Incidence of sexually transmitted infections and association with behavioural factors: Time-to-event analysis of a large pre-exposure prophylaxis (PrEP) cohort.

OBJECTIVES: Our objective was to obtain long-term data on the incidence of sexually transmitted infections (STIs) and their association with behavioural factors after widespread pre-exposure prophylaxis (PrEP) implementation. METHODS: This was a time-to-event analysis of a national PrEP cohort in Switzerland (SwissPrEPared study). Participants were people without HIV interested in taking PrEP with at least two STI screening visits. Primary outcomes were incidence rate of gonorrhoea, chlamydia, and syphilis. The association between behavioural factors and STI diagnosis was expressed using hazard ratios. We adjusted for testing frequency and calendar year. RESULTS: This analysis included 3907 participants enrolled between April 2019 and April 2022, yielding 3815.7 person-years of follow-up for gonorrhoea (15 134 screenings), 3802.5 for chlamydia (15 141 screenings), and 3858.6 for syphilis (15 001 screenings). The median age was 39 years (interquartile range [IQR] 32-47), 93.8% (n = 3664) identified as men who have sex with men (MSM). The incidence was 22.8 (95% confidence interval [CI] 21.3-24.4) per 100 person-years for gonorrhoea, 26.3 (95% CI 24.7-28.0) for chlamydia, and 4.4 (95% CI 3.8-5.1) for syphilis. Yearly incidence rates decreased between 2019 (all bacterial STIs: 81.6; 95% CI 59.1-109.9) and 2022 (all bacterial STIs: 49.8; 95% CI 44.6-55.3). Participants reporting chemsex substance use were at higher risk of incident STIs, as were those reporting multiple sexual partners. Younger age was associated with a higher risk of gonorrhoea and chlamydia. CONCLUSIONS: Incidence rates of bacterial STIs decreased over time. Young MSM, those with multiple partners, and those using chemsex substances were at increased risk of STIs.

Abuse and neglect as indicators of unhealthy behaviours among 15-year-old schoolchildren in Albania.

OBJECTIVE: We assessed the independent associations of lifetime child abuse and neglect indices with behavioural characteristics of children. STUDY DESIGN: A cross-sectional study was conducted in Albania in 2022. METHODS: Participants consisted of a nationwide representative sample of 1877 schoolchildren aged 15 years (55 % girls; response: 96 %). Data on lifetime child abuse and neglect were collected, along with behavioural factors and sociodemographic characteristics. Binary logistic regression was used to assess the independent associations of child abuse and neglect with behavioural factors of schoolchildren. RESULTS: Irrespective of sociodemographic characteristics, lifetime physical abuse was positively related to lifetime smoking (OR = 1.8, 95%CI = 1.4-2.3), lifetime alcohol consumption (OR = 2.4, 95%CI = 1.9-2.9), and breakfast skipping (OR = 1.3, 95%CI = 1.0-1.6). Furthermore, positive independent factors associated with emotional abuse included lifetime alcohol intake (OR = 1.7, 95%CI = 1.3-2.1) and breakfast skipping (OR = 1.4, 95%CI = 1.0-1.8). Additionally, positive factors associated with lifetime emotional neglect consisted of lifetime smoking (OR = 2.2, 95%CI = 1.6-3.0) and alcohol intake (OR = 2.0, 95%CI = 1.5-2.6), and a lower fruit consumption (OR = 1.7, 95%CI = 1.3-2.3). Positive factors associated with lifetime sexual abuse included lifetime alcohol consumption (OR = 2.4, 95%CI = 1.4-4.1) and especially smoking (OR = 4.3, 95%CI = 2.6-7.3). Also, lifetime witnessing of family violence was positively related to lifetime smoking (OR = 2.7, 95%CI = 1.8-4.1) and alcohol intake (OR = 1.7, 95%CI = 1.2-2.6). CONCLUSIONS: We evidenced strong and consistent links between child maltreatment indices and unhealthy behavioural practices among 15-year-old children in Albania. These findings underscore the potential impact of early trauma on developmental trajectories. The association between child abuse and the adoption of detrimental behaviours highlights the urgent need for comprehensive support and intervention strategies to break the cycle of harm.

Intensity of adaptations to heat stress in poultry farms: A behavioural analysis of farmers in Ondo state, Nigeria.

