Cancer remains a major public health challenge in Saudi Arabia, and university students mainly rely on digital media for health information. Thus, the study evaluated cancer awareness among university students and examined the associations among the types of digital platforms used with their levels of cancer awareness. A crosssectional study was conducted among 429 university students using a validated self-administered questionnaire to gather sociodemographic characteristics and digital media use for information on cancer. The majority of students reported social media as their primary source for cancer information, followed by online/AI-based platforms and videos. The overall cancer awareness was average, with a better awareness of treatment side-effects compared with other awareness categories. The students' level of cancer awareness depended on their age, educational program enrolled, residence location (urban or rural), and type/frequency of digital media accessed, with students having a lower general cancer awareness level being more likely to depend on social media for information. These findings indicated that digital media, particularly social media, are significantly associated with the and control.
Despite persistently low levels of physical activity among university students following the COVID-19 pandemic, theory-driven interventions targeting inactive students remain limited. The study developed, implemented and evaluated a belief-based leisure-time physical activity promotion program for inactive university students. Inactive undergraduate students engaging in less than 150 minutes of physical activity per week were recruited from a South Korean university. A four-week jump rope intervention was implemented. Process evaluations, including reach, dose delivered, dose received, and fidelity, were assessed at the midpoint and the post-intervention stages. Group-by-time effects on leisure-time physical activity-related beliefs, intentions and behaviors were assessed using a generalized linear model with repeated measurements at four time points (pre-intervention, midpoint, post-intervention, and one-month follow-up). Significant changes in the intervention effects were observed for key leisure-time physical activity-related beliefs. Compared with the control group, physically inactive students with high intervention adherence demonstrated greater increases in perceived mental and physical health benefits from the post-intervention period through to the one-month follow-up. Improvements were also observed in the perceived "friends' approval" and control beliefs related to exercise facilities and exercise partners, particularly at the midpoint assessment. These findings indicate that belief-based leisure-time physical activity interventions informed by empirically identified beliefs can effectively modify targeted beliefs among physically inactive university students. Future studies should determine whether sustained belief changes can translate into longer-term improvements in physical activity behavior.
Legionella is a waterborne Gram-negative bacterium transmitted mainly through inhalation of contaminated aerosol from artificial water systems, such as those found in healthcare facilities and hotels. In this study we aimed to determine the prevalence and temporal trends of Legionella in hospitals and hotels in southeastern T & uuml;rkiye in order to inform prevention strategies at these study sites. Water samples were collected from hot-and cold-water systems from study sites and sent for culture and filtration with acid treatment in order to detect Legionella spp from January 2019 to December 2023. Water samples were collected from faucets, shower heads, storage reservoirs, hot and cold-water tanks and were processed within 24 hours of collection. A total of 67 hospitals and 7 hotels were purposively selected for the study. A total of 7,112 water samples were collected and included in the study; 6,934 (97.4%) from hospitals and 178 (2.6%) from hotels. Of these, 624 samples (8.8%) were positive for Legionella spp; 596 (95.5%), from hospitals and 28 samples (4.5%) from hotels (p-value<0.001). The most common sites with positive specimens were from faucets (n = 327, 52.4%) and shower heads (n = 182, 29.2%). 430 samples (68.9%) were positive for serogroups 2-14 and 182 samples (29.2%) were positive for serogroup 1 (p-value<0.001). The mean bacterial concentration among positive study samples was relatively low (52 CFU/ml). The numbers of positive samples during the Spring, Summer, Winter and Autumn were 130 (20.8%), 205 (32.9%), 111 (17.8%) and 178 (28.5%) samples, respectively (p-value<0.001). In summary, Legionella contamination was widespread in healthcare water systems in Southeast T & uuml;rkiye with the most common serogroups being L. pneumophila serogroups 2-14. Conclusion, there is a need for improved water management and continuous surveillance at the study sites to reduce the risk of contracting Legionella infection at the study institutions. After implementing these prevention measures further studies are needed to determine their efficacy.
Traumatic brain injury (TBI) creates substantial challenges for patients and their family caregivers, especially during hospital-to-home transition. Given the family caregivers' primary role in post-discharge care in PR China, this cross-sectional study enrolled TBI patients and their respective family caregivers (n = 146 for each group) at a tertiary hospital in Wenzhou, Zhejiang to assess the caregivers' readiness for patients' discharge and identify predictors of preparedness via several validated questionnaires, namely Readiness for Hospital Discharge Scale (FAM-RHDS), General Self-Efficacy Scale (GSES), Family Needs Questionnaire-Revised (FNQ-R), and Quality of Life after Brain Injury (QOLIBRI). The results showed that 64% of caregivers had high readiness. Multiple regression analysis identified caregiver education level, self-efficacy and family needs, and patient's age and quality of life as significant predictors, covering 74.6% of variance in discharge readiness. In conclusion, this study showed that a family caregiver readiness for the TBI patient's hospital discharge was affected by both caregiver-and patient-related factors, highlighting the need for targeted interventions, such as personalized education programs and support services, to enhance caregivers' readiness and optimize post-discharge outcomes for TBI patients.
