudinal StudiesABSTRACT
Reports of excess mortality during the COVID-19 pandemic in Argentina have been partial and fragmented so far. This study aimed to quantify excess deaths and explore their demographic, temporal, and geographic distribution during the period 2020-2022. Using data from 1 192 963 death records from vital statistics and population projections, expected mortality was estimated using regression models. Excess death was calculated as the difference between observed and expected mortality. An excess of 160 676 deaths (95% CI 146 861 to 174 491) was estimated, representing a rate of 116.9 (95% CI 115.5 to 118.3) additional deaths per 100 000 personyears. Significant heterogeneity was found among the different argentine provinces. The results indicate an uneven impact of the pandemic, with higher excess mortality rates in some regions and more vulnerable age groups. These patterns suggest the need for differentiated strategies of healthcare response and support to the most vulnerable populations in scenarios of new epidemics.
Los reportes del exceso de mortalidad durante la pandemia por COVID-19 en Argentina han sido parciales y fragmentados hasta el momento. Este estudio se propuso cuantificar el exceso de muertes y explorar su distribución demográfica, temporal y geográfica durante el periodo 2020-2022. Utilizando datos de 1 192 963 registros de muertes de estadísticas vitales y proyecciones poblacionales, se estimó la mortalidad esperada mediante modelos de regresión. El exceso de muertes se calculó como la diferencia entre la mortalidad observada y la esperada. Se estimó un exceso de 160 676 muertes (IC 95% 146 861 a 174 491), representando una tasa de 116.9 muertes (IC 95% 115.5 a 118.3) adicionales por cada 100 000 personas-año. Se verificó una significativa heterogeneidad entre las distintas provincias argentinas. Los resultados indican un impacto desigual de la pandemia, con mayores tasas de exceso de mortalidad en algunas regiones y grupos de edad más vulnerables. Estos patrones sugieren la necesidad de estrategias diferenciadas de respuesta sanitaria y apoyo a las poblaciones más vulnerables en escenarios de nuevas epidemias.
Subject(s)
COVID-19 , Pandemics , Argentina/epidemiology , COVID-19/mortality , COVID-19/epidemiology , Humans , Middle Aged , Male , Female , Adult , Aged , Adolescent , Young Adult , Mortality/trends , Infant , Child , Aged, 80 and over , SARS-CoV-2 , Child, Preschool , Infant, Newborn , Cause of DeathABSTRACT
Background: Vitamin A supplementation every 4-6 months is an economical, rapid, and effective strategy to enhance vitamin A status and minimize child morbidity and mortality due to vitamin A deficiency in the long run. Therefore, this study was aimed at investigating the level as well as the factors influencing VAS status among children aged 6-59 months in Tanzania. Methods: This analysis relied on data from the 2022 Tanzania Demographic and Health Survey (TDHS). The study used a weighted sample of 9,382 children aged 6-59 months. Given the effect of clustering and the binary character of the outcome variable, we employed a multilevel binary logistic regression model. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to determine statistical significance, considering the model with the lowest deviation that best fits the data. Results: In this study, vitamin A supplementation among children aged 6-59 months was found to be 53.18% [95% CI: 52.17, 54.19]. Mother's/caregiver's working status; Working [AOR = 1.59, 95% CI: 1.34, 1.89], ANC follow-up [AOR = 1.71, 95%CI: 1.34, 2.2], and health facility delivery [AOR = 1.55, 95%CI: 1.25, 1.91] were individual-level factors associated with vitamin A supplementation. Whereas administrative zones of Western [AOR = 2.02, 95% CI: 1.16, 3.52], Southern highlands [AOR = 3.83, 95% CI: 2.02, 7.24], Southern administrative zone [AOR = 2.69, 95% CI: 1.37, 5.3], and South West highlands [AOR = 0.56, 95% CI: 0.33, 0.95] were community-level factors associated with vitamin A supplementation. Conclusion: The proportion of VAS among children in Tanzania is low compared to UNICEF's target of 80. Mother's/caregiver's working status, antenatal care, place of delivery, community-level media exposure, and administrative zones were significantly associated factors with vitamin A supplementation. Therefore, interventions should be designed to improve the uptake of VAS. Provision and promotion of ANC and institutional delivery and strengthening of routine supplementation are recommended to increase coverage of childhood vitamin A supplementation. Moreover, special focus should be given to regions in the south-western highlands.
