UNASSIGNED: Use of healthcare wearable devices holds significant potential for improving the prevention and management of cardiovascular diseases (CVD). However, we have limited knowledge on the actual use of wearable devices by CVD patients and the key factors associated with their use. This study aims to assess wearable device use and willingness to share health data among CVD patients, while identifying socio-demographic, health, and technology-related factors associated with wearable technology use.
UNASSIGNED: Using a national survey of 933 CVD patients, we assess use of wearable healthcare devices (use, frequency of use and willingness to share health data from wearable with a provider), and a set of socio-demographic factors (age, gender, race, education and household income), health-related variables (general health, presence of comorbid conditions: diabetes and high blood pressure, attitude towards exercise) and technology self-efficacy using logistic regression.
UNASSIGNED: Of the 933 CVD patients, 18.34% reported using a healthcare wearable device in the prior 12 months. Of those, 41.92% indicated using it every day and another 19.76% indicated using it \'almost every day\'. 83.54% of wearable users indicated their willingness to share health data with their healthcare providers. Female CVD patients are more likely to use wearables compared to men (odds ratio (OR) = 1.65, 95% confidence interval (CI) = 1.04-2.63). The odds decrease with age, and are significantly high in patients with higher income levels. In comparison with non-Hispanic White, Hispanic (OR = 0.14, 95% CI = 0.03-0.70) and African Americans (OR = 0.17, 95% CI = 0.04-0.86) are less likely to use healthcare wearables. CVD patients who perceive their general health to be better (OR = 1.45, 95% CI = 1.11-1.89) and those who enjoy exercising (OR = 1.76, 95% CI = 1.22-2.55) are more likely to use wearables. CVD patients who use the internet for searching for medical information (OR = 2.10, 95% CI = 1.17-3.77) and those who use electronic means to make appointments with their providers (OR = 2.35, 95% CI = 1.48-3.74) are more inclined to use wearables.
UNASSIGNED: Addressing low wearable device usage among CVD patients requires targeted policy interventions to ensure equitable access. Variations in gender, age, race/ethnicity, and income levels emphasize the need for tailored strategies. Technological self-efficacy, positive health perceptions, and exercise enjoyment play significant roles in promoting wearable use. These insights should guide healthcare leaders in designing effective strategies for integrating wearables into cardiovascular care.

Background Congestive heart failure (CHF) is a leading cause of hospitalizations and readmissions, placing a significant burden on the healthcare system. Identifying factors associated with readmission risk is crucial for developing targeted interventions and improving patient outcomes. This study aimed to investigate the impact of socioeconomic and demographic factors on 30-day and 90-day readmission rates in patients primarily admitted for CHF. Methods The study was carried out using a cross-sectional study design, and the data were obtained from the Nationwide Readmissions Database (NRD) from 2016 to 2020. Adult patients with a primary diagnosis of CHF were included. The primary outcomes were 30-day and 90-day all-cause readmission rates. Multivariable logistic regression was used to identify factors independently associated with readmissions, including race, ethnicity, insurance status, income level, and living arrangements. Results A total of 219,904 patients with a primary diagnosis of CHF were used in the study. The overall 30-day and 90-day readmission rates were 17.3% and 23.1%, respectively. In multivariable analysis, factors independently associated with higher 30-day readmission risk included Hispanic ethnicity (OR 1.18, 95% CI 1.03-1.35), African American race (OR 1.15, 95% CI 1.04-1.28), Medicare insurance (OR 1.24, 95% CI 1.12-1.38), and urban residence (OR 1.11, 95% CI 1.02-1.21). Higher income was associated with lower readmission risk (OR 0.87, 95% CI 0.79-0.96 for highest vs. lowest quartile). Similar patterns were observed for 90-day readmissions. Conclusion Socioeconomic and demographic factors, including race, ethnicity, insurance status, income level, and living arrangements, significantly impact 30-day and 90-day readmission rates in patients with CHF. These findings highlight the need for targeted interventions and policies that address social determinants of health and promote health equity in the management of CHF. Future research should focus on developing and evaluating culturally sensitive, community-based strategies to reduce readmissions and improve outcomes for high-risk CHF patients.

The intricate relationship between teenagers\' literacy and technology underscores the need for a comprehensive understanding, particularly in the Spanish context. This study employs explainable artificial intelligence (AI) to delve into this complex interplay, focusing on the pivotal role of reading comprehension skills in the personal and career development of Spanish teenagers. With a sample of 22,400 15-year-olds from the PISA dataset, we investigate the impact of socioeconomic factors, technology habits, parental education, residential location, and school type on reading comprehension skills. Utilizing machine learning techniques, our analysis reveals a nuanced connection between autonomy, technological proficiency, and academic performance. Notably, family oversight of technology use emerges as a crucial factor in managing the impact of digital technology and the Internet on reading comprehension skills. The study emphasizes the necessity for a balanced and supervised introduction to technology from an early age. Contrary to current trends, our findings indicate that online gaming may not contribute positively to reading comprehension skills, while moderate daily Internet use (1-4 h) proves beneficial. Furthermore, the study underscores the ongoing nature of acquiring reading comprehension and technological skills, emphasizing the need for continuous attention and guidance from childhood. Parental education levels are identified as partial predictors of children\'s performance, emphasizing the importance of a holistic educational approach that considers autonomy and technological literacy. This study advocates for addressing socio-economic and gender inequalities in education and highlights the crucial role of cooperation between schools and families, particularly those with lower educational levels.

