Search Results (1,668)

Background and Objectives: Hypertension in young adulthood is increasingly recognized as a precursor to future cardiovascular disease. Early identification of modifiable risk factors, such as dietary habits, lifestyle behaviors, and psychological indicators, is critical for prevention. This study aimed to examine the elevated clinic blood pressure and associated factors in 19-year-old individuals in Serbia. Materials and Methods: A cross-sectional study was conducted using data from the 2019 Fourth National Health Survey. A total of 212 participants underwent blood pressure measurement, anthropometric assessment, and completed standardized questionnaires on diet, physical activity, depressive symptoms, and sociodemographic characteristics. Blood pressure was classified according to ESC/ESH guidelines. Associations with elevated blood pressure were assessed using chi-square tests and multivariate logistic regression. Results: Most participants had optimal or normal blood pressure, while 18.9% had elevated blood pressure, including high-normal and Grade I–II hypertension. Elevated blood pressure was more prevalent among males and was associated with depressive symptoms. Nutrition status was significantly associated with elevated blood pressure, and some dietary habits like consumption of pure fruit or vegetable juices and the intake of processed meat products. Other socioeconomic factors, eating habits and physical activity were not significantly correlated. In multivariate logistic regression, elevated arterial blood pressure was significantly associated with consuming pure fruit or vegetable juices less than once per week (OR = 3.239; 95% CI: 1.413–7.427) and with consuming processed meat products several times per week in comparison to the daily consumption (OR = 0.325; 95% CI: 0.130–0.812), while no other variables remained statistically significant. Conclusions: Clinically elevated arterial blood pressure is present in a substantial proportion of 19-year-olds. Early lifestyle interventions targeting nutrition and psychological health may prevent progression to hypertension and reduce long-term cardiovascular risk. Full article

To improve shared decision-making about the potential risks and benefits of hormone therapy (HT), it is crucial to understand the joint effects of menopausal age and HT use on hypertension onset. This study examines the combined and individual effects of age at menopause and HT on hypertension onset in U.S. women based on their hysterectomy and oophorectomy history. This population-based, cross-sectional study included 4776 postmenopausal women with and without hysterectomy and oophorectomy history from the 2011–2020 National Health and Nutrition Examination Survey (NHANES). Age at hypertension onset was defined as the time scale at which a respondent was diagnosed with hypertension following the menopause onset. The weighted prevalence of hypertension was 40.0% (95% CI 38.2–41.8%) overall, highest in those who had an oophorectomy with or without hysterectomy (51.6%), followed by those with hysterectomy alone (45.3%), then in those with an intact uterus and ovaries (33.7%), p < 0.0001. Among women with an intact uterus and ovaries, those who experienced menopause before age 45 and used HT had a comparable risk of hypertension (aHR = 1.34, 95% CI: 0.81–2.22) to women who experienced menopause between ages 45 and 54 and did not use HT. Conversely, women who experienced menopause before age 45 and did not use HT showed a significantly increased risk of hypertension (aHR = 1.68, 95% CI: 1.27–2.22). The findings suggest that the absence of ovaries, with or without a uterus, HT use, and age at menopause are associated with the likelihood of hypertension development. This study highlights the need for personalized management and decision-making to reduce the risk of hypertension and cardiovascular disease in peri- and postmenopausal women. Full article

Background/Objectives: Cardiovascular diseases (CVDs) remain a leading cause of mortality worldwide, with a particularly high burden in Central Asian countries. Despite ongoing urbanization, rural populations constitute a significant demographic in this region, yet epidemiological data stratified by urban and rural residence are limited and fragmented. This systematic review aimed to synthesize current evidence on the incidence, prevalence, mortality, and risk factor profiles of CVDs among urban and rural populations in Central Asia, identify disparities, and inform targeted prevention and control strategies. Methods: A systematic literature search was conducted across the PubMed, Science Direct, Web of Science, and Google Scholar databases for studies published between 2015 and 2025. Included studies reported cardiovascular health indicators with urban–rural stratification in Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, and Turkmenistan. Data extraction and qualitative synthesis were performed, with methodological quality assessed using the Newcastle–Ottawa Scale. Results: Eight original studies met the inclusion criteria, encompassing national and regional datasets with diverse designs, including retrospective analyses, cross-sectional surveys, and registry data. Overall, CVD incidence and prevalence showed increasing trends in both urban and rural areas, with consistently higher mortality rates in urban populations. Key modifiable risk factors—hypertension, obesity, dyslipidemia, and smoking—were prevalent, particularly in rural settings. Variability in healthcare access and preventive program implementation contributed to the observed disparities. Limited data from some countries, particularly Tajikistan and Turkmenistan, highlight gaps in epidemiological surveillance. Conclusions: The cardiovascular disease burden in Central Asia demonstrates significant urban–rural disparities, underscoring the need for tailored public health interventions and enhanced healthcare resource allocation in rural regions. Strengthening epidemiological monitoring and implementing region-specific prevention programs targeting modifiable risk factors are imperative for reducing CVD morbidity and mortality. Further high-quality research is necessary to address existing data gaps and optimize cardiovascular health strategies across the region. Full article

