Saxon Epidemiological Study in General Practice-6 (SESAM-6): protocol of a cross-sectional study.

INTRODUCTION: General practitioners (GPs) are mostly the first point of contact for patients with health problems in Germany. There is only a limited epidemiological overview data that describe the GP consultation hours based on other than billing data. Therefore, the aim of Saxon Epidemiological Study in General Practice-6 (SESAM-6) is to examine the frequency of reasons for encounter, prevalence of long-term diagnosed diseases and diagnostic and therapeutic decisions in general practice. This knowledge is fundamental to identify the healthcare needs and to develop strategies to improve the GP care. The results of the study will be incorporated into the undergraduate, postgraduate and continuing medical education for GP. METHODS AND ANALYSIS: This cross-sectional study SESAM-6 is conducted in general practices in the state of Saxony, Germany. The study design is based on previous SESAM studies. Participating physicians are assigned to 1 week per quarter (over a survey period of 12 months) in which every fifth doctor-patient contact is recorded for one-half of the day (morning or afternoon). To facilitate valid statements, a minimum of 50 GP is required to document a total of at least 2500 doctor-patient contacts. Univariable, multivariable and subgroup analyses as well as comparisons to the previous SESAM data sets will be conducted. ETHICS AND DISSEMINATION: The study was approved by the Ethics Committee of the Technical University of Dresden in March 2023 (SR-EK-7502023). Participation in the study is voluntary and will not be remunerated. The study results will be published in peer-reviewed scientific journals, preferably with open access. They will also be disseminated at scientific and public symposia, congresses and conferences. A final report will be published to summarise the central results and provided to all study participants and the public.

Effort-reward imbalance and sleep quality in railway locomotive stewards: a cross-sectional study.

OBJECTIVE: To assess the correlation between the effort-reward imbalance (ERI) and sleep quality among railway locomotive stewards. DESIGN: Cross-sectional study. SETTING: Lanzhou Bureau Group, China Railway, between July and August 2022. PARTICIPANTS: Railway locomotive stewards. PRIMARY AND SECONDARY OUTCOME MEASURES: Sleep quality was assessed using the Pittsburgh Sleep Quality Index Scale (PSQI), categorising scores of >14 as poor, 8-14 as fair and <8 as good. RESULTS: A total of 5738 valid questionnaires (mean age of 30.85±6.91 years and 5730 males) were included. The response rate was 92.27%. The PSQI score was 11.52±3.95; 2304 (40.15%) respondents had good sleep quality, 1590 (27.71%) had fair sleep quality and 1844 (32.14%) had poor sleep quality. Stepwise multivariable logistic regression analysis showed that, compared with poor sleep quality, Jiayuguan Locomotive Depot workers (OR 0.775, 95% CI 0.587 to 0.971, p=0.028), electric locomotive drivers (OR 0.499, 95% CI 0.316 to 0.786, p=0.003), passenger train locomotive drivers (OR 0.209, 95% CI 1.313 to 3.337, p=0.002), working <40 hours weekly (OR 2.291, 95% CI 1.686 to 3.112, p<0.001), working 40-50 hours weekly (OR 1.602, 95% CI 1.299 to 1.977, p<0.001), senior titles (OR 0.727, 95% CI 0.570 to 0.928, p=0.010), high effort/low reward (OR 2.812, 95% CI 2.218 to 3.564, p<0.001) and low overcommitment (OR 5.848, 95% CI 4.710 to 7.261, p<0.001) were independently associated with fair sleep quality. Electric locomotive drivers (OR 0.535, 95% CI 0.364 to 0.787, p=0.001), diesel locomotive drivers (OR 0.567, 95% CI 0.348 to 0.924, p=0.023), passenger train locomotive drivers (OR 1.471, 95% CI 1.005 to 2.155, p=0.047), working <40 hours weekly (OR 1.549, 95% CI 1.196 to 2.006, p=0.001), working 40-50 hours weekly (OR 1.340, 95% CI 1.141 to 1.574, p<0.001), high school diploma or less (OR 1.448, 95% CI 1.062 to 1.975, p=0.019), high effort/low reward (OR 1.237, 95% CI 1.006 to 1.521, p=0.044), balanced effort-reward (OR 0.653, 95% CI 0.478 to 0.892, p=0.007) and low overcommitment (OR 2.553, 95% CI 2.224 to 2.931, p<0.001) were independently associated with good sleep quality. CONCLUSION: The results revealed an acceptable ERI and poor sleep quality among railway stewards. ERI was correlated with sleep quality. Health education, lifestyle changes and improved work schedules may help boost sleep quality and well-being among railway locomotive stewards.