Background: Breast cancer (BC) is one of the leading causes of mortality worldwide. There are observed disparities in patients with disability as compared to those without disability, which leads to poor BC screening attendance, thereby worsening disease management. Aim: The aim of this systematic review is to investigate if there are disparities in screening rates in women with disability as compared to those without disability, as well as the different factors that pose barriers to patients with disability for enrolment in BC screening programs. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed published articles between 2008 and 2023, which assessed different factors that contributed to poor attendance in BC screening programs held across different countries. Detailed study characteristics were obtained, and methodological quality assessment was performed on the individual studies included in this review. Result: A total of fifty-three articles were identified as eligible studies based on the pre-defined inclusion and exclusion criteria. These included 7,252,913 patients diagnosed with BC (913,902 patients with disability/6,339,011 patients without disability). The results revealed there are demographic, clinical, financial, and service-related barriers that contributed to lower screening rates in disabled patients as compared to non-disabled. Patient age is the most common factor, with the highest effect observed for 80 years (vs. 30-44 years) [odds ratio (OR) = 13.93 (95% confidence interval (CI) = 8.27-23.47), p < 0.0001], followed by race/ethnicity for Hispanic (vs. non-Hispanic white) [OR = 9.5 (95%CI = 1.0-91.9), p < 0.05]. Additionally, patients with multiple disabilities had the highest rate of dropouts [OR = 27.4 (95%CI = 21.5-33.3)]. Other factors like education, income, marital status, and insurance coverage were essential barriers in screening programs. Conclusions: This study presents a holistic view of all barriers to poor BC screening attendance in disabled patients, thereby exacerbating health inequalities. A standardized approach to overcome the identified barriers and the need for a tailored guideline, especially for disability groups, is inevitable.

African Swine Fever (ASF) is a contagious viral disease that infects wild and domesticated swine. In early 2022, the virus was found in wild boar in the Apennine mountains of mainland Italy.2 Since then, it has spread from wild boar to domesticated swine. To control the spread of ASF, an effective surveillance system and the implementation of strict biosecurity measures on farms are required yet are unevenly implemented across husbandry systems. Smallholder farms in particular are known to have low levels of biosecurity. In the Apennine mountains of Italy, small commercial farms have been found to have low levels of biosecurity despite being located in areas with high densities of wild boar, and, hence, being high-risk sites for potential ASF incursion and subsequent diffusion. To address the question as to why the level of biosecurity is low, interviews and participant observation were conducted with smallholder commercial farmers. The interviews identified the social, cultural, and ecological factors that affect the implementation of biosecurity measures in small commercial swine farms in the Apennines. Farmers expressed knowledge of priority biosecurity measures and an overall willingness to follow rules and regulations; however, the application of the measures in practice was uneven across farms. Economic, political, and ecological factors as well as farmer beliefs about biosecurity emerged as important factors affecting the implementation of biosecurity measures. These include economic constraints, challenges posed by the mountain environment, a shifting regulatory environment, and ideas about animal welfare. Other important factors include cultural factors such as the use of traditional agricultural methods and norms about customer access to animals, time constraints and the perceived hassle of implementing the measures, farmer age, farmer relationships with government officials and veterinarians, and the role of pigs in reducing farm waste. The study confirmed that wild boar are present in high numbers and in close proximity to smallholder commercial farms in the Apennines.

This study investigates the relationship between dietary habits and metabolic health among women, emphasizing the role of anthropometric parameters as proxies for insulin resistance. We analyzed data from 443 women categorized into two groups based on the presence or absence of clinically diagnosed insulin resistance. Our assessments included dietary quality, socio-demographic characteristics, and a series of anthropometric measurements such as body weight, Body Mass Index (BMI), Waist-Hip Ratio (WHR), Abdominal Volume Index (AVI), and Body Adiposity Index (BAI). The results indicated significant disparities in these parameters, with the insulin-resistant group exhibiting higher average body weight (78.92 kg vs. 65.04 kg, p < 0.001), BMI (28.45 kg/m2 vs. 23.17 kg/m2, p < 0.001), and other related measures, suggesting a strong influence of dietary patterns on body composition and metabolic risk. The study underscores the importance of dietary management in addressing insulin resistance, advocating for personalized dietary strategies to improve metabolic health outcomes in women. This approach highlights the need for integrating dietary changes with lifestyle modifications and socio-demographic considerations to combat metabolic risks effectively.