Household bread and bakery product waste constitutes a growing issue in Algeria, with significant economic, environmental, and socio-cultural implications. This research is situated within the framework of sustainable food systems and responds to recent transformations in domestic food practices, driven by increased female labor force participation, time constraints, and the widespread availability of industrial bread, which have reshaped household food management and traditional home bread-making practices. The study aims to (1) review traditional Algerian breads, emphasizing their culinary, nutritional, and cultural significance; (2) examine household behaviors during the month of Ramadan in the city of Constantine, focusing on patterns of consumption, purchasing, waste generation, and strategies for reusing leftovers; and (3) assess the economic implications of these practices using the FUSIONS methodology and explore their contribution to household-level food sustainability. Methodologically, a cross-sectional exploratory survey was conducted among 100 married women, the majority of whom were middle-aged (62%; range: 27–71 years; mean age: 52.0 ± 10.21), well-educated (59% with a university degree), economically active (68%), and living in medium-sized households (63%). The findings reveal pronounced contrasts across bread categories. Industrial breads, particularly baguettes, are characterized by high daily purchase frequencies (4.16 ± 1.31 units/day) and the highest waste rates (12.67%), largely attributable to over-purchasing (92%) and low perceived value associated with subsidized prices, with convenience (100%) remaining the primary factor explaining their dominance. In contrast, traditional breads exhibit minimal waste levels (1.63%) despite frequent purchase (3.85 ± 0.70 loaves/day), reflecting more conscious food management shaped by strong cultural attachment, higher perceived value, and dietary preferences (100%). Modern bakery products, along with confections and pastries, the latter representing of 58% of total household food purchases, comprise a substantial share of food expenditure during Ramadan (2.16 ± 0.46 loaves/day and 12.07 and 7.28 ± 2.50 units/day, respectively), while generating relatively low levels of food waste (5.69%, 4.19%, and 0%, respectively). This suggests that higher prices and symbolic value encourage more careful purchasing behaviors and conscious consumption. Freezing leftovers (63%) emerges as the most commonly adopted waste-reduction strategy. Overall, this work provides original quantitative evidence at the household level on bread and bakery product waste in Algeria. It highlights the key socio-economic, cultural, and behavioral drivers underlying waste generation and proposes actionable recommendations to promote more sustainable food practices, in line with the United Nations Sustainable Development Goal 12 on responsible consumption and production. Full article

Background: Depression represents a major public health burden in Hungary, where prevalence remains higher than the global average. Although diet is an increasingly studied factor associated with mental health, evidence from Central and Eastern Europe is scarce. Methods: This cross-sectional study analyzed data from the Hungarian wave of the European Health Interview Survey (EHIS) 2019, a nationally representative sample of 5603 adults aged ≥15 years. Depressive symptom severity was assessed using the Patient Health Questionnaire-8 (PHQ-8) and categorized as none (0–4), mild (5–9), and moderate-to-severe (≥10). Self-reported frequency of consumption of fruits, vegetables, fruit juice, dairy products, fish, processed meat, sweetened beverages, coffee, and sweeteners was examined. Multivariable ordinal logistic regression models, adjusted for gender, age, education, income, physical activity, smoking, and alcohol consumption, were used to estimate associations with depressive symptom severity. Results: Overall, 77.9% of participants had no depression, 17.0% mild, and 5.1% moderate-to-severe symptoms. After full adjustment, lower consumption of fruits and vegetables, less frequent fruit juice intake, and lower processed meat consumption were associated with higher odds of more severe depressive symptoms. Moderate coffee intake (1–2 cups/day) was associated with lower odds than heavier consumption. Conclusions: In the Hungarian adult population, poorer dietary patterns, particularly low intake of fruits, vegetables, and paradoxically lower processed meat consumption, are significantly associated with greater depressive symptom severity, independent of major sociodemographic and lifestyle factors. These findings underscore the potential role of diet quality in mental health and support public health efforts to promote nutrient-rich dietary patterns in Hungary. Full article