Chiropractic attitude and utilisation of evidence-based practice in South Africa: a secondary analysis.

BACKGROUND: Evidence-Based Practice (EBP) is a model utilised by the majority of healthcare professionals and is a clinical framework that assists with decision-making related to patient care, to improve outcomes and patient satisfaction. The study aimed to analyse the attitudes, skills, and utilization of evidence-based practice (EBP) among South African chiropractors, focusing on perceived skill levels, training, use and identifying facilitators and barriers to EBP application. METHODS: A descriptive cross-sectional quantitative secondary analysis was conducted by inviting registered chiropractors in South Africa (n = 920) to participate in an anonymous online questionnaire using the Evidence-Based Practice Attitude and Utilisation Survey (EBASE). RESULTS: A total of 132 chiropractors completed the survey, yielding a response rate of 14.4%. Of the respondents, 59.9% were female, 52.3% were between 26 and 35 years old, and 63.3% had graduated from the University of Johannesburg. A third of respondents stated they have poor clinical research skills. Over half of the respondents (56.8%) indicated that EBP constituted a significant part of their education except for completing systematic reviews or meta-analyses. Published clinical evidence was ranked 6th as a source of information for clinical decisions. The obstacles indicated were time constraints and a lack of clinical research in complementary and alternative medicine. Access to the internet, databases and research tools were facilitators that were deemed to be "very useful" in promoting EBP. CONCLUSION: The majority of South African chiropractors are generally favourable towards EBP, and this practice therefore appears to be utilised and embraced, with the requisite skills.

The association between weight-adjusted-waist index and sarcopenia in adults: a population-based study.

This study aims to investigate the relationship between weight-adjusted-waist index (WWI), a new body index, and sarcopenia, while also assessing the potential of WWI as a tool for screening sarcopenic patients. The cross-sectional study involved adults who possessed complete data on WWI and appendicular skeletal muscle mass from the 1999-2006 and 2011-2018 National Health and Nutrition Examination Surveys. Weighted multivariate regression and logistic regression analyses were employed to explore the independent relationship between WWI and sarcopenia. The study included 26,782 participants. The results showed that WWI demonstrated a positive correlation with sarcopenia risk. In the fully adjusted model, with each 1 unit increase in WWI, the risk of developing sarcopenia rose 14.55 times higher among males (OR: 14.55, 95% CI 12.33, 17.15) and 2.86 times higher among females (OR: 2.86, 95% CI 2.59, 3.15). The optimal cutoff values of WWI for sarcopenia were 11.26 cm/√kg for males and 11.39 cm/√kg for females. Individuals with a higher WWI have an increased risk of developing sarcopenia, and a high WWI functions as a risk factor for sarcopenia. Assessing WWI could assist in identifying individuals at risk of sarcopenia.

The Association Between Community Dialogue and Loneliness in Rural Japanese Communities: A Cross-Sectional Study.

Introduction This investigation explores the influence of community dialogue on loneliness within rural Japanese communities amidst the backdrop of globalization, urbanization, and technological shifts. Highlighting the significance of both informal and formal community dialogues, the study aims to bridge the gap in empirical evidence regarding the role of these interactions in enhancing social cohesion and mitigating loneliness, particularly in rural areas facing demographic changes and privacy concerns. Method A cross-sectional study was performed in Unnan City, Japan, targeting individuals over 40 who regularly visited a local rural hospital. The study employed the Japanese version of the University of California, Los Angeles (UCLA) Loneliness Scale and questionnaires regarding the frequency of community dialogue, alongside examining participants' health and demographic details from hospital records. Analysis methods included t-tests, Mann-Whitney U tests, and multivariate logistic regression to examine the association between community dialogue frequency and loneliness. Results Among the 647 respondents, the participants' mean age was 71.26 years, with a male rate of 46.3%. The multivariate logistic regression analysis revealed that higher frequencies of community dialogue significantly reduce the odds of experiencing loneliness. Specifically, compared to individuals with the least frequency of community dialogue, those with more frequent and most frequent dialogues were significantly more likely to report higher loneliness levels, with odds ratios of 2.62 (95% CI: 1.60-4.29, p<0.01) and 4.11 (95% CI: 2.47-6.85, p<0.01), respectively. Additionally, an increase in BMI was inversely related to loneliness (OR: 0.95, 95% CI: 0.91-0.99, p=0.023), and individuals with a higher comorbidity index (CCI≥5) showed a decreased likelihood of reporting higher loneliness (OR: 0.64, 95% CI: 0.43-0.96, p=0.031). Conclusion This study shows compelling evidence that more frequent community interactions are inversely associated with feelings of loneliness. These findings suggest that initiatives to increase community dialogue need a nuanced approach to mental health and social cohesion in rural settings. The research further reveals an intriguing relationship between body mass index, the severity of comorbidities, and loneliness, offering insights into the complex interplay between physical health and social well-being. The importance of this study lies in its potential to inform policies and programs designed to foster social connections respecting rural contexts, thereby addressing the challenge of loneliness in rural communities.

