BACKGROUND: Cardiometabolic diseases are a major global health concern. This study aims to identify areas for targeted interventions and investigate the impact of socioeconomic status and lifestyle as a potential mediator in the context of the US.
METHODS: Our study analyzed data from the Health Information National Trends Survey 5, a nationwide survey by the National Cancer Institute. Using standardized scales and questions, we examined cardiometabolic disease outcomes, lifestyle factors, and socioeconomic status of non-institutionalized civilians aged 18 + in the US. We analyzed the data using structural equation modelling.
RESULTS: Our findings show that socioeconomic status and lifestyle significantly predict cardiometabolic disease outcomes. However, our analysis did not support lifestyle as the primary mediating factor in the association between socioeconomic status and cardiometabolic diseases, suggesting that other factors may significantly influence this relationship.
CONCLUSIONS: Cardiometabolic diseases require lifestyle and structural interventions addressing socioeconomic factors. Policymakers must consider multifaceted factors to prevent, detect, and manage these diseases effectively and equitably.

BACKGROUND: The increasing prevalence of allergies and asthma has led to a growing global socioeconomic burden. Since the outbreak of the COVID-19 pandemic, the health and lifestyles of children and adolescents have changed dramatically. It\'s unclear how this shift impacted allergy and asthma, with limited studies addressing this question. We aim to explore the difference of the prevalence of allergies and asthma among US children and adolescents during and before the COVID-19 pandemic using a nationally representative sample of US children and adolescents.
METHODS: This cross-sectional study included 31,503 participants in the National Health Interview Survey (NHIS) between 2018 and 2021. Allergies and asthma were defined on an affirmative response in the questionnaire by a parent or guardian. Chi-square tests were used to compare baseline characteristics with allergies and asthma for categorical variables. Differences in prevalence during and before the COVID-19 pandemic were estimated with weighted logistic regression, adjusting for demographic factors. Interaction analyses explored variations across strata.
RESULTS: In US children and adolescents aged 0 to 17, prevalence of any allergy was 26.1% (95% CI, 24.8%- 27.4%) in 2018 and 27.1% (95% CI, 25.9%- 28.2%) in 2021. Thereinto, in 2018, prevalence of respiratory allergies, food allergies and skin allergies were 14.0% (95% CI, 13.1%- 15.0%), 6.5% (95% CI, 5.8%- 7.1%) and 12.6% (95% CI, 11.6%- 13.5%), respectively, and in 2021, 18.8% (95% CI, 17.8%- 19.9%), 5.8% (95% CI, 5.2%- 6.4%) and 10.7% (95% CI, 9.9%- 11.5%), respectively. And prevalence of asthma was 11.1% (95% CI, 10.5%- 11.7%) in 2018-2019 and 9.8% (95% CI, 9.2%- 10.4%) in 2020-2021. Prevalence of respiratory allergies, skin allergies and asthma during and before the COVID-19 pandemic in children and adolescents had statistically significant differences. The differences persisted after adjusting for demographic and socioeconomic variables.
CONCLUSIONS: Prevalence of respiratory allergies increased and the prevalence of both skin allergies and asthma decreased among US children and adolescents during the COVID-19 pandemic compared with the pre-COVID-19 pandemic. Further research is required to explore the association between allergic diseases and the pandemic, with a particular emphasis on the impact of lifestyle changes resulting from measures to prevent COVID-19 infection.

OBJECTIVE: Healthcare workers play an important role in the timely recognition and treatment of patients who had an ischaemic stroke. However, their knowledge, attitude and practice (KAP) towards ischaemic stroke have not been well studied. This study aimed to assess the KAP towards ischaemic stroke among healthcare workers in the neurology and neurosurgery department in Shaanxi province, China.
METHODS: Cross-sectional study.
METHODS: Medical centres in Shaanxi province.
METHODS: Healthcare workers in the neurology and neurosurgery department at Shaanxi province.
METHODS: Demographic characteristics and KAP towards ischaemic stroke were collected by a self-designed questionnaire.
RESULTS: A total of 259 (96.6%) valid questionnaires were collected. Their mean KAP scores were 19.56±3.72 (total score: 23), 36.56±3.56 (total score: 40) and 27.45±3.00 (total score: 30), respectively. Multivariate logistic regression analysis demonstrated that education (bachelor\'s degree or above vs college or below: OR=2.704 (1.286-5.685), p=0.009), gender (female vs male: OR=0.401 (0.227-0.710), p=0.002) and professional title (intermediate vs no title: OR=0.280 (0.107-0.731), p=0.009) were independently associated with good knowledge; knowledge score (OR=1.266 (1.157-1.387), p<0.001) and hospital (private hospital vs public hospital: OR=0.544 (0.313-0.944), p=0.030) were independently associated with good attitude; and attitude score (OR=1.480 (1.326-1.652), p<0.001), gender (female vs male: OR=0.511 (0.264-0.993), p=0.047) and occupation (other healthcare workers vs physicians: OR=0.252 (0.129-0.495), p<0.001) were independently associated with good practice.
CONCLUSIONS: The healthcare workers in the neurology and neurosurgery department demonstrated a satisfactory KAP towards ischaemic stroke. Targeted and tailored training programmes might be an optional way to improve their practice.