Background: Health literacy is increasingly recognized as an essential determinant of health, readiness, and safety in the military, especially as health systems become more digitalized. However, evidence on general and digital health literacy in the armed forces remains limited. This study examined levels of general health literacy and digital health literacy among Lithuanian soldiers and explored their associations with sociodemographic, service-related, and health characteristics. Methods: A cross-sectional survey was conducted among 603 military personnel serving in the national armed forces. General and digital health literacy were measured with HLS19-Q12 and HLS19-DIGI. Data on sociodemographic and military characteristics, self-rated health, and self-reported long-term illnesses were collected. Descriptive statistics, correlation analyses, and multivariable regression models were used to analyze the data. Results: The sample was predominantly male (81.9%) with a mean age of 39.08 years (SD = 8.89). The mean general health literacy score was 80.1 (SD = 19.17), whereas the mean digital health literacy score was 67.81 (SD = 30.05). Overall, 45.0% of soldiers had excellent general health literacy, and 12.0% had inadequate general health literacy; 42.1% had excellent digital health literacy, and 35% had inadequate digital health literacy. Higher levels of health literacy were positively associated with better self-rated health and social status. No statistically significant associations were found between health literacy and gender, age, education, length of service, type of military service, and self-reported long-term health complaints. Conclusions: Military personnel in this study displayed relatively high general health literacy, yet digital health literacy was lower and more unevenly distributed, indicating a potential vulnerability for health outcomes as access to information, communication, and care increasingly relies on digital platforms. Given the cross-sectional design, causal inferences cannot be drawn. Military health services may build on existing health literacy strengths while considering strategies to address digital health literacy gaps (e.g., targeted training, tailored support, and user-friendly digital solutions, including service design), acknowledging that feasibility and implementation depend on organizational context and resources. Full article

Background: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are prevalent neurodevelopmental conditions in childhood. Beyond biological factors, social and environmental conditions influence developmental experiences and pathways to diagnosis. Nationally representative studies examining multiple social determinants in relation to ADHD, ASD, and comorbidity across recent years remain limited. Methods: We analyzed pooled cross-sectional data from six cycles (2018–2023) of the U.S. National Survey of Children’s Health, including 205,480 children aged 3–17 years. Parent-reported, clinician-diagnosed current ADHD and ASD were the primary outcomes; comorbid ADHD and ASD were examined secondarily. Social determinants included household income relative to the federal poverty level, parental education, health insurance type, food insecurity, and caregiver-reported neighborhood safety. Survey-weighted prevalence estimates and logistic regression models accounted for the complex sampling design and adjusted for demographic, family, regional, and temporal factors. Results: The weighted prevalence of ADHD was 9.7% and ASD was 2.9%; 1.1% of children had comorbid ADHD and ASD. Lower household income, food insecurity, unsafe neighborhood conditions, and lower parental education were associated with higher adjusted odds of both conditions. Boys had substantially higher odds of ADHD and ASD. After adjustment, non-Hispanic Black and Hispanic children had lower odds of ASD than non-Hispanic White children, consistent with differential identification rather than lower underlying prevalence. Comorbidity was concentrated among socially disadvantaged children. Conclusions: ADHD and ASD are socially patterned across U.S. children. Integrating developmental screening with assessment of social risks may support more equitable identification and intervention. Full article

Background/Objectives: Ageism is a pervasive form of prejudice that undermines health, social participation, and intergenerational solidarity, yet validated research tools for measuring ageism are lacking in many countries. The Fraboni Scale of Ageism (FSA) is one of the widely used instruments, but its psychometric properties have not previously been examined in the Czech context. This study aimed to translate the 29-item FSA, evaluate its reliability and validity, and describe ageism across generations. Methods: A quantitative cross-sectional survey based on face-to-face interviews was conducted in March 2024 among the Czech population aged 15–74 years (n = 1096). Data analysis included descriptive statistics, internal consistency indices (Cronbach’s α, McDonald’s ω, Composite Reliability, Average Variance Extracted), exploratory factor analysis (EFA) on a random half-sample, and confirmatory factor analysis (CFA) on the second half. Construct validity was also examined. Results: The Czech FSA showed very good distributional characteristics with no floor or ceiling effects and excellent internal consistency (α = 0.949; subscales α = 0.848–0.898). EFA replicated the original three-factor structure (Antilocution, Avoidance, and Discrimination) explaining 57.6% of variance. CFA supported this structure with good-to-excellent model fit. FSA scores increased systematically from Baby Boomers to Generation Z, indicating higher ageism among younger cohorts. Higher fear of old age, lower education, an earlier subjective boundary of old age, and absence of an older co-resident were associated with higher ageism scores. Conclusions: The Czech version of the FSA is a reliable and valid instrument for assessing ageist attitudes in the Czech population. Its robust psychometric properties and sensitivity to theoretically relevant correlates support its use for monitoring ageism, evaluating interventions, and enabling cross-national comparisons in aging research and policy. Full article

