Prevalence of SARS-CoV-2 Infection among Children and Adults in 15 US Communities, 2021

During January-August 2021, the Community Prevalence of SARS-CoV-2 Study used time/location sampling to recruit a cross-sectional, population-based cohort to estimate SARS-CoV-2 seroprevalence and nasal swab sample PCR positivity across 15 US communities. Survey-weighted estimates of SARS-CoV-2 infection and vaccine willingness among participants at each site were compared within demographic groups by using linear regression models with inverse variance weighting. Among 22,284 persons >2 months of age and older, median prevalence of infection (prior, active, or both) was 12.9% across sites and similar across age groups. Within each site, average prevalence of infection was 3 percentage points higher for Black than White persons and average vaccine willingness was 10 percentage points lower for Black than White persons and 7 percentage points lower for Black persons than for persons in other racial groups. The higher prevalence of SARS-CoV-2 infection among groups with lower vaccine willingness highlights the disparate effect of COVID-19 and its complications.

Sociodemographic and health-related factors associated with exclusive breastfeeding in 77 districts of Uganda.

BACKGROUND: Uganda surpasses many African nations and the global average in exclusive breastfeeding (EBF) rates. Yet, malnutrition is a critical issue, with stunting impacting roughly 29% of children under 5 years. Enhancing EBF could mitigate such nutritional challenges. This study focused on determining the current EBF prevalence and identifying associated factors across 77 surveyed districts. METHODS: Pooled data from the Lot Quality Assurance Sampling (LQAS) surveys conducted in 77 districts in Uganda during 2021 and 2022 were analyzed. The analysis involved 7,210 mothers of children under 6 months, EBF was considered as the proportion of infants who received breast milk only in the 24 hours before the survey. A mother practicing EBF was (1) currently breastfeeding (2) had not started giving foods other than breastmilk (3) had not given any other probed liquids or (4) semi-solid foods the previous day or night. Multivariable logistic regression was used to identify factors associated with EBF, presenting adjusted odds ratios (aOR) with corresponding 95% confidence intervals at a 5% significance level. RESULTS: The prevalence of EBF was 62.3%. In the adjusted analysis, EBF was more common among older mothers 20-24 years, 25-29 years and 30 + years (aOR 1.4; 95% CI 1.2,1.6), (aOR 1.4; 95% CI 1.1, 1.6) and (aOR 1.3; 95% CI 1.1, 1.5) respectively compared to teenage mothers. Also, EBF was more likely among mothers who lived in rural areas compared to urban areas (aOR 1.1; 95% CI 1.0, 1.3) and those who attended antenatal care (ANC) (aOR 2.2; 95% CI 1.5, 3.1). On the contrary, EBF was less common for children aged 3-5 months compared to younger (aOR 0.5; 95% CI 0.5, 0.6) and children who had received Vitamin A supplementation (aOR 0.7; 95% 0.6, 0.8). CONCLUSION: The study suggests that most districts in Uganda might not have made significant strides in improving EBF rates over the last twenty years, pointing to possible ongoing hurdles that need urgent attention. Particularly, there's a pressing need to focus on teenage mothers. Maintaining and strengthening programs that advocate EBF, such as ANC, is crucial to bridge the gaps and bring about more equitable rates among different groups.

Comparison of the burden of self-reported bacterial sexually transmitted infections among men having sex with men across 68 countries on four continents.

BACKGROUND: Men who have sex with men (MSM) are in general more vulnerable to sexually transmitted infections (STIs) than the heterosexual men population. However, surveillance data on STI diagnoses lack comparability across countries due to differential identification of MSM, diagnostic standards and methods, and screening guidelines for asymptomatic infections. METHODS: We compared self-reported overall diagnostic rates for syphilis, gonorrhea, and chlamydia infections, and diagnostic rates for infections that were classified to be symptomatic in the previous 12 months from two online surveys. They had a shared methodology, were conducted in 68 countries across four continents between October 2017 and May 2018 and had 202,013 participants. RESULTS: Using multivariable multilevel regression analysis, we identified age, settlement size, number of sexual partners, condom use for anal intercourse, testing frequency, sampling rectal mucosa for extragenital testing, HIV diagnosis, and pre-exposure prophylaxis use as individual-level explanatory variables. The national proportions of respondents screened and diagnosed who notified some or all of their sexual partners were used as country-level explanatory variables. Combined, these factors helped to explain differences in self-reported diagnosis rates between countries. The following differences were not explained by the above factors: self-reported syphilis diagnoses were higher in Latin America compared with Europe, Canada, Israel, Lebanon, and the Philippines (aORs 2.30 - 3.71 for symptomatic syphilis compared to Central-West Europe); self-reported gonorrhea diagnoses were lower in Eastern Europe and in Latin America compared with all other regions (aORs 0.17-0.55 and 0.34 - 0.62 for symptomatic gonorrhea compared to Central-West Europe); and self-reported chlamydia diagnoses were lower in Central East and Southeast Europe, South and Central America, and the Philippines (aORs 0.25 - 0.39 for symptomatic chlamydia for Latin American subregions compared to Central West Europe). CONCLUSIONS: Possible reasons for differences in self-reported STI diagnosis prevalence likely include different background prevalence for syphilis and syndromic management without proper diagnosis, and different diagnostic approaches for gonorrhea and chlamydia.