Prevalence of insomnia in a general adult population cohort using different diagnostic criteria: The seventh survey of the Tromsø study 2015-2016.

Insomnia disorder is a subjective complaint of sleep dissatisfaction including both night-time and daytime symptoms. Currently there are three commonly used diagnostic manuals each with their own set of criteria, which is often credited for the wide range in insomnia prevalence reported by population-based studies, especially those with self-reported insomnia. However, there are limited studies directly comparing different criteria and little is known about associations with health outcomes. Thus, the aim of this study was to compare the most commonly used diagnostic criteria for insomnia from the literature and to explore the associations with a range of physical and mental health outcomes. We used data from 21,083 women and men from the seventh survey of the population-based Tromsø Study which included adults aged 40-99 years. A revised version of the Bergen Insomnia Scale was used to define insomnia based on the 4th (revised) and 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR and DSM5), the 10th edition of the International Classification of Diseases (ICD-10), and the 3rd edition of the International Classification of Sleep Disorders (ICSD-3). We found the following prevalence of insomnia: DSM-IV-TR 23.6 %, DSM5 8.5 %, ICD-10 9.9 % and ICSD-3 20.0 %. When looking at each symptom, we found over half the participants classified as having insomnia using the DSM-IV-TR and ICSD-3 criteria did not report having impaired daytime functioning at least three days per week. Overall, participants with DSM5 and ICD-10 insomnia appeared to have worse health profiles, based on a higher percentage meeting the cut-off for possible anxiety or depression, reporting a psychological problem or chronic pain, and using antidepressants, painkillers or sleeping pills. However logistic regression models showed largely the same health factors had the same association with the odds for being classified as having insomnia disorder from each set of criteria. Overall, this study suggests that insomnia prevalence may be overestimated if daytime symptoms are not adequately included in accordance with current guidelines.

Prevalence and burden of difficult-to-treat and severe asthma in Australia: A national population survey.

BACKGROUND AND OBJECTIVE: Most evidence about difficult-to-treat and severe asthma (DTTA) comes from clinical trials and registries. We aimed to identify people with DTTA from a large nationally representative asthma population and describe their characteristics and healthcare utilization compared with people whose asthma was not 'difficult-to-treat'. METHODS: We conducted a cross-sectional survey of Australians aged ≥18 years with current asthma from large web-based survey panels. Enrolment was stratified by gender, age-group and state/territory based on national population data for people with asthma. Difficult-to-treat or severe asthma was defined by poor symptom control, exacerbations and/or oral corticosteroid/biologic use despite medium/high-dose inhaled therapy. Outcomes included exacerbations, healthcare utilization, multimorbidity, quality of life and coronavirus disease of 2019 (COVID-19)-related behaviour. Weighted data were analysed using SAS version 9.4. RESULTS: The survey was conducted in February-March 2021. The weighted sample comprised 6048 adults with current asthma (average age 47.3 ± SD 18.1 years, 59.9% female), with 1313 (21.7%) satisfying ≥1 DTTA criteria. Of these, 50.4% had very poorly controlled symptoms (Asthma Control Test ≤15), 36.2% were current smokers, and 85.4% had ≥1 additional chronic condition, most commonly anxiety/depression. More than twice as many participants with DTTA versus non-DTTA had ≥1 urgent general practitioner (GP) visit (61.4% vs. 27.5%, OR 4.8 [4.2-5.5, p < 0.0001]), or ≥1 emergency room visit (41.9% vs. 17.9%, OR 3.8 [3.3-4.4, p < 0.0001]) in the previous 12 months. CONCLUSION: Our findings emphasize the burden of uncontrolled symptoms, current smoking, multimorbidity and healthcare utilization in people with DTTA in the community, who may be under-represented in registries or clinical trials.

Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians.