The detrimental consequences of heat stress due to high ambient temperatures, particularly in the poultry industry, have led to the invention of several adaptation strategies. However, there is still limited information on the intensity of adaptations and the likely behavioural factors that influence farmers' decisions. Thus, understanding the practical adaptation behaviours of poultry farmers would improve our knowledge of the fundamental mechanisms for developing effective interventions. To fill this void, using a count data model, the study empirically examines the farmers' behavioural factors and the intensity of heat stress adaptation strategies' adoption among poultry farmers in Ondo State, Nigeria. The data were drawn from a survey of 150 poultry farmers using a multistage sampling procedure. The empirical results show that the majority of the farmers perceived an increase in temperature, frequently experienced heat stress, and believed that heat stress is induced by climate change. An average of six adaptation strategies were simultaneously adopted to mitigate heat stress in the area. The results of the count regression model reveal that farm-level factors such as permanent water sources, the quantity of feed, and bird stock density exert a significant effect on the intensity of adaptations. Climate-related factors such as access to climate information, training participation, perceived increases in temperature, attitudes toward climate change, and motives for adoption have a significant behavioural effect on the intensity of adaptations. Likewise, variables such as poultry farming experience, educational status, and access to credit are accounted for as socioeconomic behavioural factors that influence the intensity of adopting heat stress adaptation strategies in the area. This concludes that behavioural factors are crucial in addressing heat stress adaptations and assisting in improving environmental management, which would form a key variable in the policy interventions.

Contextual Factors of Face Mask Wearing During the COVID-19 Pandemic and Recommendations to Increase Compliance Rate.

Community-wide face mask wearing is recognised as an effective non-pharmaceutical defence against infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of coronavirus disease 2019 (COVID-19) pandemic. However, few studies have identified contextual factors of face mask wearing during the COVID-19 pandemic. This study aims to identify relationships between demographic factors, personal hygiene factors, online behavioural factors and face mask wearing by Malaysian adults during the COVID-19 pandemic. Data were collected via an online survey questionnaire and analysed with Statistical Package for Social Sciences version 26. Non-availability of personal protective equipment (PPE) as well as fewer social media hours and fewer hours of browsing information related to the COVID-19 pandemic were identified as factors related to low compliance rate of face mask wearing by some Malaysian adults. This study advances contextual understanding of face mask wearing by specific groups during the COVID-19 pandemic and puts forth several recommendations to increase face mask wearing compliance rate.

Life Style and Behavioural Factors are Associated with Stroke Recurrence Among Survivors of First Episode of Stroke: A Case Control Study.

BACKGROUND: Secondary stroke prevention treatment is associated with an 80% reduction in risk of recurrent stroke. But one out of every four strokes are recurrent. Adherence to pharmacological therapy and strict control of risk factors are essential for prevention of recurrent strokes. METHODS: Pair matched incident case control study was done to find out the factors associated with stroke recurrence after first ever stroke. Incident cases of recurrent strokes and age and post stroke period matched controls were recruited prospectively. The estimated sample size for the study was 70 matched pairs. Data collected from medical records and by visiting their homes. Analysis was done using R statistical software. RESULTS: Bivariate analysis showed cardio embolic stroke subtype, poor lipid control, unhealthy diet, physical inactivity, medication nonadherence, presence of depression, memory problems no discharge advice at index admission and low income were associated increased risk of recurrence. Higher mean NIHSS score and a greater number of days of hospitalisation during index stroke had less risk of recurrence. Conditional logistic regression analysis revealed non adherence to medication (OR 7.46, 1.67-33.28) and not receiving discharge advice at index admission (OR 10.79, 2.38-49.02) were associated with increased risk of recurrence whereas lacunar stroke (OR 0.08, 0.01-0.59) and a greater number of days of hospitalization during index stroke (OR 0.82, 0.67-0.99) were associated with less risk of recurrence. CONCLUSION: Individualised patient education regarding stroke, recurrence risk, medication adherence, healthy lifestyle and risk factor control can reduce stroke recurrence risk.

Socio-economic behavioural indicators of falciparum malaria parasitaemia and moderate to severe anaemia among pregnant women attending antenatal clinics in Lagos, Southwest Nigeria.

