Demographics, culture and participatory nature of multi-marathoning-An observational study highlighting issues with recommendations.

OBJECTIVES: The defining achievement of a multi-marathoner is completing 100 marathons. This study aimed to comprehensively document the phenomenon of multi-marathoning, addressing its demographics, culture and participatory nature, filling a gap in peer-reviewed research on the topic. Additionally, it aimed to provide recommendations for multi-marathon governing bodies, event organisers, health professionals and participants to address identified issues. METHODS: A global survey was distributed to participants and individuals interested in multi-marathoning. It was distributed with support from major national and international multi-marathon clubs through their social media channels, email groups and newsletters. The survey was conducted anonymously and online. RESULTS: The survey garnered responses from 830 participants across 40 countries, with an average marathon completion count of 146.54 (SD 201.83) per respondent. Gender distribution showed 60.69% men, 39.3% women and 0.1% gender variant/non-conforming. Respondents' average ages were 51.6 (SD 9.96) years for men, 48.83 (SD 9.15) years for women and 35.00 (SD 8.76) years for gender variant/non-conforming. As participants age, social and travel motivations surpass competitiveness. A majority (57%) of respondents had at least one contravention to the pre-participation screening questionnaire PARQ-+ and 67% reported taking pain relief medication around events. Notably, 93% of respondents reported multi-marathoning as beneficial for their mental health. DISCUSSION: Multi-marathoning accommodates older athletes, but a significant gender imbalance exists in participation levels. Long-term health implications warrant attention from governing bodies, event organisers, health professionals and participants alike. Multi-marathoners should seek medical advice before participation, utilise modern equipment for health monitoring and optimise training accordingly. CONCLUSION: Recommendations include encouraging diversity at events, ensuring event directors have well-resourced health plans and promoting participants' proactive health management before and during their involvement in the sport. This study not only advances our understanding of multi-marathoning as a sport but also contributes to theoretical frameworks such as SDT and HBM.

Characteristics of the health districts in Italy and their implication in primary health care policies: an analysis of socio-demographic trends.

Introduction: The Health District (HD) is a critical component of Italy's National Health Service, responsible for ensuring Primary Health Care (PHC) services in response to community health needs. The Italian government established a national strategic reform program, the National Recovery and Resilience Plan (PNRR), starting in 2022, with a series of health interventions to reorganize the PHC setting, the main reform being the Ministerial Decree 77/2022 (DM77). Our study aimed to provide a description of socio-demographic data and to assess the correlation between HDs, in order to suggest health intervention priorities in PHC reforms. Materials and methods: We conducted our analysis using a cross-sectional record linkage of data from multiple sources to compare organizational and socio-demographic variables. A dataset was created with each of the 21 Italian Regions' HDs data of population, land area, mean age, ageing index, old-age dependency ratio, birth rate and death rate. The Inland Areas Project data was integrated for a socio-economic perspective. Results: Our study identified comparable groups of HDs, considering demographical, socio-economic and geographical aspects. The study provides a baseline understanding of the Italian situation prior to the implementation of DM77. It also highlights that inhabitants number cannot be the only variable to take into account for the definition of Italian HDs organisation and PHC reform, providing intercorrelated variables that take into account geographic location, demographic data, and socio-economic aspects. Conclusion: By acknowledging the interplay of demographic, socio-economic, and geographic factors, policymakers can tailor interventions to address diverse community needs, ensuring a more effective and equitable PHC system.

Trends of cervical tumours amongst women from perspectives of demographic, socioeconomic and geographic indicators: retrospective ecological study in Czechia.