ABSTRACT
The residential sector in Ethiopia heavily relies on biomass for cooking, using inefficient cookstoves. In order to assess energy policies and decision-making for better economic development, it is essential to have final energy consumption by end-use. However, there is a lack of readily accessible data on residential energy end-use. Our study fills this gap by using data collected from surveys of 590 urban households in Ethiopia, estimating their energy end-use consumption, and analyzing their determinants. The annual final energy consumption per household is about 7.2 MWh, where 90 % is for cooking, baking, tea/coffee boiling end-uses, and only 2.3 % for lighting. The analysis reveals that income has the strongest effect on energy consumption for Injera baking and on miscellaneous end-uses, both directly and partly indirectly as a mediating variable. The study highlights the importance of end-use consumption data to plan energy efficiency, mix technology options, and make suitable policy interventions.
ABSTRACT
The article presents a comparative analysis of the process of population aging in the context of demographic and professional risks of depopulation among working population in Russia. The values of the main medical and demographic indicators of population aging for Russia and developed countries were given. The results of UN forecasts, probabilistic forecasts of the total number and some characteristics of the age-sex structure for the population of the Russian Federation were analyzed. The state of demographic disadvantage in Russia and in the world was convincingly shown. Particular attention was paid to the consideration of the demographic risks of a reduction in the working-age population and an increase in the burden on the working-age population. The need for further research on the use of geroprotectors and modern gerontotechnologies as means and methods for preventing premature decline in work ability, slowing down the aging process of workers, reducing the mortality rate among working population and increasing professional longevity has been proven.
Subject(s)
Population Dynamics , Humans , Russia/epidemiology , Population Dynamics/trends , Population Dynamics/statistics & numerical data , Male , Female , Life Expectancy/trends , Aged , Middle Aged , Mortality/trends , Aging/physiologyABSTRACT
AIMS: This study aims to investigate the factors associated with sexual initiation among male vocational high school students (MVHSS) in Zhejiang Province, and provide a scientific basis for preventing unsafe sexual behavior and sexual health issues among adolescents. BACKGROUND: The prevalence of sexual behavior among young students has risen significantly in recent years. Contracting HIV poses a serious physical and psychological burden on young individuals and their families. Thus, it is imperative to promptly and effectively address the spread of HIV among young people. OBJECTIVE: The objectives of this study are to investigate the demographic characteristics of male vocational high school students (MVHSS) who have engaged in sexual activity and to identify associated factors, such as sexual attitudes and lifestyle, that may influence sexual initiation among this population, and to offer recommendations for interventions and policy development aimed at promoting healthy sexual behaviors among MVHSS. METHODS: A survey was conducted among vocational high school students in grades one and two in Zhejiang Province. Variables that were statistically significantly associated with sexual initiation in bivariate analyses were included in a multivariate logistic regression model, which adopted a backward elimination procedure with a p-value > 0.10 as the exclusion criterion. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to describe the relationship between dependent and outcome variables. RESULTS: Of the 1032 male participants, 17.4% had initiated sexual behavior. The multivariate analysis results indicated thatThose who were frequent smokers (adjusted OR[AOR] =4.89, 95% CI: 2.36-10.13), those who reported having been in love (AOR=2.86, 95% CI: 1.84-4.44), those currently in love (AOR=4.47, 95% CI: 2.68-7.45), those willing to have sex with a high school student (AOR =2.63, 95% CI: 3.31-6.50), those willing to pay for sex (AOR =1.90, 95% CI: 1.10-3.27), and those who had received sex education and STDs/AIDS prevention education in school (AOR =2.21, 95% CI: 1.53-3.18) were more likely to initiate sexual behavior. CONCLUSION: Sexual attitudes among MVHSS are liberal, and the prevalence of sexual initiation is high. Interventions targeted at improving sexual safety education, reducing the rate of early initiation of sexual behavior, and promoting condom use among students must be implemented to reduce the risk of HIV infections and STDs among sexually active MVHSS.