Purposes: Teacher turnover has especially negative effects on schools and students when experienced and capable teachers leave. This loss is significant when those teachers also serve as mentors to their less experienced colleagues. This study aimed to advance understanding about how school leaders can positively influence the retention of their school’s teacher mentors. Methodology: The framework for the study reflects a longstanding line of research on successful leadership. Using a cross-sectional research design, evidence was provided by responses to the mentor survey component of a larger four-year study examining the effects on retention decisions of a national induction programme for early-career teachers and their mentors in England. Structural equation modelling was employed to test the direct and indirect effects of school leadership and selected school conditions on mentors’ self-efficacy, well-being and job satisfaction, and ultimately retention decisions. Findings: Developing and retaining teacher mentors was associated with a suite of leadership practices which encourage collaborative cultures, provide coherent high-quality learning opportunities, and ensure what they perceive to be manageable workloads. These organizational conditions nurture the job satisfaction and self-efficacy of experienced teachers enhancing their sense of well-being at work. Implications: Results suggest four sets of guidelines for senior school leaders. Full article

Designing and communicating physical activity guidelines takes considerable resources; thus, understanding the awareness and adoption of such guidelines by different population groups is important. A national cross-sectional survey (N = 972; aged 19+ years living in Wales) was delivered as part of a population panel using a multi-method approach (online, telephone and face-to-face). The survey measured the awareness and adoption of the 2019 UK physical activity guidelines and recommendations and socio-demographics, including age, sex, residential deprivation and disability status. Around a fifth (21.7%) of participants had heard of the physical activity guidelines. Almost a third (30.7%) reported knowing the moderate physical activity recommendation, with 13.3% knowing the vigorous physical activity recommendation and 13.4% knowing the muscle-strengthening recommendation. There were no significant socio-demographic differences in knowing the moderate recommendation (p > 0.05); however, females were less likely than males to report knowing the vigorous recommendation (p = 0.009), and participants with a disability were less likely than those without a disability to report knowing the muscle-strengthening recommendation (p = 0.026). Having heard of the physical activity guidelines increased the likelihood of knowing each of the three recommendations (all p < 0.001). Additionally, for both moderate-to-vigorous physical activity and muscle-strengthening recommendations, a positive relationship was found between knowing the recommendation and reporting meeting the recommendation (p = 0.008 and p = 0.002, respectively). The awareness of both the physical activity guidelines and their recommendations was low. The development of communication strategies to aid knowledge mobilisation should be considered. Socio-demographic differences in awareness should be considered when designing interventions in line with proportionate universalism principles. Full article

This study aims to investigate the impact of green finance on corporate sector investments and their associated environmental outcomes. The authors collected cross-sectional survey data with a sample of four hundred firms selected from the five green-relevant industries in an emerging economy. The results indicate that, over the last three years, seventy percent of firms have accessed at least one green instrument. Overall, the firms under study indicate that PKR 3.4 million is being allocated to green finance, and PKR 2.7 million is spent on CAPEX. However, each million PKR is associated with a ten percent capital expenditure, which exhibits the highest adoption of the renewable energy sector, while the manufacturing sector has the lowest adoption. Regression results depict that Greenhouse gas reduction is only achievable if expenditure on R&D is ensured for environmental gains. This study indicates a declining incremental impact when green finance exceeds PKR 5.00 million, suggesting that firms’ limitations in utilizing the additional amount may be a factor. Financially constrained firms achieve stronger environmental goals, confirming that strict criteria to finance projects show more responsibility and discipline in executing projects. However, small- and medium-sized firms are confronted with barriers, such as lack of information and transaction costs. The findings of this study highlight the need for a multi-layered regulatory framework, innovation-driven incentives, and fintech integration to fully realize the potential of green finance. The outcome enables financial institutions, sustainability practitioners, and regulators to connect financial markets, national climate, and development goals. Full article

Violence is an emerging social determinant of health in Latin America; however, empirical evidence from Peru remains limited. This study examined the association between crime rates and the prevalence of obesity and high blood pressure in Peru from 2019 to 2023. Using a repeated cross-sectional design with department–year aggregates, we analyzed nationally representative data from the Demographic and Family Health Survey, adjusting for sociodemographic, mental health, and geographic factors. Regional statistics on crime were incorporated into the analysis. The findings revealed a significant association between higher levels of crime and increased prevalence of self-reported high blood pressure and obesity. The association with obesity was particularly pronounced in border regions such as Tumbes, Madre de Dios, and Callao, where criminal activity is more prevalent. The findings indicate that prolonged exposure to violence may negatively impact biological stress responses, limit physical activity, and encourage the emergence of detrimental behaviors, consequently increasing the cardiometabolic risk burden in affected populations. Full article