Introduction: For many infectious diseases, women are at higher risk and have a more severe disease course than men for many reasons, including biological differences, social inequalities, and restrictive cultural norms. The study focuses on infections with human papillomaviruses (HPV) in the form of cervical cancer as a gender-specific disease. The main goal is to evaluate cervical tumour incidence trends in the Czech female population in the HPV vaccination period 2012-2020 in relation to selected demographic, socioeconomic, and geographic indicators. Methods: This is a retrospective ecological study. Data from publicly available databases about the incidence and mortality of cervical tumours (C53 Malignant neoplasm of cervix uteri, D06 Carcinoma in situ of cervix uteri according to ICD 10) and HPV vaccination rate were analysed and compared with demographic, socioeconomic and territorial data. Associations were searched using correlation analysis. Results: There was a decreasing trend in the incidence of cervical cancer in the observed period. Regarding cervical tumours (C53, D06) and malignant neoplasm of cervix uteri incidence (C53), the decrease was approximately 11 and 20%, respectively. Differences between regions were observed in incidences and vaccination rates. Based on correlation analysis, indicators connected with urban/rural aspects, such as a share of urban population and population density, were statistically significant. The indicators related to higher cervical cancer incidence are the high unemployment rate of women, the high number of divorces, the high number of abortions, the high share of the urban population, the high number of students, and the high number of women with only primary education. On the other hand, the indicators related to lower cervical cancer incidence are the high gross domestic product (GDP), the high average gross monthly wage per employee, the high employment rate of women, the higher average age of mothers at birth, and the high number of women with tertiary education. Conclusion: Results underline the problem of economically disadvantaged regions and families. Increasing vaccination rates, promoting regular screening for cervical cancer, and supporting awareness in the population, especially in regions with higher incidence rates, should be priorities for public health efforts.

Demographic and injury trends for car crash casualties hospitalized in Level I Trauma centers over two decades: data from the National Trauma Registry.

BACKGROUND: During the past two decades, there have been many changes in automotive and medical technologies, road infrastructure, trauma systems, and demographic changes which may have influenced injury outcomes. The aim of this study was to examine injury trends among traffic casualties, specifically private car occupants, hospitalized in Level I Trauma Centers (TC). METHODS: A retrospective cohort study was performed based on data from the Israel National Trauma Registry. The data included occupants of private cars hospitalized in all six Level I TC due to a traffic collision related injury between January 1, 1998 and December 31, 2019. Demographic, injury and hospitalization characteristics and in-hospital mortality were analyzed. Chi-squared (X2) test, multivariable logistic regression models and Spearman's rank correlation were used to analyze injury data and trends. RESULTS: During the study period, 21,173 private car occupants (14,078 drivers, 4,527 front passengers, and 2,568 rear passengers) were hospitalized due to a traffic crash. The percentage of females hospitalized due to a car crash increased from 37.7% in 1998 to 53.7% in 2019. Over a twofold increase in hospitalizations among older adult drivers (ages 65+) was observed, from 6.5% in 1998 to 15.7% in 2018 and 12.6% in 2019. While no increase was observed for severe traumatic brain injury, a statistically significant increase in severe abdominal and thoracic injuries was observed among the non-Jewish population along with a constant decrease in in-hospital mortality. CONCLUSIONS: This study provides interesting findings regarding injury and demographic trends among car occupants during the past two decades. Mortality among private car occupant casualties decreased during the study period, however an increase in serious abdominal and thoracic injuries was identified. The results should be used to design and implement policies and interventions for reducing injury and disability among car occupants.

Demographic determinants of happiness in Andalusia: insights from the 2022 social survey data.

The Social Survey of Andalusia is an instrument for monitoring the Andalusian reality developed by the regional government of Andalusia, whose dataset is open access to the citizens. The 2022 edition included questions related to happiness, social relations as well as socio-demographic factors. Based on this dataset, the present study aimed to analyse the relationship between socio-demographic factors and people's experiences of happiness. It also set out to explore which factors might be indispensable for experiencing moments of happiness as measured in the survey. A sample of 4,968 cases was gotten, conducting a descriptive analysis, a logit regression in complex samples, and a Necessary Conditions Analysis. The results found two very different social profiles in terms of the experience of happiness, determined by age, sex, educational level and economic status. However, neither factor proved to be a necessary condition for happiness. Both conclusions should be taken into consideration in any socio-community intervention.

Who is Represented in the Research on Undergraduate Research Experiences in the Natural Sciences? A Review of Literature.