Assessing capacities and resilience of health services during the COVID-19 pandemic: Lessons learned from use of rapid key informant surveys.

This article is part of the Research Topic: 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict.' Problem: Many countries lacked rapid and nimble data systems to track health service capacities to respond to COVID-19. They struggled to assess and monitor rapidly evolving service disruptions, health workforce capacities, health products availability, community needs and perspectives, and mitigation responses to maintain essential health services. Method: Building on established methodologies, the World Health Organization developed a suite of methods and tools to support countries to rapidly fill data gaps and guide decision-making during COVID-19. The tools included: (1) a national "pulse" survey on service disruptions and bottlenecks; (2) a phone-based facility survey on frontline service capacities; and (3) a phone-based community survey on demand-side challenges and health needs. Use: Three national pulse surveys revealed persisting service disruptions throughout 2020-2021 (97 countries responded to all three rounds). Results guided mitigation strategies and operational plans at country level, and informed investments and delivery of essential supplies at global level. Facility and community surveys in 22 countries found similar disruptions and limited frontline service capacities at a more granular level. Findings informed key actions to improve service delivery and responsiveness from local to national levels. Lessons learned: The rapid key informant surveys provided a low-resource way to collect action-oriented health services data to inform response and recovery from local to global levels. The approach fostered country ownership, stronger data capacities, and integration into operational planning. The surveys are being evaluated to inform integration into country data systems to bolster routine health services monitoring and serve as health services alert functions for the future.

Knowledge and awareness of oral cancer: A cross-sectional survey in Trieste, Italy.

The aim of the study was to verify the knowledge on oral cancer and to assess possible differences in awareness and information basing on different demographic and subject-related factors. An anonymous survey was provided to 750 random subjects using online-based questionnaires. Statistical analysis was performed in order to evaluate the influence of demographic variables (gender, age, education) on knowledge of oral cancer and its risk factors. 68.4% of individuals knew about the existence of oral cancer, mostly from media and family/friends. Awareness was significantly influenced by gender and higher education, but not by age. Most participants recognized smoking as a risk factor, but alcohol abuse and sunlight exposure are less known, especially among less educated subjects. On the contrary, our study shows a diffusion of false information: more than 30% of the participants indicated the possible role of amalgam fillings in oral cancer onset, independently of gender, age or education. The results of our study suggest the need for oral cancer awareness campaigns, where school and healthcare professionals should be actively involved in promoting, organizing and finding methods to monitor the medium and long-term efficacy with proper methodological quality.

Validation of the WHOQOL-BREF Quality of Life Questionnaire in an Urban Sample of Older Adults in a Neighbourhood in Zaragoza (Spain).

BACKGROUND: Nowadays, the increase in life expectancy needs to be matched by an increase in the wellbeing of older adults. A starting point is the definition of what is understood by health-related quality of life and its measurement in different contexts. Our research translates these international priorities to a local base. OBJECTIVE: To evaluate the psychometric characteristics of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) in a sample of older adults from a Spanish urban community (Casablanca). METHODS: In collaboration with the local health centre, we designed and implemented the health neighbourhood survey. Interviews took place at subjects' homes with 212 women and 135 men over the age of 60, who were residents in Casablanca. With the results, we evaluated the psychometric characteristics of WHOQOL-BREF and tested its reliability and validation. RESULTS: The instrument has a high internal consistency with a Cronbach's Alpha of 0.9. The items with higher correlation value were: ability to carry out activities in daily life, enough energy for daily life. The scale contributions of Physical Health dimension (0.809) and Psychological Health dimension (0.722) were notable. CONCLUSIONS: As with other studies, the instrument proved to be an integral evaluation of the diverse domains that condition the wellbeing of older adults.