BACKGROUND: Incidence of malaria and anaemia are of public health importance especially in pregnant women in endemic regions, due to the negative health consequences to the mother and fetus. This study aimed to assess the pattern of falciparum malaria infection and anaemia, based on malaria prevention methods practiced by participants. METHODS: A semi-structured tool was used to capture information on demographic, socio-economic and malaria prevention practices from 113 pregnant women attending antenatal clinics in 2 peri-urban health facilities in Lagos, southwest Nigeria. Malaria microscopy was conducted and haematocrit was measured. Logistic regression analysis was performed on the data collated from the survey. RESULTS: The prevalence of anaemia among pregnant women was 87.2%. The mean (± sd) packed cell volume (PCV) (%) of the 22 (19.5%) infected subjects (26.8 ± 6.6), was significantly lower (t = -2.60, P value = 0.007) than that of the 91 (80.5%) uninfected subjects (30.8 ± 6.0). The prevalence of infection was highest in the 3rd trimester (n = 40, 35.4%) at 27.5% (11/40) and among those in their first pregnancy (n = 32, 28.3%) at 25.0% (8/32). There was a significant difference (t = -2.23, P-value = 0.01) in the mean PCV % of pregnant women who consumed herbal teas in pregnancy (28.2 ± 5.2) compared to those who did not (30.8 ± 6.6). Regression analysis showed that first pregnancy, anti-malarial use and insecticide-treated nets use the night before study had increased odds of malaria infection in participants (OR = 1.35, P = 0.006, 95% CI 0.52-2.49; OR = 2.3, P = 0.005, 95% CI 0.14-0.41; OR = 1.92, P = 0.001, 95% CI 0.62-5.98) while intermittent preventive treatment (IPT) participation and formal education were strongly and significantly associated with lower risk of parasitaemia (OR = 0.95, P = 0.025, 95% CI 0.41-2.26; OR = 0.44, P = 0.005, 95% CI 0.34-10.50). CONCLUSION: Interventions that will reduce malaria and moderate to severe anaemia, especially in a first pregnancy, should include education on the correct use of long-lasting insecticide-treated bed nets (LLIN), IPT and the dangers of herbal teas in pregnancy.

Estimating neighbourhood-level prevalence of adult obesity by socio-economic, behavioural and built environment factors in New York City.

OBJECTIVES: Some studies reveal that socio-economic status, behavioural factors, accessibility to supermarket or food store, are associated with the prevalence of obesity and overweight. In this study, we aimed to examine to what extent socio-economic, behavioural and built environment characteristics can contribute to spatial disparities in adult obesity. STUDY DESIGN: The spatial analysis was undertaken to understand the association of spatial disparities in adult obesity and spatial disparities in socio-economic, behavioural and built environment characteristics. METHODS: A spatial regression model which can remove the impact of auto-correlation in the residuals of conventionally regression models was applied to modelling local-scale rate of adult obesity (N = 59). RESULTS: Owing to the presence of residual spatial auto-correlation in the non-spatial regression model estimated, a spatial regression model was set up successfully to model local-scale rate of adult obesity across New York City (R2 = 0.8353, N = 59). Compared with socio-economic and built environment factors, behavioural factors make statistically significant contributions to spatial disparities in the prevalence of adult obesity (POAO). Particularly, two behavioural factors ('sugary drinks consumption' and 'fruits and vegetable consumption') can explain more than 70% of the variance of POAO (adjusted R2 = 0.7323, N = 59). Surprisingly, physical activity prevalence (percent of physically active adults) makes no statistically significant contributions. CONCLUSIONS: The results further suggest that the reduction of adult obesity prevalence could benefit more from decreasing intake of sugary drinks than increasing physical activity. The local government and policy are advised to prioritise decreasing exposure of residents to sugary drinks through restricting advertising or increasing taxes rather than increasing neighbourhoods' walkability through urban planning.

Predictors of teenage pregnancy among girls aged 13-19 years in Uganda: a community based case-control study.