Positive outcomes from undergraduate research experiences (UREs) have resulted in calls to broaden and diversify participation in research. However, we have little understanding of what demographics are reported and considered in the analyses of student outcomes from UREs. Without this information, it is impossible to assess whether participation in UREs has been diversified and how outcomes may vary by participant identity. Through a comprehensive literature search, we systematically identified 147 peer-reviewed research articles on student participation in UREs in the natural sciences, published between 2014 and 2020. We coded each paper to document which student demographic variables are reported and considered in analyses. The majority (88%) of articles on UREs reported at least one demographic variable and 62% incorporate demographics into their analyses, but demographics beyond gender and race/ethnicity were infrequently considered. Articles on independent research apprenticeships included demographics in their analyses more frequently than studies on course-based undergraduate research experiences (CUREs). Trends in reporting and analyzing demographics did not change from 2014 to 2020. Future efforts to collect these data will help assess whether goals to diversify UREs are being met and inform how to design UREs to meet the needs of diverse student groups.

Identity and inequality misperceptions, demographic determinants and efficacy of corrective measures.

By conducting two waves of large-scale surveys in the United Kingdom and Germany, we investigate the determinants of identity and inequality misperceptions. We first show that people substantially overestimate the share of immigrants, Muslims, people under the poverty line, and the income share of the richest. Moreover, women, lower-income, and lower-educated respondents generally have higher misperceptions. Only income share misperceptions are associated more with people who place themselves on the left of the political spectrum. In contrast, the other three misperceptions are more prevalent among those who place themselves to the right. We then attempt to correct misperceptions by conducting a classic controlled experiment. Specifically, we randomly assign respondents into a treatment group informed about their initial misperceptions and a control group left uninformed. Our results indicate that information treatments had some corrective effects on misperceptions in Germany but were ineffective in the United Kingdom. Moreover, information treatments in Germany were more effective for men, centrists, and highly educated respondents. There is also no evidence of spill-over effects: correcting one misperception does not have corrective effects for the other misperceptions.

The Intersection of a Child's Demographics and Household Socioeconomic Status in the Multimorbidity of Malaria, Anaemia, and Malnutrition among Children Aged 6-59 Months in Nigeria.

Multimorbidity of malaria, anemia, and malnutrition (MAMM) is a condition in which an individual has two or more of these health conditions, and is becoming an emergent public health concern in sub-Saharan African countries. The independent associations of a child's demographic variables and household socioeconomic (HSE) disparities with a child's health outcomes have been established in the literature. However, the effects of the intersection of these factors on MAMM, while accounting for other covariates, have not been studied. Therefore, this study aimed to determine how children's sex, age, and household socioeconomic status interact to explain the variations in MAMM among children aged 6-59 months in Nigeria. Data from the 2018 Nigeria Demographic and Health Survey and the 2018 National Human Development Report (NHDR) were used. This study included weighted samples of 10,184 children aged 6-59 months in Nigeria. A three-level multilevel mixed effect ordinal logistic regression model was used, such that individual characteristics at level 1 were nested in communities at level 2 and nested in states at level 3. Subsequently, predictive probability charts and average adjusted probability tables were used to interpret the intersectional effects. Five models were created in this scenario. Model 1 is the interaction between the child's sex and household wealth status; model 2 is the interaction between the child's sex and age; model 3 is the interaction between the child's age and household wealth status; model 4 has the three two-way interactions of the child's sex, age, and household wealth status; and model 5 includes model 4 and the three-way interactions between a child's sex, age, and household wealth quintiles; while accounting for other covariates in each of the models. The prevalence of children with a 'none of the three diseases' outcome was 17.3% (1767/10,184), while 34.4% (3499/10,184) had 'only one of the diseases', and 48.3% (4918/10,184) had 'two or more' MAMMs. However, in the multivariate analyses, model 3 was the best fit compared with other models, so the two-way interaction effects of a child's age and household wealth status are significant predictors in the model. Children aged 36-47 months living in the poorest households had a probability of 0.11, 0.18, and 0.32 of existing with MAMM above the probability of children of the same age who live in the middle class, more prosperous, and richest households, respectively, while all other covariates were held constant. Thus, the variation in the prevalence of MAMM in children of different ages differs depending on the household wealth quintile. In other words, in older children, the variations in MAMM become more evident between the richer and the poorer household quintiles. Therefore, it is recommended that policies that are geared toward economic redistribution will help bridge the disparities observed in the prevalence of multiple diseases among children aged 6-59 months in Nigeria.