BACKGROUND: Health lifestyles exert a substantial influence on the quality of everyday life, primarily affecting health maintenance and enhancement. While health-related practices during the COVID-19 pandemic may have positively altered the health lifestyles of Canadians to a certain degree, government reports indicate that issues related to health behaviors, such as cigarette smoking, physical inactivity, and alcohol consumption, continue to pose challenges to the health of Canadians. Social determinants of these health behaviors thus hold significant academic value in the formulation of policy guidelines.
OBJECTIVE: The aim of this study is to scrutinize the social determinants of health with respect to social factors that have may have impacts on the health-related behaviors of Canadians. We tested health behaviors including cigarette use, alcohol consumption, and participation in physical exercise, which are integral to the promotion and improvement of individual health.
METHODS: To examine the social determinants of Canadians\' health lifestyles, we utilized nationally representative data from the 2017-2018 Canadian Community Health Survey annual component. Our data analysis involved the bootstrapping method with two-level mixed-effect logistic regressions, ordered logistic regressions, and negative binomial regressions. Additionally, we conducted several robustness checks to confirm the validity of our findings.
RESULTS: The findings show that demographic background, socioeconomic status, social connections, and physical and mental health conditions all play a role in Canadians\' smoking, physical activity, and drinking behaviors. Noticeably, the association patterns linking to these social determinants vary across specific health lifestyles, shedding light on the complex nature of the social determinants that may influence young and middle-aged Canadians\' health lifestyles. Moreover, in the context of Canada, the health-region level demographic, socioeconomic, and working conditions are significantly linked to residents\' health lifestyles.
CONCLUSIONS: Investigating the social determinants of health lifestyles is pivotal for policymakers, providing them with the necessary insights to create effective interventions that promote healthy behaviors among specific demographic groups. It is recommended that health education and interventions at the community level targeting smoking, physical inactivity, and alcohol consumption be introduced. These interventions should be tailored to specific subgroups, considering their demographic and socioeconomic characteristics, social networks, and health status. For instance, it is imperative to focus our attention on individuals with lower educational attainment and socioeconomic status, particularly in relation to their smoking habits and physical inactivity. Conversely, interventions aimed at addressing alcohol consumption should be targeted towards individuals of a higher socioeconomic status. This nuanced approach allows for a more effective and tailored intervention strategy.

OBJECTIVE: Negative life events have been reported as a risk factor for depression. However, the mechanism between negative life events and depression is still unclear. This study aimed to explore the mediating role of sleep quality and the moderating role of economic income in the association between negative life events and depression among older adults aged 60 years and over.
METHODS: A multi-stage stratified sampling method was used to select elderly individuals over 60 years old in Shandong, China, making use of the Household Health Interview Survey (2020). In total, 3868 older adults completed the measures of negative life events, sleep quality, depression, and economic income.
RESULTS: Negative life events positively predicted depression among the elderly (proportion of direct effect, 55.12%), and poor sleep quality could mediate this association (proportion of indirect effect, 44.87%). Economic income played a moderating role in the relationship between negative life events, sleep quality, and depression (the first and second half of the mediating effect, the direct effect of negative life events on depression). Both effects were weaker among the elderly with higher economic incomes.
CONCLUSIONS: Negative life events had positive effects on depression in older adults. Economic income moderated the direct effect of negative life events and the mediating effect (first and second half) of sleep quality on depression. When the elderly experience negative life events, interventions for improving their sleep quality and financial support could effectively prevent depression. Geriatr Gerontol Int 2024; 24: 751-757.

BACKGROUND: Global surveillance of physical activity (PA) of children and adolescents with questionnaires is limited by the use of instruments developed in high-income countries (HICs) lacking sociocultural adaptation, especially in low- and middle-income countries (LMICs); under-representation of some PA domains; and omission of active play, an important source of PA. Addressing these limitations would help improve international comparisons, and facilitate the cross-fertilisation of ideas to promote PA. We aim to develop and assess the reliability and validity of the app-based Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) among 8-17 years old in 14 LMICs and HICs representing all continents; and generate the \'first available data\' on active play in most participating countries.
METHODS: Our study involves eight stages: (1) systematic review of psychometric properties of existing PA questionnaires for children and adolescents; (2) development of the GAC-PAQ (first version); (3) content validity assessment with global experts; (4) cognitive interviews with children/adolescents and parents in all 14 countries; (5) development of a revised GAC-PAQ; (6) development and adaptation of the questionnaire app (application); (7) pilot-test of the app-based GAC-PAQ; and, (8) main study with a stratified, sex-balanced and urban/rural-balanced sample of 500 children/adolescents and one of their parents/guardians per country. Participants will complete the GAC-PAQ twice to assess 1-week test-retest reliability and wear an ActiGraph wGT3X-BT accelerometer for 9 days to test concurrent validity. To assess convergent validity, subsamples (50 adolescents/country) will simultaneously complete the PA module from existing international surveys.
BACKGROUND: Approvals from research ethics boards and relevant organisations will be obtained in all participating countries. We anticipate that the GAC-PAQ will facilitate global surveillance of PA in children/adolescents. Our project includes a robust knowledge translation strategy sensitive to social determinants of health to inform inclusive surveillance and PA interventions globally.