ABSTRACT
Background In the era of rapid digital advancement, the confidentiality and privacy of digital health and medical data have become paramount concerns. This study investigates the perspectives of individuals residing in Hail City regarding these critical issues, with a particular emphasis on the influence of demographic factors such as age, gender, and computer proficiency on individuals' discomfort with health professionals using computers and their trust in researchers. Gaining a deeper understanding of these factors is vital for the development of targeted interventions aimed at enhancing patient comfort and trust in digital health/medical technologies. Methodology This study employed a descriptive cross-sectional design, involving a survey of 775 individuals aged 18 and above in Hail City. The questionnaire was designed to gather information on participants' demographic characteristics, computer proficiency, experiences with digital health and medical information, and perceptions of health information safety and privacy. To examine the associations and predictive relationships between variables, chi-square tests, correlation analyses, and logistic regression were performed. Results Significant associations were found between gender and discomfort with health professionals using computers (chi-square = 60.29, p < 0.0001), and between age and trust in researchers regarding the privacy of medical information (chi-square = 50.14, p < 0.0001). Positive correlations were observed between computer proficiency and perception of health information safety (r = 0.12, p = 0.0002), while a negative correlation was found between computer ownership and avoidance of medical tests due to privacy concerns (r = -0.08, p = 0.03). Logistic regression analysis identified age, gender, and computer proficiency as significant predictors of discomfort with health professionals using computers. The findings highlight the crucial role that demographic factors play in shaping attitudes toward the privacy and security of digital health and medical information. Conclusions The findings of this study highlight the crucial role that demographic factors play in shaping attitudes toward the privacy and security of digital health and medical information. Gender and age were found to significantly influence individuals' levels of discomfort and trust, while computer proficiency was shown to enhance perceptions of safety. Based on these findings, the researchers recommend implementing targeted interventions, such as gender-sensitive training programs and initiatives, to enhance digital literacy and improve patient comfort and trust in digital health technologies.
ABSTRACT
Recent evidence challenges the belief that Duffy-negative individuals are resistant to Plasmodium vivax due to lacking Duffy Antigen Receptor for Chemokines (DARC). Erythrocyte Binding Protein (EBP/DBP2) has shown moderate binding to Duffy-negative erythrocytes in vitro. Reticulocyte Binding Protein 2b (RBP2b) interactions with Transferrin Receptor 1 (TfR1) suggest involvement in Duffy-negative infections. Gene copy number variations (CNVs) in PvDBP1, PvEBP/DBP2, and PvRBP2b were investigated in Duffy-positive and Duffy-negative P. vivax-infected individuals from Ethiopia. Among Duffy-positive samples, 34% displayed PvDBP1 duplications (Cambodian-type). In Duffy-negative infections, 30% showed duplications, mostly Cambodian-type. For PvEBP/DBP2 and PvRBP2b, Duffy-positive samples exhibited higher duplication rates (1-8 copies for PvEBP/DBP2, 1-5 copies for PvRBP2b 46% and 43% respectively) compared to Duffy-negatives (20.8% and 26% respectively). The range of CNVs was lower in Duffy-negative infections. Demographic and clinical factors associated with gene multiplications in both Duffy types were explored, enhancing understanding of P. vivax evolution in Duffy-negative Africans.
ABSTRACT
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.