Type 2 diabetes mellitus imposes a disproportionate health burden on older adults of ethnic minorities in northern Thailand. These groups face a "double burden" of geographic isolation and language barrier, the latter stemming from the use of Thai in health information dissemination. The study aimed to examine the predictive relationships of health literacy (HL), diabetes distress and self-management behaviors with clinical outcomes (fasting blood sugar [FBS] and body mass index [BMI]). A cross-sectional predictive correlational study was conducted among 150 ethnic minority older adults recruited from five sub-district health-promoting hospitals in Chiang Rai Province, northern Thailand. Data were collected through face-to-face interviews using the Diabetes Self-Management Questionnaire (DSMQ) and Diabetes Distress Scale (DDS-17). Participants (66 +/- 6 years of age) exhibited high vulnerability, namely 70% with no formal education and 58% obesity. Multiple linear regression models revealed that age (beta =-0.296, p-value <0.001) and HL (beta =-0.263, p-value = 0.001) are significant negative predictors of FBS; whereas self-management is a significant positive predictor of FBS (beta = 0.169, p-value = 0.029), suggesting a "reactive management". Age is the sole significant negative predictor of BMI (beta =-0.166, p-value = 0.047). HL acted as a critical determinant of glycemic control, distinct from diabetes distress. The findings indicated that public health interventions should shift from text-based directives to visual, bilingual models to overcome any language barrier.
Physical activity has been reported to be an effective method to reduce the risk of sarcopenia. In this cross-sectional study, we aimed to determine if there is a significant association between physical activity levels and the prevalence of sarcopenia among middle-aged and older adults in China in order to inform efforts to prevent and manage sarcopenia in the study population. The data used in our study were obtained retrospectively from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. The CHARLS assessed physical activity levels among study subjects using the International Physical Activity Questionnaire (IPAQ) asking about activity during the previous week, expressed as metabolic equivalents of task in minutes (MET-minutes) per week. Sarcopenia in our study was defined using the 2019 Asian Working Group for Sarcopenia (AWGS) criteria and classified as possible sarcopenia, sarcopenia and severe sarcopenia. Study subjects were divided into 3 groups based on their physical activity levels following IPAQ criteria as: low (<600 MET-min/week, reference group), moderate (600-3,000 MET-min/week) and high (>3,000 MET-min/week). We used multivariable logistic regression analysis and restricted cubic splines to identify significant associations between physical activity levels and sarcopenia. A total of 8,449 subjects were included in the study: 52.4% (n = 4,426) females. The mean (+/- standard deviation (SD)) age of study subjects was 66.1 (+/- 8.6) years (range: 45-90 years). The mean (+/- SD) body mass index (BMI) of subjects was 23.56 (+/- 3.70) kg/m(2). 1,855 subjects (22.0%) met the 2019 AWGS criteria for having possible sarcopenia and 1,346 (15.9%) met the criteria for sarcopenia and 605 (7.2%) met the criteria for severe sarcopenia. The median (interquartile range (IQR)) physical activity levels among subjects without sarcopenia, those having possible sarcopenia, sarcopenia and severe sarcopenia were: 2,562.00 (933.00-7,337.00), 1,782.00 (462.00-6,716.25), 2,032.50 (309.50-6,318.00) and 1,732.50 (462.00-5,544.00) MET-min/week, respectively. The median IQR among subjects without sarcopenia was statistically higher than among subjects in the other 3 groups (p-value <0.001). After adjusting for age, gender, marital status, location of residence, education level, body mass index, smoking status, alcohol consumption status and retirement status, subjects in the moderate and high physical activity level groups had significantly lower odds of having possible sarcopenia than subjects in the low physical activity group (moderate activity level versus (vs) low activity level: adjusted odds ratio (aOR): 0.791; 95% confidence interval (CI): 0.683-0.915, p-value = 0.002 and high activity level vs low activity level: aOR: 0.679; 95% CI: 0.594-0.776, p-value <0.001). Subjects in the high physical activity level had significantly lower odds of having sarcopenia than subjects in the low activity level group (aOR: 0.745; 95% CI: 0.584-0.950, p-value = 0.017). Subjects in the high physical activity level group had significantly lower odds of having severe sarcopenia than subjects in the low activity level group (aOR: 0.679; 95% CI: 0.499-0.923, p-value = 0.013). Restricted cubic spline analysis showed subjects in the high activity group had significantly lower odds of having possible sarcopenia by overall association than subjects in the low activity group (p-value <0. 