HUNT for better public health.

AIMS: The Trøndelag Health Study (HUNT) has collected population data through comprehensive decennial surveys over the last four decades and has so far collected data from 240,000 participants. The participants are identified with the unique Norwegian birth number, which enables them to be followed throughout different life stages, from survey to survey, and to endpoint measures in Norwegian national health registers without attrition bias. METHODS: The study design of HUNT offers several advantages: it provides an overview of the public health development in the population over decades, the data can be used in health services research, clinical epidemiology, studies of causation, trajectories, and consequences of diseases, and to study gene × environment interactions. RESULTS: HUNT data have shown major shifts in public health trends, such as decreasing mean blood pressure and resting heart rate among adults, increasing prevalence of obesity, geographical and socioeconomic inequalities in health, increasing mental health distress among adolescents and young adults with an opposite development among the elderly. Data from HUNT have been used in several major international research projects, where data harmonization with several other population cohorts internationally has been done. HUNT has placed great emphasis on safeguarding research ethics, privacy, and data security. The Norwegian authorities established national regulations for the surveys from the time General Data Protection Regulation was introduced in 2018. CONCLUSIONS: Researchers can apply for HUNT data access from HUNT Research Centre provided they have obtained project approval from the Regional Committee for Medical and Health Research Ethics. Researchers not affiliated to a Norwegian research institution must collaborate with and apply through a Norwegian principal investigator. Information on the application and conditions for data access is available at www.ntnu.edu/hunt/data.

Omicron SARS-CoV-2 epidemic in England during February 2022: A series of cross-sectional community surveys.

Background: The Omicron wave of COVID-19 in England peaked in January 2022 resulting from the rapid transmission of the Omicron BA.1 variant. We investigate the spread and dynamics of the SARS-CoV-2 epidemic in the population of England during February 2022, by region, age and main SARS-CoV-2 sub-lineage. Methods: In the REal-time Assessment of Community Transmission-1 (REACT-1) study we obtained data from a random sample of 94,950 participants with valid throat and nose swab results by RT-PCR during round 18 (8 February to 1 March 2022). Findings: We estimated a weighted mean SARS-CoV-2 prevalence of 2.88% (95% credible interval [CrI] 2.76-3.00), with a within-round effective reproduction number (R) overall of 0.94 (0·91-0.96). While within-round weighted prevalence fell among children (aged 5 to 17 years) and adults aged 18 to 54 years, we observed a level or increasing weighted prevalence among those aged 55 years and older with an R of 1.04 (1.00-1.09). Among 1,616 positive samples with sublineages determined, one (0.1% [0.0-0.3]) corresponded to XE BA.1/BA.2 recombinant and the remainder were Omicron: N=1047, 64.8% (62.4-67.2) were BA.1; N=568, 35.2% (32.8-37.6) were BA.2. We estimated an R additive advantage for BA.2 (vs BA.1) of 0.38 (0.34-0.41). The highest proportion of BA.2 among positives was found in London. Interpretation: In February 2022, infection prevalence in England remained high with level or increasing rates of infection in older people and an uptick in hospitalisations. Ongoing surveillance of both survey and hospitalisations data is required. Funding: Department of Health and Social Care, England.

Knowledge, Attitude, and Acceptability of COVID-19 Vaccine in Oman: A Cross-sectional Study.

Objectives: To evaluate the knowledge, attitude, and acceptance of COVID-19 vaccine among the general population of Oman, on the eve of the rollout of vaccination program in the country. Methods: A cross-sectional study was conducted using a structured and validated online questionnaire. Adults residing in Oman were invited to participate in the study between 22 and 24 December 2020. Logistic regression analysis was used to identify the factors associated with COVID-19 vaccine acceptability. Results: Of the total of 966 participants, the majority (612; 63.4%) were women. Most participants were younger than 40 years (572; 59.3%). Participants displayed good awareness about COVID-19 (946; 97.9%) and the global vaccine development initiatives (831; 86.0%). Only 265 (27.4%) participants were willing to get themselves vaccinated. The majority were either uncertain 365 (37.8%) or unwilling 336 (34.8%). The main driver of vaccine acceptance was to protect oneself and others (186/265; 70.0%). The main reasons given for vaccination hesitation/refusal were concerns over possible side-effects (505/701; 72.0%), safety concerns (386/701; 55.0%), and ineffectiveness of the vaccine (107/701; 15.3%). Conclusions: On the eve of the first-ever rollout of COVID-19 vaccine in Oman in December 2020, the surveyed residents of the country expressed significant hesitancy to get themselves vaccinated. Participants' perceptions of risk of contracting COVID-19, their trust in vaccines, government, and their health system were important predictors of vaccine acceptance. These results enabled development of strategies to address such concerns to facilitate vaccine acceptance among the residents of Oman. The results of this study can be used by researchers to conduct comparative research in future, with more emphasis on Omani youth (< 40 years).