Subject(s)
Breast Neoplasms , Humans , Sierra Leone/epidemiology , Female , Case-Control Studies , Risk Factors , Breast Neoplasms/epidemiology , Middle Aged , Adult , Surveys and Questionnaires , Exercise , Educational Status , Smoking/epidemiology , Aged , Logistic Models , Young AdultABSTRACT
Objectives: To characterize the epidemiology of simultaneous traumatic brain injury (TBI) and ocular trauma. Materials and Methods: In this retrospective, observational study, de-identified data from patients admitted with ocular trauma and TBI was extracted from the National Trauma Data Bank (2008-2014) using International Classification of Diseases 9th Revision, Clinical Modification diagnostic codes and E-codes relating to injury circumstances. Mechanisms, types of ocular and head injuries, intention, and demographic distribution were determined. Association of variables was calculated with Student's t and chi-squared tests and logistic regression analysis. Results: Of 316,485 patients admitted with ocular trauma, 184,124 (58.2%) also had TBI. The mean (standard deviation [SD]) age was 41.8 (23) years. Most were males (69.8%). Race/ethnicity distribution was 68.5% white, 13.3% black, and 11.4% Hispanic patients. The mean (SD) Glasgow Coma Score (GCS) was 12.4 (4.4) and Injury Severity Score (ISS) was 17 (10.6). Frequent injuries were orbital fractures (49.3%) and eye/adnexa contusions (38.3%). Common mechanisms were falls (27.7%) and motor vehicle-occupant (22.6%). Firearm-related trauma (5.2%) had the greatest odds of very severe injury (ISS >24) (odds ratio [OR]: 4.29; p<0.001) and severe TBI (GCS <8) (OR: 5.38; p<0.001). Assault injuries were associated with the greatest odds of mild TBI (OR: 1.36; p<0.001) and self-inflicted injuries with severe TBI (OR: 8.06; p<0.001). Eye/adnexal contusions were most associated with mild TBI (OR: 1.25; p<0.001). Optic nerve/visual pathway injuries had greater odds of severe TBI (OR: 2.91; p<0.001) and mortality (OR: 2.27; p<0.001) than other injuries. Of associated head injuries, the odds of severe TBI were greatest with skull base fractures (OR: 4.07; p<0.001) and mortality with intracerebral hemorrhages (OR: 4.28; p<0.001). Mortality occurred in 5.9% of patients. Conclusion: TBI occurred in nearly two-thirds of ocular trauma admissions. The mortality rate was low with implications for challenging rehabilitation and long-term disability in survivors.
ABSTRACT
BACKGROUND: Silkie is a traditional Chinese chicken breed characterized by its unique combination of specialized morphological traits. While previous studies have focused on the genetic basis of these traits, the overall genomic characteristics of the Silkie breed remain largely unexplored. In this study, we employed whole genome resequencing data to examine the genetic diversity, selective signals and demographic history of the Silkie breed through comparative analyses with seven other Chinese indigenous breeds (IDGBs), a commercial breed, and the wild ancestor Red Jungle Fowl. RESULTS: In total, 20.8 million high-quality single nucleotide polymorphisms and 86 large structural variations were obtained. We discovered that Silkie exhibits a relatively high level of inbreeding and is genetically distinct from other IDGBs. Furthermore, our analysis indicated that Silkie has experienced a stronger historical population bottleneck and has a smaller effective population size compared with other IDGBs. We identified 45 putatively selected genes that are enriched in the melanogenesis pathway, which probably is related to the feather color. Among these genes, LMBR1 and PDSS2 have been previously associated with the extra toe and the hookless feathers, respectively. Six of the selected genes (KITLG, GSK3B, SOBP, CTBP1, ELMO2, SNRPN) are known to be associated with neurodevelopment and mental diseases in human, and are possibly related to the distinct behavior of Silkie. We further identified structural variants in Silkie and found previously reported variants linked to hyperpigmentation (END3), muff and beard (HOXB8), and Rose-comb phenotype (MNR2). Additionally, we found a 0.61 Mb inversion overlapping with the GMDS gene, which was previously linked to neurodevelopmental defects in zebrafish and humans. This may also be related to the behavior distinctiveness of Silkie. CONCLUSIONS: Our study revealed that Silkie is genetically distinct and relatively highly inbred compared to other IDGB chicken populations, possibly attributed to more prolong population bottlenecks and selective breeding practice. These results enhance our understanding of how domestication and selective breeding have shaped the genome of Silkie. These findings contribute to the broader field of domestication and avian genomics, and have implications for the future conservation and breeding efforts.