Indian agriculture transitioned from a food deficit sector to a food surplus following the Green Revolution. However, the continued progress of Indian agriculture has been hampered by climate change. This research explores the district-wise vulnerability in Madhya Pradesh, India, to climate change by assessing the composite vulnerability index using the agricultural vulnerability index (AVI) and socio-economic vulnerability index (SEVI). The study seeks to understand how agricultural and socio-economic factors lead to variations in vulnerability across districts and influence targeted adaptation and mitigation strategies. The trend analysis results present declining rainfall and inclining temperature from 1951 to 2021 in Madhya Pradesh, directly affecting the agricultural sector and human livelihood. The composite vulnerability index (CVI) results revealed that districts with low values (< 0.394), such as Burhanpur and Balaghat, demonstrate reduced susceptibility due to limited cultivation, low reliance on rainfall, lower drought susceptibility, and decreased population density. Districts such as Panna and Bhopal show moderate vulnerability (0.394-0.423), with lower fallow land, reduced rainfed agriculture, and socio-economic vulnerability. Extensive agriculture and marginalised workers\' presence influence high vulnerability (0.423 to 0.456) in districts such as Tikamgarh and Indore. Districts like Barwani and Jhabua have the highest CVI values (> 0.456), indicating substantial susceptibility to climate impacts. The cluster analysis validates the results of the vulnerability index. The findings highlight the urgent need for tailored adaptation strategies to address the diverse agricultural and socio-economic indicators creating vulnerability in Madhya Pradesh. The study helps understand regional vulnerability patterns and provides evidence-based policy approaches for resilience to climate change effects.

The COVID-19 pandemic brought on a marked increase in intimate partner violence (IPV) worldwide, Mexico being no exception. Factors that exacerbated gender-based violence (GBV) in the household during the pandemic include gendered loss of income, regression in access to social and legal justice resources, reversal to more traditional gender norms and roles, and increased alcoholism. While there are studies about the prevalence and determinants of IPV in rural and urban Mexico, there appears to be a lack of information regarding how these realities differed as they interacted with the compounding pressures of the COVID-19 pandemic. Stemming from 10 ethnographic interviews with women across rural and urban localities of Oaxaca, Mexico City, and Mexico State, who were recruited from NGOs providing psychological and legal services against GBV, we analyze some factors associated with the prevalence of IPV during confinement. We conclude that all women in our study experienced IPV both before and during the pandemic, with variations in IPV patterns influenced by their rural or urban residence, socio-economic status, ethnic-racial identity, and proximity to the abuser\'s network. We also found that not all impacts were negative, rather COVID-19 measures had a paradoxical effect for some women where restrictions on geographical mobility and decrease in access to alcohol became pivotal protective factors. We recommend that public policymakers and civil society organizations alike pay attention to these differential challenges and benefits in their crisis responses.

This study examined the association of socio-economic factors and the structure of primary care centres (PCCs) with measles, mumps, and rubella (MMR) vaccination coverage among the 8-year-old population in Catalonia, Spain. We conducted an ecological study to retrospectively assess the MMR vaccination-recorded status of children born in 2012, using public health data extracted in December 2020. For each of 300 PCCs serving 70,498 children, we calculated vaccination coverage rates from electronic health records and linked these rates to a composite deprivation index corresponding to the territory served by each PCC. We identified a relationship between unfavourable socio-economic factors and higher recorded vaccination coverage. On average, directly managed PCCs had higher vaccination coverage rates than indirectly managed PCCs. Greater utilisation of primary care services by the population was also associated with higher vaccination coverage rates. Further research is needed to generate knowledge valuable for informing more equitable child-vaccination service delivery models.

OBJECTIVE: Estimate the impact of 20 % flat-rate and tiered sugary drink tax structures on the consumption of sugary drinks, sugar-sweetened beverages and 100 % juice by age, sex and socio-economic position.
METHODS: We modelled the impact of price changes - for each tax structure - on the demand for sugary drinks by applying own- and cross-price elasticities to self-report sugary drink consumption measured using single-day 24-h dietary recalls from the cross-sectional, nationally representative 2015 Canadian Community Health Survey-Nutrition. For both 20 % flat-rate and tiered sugary drink tax scenarios, we used linear regression to estimate differences in mean energy intake and proportion of energy intake from sugary drinks by age, sex, education, food security and income.
METHODS: Canada.
METHODS: 19 742 respondents aged 2 and over.
RESULTS: In the 20 % flat-rate scenario, we estimated mean energy intake and proportion of daily energy intake from sugary drinks on a given day would be reduced by 29 kcal/d (95 % UI: 18, 41) and 1·3 % (95 % UI: 0·8, 1·8), respectively. Similarly, in the tiered tax scenario, additional small, but meaningful reductions were estimated in mean energy intake (40 kcal/d, 95 % UI: 24, 55) and proportion of daily energy intake (1·8 %, 95 % UI: 1·1, 2·5). Both tax structures reduced, but did not eliminate, inequities in mean energy intake from sugary drinks despite larger consumption reductions in children/adolescents, males and individuals with lower education, food security and income.
CONCLUSIONS: Sugary drink taxation, including the additional benefit of taxing 100 % juice, could reduce overall and inequities in mean energy intake from sugary drinks in Canada.