BACKGROUND: The COVID-19 pandemic has presented multiple psychological challenges for healthcare workers, such as anxiety, depression, burnout, and substance use disorders. In this research, we investigate the different ways Romanian physicians dealt with the difficult period of the COVID-19 pandemic. We also analyze how positive and negative stress-reducing strategies, as well as demographic variables, affect their psychological resilience and quality of life. Our goal is to provide a comprehensive overview of how physicians coped with the unprecedented global health challenges. METHODS: We carried out a national cross-sectional study of 265 physicians in Romania between January 2021 and January 2022 using a web-based questionnaire. The study employed a web-based questionnaire to assess coping mechanisms using the COPE inventory, resilience through the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and quality of life via the WHOQOL-BREF scale. The COPE inventory, consisting of 60 items across 15 subscales, categorizes coping strategies into problem-focused, emotion-focused, and dysfunctional types, with each item rated on a 4-point scale. The CD-RISC 25 measures resilience on a 5-point Likert scale, with total scores ranging from 0 to 100. WHOQOL-BREF assesses quality of life through 26 items in 4 domains: physical, mental, social relations, and environmental, scored from 1 to 5 and converted to a 0-100 scale for domain scores. Univariate and multivariate linear regression models were employed to discern the intricate relationships between coping strategies, resilience levels, quality of life dimensions, and pertinent demographic factors. RESULTS: The average CD-RISC score among participants was 66.2. The mean scores for the values for the QOL subscales were 64.0 for physical well-being, 61.7 for psychological well-being, 61.2 for social relationships, and 64.7 for environment. Individuals tend to use problem-focused and emotion-focused coping more than dysfunctional mechanisms, according to the COPE inventory. Problem-focused and emotion-focused coping are positively correlated with resilience, while dysfunctional coping is negatively correlated. Resilience is significantly influenced by gender and professional status, with males and senior specialists reporting higher levels while younger physicians and residents reporting lower levels. CONCLUSIONS: Our data points to specific protective characteristics and some detrimental factors on physicians' resilience and quality of life during the pandemic.

Self-Medication and its Associated Factors among University Students: A Cross-Sectional Study.

Background: Self-medication is a global concern among professionals and non-professionals, with a rapid increase in prevalence. The study aims to assess the prevalence of self-medication and its associated factors among university students. Materials and Methods: A cross-sectional, descriptive study was conducted in three universities, and a total of 817 college students participated in this study. Results: About 75.40% of the participants reported using medications without a professional prescription. The category of analgesics was the most commonly used in self-medication (82.80%), while the most common symptom was a headache (81.50%). Almost 74.10% percent of participants who have practiced self-medication stated that the reason was the "lack of time to consult a physician." Most participants who have used self-medication (90.30%) stated that the source of knowledge was "previous prescription." Conclusions: Health education programs concerning self-mediation should be held in university settings to improve attitudes and practices toward self-mediation.

Exploring the Relationship Between Serum Creatinine and Salivary Creatinine Levels in Patients With Chronic Kidney Disease in South India: A Cross-Sectional Study.

Background In this study, researchers investigated non-invasive methods for analyzing creatinine levels by using saliva to address the need for frequent phlebotomy in chronic kidney disease (CKD) patients, which can damage their veins due to repeated blood withdrawals for creatinine level assessments. Methods This is a cross-sectional study in a tertiary healthcare setting conducted on 50 patients diagnosed with CKD. After collecting serum and salivary creatinine, we used Pearson correlation to assess the correlation between the two factors. Results The mean age of the patients was 50 years with a standard deviation of ± 15.32 years. 33 (66%) patients were males and 17 (34%) were females. Most patients were in the age group of 51 - 70 years, comprising 26 (52%) of the sample. The serum creatinine and salivary creatinine values ranged between 7.26-12.00 and 0.45-0.98, respectively. The median values were 9.72 and 0.75, respectively. There was a very weak positive linear relationship between serum and salivary creatinine levels; however, there was no significant association between them (p = 0.52). Nonetheless, a statistically significant, moderately negative linear correlation exists between serum urea and serum albumin (r = -0.36; p = 0.01). Additionally, there is a statistically significant weak negative linear correlation between serum chloride and serum urea (r = -0.3; p = 0.03). Comparing serum chloride and serum sodium reveals a statistically significant, moderately positive linear relationship (r = 0.4; p = 0.004). Serum phosphorus and serum creatinine display a statistically significant moderate positive linear relationship (r = 0.44; p = 0.001). Moreover, estimated glomerular filtration rate (eGFR) and serum creatinine exhibit a statistically significant strong negative linear correlation (r = -0.79; p < 0.001), while eGFR and serum phosphorus demonstrate a statistically significant weak negative linear correlation (r = -0.30; p = 0.03). Conclusion The study found no significant association between salivary and serum creatinine levels. Further multicentric studies on a larger population must be conducted to find the potential correlation between serum and salivary markers.