001) and subjects in the high activity group had significantly lower odds of having possible sarcopenia by nonlinear association than subjects in the low physical activity group (p-value = 0.001). However, subjects in the high activity group did not have significantly lower odds of sarcopenia than subjects in the low physical activity group by overall association or nonlinear association (p-value = 0.560). For severe sarcopenia, the overall association approached significance but was not significant (p-value = 0.054). When all sarcopenia categories were combined, on restricted cubic spline analysis, subjects with high activity levels had significantly lower odds of having any kind of sarcopenia than subjects in the low physical activity group for overall association (p-value <0.001) and nonlinear association (p-value = 0.002). Subgroup analysis revealed subjects who did not smoke and had a high activity level had lower odds of having possible sarcopenia than subjects with a high activity level who did smoke (aOR: 0.644; 95% CI: 0.553-0.750, p-value <0.001). Subgroup analysis also showed subjects who were not retired and who had a high physical activity level had lower odds of having possible sarcopenia than retired subjects who had a high physical activity level (aOR: 0.654; 95% CI: 0.566-0.756, p-value <0.001). No significant differences were found by sarcopenia category (p-value for interaction >0.05). In summary, subjects with higher physical activity levels had significantly lower odds of having possible sarcopenia, sarcopenia and severe sarcopenia than subjects with low physical activity levels. We conclude, moderate to high physical activity levels are recommended for subjects in the study group in order to prevent or manage sarcopenia. Further studies are needed to determine if interventions to increase physical activity are able to prevent or reduce sarcopenia in this population.
Patients in the intensive care unit (ICU) are at a high risk of developing multidrug-resistant organism (MDRO) infections because of their critical condition, frequent invasive procedures and inappropriate use of broad-spectrum antibiotics. This study evaluated the effect of the Plan-Do-Check-Act (PDCA) cycle system on controlling the risk of MDRO infections in ICU patients. Patients who tested negative for bacterial infection upon hospital admission were randomly assigned to control and PDCA groups (n = 64 per group) for routine MDRO prevention and control measures (the former group) and routine measures together with the PDCA cycle-based management (the latter group) during their length of stay, total hospitalization stay and ICU MDRO contamination were significantly reduced in the PDCA group compared to the control (p-value <0.050). However, the 28-day mortality was not different between the two groups. In addition, nurses' hand hygiene behavior (n = 30 per group). The results confirmed the utility of the PDCA cycle cohort size and extending the intervention duration.
Global warming poses a major health threat, particularly through heat-related illnesses among vulnerable populations. A crosssectional analytical study was used to analyze the determinants of heat-related illness (HRI) prevention behaviors among older adults in southern Thailand to assist effective interventions for reducing heat-related morbidity and mortality. A multistage cluster sampling was used to recruit functioning older adults (n = 280, Barthel ADL Index >= 12) residing in five provinces with the highest average temperatures in southern Thailand, namely Krabi, Nakhon Si Thammarat, Phuket, Songkhla, and Surat Thani. Data were collected between June and October using a structured questionnaire based on the Health Belief Model framework. Results revealed that income, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, and cues to action were positively correlated with HRI prevention behavior (p-value <0.01), whereas age and perceived barriers were negatively correlated (r =-0.13 and-0.25, respectively). Among 13 variables entered into a regression model, perceived self-efficacy, cues to action and perceived benefits were significantly associated with HRI prevention behaviors (p-value <0.001), explaining 47% of the variance. Cues to action emerged as the strongest predictor. These findings underscored the crucial role of psychological and motivational factors in shaping heat protection behaviors among older adults in high-temperature regions. Strengthening self-efficacy, enhancing awareness of benefits and promoting cues to action can guide the development of targeted heat illness prevention programs to protect vulnerable older adult populations from escalating heat-related health risks in southern Thailand.
As the global older population increases, promoting healthy, sustainable diets for older adults is vital to prevent age-related diseases and enhance well-being. The study assessed nutritional awareness, sustainable, healthy eating behavior and barriers among older adults in the Abha District, Saudi Arabia, using the Arabic Nutritional Awareness (NAS) and Sustainable Healthy Eating Behaviors Scales (SHEBS). Participants in the study consisted of 400 community-dwelling older adults, 53% females and 47% males, 60-89 years of age, with a mean age of 71.7 +/- 7.1 years. The study also collected data on demographics, lifestyles and barriers to sustainable, healthy eating. High NAS and SHEBS scores were recorded in 53% and 54% of the participants respectively. Higher NAS score was significantly associated with younger age, urban residence, having a sufficient income, and taking physical exercise (p-value <0.001, 0.034, <0.001, and <0.001, respectively); whereas a lower score was significantly associated with married status, chronic illness and eating an ordinary diet (p-value <0.001, 0.002 and <0.001, respectively). For SHEBS, a higher score was significantly associated with having a sufficient income and taking physical exercise (p-value = 0.029 and <0.001 respectively); whereas a lower score was significantly associated with married status and inadequate sleep (p-value <0.001 for both). Although many older adults reported having high nutrition awareness, barriers (mainly psychological and social) still hindered attaining sustainable, healthy eating. These findings emphasized the importance of targeted public health initiatives to enhance access to affordable and sustainable, healthy food, thereby promoting a healthy older population in Saudi Arabia.