Subject(s)
Chickens , Genetic Variation , Polymorphism, Single Nucleotide , Animals , Chickens/genetics , Selection, Genetic , Whole Genome Sequencing , Breeding , Genetics, Population , Genomics/methodsABSTRACT
This study aimed to analyze factors associated with obstetric fistula care-seeking behavior in Guinea, based on data from the 2018 Demographic and Health Survey. Women aged 15-49 years who reported having obstetric fistula constituted the study population, statistical analysis was using Stata 16.0 software. Multivariate logistic regression was used to identify the factors associated with fistula care-seeking behavior. Among women with obstetric fistula, 78.9% sought care; 21.1% of those who sought care underwent repair. Factors associated with care-seeking behavior were being divorced (AOR =8.08; 95% CI:1.56-41.84), having a job (AOR =3.23; 95% CI: 1.11-9.44), being a member of a poor household (AOR =6.49; 95% CI:1.21-34.82) and whose fistula had appeared 6 days or more after the occurrence of the causal circumstance (AOR =3.63 95% CI: 1.28-10.28). This study suggests that the foundations on which fistula prevention and treatment programs are built should be reviewed, taking into account the factors highlighted by this study.
Cette étude visait à analyser les facteurs associés aux comportements de recherche de soins pour la fistule obstétricale en Guinée, partant des données de l'enquête démographique et de santé de 2018. Les femmes âgées de 15 à 49 ans ayant déclaré avoir une fistule obstétricale ont constitué la population d'étude, l'analyse statistique a été réalisée à l'aide du logiciel Stata 16.0. La régression logistique multivariée a été utilisée pour identifier les facteurs associés aux comportements de recherche de soins pour la fistule. Parmi les femmes atteintes de fistule obstétricale, 78,9 % ont eu recours à des soins ; 21,1 % de celles qui ont recouru ont subi une réparation. Les facteurs associés aux comportements de recherche de soins étaient le fait d'être divorcée (ORA=8.08 ; 95% IC :1.56-41.84), d'avoir un travail (ORA =3.23 ; 95% IC : 1.11-9.44), d'être membre d'un ménage pauvre (ORA =6.49 ; 95% IC :1.21-34.82) et dont la fistule était apparue 6 jours ou plus après la survenue de la circonstance causale (ORA =3.63 95% IC : 1.28-10.28). Cette étude suggère de revoir les bases sur lesquelles les programmes de prévention et de traitement de la fistule sont construits, tout en prenant en compte les facteurs mis en évidence par cette étude.
Subject(s)
Obstetric Labor Complications , Patient Acceptance of Health Care , Humans , Female , Adult , Adolescent , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Guinea/epidemiology , Young Adult , Pregnancy , Obstetric Labor Complications/epidemiology , Health Surveys , Vesicovaginal Fistula/epidemiology , Socioeconomic Factors , Vaginal Fistula/epidemiologyABSTRACT
Background: Although the prevalence of childhood illnesses has significantly decreased, acute respiratory infections continue to be the leading cause of death and disease among children in low- and middle-income countries. Seven percent of children under five experienced symptoms in the two weeks preceding the Ethiopian demographic and health survey. Hence, this study aimed to identify interpretable predicting factors of acute respiratory infection disease among under-five children in Ethiopia using machine learning analysis techniques. Methods: Secondary data analysis was performed using 2016 Ethiopian demographic and health survey data. Data were extracted using STATA and imported into Jupyter Notebook for further analysis. The presence of acute respiratory infection in a child under the age of 5 was the outcome variable, categorized as yes and no. Five ensemble boosting machine learning algorithms such as adaptive boosting (AdaBoost), extreme gradient boosting (XGBoost), Gradient Boost, CatBoost, and light gradient-boosting machine (LightGBM) were employed on a total sample of 10,641 children under the age of 5. The Shapley additive explanations technique was used to identify the important features and effects of each feature driving the prediction. Results: The XGBoost model achieved an accuracy of 79.3%, an F1 score of 78.4%, a recall of 78.3%, a precision of 81.7%, and a receiver operating curve area under the curve of 86.1% after model optimization. Child age (month), history of diarrhea, number of living children, duration of breastfeeding, and mother's occupation were the top predicting factors of acute respiratory infection among children under the age of 5 in Ethiopia. Conclusion: The XGBoost classifier was the best predictive model with improved performance, and predicting factors of acute respiratory infection were identified with the help of the Shapely additive explanation. The findings of this study can help policymakers and stakeholders understand the decision-making process for acute respiratory infection prevention among under-five children in Ethiopia.