Resultados de una encuesta nacional sobre conocimiento y uso de pseudociencias por parte de los pediatras / Results of a national survey on knowledge and use of complementary and alternative medicine by paediatricians

Introducción: El uso de determinadas pseudociencias en niños está documentado en España. El objetivo principal del estudio es estimar el grado de conocimiento, la recomendación y el uso de algunas pseudoterapias por parte de los pediatras españoles. Material y métodos: Estudio transversal, descriptivo y de ámbito nacional, mediante encuesta en línea, enviada por correo electrónico a pediatras socios de la Asociación Española de Pediatría (AEP), entre junio y julio de 2020. (AU)

Introduction: The use of certain Complementary and Alternative Medicines (CAM) in children has been documented in Spain. The main aim of this study is to estimate the knowledge, recommendations, and use of CAM by Spanish paediatricians. Material and methods: A national study was conducted from June to July 2020 using an online questionnaire. Two e-mails were sent to paediatricians who were members of the Spanish Association of Paediatrics (AEP). (AU)

Results of a national survey on knowledge and use of complementary and alternative medicine by paediatricians.

INTRODUCTION: The use of certain Complementary and Alternative Medicines (CAM) in children has been documented in Spain. The main aim of this study is to estimate the knowledge, recommendations, and use of CAM by Spanish paediatricians. MATERIAL AND METHODS: A national study was conducted from June to July 2020 using an online questionnaire. Two e-mails were sent to paediatricians who were members of the Spanish Association of Paediatrics (AEP). RESULTS: Out of 1414 responses received, acupuncture was considered as a science by 31.8%. Homeopathy was recommended to parents by 28.1%. CAM was used by 21.3% of physicians, at least once, to improve their own health. Only 3.8% had ever replaced a conventional treatment with CAM. The following variables were associated with a greater disposition to prescribe homeopathy: female, age over 45 years old, paediatricians working in Primary Care, and paediatricians working in private healthcare. CONCLUSIONS: This AEP Committee on Medicines questionnaire provides new data that should be considered alarming and should ask for a serious thinking on the use of CAM in Spain. Some paediatricians are recommending parents to give treatments not supported by scientific evidence to their children. This practice could be potentially harmful, especially when conventional treatment is being replaced.

Identifying trends over time in food affordability: The Illawarra Healthy Food Basket survey, 2011-2019.

OBJECTIVE: To determine the affordability of a healthy food basket (HFB) for welfare recipients and average income earners in 2019 and to compare trends from 2011. METHODS: Fifty-seven food items' prices were collected from fifteen stores across five suburbs representing low, medium and high socio-economic status. Costs were compared with average weekly income and welfare payments to assess the baskets' affordability for a family of four and five. RESULTS: In 2019, a HFB was affordable (below 30% of household income) for a five-person reference family with a pensioner, representing 24.8% of weekly welfare payments, but not for a four-person reference family (33.0%). The cost of the HFB increased slightly over time from AU$288.91 in 2011 to AU$291.79 in 2019. The food affordability improved for a family of five including a pensioner over this period due to an increase of average weekly earnings and welfare payments. CONCLUSION: In 2019, the HFB was affordable for a five-person family; however, a four-person family receiving welfare benefits would have experienced significant "food stress," with the food basket costing above 30% of household income. IMPLICATIONS FOR HEALTH PROMOTION: Inequity in the affordability of healthy food is a major public health concern and one that demands recognition and national action. The impact of policies affecting welfare support and wages needs to be considered, as well as food pricing strategies and possible food subsidies for those at greatest risk of food insecurity.