Smoking behaviour in post-acute myocardial infarction patients: cross-sectional study.

Introduction: Heart disease remains the leading cause of death in developed countries, and cigarette smoking contributes to a significant proportion of cardiovascular-related deaths. Abstaining from tobacco use is associated with a significant reduction in the risk of recurrent myocardial infarctions. Methodology: In this cross-sectional study, 384 participants post-acute myocardial infarction (MI) were recruited through random sampling to explore the associations between smoking status and intention to quit smoking. Data collection took place over a 6-month period at a tertiary care hospital, Islamabad, Pakistan. Results: The majority of participants were male (59.9%) and fell into the age category of 46-50 years (37.5%). Heavy daily smokers comprised the largest smoking group (41.6%), and non-ST-elevated MI was the most common subtype (40.1%). Intention to quit smoking varied among participants, with the pre-contemplation stage having the highest representation (19.3%), followed by contemplation (25.8%). Notably, a significant proportion of participants expressed no intention to quit smoking (35.4%). Conclusion: Multinomial logistic regression analysis identified current smoking as a significant predictor of intention to quit in the preparation and contemplation stages. Overall, this study underscores the importance of considering smoking behaviour when evaluating the intention to quit smoking post-MI and highlights the need for tailored interventions and support strategies to address smoking cessation in this population. These findings offer valuable insights for the development of effective strategies aimed at reducing persistent smoking following MI and improving patient outcomes.

Predictors of emergency preparedness among parents in Hawaii: A cross-sectional survey.

OBJECTIVE: To determine factors predicting emergency preparedness (EP) behaviors among Hawaii parents. METHODS: A cross-sectional online survey of parents of children (age 0-12 years) living in Honolulu, Hawaii in March 2023 examined associations with 1) having an EP kit (supplies for use during emergencies) and 2) having a family emergency plan (what to do, where to go, how to communicate during emergencies) with demographics/household characteristics and theoretical constructs of the Health Belief Model. A multivariable regression model obtained odds ratios and 95% confidence intervals. RESULTS: Participants (N=278) were mainly female (84%), college-educated (68%), and were similar in diverse racial/ethnic composure (White, 13.3%) to the overall Honolulu County. Logistic regression determined participants with lower perceived susceptibility to disasters, greater time barriers, and those who needed help to prepare for emergencies were less likely to have an EP kit. Among participants without an EP kit, a website able to create personalized instructions for household EP would be useful. Participants who needed help to prepare for emergencies were less likely to have a family emergency plan. CONCLUSION: Future interventions should focus on evidence-based strategies that improve self-efficacy associated with developing EP kits and family emergency plans.

Nurses' Personality Traits and Perceived Work Environments During Public Health Emergencies: Implications for Nursing Workforce Planning.

Background: The nursing workforce faces substantial challenges, particularly in the aftermath of the COVID-19 era. Developing an effective strategy for workforce maintenance and the strategic deployment of nurses is crucial. Purpose: This study aimed to explore and categorize nurses' personality traits, with a focus on analyzing differences in their perceptions of the nursing work environment. Participants and Methods: Between January 2023 and February 2023, a multi-center cross-sectional study was carried out involving nurses from 12 tertiary hospitals actively engaged in frontline COVID-19 response duties. Through cluster sampling, surveys were distributed among eligible nursing staff, comprising a general information questionnaire, the Chinese Big Five Personality Questionnaire-Short Form, subjective evaluations of emergency nursing management, and the Chinese Nursing Work Environment Scale for Public Health Emergencies. Various statistical analyses, such as descriptive analysis, cluster analysis, non-parametric tests, and general linear model analysis, were employed to investigate the correlation between personality types and the perception of nursing work environments. Results: The analysis encompassed 1059 valid questionnaires, reflecting the experiences of frontline nurses. The majority of these nurses possessed 1-5 years of experience, held junior professional titles, volunteered for their roles, and served as attending nurses. Categorization based on personality traits revealed three groups: resilient (35.60%), ordinary (16.15%), and distressed (48.25%) types. Significantly distinct perceptions of nursing work environments emerged among these categories, with resilient and ordinary types expressing notably higher satisfaction compared to the distressed group (H value = 256.487, p < 0.001). Conclusion: This study illustrates the connection between nurses' perceived working environment and their personality traits. Nursing managers should factor in nurses' personality traits when choosing and deploying frontline responders during public health emergencies. Prioritizing resilient-type nurses and crafting a supportive work environment that aligns with nurses' characteristics is indispensable for an effective emergency response.