Achieve fairness without demographics for dermatological disease diagnosis.

In medical image diagnosis, fairness has become increasingly crucial. Without bias mitigation, deploying unfair AI would harm the interests of the underprivileged population and potentially tear society apart. Recent research addresses prediction biases in deep learning models concerning demographic groups (e.g., gender, age, and race) by utilizing demographic (sensitive attribute) information during training. However, many sensitive attributes naturally exist in dermatological disease images. If the trained model only targets fairness for a specific attribute, it remains unfair for other attributes. Moreover, training a model that can accommodate multiple sensitive attributes is impractical due to privacy concerns. To overcome this, we propose a method enabling fair predictions for sensitive attributes during the testing phase without using such information during training. Inspired by prior work highlighting the impact of feature entanglement on fairness, we enhance the model features by capturing the features related to the sensitive and target attributes and regularizing the feature entanglement between corresponding classes. This ensures that the model can only classify based on the features related to the target attribute without relying on features associated with sensitive attributes, thereby improving fairness and accuracy. Additionally, we use disease masks from the Segment Anything Model (SAM) to enhance the quality of the learned feature. Experimental results demonstrate that the proposed method can improve fairness in classification compared to state-of-the-art methods in two dermatological disease datasets.

Demographic models predict end-Pleistocene arrival and rapid expansion of pre-agropastoralist humans in Cyprus.

The antiquity of human dispersal into Mediterranean islands and ensuing coastal adaptation have remained largely unexplored due to the prevailing assumption that the sea was a barrier to movement and that islands were hostile environments to early hunter-gatherers [J. F. Cherry, T. P. Leppard, J. Isl. Coast. Archaeol. 13, 191-205 (2018), 10.1080/15564894.2016.1276489]. Using the latest archaeological data, hindcasted climate projections, and age-structured demographic models, we demonstrate evidence for early arrival (14,257 to 13,182 calendar years ago) to Cyprus and predicted that large groups of people (~1,000 to 1,375) arrived in 2 to 3 main events occurring within <100 y to ensure low extinction risk. These results indicate that the postglacial settlement of Cyprus involved only a few large-scale, organized events requiring advanced watercraft technology. Our spatially debiased and Signor-Lipps-corrected estimates indicate rapid settlement of the island within <200 y, and expansion to a median of 4,000 to 5,000 people (0.36 to 0.46 km-2) in <11 human generations (<300 y). Our results do not support the hypothesis of inaccessible and inhospitable islands in the Mediterranean for pre-agropastoralists, agreeing with analogous conclusions for other parts of the world [M. I. Bird et al., Sci. Rep. 9, 8220 (2019), 10.1038/s41598-019-42946-9]. Our results also highlight the need to revisit these questions in the Mediterranean and test their validity with new technologies, field methods, and data. By applying stochastic models to the Mediterranean region, we can place Cyprus and large islands in general as attractive and favorable destinations for paleolithic peoples.

The threshold of rural placement frequency and duration: A repeated cross-sectional study examining rural career aspirations among student nurses.

AIM: This study aimed to explore what changes rural placement had on the perceptions of nursing students and the impact of placement frequency and duration on student considerations for rural practice. BACKGROUND: A strong rural healthcare workforce is a global concern and has led countries to look for creative ways to address this challenge. One approach is to train more health professionals, however, nursing students who grew up or lived in metropolitan or urbanised areas are suggested to be less inclined to pursue a rural career. As such it is posited that recurrent exposure to rural settings may exert a positive impact on future intention for rural practice. However, there is a need to explore the specific thresholds related to both the frequency and duration of rural placement exposure, as well as the cumulative impact multiple rural placements may have on the intention to engage in rural practice. DESIGN: A repeated cross-sectional design. METHODS: All nursing students from an Australian regional university were invited to complete an online questionnaire between 2019 and 2023. Demographic and placement specific questions were included. A modified version of the Nursing Community Apgar tool also measured the importance of key variables in rural career decision-making. Data were analysed using independent sample t-tests and one-way ANOVAs. Significance was determined at two-tailed p≤.05. RESULTS: Among the 835 respondents (response rate 15.4%), the average number and duration of rural placements was 2.45 placements and 3.01 weeks respectively. Rural placements did not have an impact on students who resided rurally or regionally. However, among metropolitan students who had experienced more than three rural placements, or more than sixteen cumulative weeks of placement, were significantly more likely to consider rural employment. Greater number of rural placements and longer cumulative duration had the greatest impact. CONCLUSION: Issues related to the nursing rural workforce are dynamic and complex. Understanding the unique drivers that improve the rural experiences among students, particularly metropolitan students, can have an impact on decision-making to pursue employment in rural environments. Importantly, whilst professional and clinical motivation and experiences are influential factors, the socialisation, environment and community features are essential elements that influence students' decisions to pursue a career in rural practice. Undertaking a nuanced approach that facilitates rural practice understanding among students may help shape future employment decision-making.