BACKGROUND: Teenage pregnancy is a serious public health and social problem, with 95% occurring in developing countries. The aim of the study was to investigate the behavioural, familial and social factors associated with teenage pregnancy among girls aged 13-19 years in Lira District, Uganda. METHODS: Primary data from a case-control study of teenage girls (aged 13-19 years) in Lira District, Uganda was analysed. A Structured questionnaire was administered using face-to-face interviews to collect data on 495 participants, identified through simple random sampling from 32 villages in two counties in Lira District. Data analyses were done using SPSS Statistics 23 for descriptive, bivariate (i.e. Chi-square tests) and multivariable analyses (i.e. logistics regression) used for determining independent associations. RESULTS: A total of 495 teenage girls participated in the study, however, final analyses were undertaken for 480 respondents. At bivariable analysis, all variables except alcohol consumption were significantly associated with teenage pregnancy. Among the behavioural factors assessed, multivariable analyses showed that having multiple sexual partners, frequent sex and irregular contraceptive use increased the likelihood of teenage pregnancy. Among familial factors, being married was found to increase the likelihood of teenage pregnancy. Peer pressure, sexual abuse and lack of control over sex was observed to increase the likelihood of teenage pregnancy. CONCLUSIONS: Demographic, behavioural, familial and social factors are important predictors of teenage pregnancy in Lira District. Interventions focussing on: retaining pregnant and married girls at school, information on sexual and reproductive health of teenage girls, improving access to and information about contraceptive use among teenage girls, improving socio-economic status of households, and law enforcement on sexual abuse among girls may come a long way to improving adolescent sexual and health services in the low-income settings.

Prevalence and behavioural associations of unintentional injuries among Chinese college students: a 50-University population-based study.

OBJECTIVE: To assess the prevalence, demographic characteristics and behavioural correlates of unintentional injuries among Chinese college students. METHODS: A cross-sectional multistage survey sampling process was conducted among 11 770 undergraduates from 50 universities in China. Students were asked to report different types of unintentional injuries that required medical attention from a doctor over the past year. The χ² test and multiple logistic regression analysis were used to identify factors associated with these injuries. RESULTS: The overall unintentional injury prevalence was 47.9% (95% CI 47.6% to 48.2%). Most injuries occurred at sport venues (24.0%), following by home/dormitory injuries (20.5%) and traffic injuries (13.0%). Some behavioural factors exhibiting significant associations with overall unintentional injuries were: sleeping less than 7 hours (OR=1.32, 95% CI 1.27 to 1.37), smoking (OR=1.28, 95% CI 1.23 to 1.32), alcohol consumption (OR=1.74, 95% CI 1.69 to 1.78) and heavy internet use (OR=1.60, 95% CI 1.52 to 1.67). Male students were more likely to be involved in traffic and sport injuries than female students. Students majoring in non-medical fields had a higher risk of sport and home injuries than students majoring in medical fields. Those who drank alcohol, slept less than 7 hours or who reported heavy internet use were more likely to experience all types of injuries than students who did not participate in these behaviours. Finally, students who smoked had a higher likelihood of traffic and sport injuries than non-smoking students. CONCLUSIONS: A substantial number of college students reported injuries in the past year, and several key behavioural factors were associated with injuries. These findings could be beneficial for the design, implementation and assessment of injury intervention programme with college students. Based on these findings, policy implications for unintentional injury prevention and control were also considered.

The dynamics and determinants of household shared sanitation cleanliness in a heterogeneous urban settlement in Southwest Nigeria.

OBJECTIVES: The study assessed the behavioural contexts of household shared sanitation (SS), the factors that could enhance its cleanliness and sustainable maintenance in the study area. STUDY DESIGN: The study design was cross-sectional in nature. METHODS: A pretested, interviewer-administered questionnaire with 113 questions provided information on knowledge, attitude and SS maintenance practices from 312 respondents selected through a four-stage sampling technique. Data were analysed by descriptive, chi-square and logistic regression statistics with attitude and toilet cleanliness as the dependent variables, while the sociodemographic characteristics, knowledge and practice, including the toilet cleanliness index, were the explanatory variables at P < 0.05. RESULTS: The mean age of respondents was 46.1 ± 16.4 years. The majority were women (62.7%), tenants (64.7%) and had a secondary education (61.3%). In addition, 27.9% and 2.7% of respondents had shops and gender-segregated SS, respectively. Their knowledge and attitudes were good (66.3%) and positive (72.1%), while the majority (60.3%) of the SS was dirty. Almost two-thirds (62.8%) and 37.2% of respondents, respectively, had one and two or more compartments of unimproved pit toilets (31.6%) and water closets (28.6%), while 1.4% practiced open defaecation, despite having SS. More than two-fifths of SS were cleaned daily (45.4%) by women (52%), using water and soap (33.4%). Most households (93.4%) complied with the SS cleaning routines, with non-compliance attributed to lack of interest (29.5%), apathy when others defaulted (27.9%), lack of time (26.2%) and inadequate water (14.8%). There was a significant association between attitudes and education (P = 0.025), wealth (P = 0.011) and toilet-cleaning frequency (P = 0.015). The positive behaviour determinants of SS are factual knowledge (P = 0.039), efforts required to clean (P = 0.019), the ability to remember (P = 0.011) and cleaning commitment (P = 0.040), while freedom of expression among households using SS was a positive predictor of avoiding conflict, among the social dilemma factors. CONCLUSIONS: Good knowledge and positive attitudes were reported among users of SS, although with mixed practice and behaviour patterns. Factual knowledge, cleaning commitments and freedom of expressions predict SS cleanliness, which should be reinforced using periodic messages and structured health promotion strategies.