Cross-National Comparisons of Cognitive and Physical Health in Older Adults Across China, Japan, and Korea: A Systematic Review.

BACKGROUND: Cross-national studies are an emerging research area in public health. Specifically, cross-national health comparisons are important for understanding the factors driving the success or failure of public health policies. Therefore, this study systematically analyzed studies that compared health status (physical health and cognition) of the older adults using national panel data for three East Asian countries-China, Japan, and Korea. METHODS: Google Scholar and PubMed were used for the literature search. The search strategy targeted papers published between 2005 and 2020, yielding a total of 2690 papers, of which seven were selected for the review. The Center for Evidence-Based Medicine (CEBM) criteria was used to assess study design quality. The risk of bias for non-randomized studies (RoBANS) tool, a quality assessment tool developed in Korea to evaluate non-randomized interventional studies, measured risk of bias. RESULTS: Of the seven included papers, two studies performed cognitive comparisons, four studies performed physical health comparisons, and one study compared both cognition and physical health. The studies selected for this study by CEBM criteria included four prospective cohort studies (Level 2B) and three expert opinions without explicit critical appraisal (Level 5). Risk of bias using the RoBANS tool found a risk of confounding variables in four out of seven papers. Finally, measurement items of cognitive and physical health differed across all three countries' panel surveys. CONCLUSION: These results suggest that in order to compare East Asian health policies according to the aging society, it is necessary to develop consistent cognitive and physical health evaluation tools in the future.

[Results of a national survey on knowledge and use of complementary and alternative medicine by paediatricians]. / Resultados de una encuesta nacional sobre conocimiento y uso de pseudociencias por parte de los pediatras.

INTRODUCTION: The use of certain Complementary and Alternative Medicines (CAM) in children has been documented in Spain. The main aim of this study is to estimate the knowledge, recommendations, and use of CAM by Spanish paediatricians. MATERIAL AND METHODS: A national study was conducted from June to July 2020 using an online questionnaire. Two e-mails were sent to paediatricians who were members of the Spanish Association of Paediatrics (AEP). RESULTS: Out of 1,414 responses received, acupuncture was considered as a science by 31.8%. Homeopathy was recommended to parents by 28.1%. CAM was used by 21.3% of physicians, at least once, to improve their own health. Only 3.8% had ever replaced a conventional treatment with CAM. The following variables were associated with a greater disposition to prescribe homeopathy: female, age over 45 years old, paediatricians working in Primary Care, and paediatricians working in private healthcare. CONCLUSIONS: This AEP Committee on Medicines questionnaire provides new data that should be considered alarming and should ask for a serious thinking on the use of CAM in Spain. Some paediatricians are recommending parents to give treatments not supported by scientific evidence to their children. This practice could be potentially harmful, especially when conventional treatment is being replaced.

Impact of Graphic Warning Labels on Cigarette Packs in Changing Smokers' Views and Habits: An Opinion Survey.

BACKGROUND: Smoking has become a major issue worldwide. With the advancement in technology, more vulnerable populations, such as teenagers, are also being harmed. One deterrent is the presence of graphic labels on cigarette packs. With this rationale in mind, the objective of our study is to assess the impact of these warning labels on the habits and opinions of smokers. METHODS: A cross-sectional study was conducted by distributing a validated paper-based questionnaire. The sample size was calculated to be 200 using statistical software. The study targeted students of Islamabad, Pakistan, who were studying in twelfth grade and were smokers. The sampling method used was 'snowball sampling'. FINDINGS: 128 (64%) males and 72 (36%) females participated in the study. The mean age of the participants was 17.59 ± 0.51 years. 40 participants reported choosing local brands for cigarettes due to cigarette 'freshness', regardless of presence or absence of a graphic label, which was a new concept. 94% of participants believed that presence of a visual label helped with understanding the harm and 78% believed that the side effects were accurately portrayed. Participants who were more than 17 years of age believed that the graphic label provided a clear description of the consequences of smoking. Similar results were seen in the female participants of the study. CONCLUSION: There is a general consensus on graphic labels altering the opinions of smokers. The presence of these labels is, however, targeting only a specific type of audience and hence, should be expanded for a larger audience.

Knowledge, attitudes, and practices regarding dengue, chikungunya, and Zika in Cali, Colombia.