暂无摘要。

OBJECTIVE: To investigate the associations of body mass index (BMI), waist circumference (WC) and the weight-adjusted waist index (WWI) with the impairment of activities of daily living (ADL) in older Chinese people.
METHODS: A total of 13 260 participants aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey were included in this cross-sectional study. BMI, WC and the WWI were calculated from measurements of height, weight and WC. Binary logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Non-linear correlations were investigated using restricted cubic spline curves.
RESULTS: In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between WC and WWI and ADL impairment, with adjusted ORs (95% CI) of 1.01 (1.00, 1.01) and 1.08 (1.03, 1.12), respectively. Meanwhile, participants with a high WWI had a higher risk of ADL impairment compared with those with a low WWI, with an adjusted OR (95% CI) of 1.12 (1.02, 1.23). Subgroup analyses showed that only the association between WWI and ADL impairment did not differ in any of the different populations. In addition, we found that BMI, WC and WWI were non-linearly associated with ADL impairment.
CONCLUSIONS: There are significant associations between WC and WWI and ADL impairment in older Chinese people. The findings show the ability of the WWI to serve as a comprehensive and effective indicator of obesity in older Chinese people and emphasize the importance of assessing WWI in screening and preventing ADL impairment in older people.

BACKGROUND: Hearing loss affects over 1.5 billion individuals globally, with significant implications for mental health. This study investigates the association between hearing aid use and mental health outcomes, by particularly focusing on depression and unmet mental health needs (UMHN), across a diverse international sample.
METHODS: Utilizing data from the third wave of the European Health Interview Survey (EHIS), this study involved 17,660 participants with hearing impairment from 28 countries. The study examined the association between hearing aid use and mental health outcomes, including the likelihood of moderate and severe depression and UMHN due to lack of contact with general practitioners (GPs) and mental health specialists. Logistic regression models, adjusted for socio-demographic characteristics, health risk behaviours, and other relevant variables, were employed. Inverse probability weights were used to mitigate potential selection bias.
RESULTS: Hearing aid usage was associated with significantly lower likelihoods of moderate depression (Odds Ratio [OR] = 0.58, 95%CI = [0.54, 0.63]) and severe depression (OR = 0.61, 95%CI = [0.55, 0.69]), compared to non-usage. Hearing aid usage was also associated with reduced UMHN due to lack of GP contact for moderate (OR = 0.82, 95%CI = [0.75, 0.89]) and severe depression (OR = 0.75, 95%CI = [0.59, 0.95]). The depression risk reductions were greater among females and higher-educated subgroups but lower in individuals aged ≥65 years. Income level and rurality also impacted UMHN due to the lack of GP contact. No associations were found between hearing aids and UMHN due to the lack of mental health specialist contact.
CONCLUSIONS: Hearing aid adoption showed protective associations against mood disorders and lowered unmet primary mental healthcare needs. Tailoring intervention strategies to vulnerable sociodemographic profiles could optimize mental health benefits among those with hearing loss. Integrating hearing health services within mental healthcare delivery frameworks is vital amidst the rising global burden.

UNASSIGNED: Analyzing the differences in caregiving models for disabled older adult individuals after stroke and the influencing factors, to provide a basis for addressing relevant social demographic issues.
UNASSIGNED: The older adult diagnosed with stroke were screened from the Chinese Geriatric Health Survey (CLHLS), and were further divided into subgroups of disability, which was based on their ability of or whether they need help in performing activities such as dressing, bathing, eating, toileting or bowel and bladder control using the international common Katz scale. The care model was divided into formal care, informal care and home care. Multivariate logistic regression was used to screen the influencing factors of the choice of care model for the disabled older adult after stroke.
UNASSIGNED: The results of univariate analysis showed that there were statistical differences in the choice of care mode among different ages, household registration types, number of children, years of education, degree of disability, community services, retirement pension, marital status and medical insurance. Multiple logistic regression showed that, The rural older adult with more children, shorter education years, living with spouse and no help from community tend to choose informal care. Older adult people with higher levels of education, urban household registration, and access to community services are more likely to choose formal care. Older adult women with multiple children are more likely to receive care from their children.
UNASSIGNED: In the future, vigorous support for the development of formal caregiving institutions and the improvement of the management system of formal caregiving will help enhance the subjective initiative of disabled older adult individuals in choosing caregiving models and alleviate the burden of family caregiving.