A global assessment of the gender gap in self-reported health with survey data from 59 countries.

BACKGROUND: While surveys in high-income countries show that women generally have poorer self-reported health than men, much less is known about gender differences in other regions of the world. Such data can be used to examine the determinants of sex differences. METHODS: We analysed data on respondents 18 years and over from the World Health Surveys 2002-04 in 59 countries, which included multiple measures of self-reported health, eight domains of functioning and presumptive diagnoses of chronic conditions. The age-standardized female excess fraction was computed for all indicators and analysed for five regional groups of countries. Multivariate regression models were used to examine the association between country gaps in self-reported health between the sexes with societal and other background characteristics. RESULTS: Women reported significantly poorer health than men on all self-reported health indicators. The excess fraction was 15 % for the health score based on the eight domains, 28 % for "poor" or "very poor" self-rated health on the single question, and 26 % for "severe" or "extreme" on a single question on limitations. The excess female reporting of poorer health occurred at all ages, but was smaller at ages 60 and over. The female excess was observed in all regions, and was smallest in the European high-income countries. Women more frequently reported problems in specific health domains, with the excess fraction ranging from 25 % for vision to 35 % for mobility, pain and sleep, and with considerable variation between regions. Angina, arthritis and depression had female excess fractions of 33, 32 and 42 % respectively. Higher female prevalence of the presumptive diagnoses was observed in all regional country groups. The main factors affecting the size of the gender gap in self-reported health were the female-male gaps in the prevalence of chronic conditions, especially arthritis and depression and gender characteristics of the society. CONCLUSIONS: Large female-male differences in self-reported health and functioning, equivalent to a decade of growing older, consistently occurred in all regions of the world, irrespective of differences in mortality levels or societal factors. The multi-country study suggests that a mix of biological factors and societal gender inequalities are major contributing factors to gender gap in self-reported measures of health.

Urban-rural differences in asthma prevalence among young adolescents: The role of behavioural and environmental factors.

BACKGROUND: Asthma prevalence has been reported to be lower in rural areas compared to urban areas, although this has been inconsistent. This study aims to identify the influence of urban-rural residence on asthma prevalence in adolescents in the Republic of Macedonia and to investigate characteristics that may explain observed associations. METHODS: Following International Study of Asthma and Allergies in Childhood protocol, a national sample of Macedonian urban and rural dwelling adolescents (12-16 years) was recruited in 2006. Self-completed questionnaires were used to collect data on wheeze and asthma as well as personal, environmental and dietary characteristics. Following descriptive and multiple logistic regression analyses, a mediation analysis approach was performed to help explain observed associations. RESULTS: A lower prevalence of current wheeze and ever-diagnosed asthma was observed in rural compared to urban dwelling adolescents (4.9% vs. 7.2% and 1.2% vs. 1.9%, respectively). After adjustment for potential confounders, the associations, although still protective, were not statistically significant (wheeze: OR=0.74, 95%CI=0.46-1.21; asthma: OR=0.97, 95%CI=0.38-2.46). The associations between urban-rural status with current wheeze and asthma were mediated by region of the country (wheeze 9%; asthma 19%) and by diet (>5% change for both wheeze and asthma). Having a dog resulted in a strengthening of the association between urban-rural status and current wheeze by 11.9%. CONCLUSIONS: The prevalence of asthma and wheeze was lower in rural dwelling Macedonian adolescents and the association was mediated by the region of the country with diet likely to be part of the reason for this mediating effect.