Introduction: The anonymisation of Personal Data (PD) and its release as Open Data (OD) hold considerable potential for innovation across health, research, public administration, and the economy. However, practical experiences regarding data anonymisation and OD publication remain underexplored in Germany. This study empirically investigates the current state of anonymised data practices, the barriers to implementation, and the desired support mechanisms for publishing formerly PD as OD. Methods: Embedded in a mixed-methods approach, this cross-sectional study examines research interest in the collection, processing, and use of anonymised data, as well as potential barriers and support services for the anonymisation and publication of former PD. A nationwide online survey was conducted in October–November 2024 via LimeSurvey. A total of 215 responses were included in the descriptive analysis. Results: The findings indicate limited experience with PD anonymisation and OD publication across industries. The potential added value of these processes was often not fully recognised, and data-handling responsibilities were rarely standardised. Data collectors, data protection officers, and IT departments were identified as the most frequently involved parties in these processes. Technical and educational support were the most desired forms of assistance. Discussion: To foster broader OD utilisation, stakeholders require comprehensive support. According to the sample, specific training and further education on the anonymisation and publishing process, as well as the desired software, are most important. Developing standardised process descriptions that integrate ethical and legal considerations, supported by national networks or governmental institutions, could significantly enhance the responsible and effective use of anonymised OD in Germany. Full article

Background and Objectives: To evaluate whether regional climatic factors, particularly relative humidity (RH) and temperature, are associated with geographic variation in dry eye disease (DED) prevalence in Argentina. Materials and Methods: A secondary analysis of a nationwide voluntary online cross-sectional survey of DED in Argentina (April 2022; non-probability sample; n = 10,812) was performed. Participants were assigned to one of five standard geopolitical regions. DED prevalence (%) was estimated at regional levels. Monthly mean, maximum, and minimum temperature and RH for April 2022 were obtained from the National Meteorological Service; for each province/region, data corresponded to the principal synoptic station in the provincial capital. Because the survey and climate data were restricted to April, seasonal effects could not be evaluated. Region-level analyses of climate–DED patterns were prespecified as exploratory and descriptive given the small number of regional units (n = 5). Weighted descriptive models were used to compare RH–DED patterns while accounting for regional age and sex distributions. Results: Regional DED prevalence ranged from 37.7% (Northwest) to 49.8% (Cuyo). RH showed a clear inverse pattern with regional DED prevalence, whereas temperature showed no consistent relationship. Weighted descriptive models showed a similar qualitative RH–DED pattern, although residual confounding cannot be excluded. Conclusions: DED prevalence in Argentina shows geographic variability and a descriptive inverse pattern with ambient RH. These ecological findings are hypothesis-generating and must be interpreted cautiously due to sampling bias. Future seasonal, longitudinal, or individual-level studies are needed to confirm and quantify these preliminary signals. Full article

Nonalcoholic fatty liver disease (NAFLD) is a major public health concern with a global prevalence of approximately 32%. This study examined the association between the “weekend warrior”, other leisure-time physical activity patterns, and NAFLD in Korean adults. We included 44,264 individuals from the Korea National Health and Nutrition Examination Survey (2014–2023). Physical activity was measured using the Global Physical Activity Questionnaire (GPAQ), a self-reported instrument, and physical activity patterns were classified as inactive, weekend warrior (≥150 min/week of moderate-to-vigorous physical activity [MVPA] performed in 1–2 days), and regularly active. NAFLD was identified using the Hepatic Steatosis Index with a cutoff of >36. Weighted logistic regression was used to examine the association between physical activity patterns and NAFLD. The prevalence of NAFLD was 24%. After adjustment for sociodemographic and metabolic factors, both the weekend warrior (odds ratio [OR] = 0.80, 95% confidence interval [CI]: 0.64–0.99) and regularly active (OR = 0.83, 95% CI: 0.77–0.89) groups had significantly lower odds of NAFLD compared to the inactive group. When stratified by total MVPA level, both the weekend warrior and regularly active patterns with >300 min/week of MVPA showed even lower odds of NAFLD, compared to those with 150–300 min/week of MVPA. Both regularly active and weekend warrior patterns were associated with a lower prevalence of NAFLD, suggesting that the weekend warrior pattern may represent a feasible behavioral pattern associated with lower NAFLD prevalence for individuals with time constraints. Full article