Understanding perceptions and practices of medical errors in primary healthcare facilities is essential for enhancing patients' safety and fostering a culture of transparency. A descriptive cross-sectional study was conducted regarding frontline healthcare professionals' perceptions of the identification, reporting and outcome of medical errors within diverse clinical settings. The survey was carried out in were mainly physicians, nurses and clinical laboratory technicians. Significant associations were observed between biological gender and profession, as well as perceptions of medical errors (p-value <0.05). Female responders were mainly nurses, while male responders were physicians and technicians. Males perceived medical errors as being underreported and reporting procedures unclear and time-consuming, while females perceived a lower frequency of medical errors and less uncertainty about the reporting procedures. Stratification of perceptions of medical errors according to years of work experience revealed, interestingly, no significant differences, but stratification according to sociodemographic parameters showed low perception rating among female respondents and respondents working in rural regions. The findings highlighted the importance of designing target-based interventions in reducing medical errors and impediments to the reporting process.
Physical activity has been reported to be an effective method to reduce the risk of cardiometabolic multimorbidity (CMM). In this prospective cohort study, we aimed to determine if there is a significant association between physical activity levels and the incidence of CMM among middle-aged and older adults in China in order to inform efforts to reduce CMM in the study population. CMM was defined as the concurrent presence of at least two of the following three diseases: heart disease, stroke, and diabetes, based on self-reported physician diagnoses. This study was based on data from the China Health and Retirement Longitudinal Study (CHARLS) conducted during 2015-2020. Study subjects were randomly selected using multistage stratified probability proportional sampling from 28 provinces across China. Inclusion criteria for study subjects were being aged >= 45 years at baseline (2015), having no history of stroke, diabetes or heart disease at baseline, completing all three waves of follow-up, and having complete data regarding physical activity and other study variables. Exclusion criteria for subjects were having CMM at baseline, incomplete follow-up data and missing key variables. Physical activity level was assessed using a standardized questionnaire asking about vigorous, moderate, and light activities during the previous week, expressed as metabolic equivalents of task in minutes (MET-minutes) per week. Study subjects were then equally divided into 4 groups based on their baseline total weekly MET-minutes as follows: Quartile (Q)1 (reference group) (<1,732.5 MET-min/week), Q2 (1,732.5-5,287.5 MET-min/week), Q3 (5,287.5-11,848.5 MET-min/ week) and Q4 (>= 11,848.5 MET-min/week). We used time-varying Cox proportional hazards regression analysis and restricted cubic splines to identify significant associations between physical activity levels and CMM incidence. A total of 4,516 subjects were included in the study (1,129 subjects in each quartile): 52.8% (n = 2,384) females. The mean (+/- standard deviation (SD)) age of study subjects was 57.3 (+/- 8.9) years. The mean (+/- SD) body mass index of subjects was 23.8 (+/- 3.7) kg/m(2). During the follow-up period, 151 subjects (3.3%) developed CMM. The mean (+/- SD) physical activity levels were 6,190.8 (+/- 7,106.5) MET-min/week for the CMM group and 7,430.9 (+/- 6,779.4) MET-min/week for the non-CMM group (p-value = 0.036). After adjusting for age, gender, marital status, residence, education, BMI, smoking, drinking, and retirement status, subjects in Q2, Q3, and Q4 had significantly lower hazard ratios (HR) (Q2: HR = 0.537; 95% confidence interval (CI): 0.351-0.821, p-value = 0.004; Q3: HR = 0.490; 95% CI: 0.313-0.767, p-value = 0.002; Q4: HR = 0.479; 95% CI: 0.282-0.814, p-value = 0.007) of developing CMM than subjects in Q1. Subgroup analyses revealed that the protective effects of physical activity were particularly pronounced among non-smokers (Q2: HR = 0.382; 95% CI: 0.230-0.634, p-value <0.001; Q3: HR = 0.475; 95% CI: 0.293-0.772, p-value = 0.003; Q4: HR = 0.522; 95% CI: 0.297-0.918, p-value = 0.024) with a significant interaction (p-value for interaction = 0.006). The protective effects of activity were also significantly greater among overweight and obese participants (Q2: HR = 0.568; 95% CI: 0.337-0.958, p-value = 0.034; Q3: HR = 0.319; 95% CI: 0.168-0.605, p-value <0.001; Q4: HR = 0.433; 95% CI: 0.215-0.869, p-value = 0.019). Restricted cubic spline analysis revealed a significant overall association between total physical activity and CMM risk (p-value for overall = 0.007), although the nonlinear association was not statistically significant (p-value for nonlinear = 0.210). In summary, subjects with higher levels of physical activity had significantly lower risk of developing CMM than subjects in the lowest activity quartile, and this protective effect was particularly evident among non-smokers and overweight and obese individuals. We conclude that higher physical activity levels are associated with reduced CMM risk among study subjects. Further studies are needed to determine if interventions to increase physical activity are able to prevent CMM in this population and to elucidate the mechanisms underlying the differential effects across subgroups.