Evaluation of biological markers for the risk assessment of carbon black in epidemiological studies.

Background/objectives: Engineered nanomaterials (ENMs) have been suggested as being capable of promoting inflammation, a key component in the pathways associated with carcinogenesis, cardiovascular disease, and other conditions. As a result, the risk assessment of biological markers as early-stage indicators has the potential to improve translation from experimental toxicologic findings to identifying evidence in human studies. The study aims to review the possible early biological changes in workers exposed to carbon black (CB), followed by an evidentiary quality evaluation to determine the predictive value of the biological markers. Methods: We conducted a literature search to identify epidemiological studies that assessed biological markers that were involved in the inflammatory process at early stages among workers with exposure to CB. We reviewed the studies with specific reference to the study design, statistical analyses, findings, and limitations. Results: We identified five Chinese studies that investigated the potential impact of exposure to CB on inflammatory markers, bronchial wall thickening, genomic instability, and lung function impairment in CB production workers. Of the five Chinese studies, four were cross-sectional; another study reported results at two-time points over six years of follow-up. The authors of all five studies concluded positive relationships between exposure and the inflammatory cytokine profiles. The weak to very weak correlations between biomarkers and early-stage endpoints were reported. Conclusion: Most inflammatory markers failed to satisfy the proposed evidentiary quality criteria. The significance of the results of the reviewed studies is limited by the cross-sectional study design, inconsistency in results, uncertain clinical relevance, and high occupational exposures. Based on this review, the risk assessment relying on inflammatory markers does not seem appropriate at this time. Nevertheless, the novel research warrants further exploration in assessing exposure to ENMs and corresponding potential health risks in occupational settings.

COVID-19 vaccine coverage, determinants and inequity amongst refugees and migrants in Pakistan: a cross-sectional study.

OBJECTIVE: Migrants and refugees are at a disadvantage in accessing basic necessities. The objective of this study is to assess the inequity in access, needs and determinants of COVID-19 vaccination among refugees and migrant populations in Pakistan. DESIGN: We conducted a mixed-method study comprising a cross-sectional survey and a qualitative study. In this paper, we will only report the findings from the cross-sectional survey. SETTING: This survey was conducted in different cities of Pakistan including Quetta, Karachi and Hyderabad. PARTICIPANTS: A total of 570 participants were surveyed including refugees and migrants, both in regular and irregular situations. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome of the study was to estimate the proportion of refugees and migrants, both in regular and irregular situations vaccinated against COVID-19 and assess the inequity. The χ2 test and Fisher's exact test were used to determine the significant differences in proportions between refugees and migrants and between regions. RESULTS: The survey showed that only 26.9% of the refugee and migrant population were tested for COVID-19, 4.56% contracted coronavirus, and 3.85% were hospitalised due to COVID-19. About 66% of the refugees and migrants were fully vaccinated including those who received the single-dose vaccine or received all two doses, and 17.6% were partially vaccinated. Despite vaccination campaigns by the government, 14.4% of the refugee and migrant population remained unvaccinated mostly because of vaccines not being offered, distant vaccination sites, limited access, unavailability of COVID-19 vaccine or due to a difficult registration process. Vaccination rates varied across provinces, genders and migrant populations due to misconceptions, and several social, cultural and geographical barriers. CONCLUSION: This study highlights the COVID-19 vaccine coverage, access and inequity faced by refugees and migrants during the pandemic. It suggests early prioritisation of policies inclusive of all refugees and migrants and the provision of identification documents to ease access to basic necessities.

Using an ecological model of health behaviour to identify factors associated with smoking behaviour among Buddhist novices in Thailand: a cross-sectional digital survey.