A new approach to geostatistical synthesis of historical records reveals capuchin spatial responses to climate and demographic change.

Recent proliferation of GPS technology has transformed animal movement research. Yet, time-series data from this recent technology rarely span beyond a decade, constraining longitudinal research. Long-term field sites hold valuable historic animal location records, including hand-drawn maps and semantic descriptions. Here, we introduce a generalised workflow for converting such records into reliable location data to estimate home ranges, using 30 years of sleep-site data from 11 white-faced capuchin (Cebus imitator) groups in Costa Rica. Our findings illustrate that historic sleep locations can reliably recover home range size and geometry. We showcase the opportunity our approach presents to resolve open questions that can only be addressed with very long-term data, examining how home ranges are affected by climate cycles and demographic change. We urge researchers to translate historical records into usable movement data before this knowledge is lost; it is essential to understanding how animals are responding to our changing world.

Demographic and Socioeconomic Predictors of Prehypertension and Hypertension in the Adult Population: Serbian National Health Survey.

Background and Objectives: Prehypertension and hypertension are the most common cardiovascular disorders worldwide and are increasingly considered one of the most serious public health problems, particularly in developing countries. The objective of this study was to determine the frequency and demographic and socioeconomic predictors of prehypertension and hypertension in the adults in Serbia, and to examine the relationship between prehypertension and hypertension and health behavior determinants (smoking, alcohol use, physical activity) and individual aspects of health (a health self-assessment, multimorbidity, BMI, depressive symptoms). Materials and Methods: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 20 and over were used. Results: Women are at a reduced risk for both prehypertension (OR = 0.328) and hypertension (OR = 0.349) by nearly 70%. Similarly, those aged below 60 years have a lower risk for prehypertension and those younger than 40 years have a lower risk for hypertension (OR = 0.995), whereas people with a lower education have a 4.3 times higher risk of prehypertension (OR = 4.323) and a 1.6 times higher risk of hypertension (OR = 1.614). The poor have a 1.4 times higher risk of prehypertension (OR = 1.413) and a 1 times higher risk of hypertension (OR = 1.035). People with multimorbidity have a 1.2 times higher risk of both prehypertension (OR = 1.218) and a 4.8 times higher risk of hypertension (OR = 4.867). Conclusions: Male gender, lower education, poverty, age and the presence of multimorbidity are significant predictors of prehypertension and hypertension in the Serbian adult population, so preventive strategies should be aimed at these sensitive population groups.

Demographic and Clinical Characteristics of Functional Dyspepsia and Its Subtypes in Adult Patients: An Experience from a Tertiary Care Centre in Bangladesh.