The study examined the impact of perceptions toward coronavirus disease 2019 (COVID-19) and participation in physical activity (PA) among university students (73 males and 77 females) in Seoul, South Korea. An online questionnaire based on an Extended Health Belief Model was used to collect data for a gender-stratified multiple regression analysis, which revealed that both male and female students (beta= 432 and 396; p-value <0.01 and <0.05, respectively) were more participatory in vigorous PA if they had higher self-efficacy. Male students participated more in moderate (M)PA when they perceived fewer barriers to PA (beta= -161, p-value <0.05), while females took part in MPA when they perceived a low risk of COVID-19 infection (beta = -76, p-value <0.05). The findings of this research, highlighting the different perceptions on COVID-1 9 and PA participation among male and female university students, can form a basis for developing effective intervention programs in future pandemics in South Korea.
Coronavirus disease 2019 (COVID-19) remains a public health concern in Thailand, posing significant risks to individuals with chronic illnesses and the elderly. To reduce the spread of COVID-19, village health volunteers (VHVs) play a vital role in preventing and controlling diseases at the community level. The cross-sectional study examined factors associated with COVID-19 prevention behavior among VHVs in Chiang Rai Province. Participants (n = 362) were selected using a two-stage cluster random sampling method, and data were collected between June and August 2022 using a structured questionnaire. The results showed that VHVs had a high level of COVID-19 prevention behavior, which was associated with knowledge of disease, perceived self-efficacy, work motivation, and social support. Female VHVs exhibited significantly better prevention behavior than males (p-value <0.05). To further maintain and reinforce VHVs' COVID-1 9 prevention behavior, more training programs should be organized, and initiatives that foster self-efficacy, boost work motivation and offer ongoing social support should be implemented.
It is important to correctly manage elderly patient with type 2 diabetes mellitus (T2DM) with multimorbidity to prevent an increase in morbidity and mortality. This study had two parts. In Part 1 we aimed to determine the prevalence of multimorbidity among elderly T2DM patients in Thailand and in Part 2 we aimed to assess the management of elderly T2DM patients in Thailand at primary level care (PLC) institutions in order to inform strategies to reduce morbidity and mortality in the study population. Inclusion criteria for subjects in both study parts were being aged >= 60 years and having T2DM. Subjects in both study parts having incomplete or inaccurate medical records or having only one visit for T2DM were excluded from the study. The data used for Part 1 of this study were population health data obtained from the Ministry of Public Health, Health Data Center (HDC) for the year 2019. The data used for Part 2 of this study were obtained from the medical records of the study subjects at 4 purposively selected PLC district hospitals. The care given at these 4 hospitals was compared with the Thailand's 2017 Clinical Practice Guidelines for Diabetes. 529,277 subjects were included in Part 1 of the study, 348,376 (65.82%) females. The mean (+/- standard deviation (SD)) age of study subjects was 70.0 (+/- 8.8) years. 377,630 subjects (71.35%) had multimorbidity. Of the subjects in Part 1, among patients who received care at all PLC institutions, 157,951 (71.72%) had >= 1 comorbid condition in addition to their T2DM. 6,460 subjects were included in Part 2 of the study, 4,171 (64.57%) females. The mean (+/- SD) age of subjects was 70.0 (+/- 7.6) years. Of the subjects in Part 2, 6,112 (94.61%) had >= 1 comorbid condition. The most common comorbid conditions were hypertension (n = 5,045, 78.10%), dyslipidemia (n = 3,125, 48.37% and renal insufficiency (n = 2,684, 41.55%). Among subjects with multimorbidity at the 4 study institutions, from 648 of 1,090 (59.45%) to 867 of 1,054 (82.26%) subjects had yearly HbA1c testing following the recommendations in the 2017 Clinical Practice Guidelines for Diabetes and from 97 of 1,090 (14.97%) to 256 of 1,126 (27.71%) subjects achieved the HbA1c target of <= 7.0% following the recommendations in the 2017 Clinical Practice Guidelines for Diabetes. In summary, in our study population, the proportion of subjects with multimorbidity was relatively high and much of the care at the PLC study institutions did not meet recommended guidelines. We conclude there is a need to improve the care of elderly patients with T2DM at the study institutions. Further studies are needed to determine what factors caused the failure to reach care guidelines in the study population at the study PLC institutions and how to improve compliance rates with those guidelines, in order to reduce morbidity and mortality in the study population at the studied PLC institutions.