Dengue fever (DENF), chikungunya (CHIK), and Zika are responsible for the majority of the burden caused by vector-borne diseases (VBDs); which are produced by viruses primarily transmitted by the Aedes mosquito. Aedes have become prolific in urban areas due to a combination of climate change, rapid urbanization, increased human mobility, and globalization, causing the three VBDs to emerge in novel regions. Community knowledge can provide detailed insights about the spatial heterogeneity of disease risk and rates within a particular region, improving public health interventions. Knowledge, Attitude, and Practice (KAP) surveys are used to shed light on at-risk communities' understanding of the vector, the pathogen, prevention and treatment strategies. Little is known how KAP varies among diseases, and among neighborhoods within a city. Understanding KAP variation among co-circulating VBDs at a fine-level, especially differences between endemic and emerging diseases, can improve targeted interventions, education programs, and health policy. We administered KAP surveys to 327 individuals in healthcare centers and selected neighborhoods in Cali, Colombia in June 2019. We utilized generalized linear models (GLMs) to identify significant predictors of KAP. Our findings suggest that knowledge is related to community characteristics (e.g. strata), while attitudes and practices are more related to individual-level factors. Access to healthcare also forms significant predictor of residents participating in preventative practices. The results can be leveraged to inform public health officials and communities to motivate at-risk neighborhoods to take an active role in vector surveillance and control, while improving educational and surveillance resources in Cali, Colombia.

Validation of self-reported help-seeking, and measurement of the patient interval, for cancer symptoms: an observational study to inform methodological challenges in symptomatic presentation research.

BACKGROUND: To improve earlier presentation with potential symptoms of cancer, accurate data are needed on how people respond to these symptoms. It is currently unclear how self-reported medical help-seeking for symptoms associated with cancer by people from the community correspond to what is recorded in their general practice records, or how well the patient interval (time from symptom onset to first presentation to a health-professional) can be estimated from patient records. METHOD: Data from two studies that reviewed general practice electronic records of residents in Scotland, (i) the 'Useful Study': respondents to a general population survey who reported experiencing symptoms potentially associated with one of four common cancers (breast, colorectal, lung and upper gastro-intestinal) and (ii) the 'Detect Cancer Early' programme: cancer patients with one of the same four cancers. Survey respondents' self-reported help-seeking (yes/no) was corroborated; Cohen's Kappa assessed level of agreement. Combined data on the patient interval were evaluated using descriptive analysis. RESULTS: 'Useful Study' respondents' self-report of help-seeking showed exact correspondence with general practice electronic records in 72% of cases (n = 136, kappa 0.453, moderate agreement). Between both studies, 1269 patient records from 35 general practices were reviewed. The patient interval could not be determined in 44% (n = 809) of symptoms presented by these individuals. CONCLUSIONS: Patient self-report of help-seeking for symptoms potentially associated with cancer offer a reasonably accurate method to research responses to these symptoms. Incomplete patient interval data suggest routine general practice records are unreliable for measuring this important part of the patient's symptom journey.

Development of a dish-based food frequency questionnaire for Iranian population.

Background: Food frequency questionnaires (FFQs) are widely used in large studies worldwide. They usually seek to rank people according to their usual food intake rather than a specific period of time. In the present study, we aimed to develop a dish-based, semi-quantitative FFQ to seek habitual diet of general population aged 9 to 65 years in Tehran. Methods: To develop the FFQ, four main steps were taken. At the beginning a list of commonly consumed Iranian foods and mixed dishes was prepared. To prevent excessive questionnaire length, some food items were grouped. Then, reference portion sizes were defined for each mixed dish in the list. The portion sizes were defined either based on the most common food portions reported in existing data or based on conventional portioning. In the third step the frequency response for consumption of food items and mixed dishes were determined. In the last step, recipes were developed for mixed dishes based on several data sources, including previous surveys. Finally, the content validity of the questionnaire was evaluated by the expert panel. Results: The final food list of the FFQ comprised 142 food items and mixed dishes in six major food groups, including dairy products, breads, mixed dishes, dried fruits, nuts and seeds, fruits and vegetables, and miscellaneous food items and beverages. Nine frequency response options for all food items varying from "never or less than once per month" to "more than 6 times a day" were considered. A portion size was included for each item, whether food items or mixed dishes. Conclusion: As Iranian food recipes are typically characterized by various ingredients it is very difficult for the respondent to recall the amount and type of the ingredients. Likewise, information about cooking methods beside ingredients of foods are important to estimate their nutritive values, which can be explored only through asking about consumption of mixed dishes. The current FFQ was developed to overcome the mentioned problems. It can be applied in nationwide studies in which foods and/or nutrients are predominant determinant of health and/or diseases.