Sociodemographic and Behavioural Factors Affecting the Oral-Health-Related Quality of Life as Measured with the Child-OIDP Index in Adolescents.

PURPOSE: Environmental factors modulate oral-health-related quality of life (OHRQoL). The aim of this study was to analyse sociodemographic and behavioural factors affecting the OHRQoL in Spanish adolescents, by using the Child-OIDP (Child-Oral Impacts on Daily Performances) index. MATERIALS AND METHODS: A cross-sectional study was conducted in 337 adolescent schoolchildren aged 13-15 years. A questionnaire on sociodemographic, behavioural and oral self-perception factors was administered with the Child-OIDP questionnaire. Descriptive statistics, Kruskal-Wallis and Mann-Whitney U-tests, as well as a regression model were used in the data analysis. RESULTS: The overall mean Child-OIDP index was 3.28±6.55. It was statistically significantly higher in females than in males (p < 0.001). Mothers having a managerial job showed statistical association with worse OHRQoL (p < 0.001). Caries experience and history of dental trauma were not associated with the oral-health-related quality of life (p > 0.05). Halitosis statistically significantly affected the activities of daily living (p < 0.001). Perceived dental problems, dental treatment needs, self-assessment of oral health status and satisfaction with oral health were associated with the impact index (p < 0.05). CONCLUSION: Mothers who were managers, female sex, presence of halitosis, and perceived dental treatment needs were the most important predictors of the impact index, while dietary habits, oral hygiene, and dental visits did not affect it. Knowledge of these factors will help dental professionals to apply adequate preventive and therapeutic measures.

Socio-behavioural factors influencing meat intake and meat reduction intention in Vietnam and Switzerland.

Meat consumption is declining in developed countries but increasing in emerging countries. This study, for the first time, compares the socio-behavioural factors influencing individuals' meat consumption level and meat reduction intention between Vietnam, an emerging economy and Switzerland, a developed country. Online consumer surveys were conducted in late 2022, yielding 552 usable replies from Switzerland and 592 from Vietnam for this study. Drawing upon an extended Protection Motivation Theory and using structural equation modelling, we found similarities as well as differences in the determinants of meat consumption behaviour. Perceived health risks of meat overconsumption, self-efficacy of meat reduction, attitude toward ethical and environmental issues, and pressure from family members' reluctance to change diet drove the intention to reduce meat in both countries. Meat attachment emerges as the most important determinant of meat consumption level in not only Switzerland but also Vietnam and thus presents the largest barrier to meat reduction. The association between response cost of eating less meat and intention to reduce meat was negative in Switzerland but positive in Vietnam. Self-efficacy of meat consumption reduction influenced meat consumption level solely in Switzerland. Ethical and environmental attitudes significantly facilitated meat reduction intention of Swiss respondents only, reflecting cultural differences. Policy implications were discussed.

Sociodemographic and behavioural differences between frequent and non-frequent users of convenience food in Germany.

Introduction: Convenience foods are a double-edged sword in that they provide quick and easy nutrition but may promote non-communicable diseases related to excess intakes of sugar, fat, and salt. To inform the German national reduction and innovation strategy for less sugar, fat, and salt in processed foods, the present study sought to analyse the consumption frequency of selected convenience foods and to determine sociodemographic and behavioural factors that characterise frequent users. Methods: In a representative computer-assisted telephone interview survey in the adult German population (N = 3,997) conducted in 2018, consumption frequency of 21 convenience foods was assessed. To characterise frequent in contrast to non-frequent users, data on sociodemographics and behavioural aspects were compared. Statistical analyses comprised chi-square tests with Bonferroni correction as well as Spearman's rank correlation. Cramer's V was used to determine the strength of an association. Results: Overall and among frequent users (7.7% of the sample) sweet convenience foods and savoury cooking aids were consumed most frequently. Around 75% of the participants indicated little-to-no consumption of 19 of the 21 convenience foods. Male gender (p < 0.001), younger age (p < 0.001), and not having a high level of education (p = 0.017) were identified as key characteristics of frequent users. Furthermore, frequent users were more likely than non-frequent users to live in a family household (p = 0.003) or without a partner (p < 0.001), and to work in shifts (p = 0.002). Additionally, they showed significantly lower cooking skills (p < 0.001). Conclusion: Public health interventions to limit excess intakes of sugar, fat, and salt from convenience food in Germany should target people of male gender, younger age, and having a lower level of education. On the behavioural side, developing the skills to cook from scratch emerged as major point of focus. Simultaneously, reformulation of the food offer should continue in order to help transition to a more health-promoting food environment.

