Predictors of adherence with home quarantine during COVID-19 crisis: the case of health belief model.

Although Jordan has applied lockdown in response to COVID-19 pandemic, many people were not adherent to the quarantine. We aimed to examine the attitudes of the Jordanians and how these attitudes can predict their adherence using the health belief model (HBM). A cross-sectional study of 5057 participants using an internet-based questionnaire was conducted during lockdown. Multivariable ordinal regression analyses were used to estimate predictors of adherence to home quarantine. Overall, 646 (12.8%), 2078 (41.2%), and 2317 (46%) of participants showed poor, intermediate, and strict adherence, respectively. Of the HBM constructs, seriousness (ß= 0.116, 95% CI 0.027 to 0.205), benefits (ß= 0.056, 95% CI 0.002 to 0.110) and barriers (ß= -0.025, 95% CI -0.035 to -0.015) were significant predictors. We identified income insecurity (ß= -0.096, 95% CI -0.144 to -0.046), social withdrawal (ß= -0.062, 95% CI -0.121 to -0.004), religious concerns (ß= -0.149, 95% CI -0.202 to -0.096) and health consequences (ß= 0.065, 95% CI 0.011 to 0.11) as barriers. Governmental instructions were the only predictive external cue (ß= 0.055, 95% CI 0.004 to 0.014). Our findings suggest that a high number of Jordanians are adherent with the quarantine, demonstrating the ability of governmental policies in tackling potential barriers.

Association Between Body Fat Mass and Kidney Stones in US Adults: Analysis of the National Health and Nutrition Examination Survey 2011-2018.

BACKGROUND: The association between total and truncal body fat and kidney stone (KS) remains unclear. OBJECTIVE: To evaluate the association between total and truncal body fat and KS in the US adult population. DESIGN, SETTING, AND PARTICIPANTS: The National Health and Nutrition Examination Survey (NHANES) comprises a series of nationally representative cross-sectional surveys. Data from females and males aged 20-59 yr who participated in four 2-yr NHANES cycles between 2011 and 2018 were obtained. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable-adjusted logistic regression models were used to investigate the association between dual-energy x-ray absorptiometry (DXA) scan-measured total and truncal body fat percentage and mass with KS. RESULTS AND LIMITATIONS: A total of 10 271 participants (50.3% females) were included. Weighted KS prevalence was 8.11% in femalesand 7.55% in males. In males, higher fat percentage was associated with higher odds of KS (per 5% total fat: odds ratio [OR] = 1.19, 95% confidence interval [CI] 1.08-1.32; per 5% truncal fat: OR = 1.22, 95% CI 1.10-1.35), particularly in those aged 40-59 yr (per 5% total fat: OR = 1.36, 95% CI 1.16-1.59; per 5% truncal fat: OR = 1.41, 95% CI 1.20-1.65, p-interaction < 0.05). In females, higher fat percentage was associated with higher odds of KS overall (per 5% total fat: OR = 1.23, 95% CI 1.10-1.37; per 5% truncal fat: OR = 1.20, 95% CI 1.08-1.33) and in both age groups (20-39 and 40-59 yr, p-interaction > 0.05). The observed associations were stronger in "other" ethnicities and non-Hispanic white. Similar patterns were observed for per 5 kg body fat mass. CONCLUSIONS: Total and truncal fat parameters are associated with a higher prevalence of KS in adult females and males who are ≥40 yr old. Truncal fat mass may be at least equal or superior to total fat mass in assessing the association of body fat with KS. Further studies are warranted to elaborate on the pathophysiologic mechanism of this association to decrease the prevalence of KS. PATIENT SUMMARY: Total and truncal body fat are associated with a higher prevalence of kidney stone (KS) in adult females and males aged ≥40 yr. Truncal fat mass may be similar or superior to total fat mass in assessing the association between body fat and KS.

Prevalence and trends in urinary incontinence among women in the United States, 2005-2018.