The prevalence of overweight and obesity in human societies is associated with many chronic syndromes, such as heart disease, high blood pressure and diabetes. The prevalence of obesity is 33.7% in the Kingdom of Saudi Arabia. A cross-sectional study was conducted on a cohort of randomly selected 132 female office employees at Qassim University, excluding pregnant women and breastfeeding mothers. The study aimed to identify dietary habits and lifestyle associated with obesity using a questionnaire and personal interviews. The majority of participants also attended a lecture on food educational program, and after one month, were assessed on the outcomes of their dietary habits, lifestyle and body physical parameters. The prevalence of overweight and obesity was 38 and 45% respectively. Lunch was the main meal, but nearly half of the participants neglected breakfast; the majority did not consume sugary juices; and ate while watching television or a mobile device, and also when upset or depressed. Slightly over half of the female office employees regularly conducted physical exercise, 1-2 times a week for two hours or less. Daily nutrient intake of energy, protein, carbohydrates, and vitamins was within the recommended allowances, but below the accepted range for fiber, unsaturated fat, vitamins B3, B6, C, and D, and the essential chemical elements, while that of sugar was higher. Attendance of the lecture resulted in only minor changes in the participants' dietary habits and lifestyle: attention to reducing calorie intake and taking more exercise. On average, there is a significant decrease in waist circumference and total body water mass, an increase in the body percent fat mass, but no change in body mass index. In conclusion, the study highlights the need for more awareness of the high prevalence of overweight/obesity among Saudi female office employees and for a better knowledge of ways to maintain a healthy weight and avoid the overweight/obesity-related health risks.
Physical activity has been reported to be an effective method to reduce risk for developing depression. In this cross-sectional observational study, we aimed to determine if there is a significant association between physical activity levels and the presence of depression symptoms among middle school students in Xiamen, People's Republic of China in order to inform efforts to reduce depression in the study population. Study subjects were randomly chosen from grades 7-9 at the study school. Inclusion criteria for study subjects were being a student aged 12-16 years, attending the study school, completing the study questionnaire and the subjects and their parents/ guardians were giving informed consent to participate in the study. Exclusion criteria for subjects were being diagnosed with a mental health condition, having a physical disability that prevents exercising and not completing the study questionnaire. The minimum number of subjects calculated to be needed for the study was 1,225. The presence of depressive symptoms was determined using the using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). Heights and weights were measured for each subject and the body mass index (BMI) was calculated and subjects were categorized into underweight (BMI <18.5 kg/m2), normal weight (18.5-22. 9 kg/m2), overweight (23.0-24.9 kg/m2) and obese (>= 25.0 kg/m2). Physical activity level was assessed using a standardized questionnaire asking about the subject's activity level during the previous 7 days, expressed as metabolic equivalents of task in hours (MET-hours) per week. Study subjects were then divided into 4 equal groups based on their total weekly MET-hours as follows: sedentary activity level (Group Q1: <= 28.2 MET-hours/week, n = 361), low physical activity (Group Q2: 28.7-33.8 MET-hours/week, n = 361), medium physical activity (Group Q3: 33.8-41.7 MET-hours/week, n = 360) and high physical activity (Group Q4: >41.7 MET-hours/week, n = 361). We used logistic regression analysis and restricted cubic splines to identify significant associations between activity levels and having a CES-D-10 score >= 10. A total of 1,443 subjects were included in the study: 52.1% (n = 752) females. The mean (+/- standard deviation (SD)) age of study subjects was 14 (+/- 1.0); range: 11-17 years. The mean (+/- SD) body mass index of subjects was 20.63 (+/- 3.67); range 14.05-40.45 kg/ m2. The mean (+/- SD) CES-D-10 scores were 8.05 (+/- 6.51) for Group Q1, 8.59 (+/- 5.47) for Group Q2, 8.40 (+/- 5.48) for Group Q3 and 6.72 (+/- 5.28) for Group Q4. 452 subjects (31.4%) were underweight; 810 (56.1%) had a normal weight; 146 (10.1%) were overweight; and 35 (2.4%) were obese. After adjusting for age, gender, grade, and BMI, subjects in Group Q4 had significantly lower (aOR = 0.59; 95% CI: 0.42-0.82, p-value <0.001) odds of having a CES-D-10 score >= 10 than subjects in Group Q1. Underweight subjects in Group Q4 had significantly lower odds (aOR = 0.32, 95% CI: 0.17-0.57, p-value <0.001) of having a CES-D-10 score >= 10 than underweight subjects in Group Q1. In summary, subjects with high levels of physical activity (Group Q4) had significantly lower odds of having a CES-D-10 score >= 10 than subjects who were sedentary (Group Q1) and underweight subjects in Group Q4 had significantly lower odds of having a CES-D-10 score >= 10 than subjects in Group Q4 who were normal weight, overweight or obese. We conclude subjects with a high level of physical activity and underweight subjects are less likely to have depressive symptoms. Further studies are needed to determine if counselling to increase physical activity and control weight are able to prevent major depression in this study population.