Factors influencing different types of malocclusion and arch form-A review.

AIM: This review intends to highlight malocclusion as a multifactorial issue and review the different factors that influence different types of malocclusion and arch form. METHODS: An online article search was performed on the factors influencing malocclusion and arch form from January 1990 through April 2020. The search was performed within the Google, Rutgers library, PubMed, MEDLINE databases via OVID using the keywords mentioned in the PubMed and MeSH headings for the English language published articles January 1990 through April 2020, which evaluated different factors that influence malocclusion and arch form. RESULTS: Of the 300 articles found in initial search results, 31 articles met the inclusion criteria set for this review. These 31 studies were directly related to the factors that impact malocclusion and different arch forms. CONCLUSION: Genetic inheritance, genetic mutations, age, gender, ethnicity, dental anomalies like macrodontia, congenital diseases, muscular diseases, hormone imbalance, and human behaviour are all factors that influence malocclusion and arch forms. The elements within the individual's control like behaviours can aid in preventing malocclusion. However, it seems as if the underlying reason for most of these factors indicates that malocclusion is a by-product of genetics and pathology.

Antibiotics use versus profitability on sow farms in the Netherlands.

In 2009, the Dutch government provided policy objectives (i.e., targets) for a reduction in veterinary antibiotics use of -20 % in 2011, -50 % in 2013 and -70 % in 2015 relative to the use in 2009. The relationship between antibiotics use and performance of Dutch sow farms during this policy reform was analysed using the Farm Accountancy Data Network database comprising cross-sectional farm data from 2004 to 2016. The results show that there is a significant downward trend in antibiotics use of 57 %. Panel data analysis (n = 74 sow farms) revealed that the reduction in antibiotic use did not lead to negative effects on technical or economic farm results. A follow-up survey was conducted on measures taken to improve animal health, which made the reduction in antibiotic use feasible. Of the 79 sow farmers approached, 55 participated in this survey. Sow farmers used a variety of relatively easy and affordable measures, such as more attention to hygiene, use of pain killers and anti-inflammatory agents, or applied more preventive vaccinations. Multivariable linear regression models showed that the intention, perceived risk and uncertainty, and perceived capability (to keep or get the use of antibiotics under the target value) were the most important predictors for antibiotics use from 2014 to 2016. Sow farmers who used more antibiotics were more concerned that low antibiotics use compromises their farm results, perceived more risk and uncertainty, and thought to a lesser extent that they have enough knowledge and time. These results indicate that providing these farmers with knowledge and information on management practices to reduce the use of antibiotics may be helpful. Thereby, it would be useful to focus on continuous involvement of the veterinarian and possibly the feed supplier, preferably by means of individual advice, as the results showed that individual advice was the preferred way to gather knowledge for the interviewed sow farmers and the veterinarian appeared to be the most important source of information to the interviewed sow farmers, followed by the feed supplier. In summary, the study shows that decrease in antibiotics use can be quite successful without compromising on the economic or technical performance, and moreover taking into account farmers' attitudes, perceptions and preferences can be helpful to get a better understanding of farmers' decision making and is useful for the design of tailor-made interventions.

Cohort profile: why do people keep hurting their back?

OBJECTIVE: Low back pain (LBP) is one of the most disabling and costly conditions worldwide. It remains unclear why many individuals experience persistent and recurrent symptoms after an acute episode whereas others do not. A longitudinal cohort study was established to address this problem. We aimed to; (1) evaluate whether promising and potentially modifiable biological, psychological, social and behavioural factors, along with their possible interactions, predict LBP outcome after an acute episode; (2) compare these factors between individuals with and without acute LBP; and (3) evaluate the time-course of changes in these factors from LBP onset. This paper outlines the methodology and compares baseline characteristics between acute LBP and control, and LBP participants with and without follow-up. RESULTS: 133 individuals with acute LBP and 74 pain-free individuals participated. Bio-psycho-social and behavioural measures were collected at baseline and 3-monthly for 12 months (LBP) or 3 months (control). Pain and disability were recorded fortnightly. Baseline characteristics were mostly similar between those who did and did not return for follow-up. Initial analyses of this cohort have revealed important insights into the pathways involved in acute-to-chronic LBP. These and future findings will provide new targets for treatment and prevention of persistent and recurrent LBP.