OBJECTIVE: Buddhist novices reside in Buddhist temples, which are legally designated as smoke-free areas. Nevertheless, similar to other men in their age group, they are susceptible to various risk factors that lead to smoking. This digital survey aimed to examine tobacco smoking and its associated factors among Buddhist novices in Thailand. DESIGN: A cross-sectional digital survey. SETTING: 88 temple-based schools in Thailand. PARTICIPANTS: A stratified two-stage cluster sampling method was employed to select 5371 novices. Data were collected between June and August 2022 using self-administered electronic questionnaires. MEASURE: Descriptive statistics and multivariable logistic regression analysis were used to identify the associated factors. RESULTS: Overall, 32.8% of the respondents reported they had tried smoking, and the average age of initiation was 12.4 years. In the past 30 days, 25.7% had smoked any tobacco product. Multiple factors following the ecological model of health behaviour were found to be statistically associated with smoking by 37.3%. Among these were intrapersonal-level factors, such as age, living in the southern region and attempted smoking. Two were interpersonal-level factors: the smoking behaviour of close relatives, specifically parents, and their respected monks. Two were institutional-level factors: perceiving that temple-based schools are smoke-free areas and exposure to secondhand smoke. Three factors at the community and policy levels were noticed tobacco advertising at the point of sale, social media and tobacco promotion. CONCLUSION: The findings of this study support the development of comprehensive intervention programmes that address the multiple factors to prevent Buddhist novices from smoking.

Most Cited Articles in Body Contouring: A Bibliometric Analysis of the Past 45 Years.

Introduction: The purpose of this study is to produce a bibliometric review of the 30 most cited articles related to 6 major domains of body contouring-abdominoplasty, thighplasty, brachioplasty, gluteoplasty, body lift, and liposuction-for resident and fellow education. Methods: The authors utilized the Web of Science Citation Index to identify the 30 most cited articles related to surgery for body contouring published from 1975 to 2020. Articles were classified according to their level of evidence, type of study, and country of publication. Results: A total of 336 articles were reviewed to compile our list. The mean number of citations across the articles was 114.7 ± SD 86.1. The highest prevalence of the papers was published between 2000 and 2009 (n = 15, 50%). The country with the highest number of contributions was the United States (n = 22, 73%). Plastic and Reconstructive Surgery served as the main journal of publication for these papers (n = 22, 73.3%). The majority of articles were designated for clinical-type studies (n = 26, 86.7%). No basic science or prevalence study design papers were listed. In terms of level of evidence (LoE), most papers were assigned IV (n = 11, 36.7%) and III (n = 7, 23.3%). Conclusions: Our study reveals that the most cited papers in body contouring are of LoE III and IV. Although the LoE of plastic surgery research, in general, has improved, in the past decade, a call for higher quality papers remains. Overall, this analysis provides an easy, electronic starting point for residents and fellows interested in understanding the field's evolution.

Introduction : La présente étude vise à produire une analyse bibliométrique de 30 articles influents liés à six grands domaines du remodelage corporel (l'abdominoplastie, le redrapage des cuisses, la brachioplastie, la glutéoplastie, le redrapage du corps et la liposuccion) pour la formation des résidents et des étudiants en stage de perfectionnement postdoctoral. Méthodologie : Les auteurs ont utilisé l'index de citation de Web of Science pour extraire les 30 articles les plus cités sur les opérations de remodelage corporel publiés entre 1975 et 2020. Ils ont classé les articles d'après la qualité des preuves, le type d'étude et le pays de publication. Résultats : Au total, les auteurs ont analysé 336 articles pour compiler leur liste. Les articles contenaient un nombre moyen de 114,7± ÉT 86,1 citations. La plus forte prévalence d'articles a été publiée entre 2000 et 2009 (n = 15, 50 %). La majorité des articles provenaient des États-Unis d'Amérique (n = 22, 73 %), et c'est la revue Plastic and Reconstructive Surgery© qui en a publié le plus (n = 22, 73,3 %). La plupart des articles prenaient la forme d'études de type clinique (n = 26, 86,7 %). Aucun article de science fondamentale ni étude de prévalence n'a été répertorié. Pour ce qui est de la qualité des preuves, la plupart des articles ont obtenu un classement de IV (n = 11, 36,7 %) et de III (n = 7, 23,3 %). Conclusions : L'étude révèle que la qualité de preuve de la plupart des articles dans ce domaine était de III et IV. Même si la chirurgie plastique se prête moins bien aux études randomisées et contrôlées que la médecine, elle mérite des articles comportant une meilleure qualité de preuves. Grâce à la présente analyse, les résidents et les étudiants en stage de perfectionnement peuvent accéder rapidement et facilement à des concepts influents pour comprendre l'évolution du domaine par voie électronique. Termes MeSH : abdominoplastie, bibliométrie, chirurgie plastique, études transversales, liposuccion, remodelage corporel.

Regional Inequalities in Oral Frailty and Social Capital.