Hypertension (HT) and type 2 diabetes mellitus (DM) affect the morbidity and mortality of elderly Chinese. In this study, we aimed to determine the efficacy of the Innovative Care for Chronic Conditions (ICCC) program for improving blood sugar levels, blood pressure levels, lipid levels, medication compliance and mental health among elderly Chinese with HT and DM in order to inform efforts to reduce morbidity and mortality caused by these conditions in the study population. The ICCC program, administered along with standard pharmacotherapy in the study population (valsartan and metformin), consists of a 6-month program of a supervised low-salt/fat diet, a regular exercise program, daily self-monitoring of blood pressure and blood sugar and psychological support. The minimum number of subjects calculated to be needed for the study was 322. Study subjects were recruited from patients with HT and DM admitted to Nanjing First Hospital, China during April 2021-January 2025. Inclusion criteria for study subjects were: 1) being aged >= 65 years, 2) having diagnoses of HT and DM, 3) living in the study area for at least 6 months, and 4) giving written informed consent to participate in the study. Exclusion criteria for study subjects were: 1) having severe cardiac, hepatic or renal disease, 2) having a malignant neoplasm, a mental health condition or an active peptic ulcer, 3) being allergic to or intolerant of valsartan and/or metformin, 4) having undergone major surgery in the previous 3 months or 5) having had a serious infection in the previous 3 months. All patients received standardized pharmacotherapy (valsartan 80-160 mg/day and metformin 1500 which is standard treatment in this study population. Subjects were randomly assigned to either the usual treatment (control) group (n = 161) or the ICCC group (n = 161). The following were conducted both prior to and after the intervention: blood tests consisting of a fasting blood glucose (FBG) level and lipid profile (consisting of a total cholesterol (TC) level, triglyceride (TG) level, a low density lipoprotein cholesterol (LDL-C) level and a high density lipoprotein cholesterol (HDL-C) level), a blood pressure (BP), a medication compliance assessment (using the Medication Adherence Report Scale (MARS-5) where good compliance was given a score of 5, moderate compliance a score of 3-4 and poor compliance a score of <= 2), a mental health assessment (using the Self-related Anxiety Scale (SAS) and the Self-related Depression Scale (SDS), where the higher the SAS/SDS score the more severe the anxiety/depression) and being asked about treatment adverse reactions with each adverse reaction being counted separately when more than one was present). A total of 322 subjects were included in the study: 161 in the ICCC (n = 104, 64.6% males) and 161 in the control (n = 97, 60.2% males) group. The mean (+/- standard deviation (SD)) ages of study subjects in the ICCC and Control groups were 69 (+/- 3) (range: 65-76) and 69 (+/- 3) (range: 65-74) years, respectively. Among the ICCC and Control groups after the intervention, the mean (+/- SD) FPG results were 7.0 (+/- 0.8) and 7.6 (+/- 0.96) mmol/l (p<0.05), the mean (+/- SD) HbA1c results were 7.1 (+/- 0.6%) and 7.5 (+/- 0.9%) (p<0.05), the mean (+/- SD) TC levels were 4.6 (+/- 0.6) and 5.0 (+/- 0.7) mmol/l (p<0.05), the mean (+/- SD) TG levels were 1.5 (+/- 0.4) and 1.6 (+/- 0.3) mmol/l (p<0.05), the mean (+/- SD) LDL-C levels were 3.0 (+/- 0. 7) and 3.6 (+/- 0.8) mmol/l (p<0. 05), the mean (+/- SD) HDL-C levels were 1.3 (+/- 0.2) and 1.1 (+/- 0.2) mmol/l (p<0.05), the mean (+/- SD) SBP levels were 125.1 (+/- 14.7) and 137.1 (+/- 10.9) mmHg (p<0.001), the mean (+/- SD) DBP levels were 77 (+/- 9) and 81 (+/- 7) mmHg (p<0.001), the mean (+/- SD) SAS scores were 25.8 (+/- 4.2) and 30.9 (+/- 5.2) (p<0.001), the mean (+/- SD) SDS scores were 24.8 (+/- 4.9) and 28.3 (+/- 4.4) (p<0.001), the incidence of adverse reactions were 9.3% and 17.4% (p=0.033), the proportions of subjects with good blood pressure control were 78.9% and 50.3% (p<0.001) and the proportions of subjects with good treatment compliance were 88.2% and 79.5% (p< 0.05), respectively. In summary, the ICCC program was significantly more effective than the usual treatment for lowering blood sugar, lowering blood lipids, lowering blood pressure, improving SAS and SDS scores, improving medication compliance and reducing adverse reactions. We conclude the ICCC program should be considered for use in the study population to improve outcomes. Further studies are needed to determine if the results of this study can be applied to other populations in China and if the financial benefits of the ICCC program outweigh the additional costs of the program.