Selected Behavioural Factors Affecting Oral Health in Schoolchildren: Results from the Health Behaviour in School-Aged Children (HBSC) Slovak Study.

Oral diseases, particularly dental caries, affect as much as nine in 10 persons globally. Its development starts during childhood. Behavioural factors play an important role in its aetiology. The aim of the research was to analyse the prevalence of selected behavioural factors associated with dental caries in Slovak adolescents. Selected factors, such as toothbrushing less than once a day, consumption of sweets and sweetened soft drinks daily and their combination, were analysed using data from Health Behaviour in School-Aged Children surveys carried out in 2005/2006, 2009/2010, 2013/2014 and 2017/2018 in Slovakia. The target group consisted of 11- to 13-year-old schoolchildren. The results were analysed by sex and socioeconomic status. The consumption of sweets and sweetened soft drinks, despite declining, remains widespread (41.3% of boys and 39.6% of girls in 2017/2018). The absence of daily toothbrushing, similarly as a co-occurrence of factors, were more frequent in boys (10.6% and 5.0% in 2017/2018, respectively) than in girls (5.1% and 2.3% in 2017/2018, respectively). The absence of daily toothbrushing was associated with a lower socioeconomic situation. In conclusion, behavioural risk factors affecting oral health are widespread in Slovak adolescents. Despite the positive development of the epidemiological situation, effective interventions, as well as the improvement of oral hygiene in lower socioeconomic groups, are needed.

Role of container type, behavioural, and ecological factors in Aedes pupal production in Dhaka, Bangladesh: An application of zero-inflated negative binomial model.

The container-inhabiting Aedes mosquitoes are the major vectors transmitting dengue and several other arboviral diseases such as chikungunya and zika across the tropical world. Surveillance for immature Aedes, particularly pupae, is an effective tool for measuring dengue outbreak risk. While in Bangladesh, the greatest burden of dengue fever and dengue hemorrhagic fever cases has periodically been occurring since the first major outbreak in 2000, very limited research has yet been pursued to understand the dynamics of Aedes pupal production in this country. In this backdrop, this study was carried out to i) identify containers at household premises contributing to dengue vector productivity; ii) measure the extent of pupae productivity of household containers; and, iii) determine the effects of household ecological factors upon productivity of pupae in the city of Dhaka, Bangladesh. During the monsoon months of 2013, a total of 1,033 containers (674 wet and 363 dry) in 727 household premises in 12 wards of the city of Dhaka were inspected to measure container productivity and collect household ecological, and human behavioural data. The results reveal that the majority of immature mosquitoes (73.52% larvae and 84.91% pupae) developed in containers located outdoor that are used mostly for household chores. Plastic containers (57.55% of all immature mosquito-positive containers) used for household chores produce most of the immature mosquitos. The results of the zero-inflated negative binomial (ZINB) model reveal that pupae production significantly varies by container type (p-value = 0.0136) for the count regression group. However, when considering container size along with container type, container size is found significant for pupae production (p-value = 0.0041), showing that container size is confounded with the container type and the pupae production. Containers greater than 50 litres (L) are likely to produce 4.9 times more pupae than containers with <1L. Two household ecological factors are found to be significant (shade: p-value = 0.005 in the count regression group and type of water: p-value = 0.001 in the excess zero group) for pupae production. We found that containers with partial shade produce 4.6 times more pupae than without any shade, whereas in the excess zero group the expected number of observed zero pupae count is 86.5% lower in containers filled with rain water than those with tap water, tube-well water, ring well water and water from other sources. The most commonly used plastic-made containers (i.e., refrigerator trays, drums, buckets) and flower tubs/trays are the most abundant immature mosquito-positive containers. These findings would help the concerned authorities to formulate programs for changing human behaviour targeting the most productive containers for Aedes habitat management and vector control in the city of Dhaka, Bangladesh.