ABSTRACT
BACKGROUND: Working mothers are in a situation where they have to manage both their job and maternal roles simultaneously. We aim to show the relationship between mothers' breastfeeding behavior and working status, as well as the effect of their working conditions on the continuation of breastfeeding. METHODS: This study examined 3557 (weighted 3490) child-mother pairs from Turkey's Demographic Health Survey data in 2008, 2013, and 2018 with a complex sample multiple logistic regression analysis to explore the relationship between breastfeeding and maternal employment. RESULTS: In our study, 35.5% of the mothers had never worked, 18.6% were still working, and 45.9% had worked in the past but were not currently working. When breastfeeding percentages were examined based on maternal working status, mothers who worked in 2008 had significantly lower breastfeeding percentages than those who had never worked or had worked previously but not currently. In both 2013 and 2018, after legal regulations, maternal employment didn't affect breastfeeding. After adjusting for confounding factors, maternal employment in the industry sector had lower breastfeeding percentages [AOR:0.06 (95% CI: 0.01-0.48)] than those working in agriculture. CONCLUSION: It seems that adhering to legal regulations such as paid maternity leave and lactation leave can promote breastfeeding. It is necessary to raise awareness of mothers working in the industry about the continuation of breastfeeding and to monitor their legal rights.
Subject(s)
Breast Feeding , Employment , Women, Working , Breast Feeding/statistics & numerical data , Humans , Female , Adult , Employment/statistics & numerical data , Turkey , Mothers , Young Adult , Infant, NewbornABSTRACT
OBJECTIVE: Analyzing the variations in induced abortion (IA) rates across different subpopulations in Spain based on country of origin, while considering educational and age composition. METHOD: Using 2021 Voluntary Termination of Pregnancy register and 2021 Spanish Census microdata, we calculated crude IA rates and age-specific abortion rates. We used age-standardized IA rates (ASIAR) to account for the confounding effect of age composition. We compared seven subpopulations residing in Spain, taking into account simple ages and educational levels aggregated into four categories. RESULTS: Immigrant women, especially those from Sub-Saharan and Latin American countries, consistently had higher IA rates compared to native Spanish women. According to age-specific IA rates, university-educated women had considerably fewer abortions than women with other education levels at any age. Age-standardized rates stratified by migratory origin revealed that native Spanish women with primary education or less had higher IA rates than their immigrant counterparts. There was a clear non-linear, association between educational level and IA rates among immigrants. The highest propensity for IA was found among secondary school graduates, while university graduates had the lowest IA rate. CONCLUSIONS: The study demonstrated that variability in sociodemographic characteristics had an impact on IA rates. Young women with middle educational attainment and immigrant background had a higher likelihood of undergoing IA in Spain. The relationship between educational level and IA rates was complex, with variations observed among different groups and changes over time.
ABSTRACT
Japan's unique demographic trajectory, marked by population decline and aging, coupled with continued urbanization, presents distinct challenges for aligning built environment capacity with resource efficiency. This study aims to investigate the historical evolution and project future scenarios of building material stock (MS) and their spatial distribution across Japan's three major metropolitan areas. Through a comprehensive material flow and stock analysis, the historical accumulation of building materials from 2009 to 2020 was quantified, revealing a dominance of concrete and an increasing overall stock. The contributions of various driving factors to changes in construction areas were explored, identifying population dynamics as the predominant influence. Leveraging shared socioeconomic pathway scenarios (SSPs), this research forecasted building floor area and MS until 2050 under five distinct SSPs. The results indicated an overall reduction across all scenarios, yet with a continued concentration in high-density urban cores. The substantial gap between the highest and lowest projected MS scenarios highlighted opportunities for material conservation and emission reductions through sustainable practices. Sustainable urban development in densely populated regions necessitates a balance between infrastructure provision and environmental conservation, while in sparsely populated areas, the focus shifts to the efficient management and utilization of vacant properties and materials to cope with the impacts of significant population declines. By offering insights into the building floor area and MS implications of Japan's demographic changes, this study underscores the necessity of sustainable urban planning and resource management strategies to navigate the challenges posed by demographic shifts, ultimately contributing to sustainable development and environmental conservation goals.