The study evaluated the chemical composition and antibacterial activity of essential oils from Aquilaria agallocha, Artemisia absinthium, Hyssopus officinalis, and Mentha pulegium. Gas chromatography/gas chromatography mass spectrometry (GC/GC-MS) was used to analyze the essential oils' volatile components; their antibacterial activity against multidrug-resistant clinical bacterial isolates was assessed using a disk diffusion susceptibility assay together with the determination of minimum inhibitory concentration (MIC). The major volatile chemical compound of Aq. agallocha, Ar. absinthium, H. officinalis, and M. pulegium oils were dimethyl ester dodecanedioic acid (19.65%), beta-caryophyllene (18.51%), camphor (14.2%), and pulegone (58.5%), respectively. All essential oils had varying bactericidal activity against the test isolates of Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pyo genes, but not Pseudomonas aeruginosa. The essential oil with the overall highest antibacterial activity was that of M. pulegium, followed by H. officinalis, Aq. agallocha and Ar. absinthium. The findings confirm that medicinal plant essential oils can play a role as an alternative treatment option against current clinical multidrug-resistant microorganisms.
Microsporidia are obligate intracellular spore-forming protozoan parasites in humans. Two species commonly reported as etiology agents in humans are Enterocytozoon bieneusi and Encephalitozoon intestinalis. In Malaysia, microsporidiosis has been reported among hospitalized patients and the rural aboriginal community. However, recent concern has emerged regarding the health of refugee communities in Malaysia, due to their neglect by relevant governmental agencies. This study determined the prevalence of microsporidia among refugee school children in five districts of Selangor. Stool samples (n = 91) were collected and the presence of microsporidia was identified by diagnostic multiplex PCR of the small subunit ribosomal (SSU r) DNA. Ent. bieneusi, Enc. intestinalis and both species was present in 20, 2 and 2%, respectively. Phylogenetic analysis of the SSU rDNA sequences revealed each microsporidia species clustered into a single clade, with that of Ent. bieneusi having 87% similarity to a reference sequence from immunocompromised patients in Kuala Lumpur, while that of Enc. intestinalis a 38% sequence similarity to a reference sequence from diarrheal patient(s) in Pakistan. Thus, we suggest that sensitive and frequent surveillance together with intervention programs of microsporidia infection should be implemented in the marginalized communities in the country to minimize the potential emergence of public health issues.
The rapid integration of screen-based media into daily life has altered parent-child interactions, raising concerns about its impact on early childhood development. To measure parent media addiction and dependency, two English-language instruments, namely the 'Parent Problematic Digital Technology Use Scale' and the 'Media and Technology Usage and Attitudes Scale' were translated to Bahasa Malaysia and cross-culturally adapted in this study. A cross-sectional study was conducted in a district of Selangor, Malaysia, among parents and caretakers with normal children 18 and 36 months of age to test the Bahasa Malaysia version of instruments' content validity, internal consistency, and floor ceiling effect involving 100 participants and test-retest reliability involving 60 participants. The Cronbach's Alpha value of 0.734 was reported for 'Parent Problematic Digital Technology Use Scale' and 0.839 for the Media and Technology Usage and Attitudes Scale. The items in the scales correlate adequately in the construct and lack of discriminant validity was reported to be unlikely. Thus, the Bahasa Malaysia scales provide an effective method for measuring parent media addiction and dependency, crucial factors in understanding the impact of smartphone and online use on parent-child interaction. This validated instrument should enable further exploration into the role of digital technology on parent behavior and its influence on early child development, and may guide programs and policies fostering healthier media habits in Malaysian families.