BACKGROUND: Women are disproportionately affected by urinary incontinence compared with men. Urinary incontinence results in physical and psychological adverse consequences and impaired quality of life and contributes to significant societal and economic burden. Previous studies reported high urinary incontinence burden in the United States. However, the current prevalence and recent trends in urinary incontinence and its subtypes among US women have not been described. In addition, correlates of urinary incontinence among US women have not been systematically evaluated in the contemporary population. OBJECTIVE: The purpose of this study was to determine the prevalence and trends in urinary incontinence among adult women in the United States from 2005 to 2018. In addition, this study aimed to investigate the relationship of urinary incontinence subtypes with several sociodemographic, lifestyle, health-related, and gynecologic factors. STUDY DESIGN: We used data from the National Health and Nutrition Examination Survey, a nationally representative series of surveys that was designed to evaluate the health status of the US population. Data on urinary incontinence from 7 consecutive 2-year cycles (2005-2006 to 2017-2018) were used for this study. A total of 19,791 participants aged ≥20 years were included. Weighted prevalence estimates and 95% confidence intervals were calculated in each study cycle for stress, urgency, and mixed urinary incontinence. Multivariate-adjusted weighted logistic regression was used to investigate the temporal trends in urinary incontinence, in addition to determining the association between urinary incontinence subtypes with several participants' factors. RESULTS: In the 2017-2018 cycle, stress urinary incontinence was the most prevalent subtype (45.9%; 95% confidence interval, 42.1-49.7), followed by urgency urinary incontinence (31.1%; 95% confidence interval, 28.6-33.6) and mixed urinary incontinence (18.1%; 95% confidence interval, 15.7-20.5). The prevalence rates of urgency and mixed urinary incontinence were higher in women aged 60 years and older (urgency, 49.5% [95% confidence interval, 43.9-55.2]; mixed, 31.4% [95% confidence interval, 26.2-36.6]) than in those aged 40 to 59 years (urgency, 27.9% [95% confidence interval, 23.6-32.1]; mixed, 15.9% [95% confidence interval, 12.9-19.0]) and those aged 20 to 39 years (urgency, 17.6% [95% confidence interval, 13.8-21.5]; mixed, 8.3% [95% confidence interval, 5.4-11.3]). The overall prevalence of stress and mixed urinary incontinence was stable throughout 2005 to 2018 (both Ptrend=.3), with increases in mixed urinary incontinence among women aged 60 years and older (P=.001). The prevalence of urgency urinary incontinence significantly increased, particularly among women aged 60 years and older (both P=.002). Age, obesity, smoking, comorbidities, and postmenopausal hormone therapy were associated with higher prevalence of all types of urinary incontinence. Black women were less likely to report stress urinary incontinence but more likely to report urgency urinary incontinence. CONCLUSION: Although the estimated overall prevalence of stress and mixed urinary incontinence remained stable from 2005 to 2018, the prevalence of urgency and mixed urinary incontinence significantly increased among women aged 60 years and older. All subtypes of urinary incontinence were higher among women with obesity and comorbidities, those who used postmenopausal hormone therapy, and those who smoke.

Functional Outcomes after Local Salvage Therapies for Radiation-Recurrent Prostate Cancer Patients: A Systematic Review.

PURPOSE: To assess the rate and severity of functional outcomes after salvage therapy for radiation recurrent prostate cancer. METHODS: This systematic review of the MEDLINE/PubMed database yielded 35 studies, evaluating salvage radical prostatectomy (RP), brachytherapy (BT), high-intensity focal ultrasound (HIFU) and cryotherapy (CT) after failure of primary radiation therapy. Data on pre- and post-salvage rates and severity of functional outcomes (urinary incontinence, erectile dysfunction, and lower urinary tract symptoms) were collected from each study. RESULTS: The rates of severe urinary incontinence ranged from 28-88%, 4.5-42%, 0-6.5%, 2.4-8% post salvage RP, HIFU, CT and BT, respectively. The rates of erectile dysfunction were relatively high reaching as much as 90%, 94.6%, 100%, 62% following RP, HIFU, CT and BT, respectively. Nonetheless, the high pre-salvage rates of ED preclude accurate estimation of the effect of salvage therapy. There was an increase in the median IPSS following salvage HIFU, BT and CT ranging from 2.5-3.4, 3.5-12, and 2, respectively. Extended follow-up showed a return-to-baseline IPSS in a salvage BT study. The reported data suffer from selection, reporting, publication and period of study biases, making inter-study comparisons inappropriate. CONCLUSIONS: local salvage therapies for radiation recurrent PCa affect continence, lower urinary tract symptoms and sexual functions. The use of local salvage therapies may be warranted in the setting of local disease control, but each individual decision must be made with the informed patient in a shared decision working process.

Prevalence and Trends in Kidney Stone Among Adults in the USA: Analyses of National Health and Nutrition Examination Survey 2007-2018 Data.

BACKGROUND: The contemporary prevalence and trends of kidney stones are not clear. OBJECTIVE: To evaluate the gender-specific prevalence and trends in kidney stones among the US population. DESIGN, SETTING, AND PARTICIPANTS: Data on self-reported history of kidney stones from 34 749 participants aged ≥20 yr from the National Health and Nutrition Examination Survey (NHANES) were analyzed. INTERVENTION: Six 2-yr study cycles (2007-2008 to 2017-2018) of nationally representative series of surveys evaluated the health status of the US population. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Weighted prevalence estimates of kidney stones and 95% confidence intervals (CIs) were calculated in each study cycle. Multivariable-adjusted logistic regression models were used to investigate the temporal trends. RESULTS AND LIMITATIONS: In the 2017-2018 cycle, the prevalence of kidney stones was 10.9% (CI: 9.3-12.7) in men as compared with 9.5% (CI: 8-11.2) in women. The prevalence of kidney stones increased steadily from 6.5% in the 2007-2008 cycle to 9.4% in the 2017-2018 cycle (ptrend = 0.001) among women but not among men (ptrend = 0.1). These trends remained after adjusting for sociodemographic correlates in both genders. Sensitivity analyses further adjusting for dietary information held the same results in trends (men: ptrend = 0.15; women: ptrend = 0.001). Non-Hispanic white ethnicity, obesity, gout, history of two or more pregnancies, menopause, and using female hormones were associated with a higher prevalence of kidney stones. The main limitation is the cross-sectional design of the study. CONCLUSIONS: Although kidney stones are more common in men than in women in the USA, the gender gap in kidney stone prevalence appears to be closing in the past decade. Kidney stones are consistently higher among non-Hispanic white and obese, and women who have had multiple pregnancies or have used female hormone therapy. PATIENT SUMMARY: The prevalence of kidney stones remains higher in adult US men than in women, but the trend has been increasing only in women, closing the gender gap in kidney stone prevalence.