ABSTRACT
The ability of Geographic Information System (GIS) to organize, analyze, visualize and integrate spatial data has been at the top of its primary uses among professional industries. However, considering the extensive adoption of Information System (IS) throughout history for government organizations' or citizens' disaster response, the implementation of geographical elements is still minimal. Previous GIS models and framework studies, particularly in developing countries, were affected by pandemic pressure, competitiveness pressure, change management, and security factors. Thus, this study aims to develop a model for the successful adoption of GIS using the Technology Acceptance Model (TAM), and De Lone and Mc Lean Information Success Model and analyze the applicability of the existing factors to enhance the performance of Public Sector Organizations (PSOs). From the study, a new conceptual framework was proposed to examine the effects of factors on GIS adoption that impact performance among PSOs from the perspective of Saudi Arabia. Quantitative methods were used to collect data through a questionnaire distributed to 350 respondents from PSO, and only 272 were found to be valid. Partial Least Square Structural Equation Modeling (PLS-SEM) validated the GIS model. The finding revealed that system quality, service quality, change management, competitiveness pressure, perceived ease of use, perceived usefulness, and security factors significantly and positively affected GIS adoption. The study also showed that GIS adoption substantially affected PSO performance. The proposed model provides insight into how GIS adoption can eventually enhance performance among PSOs. In essence, the study contributes to the running of PSO and the decisions taken by policymakers.
ABSTRACT
Objective: To elucidate the historical trends, underlying causes and future projections of esophageal cancer incidence in Hong Kong. Methods: Utilizing the Age-Period-Cohort (APC) model, we analyzed data from the Hong Kong Cancer Registry (1992-2021) and United Nations World Population Prospects 2022 Revision. Age-standardized incidence rates were computed, and APC models evaluated age, period, and cohort effects. Bayesian APC modeling, coupled with decomposition analysis, projected future trends and identified factors influencing incidence. Results: Between 1992 and 2021, both crude and age-standardized incidence rates of esophageal cancer witnessed significant declines. Net drifts exhibited pronounced downward trends for both sexes, with local drift diminishing across all age groups. Period and cohort rate ratios displayed a consistent monotonic decline for both sexes. Projections indicate a continued decline in esophageal cancer incidence. Population decomposition analysis revealed that epidemiological changes offset the increase in esophageal cancer cases due to population growth and aging. Conclusion: The declining trend of esophageal cancer in Hong Kong is influenced by a combination of age, period, and cohort. Sustaining and enhancing these positive trends requires continuous efforts in public health interventions.
Subject(s)
Esophageal Neoplasms , Registries , Humans , Esophageal Neoplasms/epidemiology , Hong Kong/epidemiology , Male , Female , Incidence , Middle Aged , Aged , Adult , Aged, 80 and over , Age Factors , Bayes Theorem , Age Distribution , Cohort Studies , Young AdultABSTRACT
Introduction: Non-suicidal self-injury (NSSI) is a prevalent concern among adolescents with depression, yet its relationship with demographic characteristics and physiological indicators remains underexplored. This study aimed to investigate these relationships among inpatient adolescents aged 13 to 18 at a hospital affiliated with Guizhou Medical University. Methods: A cross-sectional study was conducted involving 222 adolescent inpatients diagnosed with depression. Data on NSSI occurrence, demographic variables (gender, only-child status, age), and physiological indicators (ALT, TSH, FT4, PLR, TG, HDLC, LDLC, FT3, NLR, MLR) were collected and analyzed. Statistical analyses, including correlations and group comparisons, were performed to assess the associations between NSSI and these factors. Results: The prevalence of NSSI among the participants was 40.5%. Significant correlations were found between NSSI and several demographic and physiological factors. Specifically, NSSI was significantly associated with female gender, non-only-child status, younger age, lower ALT levels, higher TSH levels, lower FT4 levels, and higher PLR values. However, no significant differences were observed in TG, HDLC, LDLC, FT3, NLR, or MLR between the NSSI and non-NSSI groups. Discussion: The findings highlight distinct demographic and physiological profiles associated with NSSI among adolescents with depression. The prevalence rate of NSSI underscores its significance as a behavioral manifestation in this population. Further research should explore the underlying mechanisms linking these factors to better inform targeted interventions and treatment strategies for adolescents experiencing NSSI in the context of depression.