National survey of awareness and training experience of automated external defibrillator

OBJECTIVE: Public concerns and awareness of automated external defibrillators (AEDs) are essential for improving the survival outcomes of out-of-hospital cardiac arrest (OHCA) in the community. On the other hand, the proportion of OHCA, in which AED is used in a prehospital setting, is very low in Korea. The aim of this study was to identify the barriers and training issues of AEDs. METHODS: A nationwide population-based survey was conducted to analyze the current public trends in AED awareness, training, and intention to use in 2017 (n=506). The barriers and training issues of AEDs were then documented. For trend analysis, previous tri-temporal surveys were obtained in 2007, 2011, and 2015. RESULTS: Public awareness of AEDs has increased: from 5.8% in 2007, to 30.6% in 2011, 82.6% in 2015, and 79.4% in 2017 (P<0.001). The training experience of AEDs has increased over time: from 0.5% in 2007 to 8.2% in 2011 and 33.2% in 2017. Thirty-two percent of respondents knew how and where to find the AEDs, but only 12.5% were able to certainly locate their public-access AED near their residency or work places. The reasons for being unwilling to use the AED included not knowing how to use (65.0%), fear of causing harm to the victim (21.3%), and legal liability (11.7%). CONCLUSION: Not knowing the location of AED and how to use it, and being unaware of the Good Samaritan Law were the major barriers to public access defibrillation. Further research is urgently needed if AEDs are to be increased and more lives saved.

"A Learned Soul to Guide Me": The Voices of Those Living with Kidney Disease Inform Physical Activity Programming.

Purpose: The purpose of this study was to (a) confirm the barriers to and facilitators of physical activity (PA) among persons living with chronic kidney disease (CKD) in Ontario and (b) inform the design of a Kidney Foundation of Canada Active Living for Life programme for persons living with CKD. Method: Adults living with CKD in Ontario were invited to participate in a cross-sectional survey investigating opinions about and needs for PA programming. The 32-item survey contained four sections: programme delivery preferences, current PA behaviour, determinants of PA, and demographics. Data were summarized using descriptive statistics and thematic coding. Results: A total of 63 respondents participated. They had a mean age of 56 (SD 16) years, were 50% female, and were 54% Caucasian; 66% had some post-secondary education. The most commonly reported total weekly PA was 90 minutes (range 0-1,050 minutes). Most respondents (84%) did not regularly perform strength training, and 73% reported having an interest in participating in a PA programme. Conclusion: Individuals living with CKD require resources to support and maintain a physically active lifestyle. We identified a diversity of needs, and they require a flexible and individualized inter-professional strategy that is responsive to the episodic changes in health status common in this population.

Objectif : la présente étude visait à a) confirmer les obstacles et les incitatifs à l'activité physique (AP) chez les personnes atteintes d'une néphropathie chronique (NPC) en Ontario et b) étayer la conception du programme Une vie active pour la vie de la Fondation canadienne du rein pour les personnes atteintes d'une NPC. Méthodologie : des adultes de l'Ontario atteints d'une NPC ont été invités à participer à un sondage transversal sur leurs avis et leurs besoins liés aux programmes d'AP. Le sondage de 32 questions était divisé en quatre parties : préférences quant à la prestation du programme, comportements actuels en matière d'AP, déterminants de l'AP et démographie. Les chercheurs ont résumé les données à l'aide de statistiques descriptives et de codes thématiques. Résultats : au total, 63 répondants ont participé. Ils avaient un âge moyen de 56 ans (ÉT de 16 ans), 50 % étaient des femmes, 54 % étaient blancs et 66 % avaient une certaine éducation postsecondaire. L'AP physique hebdomadaire totale la plus déclarée était de 90 minutes (plage de 0 à 1 050 minutes). La plupart des répondants (84 %) ne faisaient pas d'entraînement musculaire régulier, et 73 % se sont dit intéressés à participer à un programme d'AP. Conclusion : les personnes atteintes d'une NPC ont besoin de ressources pour maintenir un mode de vie actif. Les chercheurs ont repéré une diversité de besoins et la nécessité d'une stratégie interprofessionnelle personnalisée qui tient compte des changements épisodiques de l'état de santé, courants dans cette population.