INTRODUCTION: Oral frailty leads to poor nutritional status, which, in turn, leads to frailty. This cross-sectional study aimed to determine regional differences in the prevalence of oral frailty and to identify factors associated with oral frailty using 3-level multilevel models. METHODS: This study comprised 165,164 participants aged ≥65 y without long-term care requirements in the Japan Gerontological Evaluation Study. The dependent variable was oral frailty, which was calculated based on age, number of teeth, difficulty in eating tough foods, and choking. The individual-level independent variables included sociodemographics, present illness, social participation, frequency of meeting friends, and social capital. The local district-level independent variable was social capital (n = 1,008) derived from exploratory factor analyses. The municipality-level independent variable was population density (n = 62). Three-level multilevel Poisson regression analysis was performed to calculate the prevalence ratios (PRs). RESULTS: The prevalence of oral frailty in municipalities ranged from 39.9% to 77.6%. Regarding district-level factors, higher civic participation was significantly associated with a lower probability of oral frailty. At the municipality level, the PR of the rural-agricultural area was 1.17 (95% confidence interval, 1.11-1.23) (reference: metropolitan). CONCLUSION: These results highlight the usefulness of oral frailty prevention measures in encouraging social participation in rural areas. KNOWLEDGE TRANSFER STATEMENT: The results of the present study showed regional differences in oral frailty. In particular, rural-agricultural areas show higher prevalence rates of oral frailty than those in metropolitan cities. Promoting measures of social participation among older adults may help prevent oral frailty in rural areas.

Financial toxicity, family resilience and negative emotions among young and middle-aged breast cancer patients: A multicentre cross-sectional study.

PURPOSE: To determine financial toxicity in young and middle-aged women with breast cancer and examine the associations between family resilience and negative emotions. METHODS: A multicentre cross-sectional study was conducted, 538 women with breast cancer were recruited from four hospitals. FT, family resilience, and negative emotions were collected using the Comprehensive Score for FT, the Chinese version of the Family Resilience Assessment in Breast Cancer Patients, Patient Health Questionnaire-9 item, and Generalized Anxiety Disorder-7. This study adhered to the STROBE guidelines. RESULTS: The valid response rate was 96.8 % (N = 521). Overall, the score for FT was 19.63 ± 10.13. FT was significantly correlated with family resilience (r = 0.30, p < 0.010) and depression (r = -0.11, p < 0.050). The hierarchical multiple linear regression analysis showed that career status, monthly income, religion, and family resilience were the main factors influencing FT in patients with breast cancer (R2 = 0.37; F = 6.83; p < 0.001). CONCLUSIONS: FT was more prevalent among women from low-income career. Women with poor family resilience, no religious also suffer greater financial toxicity. It is necessary to pay more attention of the financial toxicity of female' low-income career, no religious belief and poor family resilience. Developing effective interventions based on family resilience might be helpful in promoting their well-being.

Prevalence and perceptions of flavour capsule cigarettes among adults who smoke in Brazil, Japan, Republic of Korea, Malaysia and Mexico: findings from the ITC surveys.

INTRODUCTION: The global market of flavour capsule cigarettes (FCCs) has grown significantly over the past decade; however, prevalence data exist for only a few countries. This study examined prevalence and perceptions of FCCs among adults who smoke across five countries. METHODS: Cross-sectional data among adults who smoked cigarettes came from the International Tobacco Control Policy Evaluation Project Surveys-Brazil (2016/2017), Japan (2021), Republic of Korea (2021), Malaysia (2020) and Mexico (2021). FCCs use was measured based on reporting one's usual/current brand or favourite variety has flavour capsule(s). Perceptions of the harmfulness of one's usual brand versus other brands were compared between those who used capsules versus no capsules. Adjusted logistic regression models examined correlates of FCC use. RESULTS: There were substantial differences in the prevalence of FCC use among adults who smoke across the five countries: Mexico (50.3% in 2021), Republic of Korea (31.8% in 2021), Malaysia (26.5% in 2020), Japan (21.6% in 2021) and Brazil (6.7% in 2016/2017). Correlates of FCC use varied across countries. Capsule use was positively associated with being female in Japan and Mexico, younger age in Japan, Republic of Korea and Malaysia, high education in Brazil, Japan and Mexico, non-daily smoking in Republic of Korea, and having plans to quit in Japan and Republic of Korea. There was no consistent pattern of consumer perceptions of brand harmfulness. CONCLUSION: Our study documented the high prevalence of FCCs in some countries, pointing to the need to develop and implement regulatory strategies to control these attractive products.