Functional dyspepsia (FD) is a common gastrointestinal problem in the world. The Rome III consensus subdivided functional dyspepsia into two groups: meal-related postprandial distress syndrome (PDS) and meal-unrelated epigastric pain syndrome (EPS). Limited data are available regarding FD in Bangladesh. The aim of this study was to investigate the demographic and clinical characteristics of FD and its sub-types. This cross-sectional study was conducted in which we recruited patients who attended the outpatient department of Gastroenterology of Bangabandhu Sheikh Mujib Medical University, Bangladesh from March 2017 to February 2018. Patients fulfilling Rome III FD criteria and a negative upper GIT endoscopy were included for this study. The patients were then subdivided into 'pure' PDS (i.e. meeting criteria for PDS without EPS symptoms), 'pure' EPS (i.e., meeting criteria for EPS without PDS symptoms), and overlapping PDS-EPS (i.e., symptoms of both PDS and EPS) groups. Total of 368 FD patients (56.0% females, mean age 32.8±8.6 years, BMI: 22.0±2.7), were included in this study. Out of them, 112(30.4%) patients (57.2% females, mean age 33.9±9.3 years, BMI: 22.0±2.7) fulfilled criteria of pure EPS and 64(17.4%) patients (68.8% females, mean age 33.2±7.8 years, BMI: 22.1±2.4) fulfilled criteria of pure PDS. However, the majority of patients [192(52.2%), 52.1% females, mean age 32.0±8.4 years, BMI: 21.9±2.8] had symptoms of overlapping EPS-PDS. More than 40% of patients in our study presented with 3 or more of the four key symptoms of FD. A longer duration of presenting symptoms was seen among patients with overlapping EPS-PDS in comparison to pure EPS and pure PDS (p<0.001). A significant overlap of symptoms of both EPS and PDS was noticed among patients with FD. The value of dividing functional dyspepsia into the subgroups of PDS and EPS is thus questionable. Further research and modification of the diagnostic criteria for FD subtypes are necessary.

Misinformation and COVID-19 vaccine uptake hesitancy among frontline workers in Tanzania: Do demographic variables matter?

Although COVID-19 vaccination has been widely considered as an important remedy to confront COVID-19, people remain hesitant to take it. The objective of this study was to assess the moderation effects of demographic characteristics on the relationship between forms of misinformation and COVID-19 vaccine uptake hesitancy among frontline workers in Dar es Salaam and Dodoma, Tanzania. Using a sample of 200 respondents, it assessed the differences in ratings on misinformation regarding COVID-19 vaccine based on respondents' demographics. The study used a Five-point Likert scale questionnaire distributed through snowball sampling to frontline workers from Dar es Salaam and Dodoma regions. Data was analyzed using binary logistic regression. It was found that the forms of misinformation revealed were manipulated imposters, satire, fabricated contents and false contents with their connection, which they influenced COVID-19 hesitancy significantly. With exception of age, that significantly moderated hesitancy, this study uncovers that, sex and education level moderated insignificantly in predicting those who are misinformed; misinformed individuals are not any less educated or not based on one's sex, different than individuals who are informed. The study informs policy makers on devising appropriate strategies to promote COVID-19 vaccination uptake among the different contextual demographic variables. Promotion of information, media and health literacy to the general public should be considered to deter spreading of vaccine-related misinformation.

Demographic risk factors for extra-pulmonary tuberculosis: a rising public health threat in Bhutan.

BACKGROUND: Recently, extra-pulmonary tuberculosis (EPTB) has been increasingly reported in Bhutan, rising from 26% in 2001 to 39% in 2010. In 2016, almost half (49%) of all reported TB cases were classified as EPTB. Thus, this study was conducted to understand the epidemiology and identify risk factors contributing to increasing notification of EPTB in Bhutan. METHODS: A case-control study was conducted by recruiting all 110 cases of nationally notified EPTB (Extrapulmonary bacteriologically confirmed/EPBC) as cases and 235 Pulmonary TB (Pulmonary bacteriologically confirmed/PBC) as controls. Data were collected on socio-demography, clinical and diagnostic, behavioral and lifestyle and environmental exposures using a structured questionnaire between April and September, 2018. RESULTS: The median age of the cases was 25 years, ranged 9-79 years. Lymphatic TB was predominant (n = 78; 70.91%) followed by genitourinary TB (n = 4 (3.64%). The likelihood of EPTB decreased with increase in age (p = 0.023). The odds of EPTB in females was 1.65 times higher than the males (p = 0.038). Increase in Body Mass Index (adjusted odds ratio (AOR): 1.1; 95% confidence interval (CI): 1.052-1.200) and urban residency were (AOR 1.6; 95% CI 1.016-2.805) were found to have higher odds of developing EPTB. CONCLUSION: Females, urban residents, and those with higher BMI are at increased risk of developing EPTB. These at-risk groups can be used to target limited public health resources to control EPTB in Bhutan.