Search Results (331)

Background: Influenza is a significant global respiratory infection, and vaccinating reproductive-age women, particularly in densely populated countries like China, cannot be overlooked. In this study, we aimed to determine influenza vaccination coverage, vaccine hesitancy, as well as associated factors among Chinese women aged 18–49 years old. Methods: A cross-sectional survey among women aged 18–49 years was conducted in China from 15 to 30 March 2023. We collected information such as past-year influenza vaccination, demographic characteristics, health-related factors, COVID-19-related factors, and perceived susceptibility and severity of influenza. Influenza vaccine acceptance among participants who did not receive influenza vaccination in the past year was also investigated. Multivariable logistic regression analyses were employed to investigate the influencing factors of vaccine coverage and vaccine hesitancy. Results: A total of 1742 reproductive-aged women were included in the final analysis. The past-year influenza vaccine coverage among women aged 18–49 years old was only 39.32% in China. Age ≥ 35 years (aOR = 0.72, 95% CI: 0.56–0.94), renting accommodation (aOR = 0.57, 95% CI: 0.44–0.75), and history of COVID-19 infection (aOR = 0.65, 95% CI: 0.47–0.89) and COVID-19 vaccine hesitancy (aOR = 0.39, 95% CI: 0.29–0.54) were all identified as negative correlates of influenza vaccine coverage among Chinese reproductive-aged women, while participants with a history of chronic diseases (aOR = 1.57, 95% CI: 1.23–2.01) and noticeable pandemic fatigue due to COVID-19 (aOR = 1.45, 95% CI: 1.05–2.00) were prone to have higher vaccination rates. Among reproductive-aged women who did not receive influenza vaccination in the past year, the hesitancy rate regarding future influenza vaccination was 31.79%. Factors such as older age, urban residence, living with others, poor self-rated health status, absence of chronic diseases, completion of full COVID-19 vaccination, COVID-19 vaccine hesitancy, pandemic fatigue, and failure to perceive the susceptibility and severity of influenza might increase influenza vaccine hesitancy. Discussion: Overall, a lower coverage rate of influenza vaccine was notably observed among Chinese reproductive-age women, as well as the hesitancy regarding future vaccination. To effectively mitigate the impact of influenza and reduce the incidence of associated diseases, it is imperative to devise targeted intervention strategies and policies tailored to reproductive-age women. Full article

Natural products possess potent pharmacological activities and health benefits. However, drawbacks such as water insolubility, poor stability, and low bioavailability limit their practical applications. This research is dedicated to the development of suitable natural self-assembled nano-delivery systems to encapsulate natural molecule drugs, improving their dispersion and stability in aqueous solution. As a model drug, curcumin (Cur) was encapsulated in zinc–adenine nanoparticles (Zn–Adenine), based on the self-assembly of a coordination matrix material. Hyaluronic acid (HA) was further functionalized on the surface of Cur@(Zn–Adenine) to realize a tumor-targeted delivery system. The morphology was characterized through TEM and zeta potential analyses, while the encapsulation mechanism of the nanoparticles was researched via XRD and FTIR. The formed Cur@(Zn–Adenine)@HA nanoparticles exhibited good drug loading efficiency and drug loading rate. Moreover, compared to free Cur, Cur-loaded (Zn–Adenine)@HA showed enhanced pH stability and thermal stability. In particular, Cur@(Zn–Adenine)@HA demonstrated excellent biocompatibility and strong specificity for targeting CD44 protein on cancer cells. The above results indicate that (Zn–Adenine)@HA NPs can serve as an effective nano-delivery system for hydrophobic substances. Full article

Background: Youth tobacco use remains a significant public health concern, particularly in urban communities disproportionately burdened by health disparities. In Baltimore City, where tobacco-related harms are elevated, understanding the relationship between tobacco use—including e-cigarettes—and mental health among high school students is essential for guiding equitable prevention and cessation strategies. The CEASE (Communities Engaged and Advocating for a Smoke-free Environment) program, in collaboration with the American Lung Association’s Not On Tobacco (N-O-T) initiative, developed an online school-based survey to inform community-responsive interventions. Aims: This study aimed to examine the associations between cigarette use, including conventional cigarette use, and self-rated mental health among high school students in Baltimore City. Methods: High school students in Baltimore City completed an anonymous online survey that assessed demographic characteristics, tobacco knowledge and use, mental health, and related behaviors. Self-rated mental health was dichotomized as poor versus fair/good. Tobacco use categories included current use of e-cigarettes and conventional cigarettes. Logistic regression models were used to examine associations between tobacco use and self-rated mental health, adjusting for age, gender, race, and parental education. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: No statistically significant associations were found between self-rated mental health and e-cigarette use and conventional tobacco use after adjusting for covariates. Conclusions: The absence of a significant association may reflect unique aspects of the social context in Baltimore City, where youth may not use tobacco products as a coping mechanism for mental health challenges. Alternatively, it may be due to limitations in measurement, particularly the use of a single-item mental health assessment. These findings should be considered preliminary. Future research using more comprehensive mental health measures and larger samples is warranted to further explore these complex relationships. Full article

Background: Sleep is a fundamental component of health, and deprivation has been linked to numerous adverse outcomes, including reduced academic and occupational performance, greater risk of accidents, and increased susceptibility to chronic diseases and premature mortality. Dietary and lifestyle behaviors are increasingly recognized as key determinants of sleep quality. Women are particularly susceptible to sleep disturbances due to hormonal fluctuations and psychosocial factors. However, women remain underrepresented in sleep research. This study aims to examine the associations between sleep quality, nutrition, and lifestyle in a large cohort of Spanish women. Methods: A cross-sectional study was conducted with 785 women aged 18–64. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the NutSo-HH questionnaire on dietary and lifestyle behaviors. Descriptive analyses, correlation matrices, Gaussian Graphical Models, and Principal Component Analyses were used to assess relationships between variables. Results: More than half of the participants rated their sleep quality as good or very good, although over 30% experienced frequent nighttime awakenings. Poor sleep quality was significantly associated with higher alcohol consumption, lower vegetable and white fish intake, and lower levels of physical activity. Diets rich in ultra-processed foods correlated moderately with subjective poor sleep and daytime dysfunction. However, no strong associations were found between stimulant consumption, late meals, or dietary patterns (e.g., Mediterranean diet) and sleep. Self-perceived health emerged as a protective factor, while nocturnal lifestyles were linked to longer sleep latency and fragmented sleep. Conclusions: In adult women, better sleep quality is linked to healthy dietary choices, regular physical activity, and a positive perception of general health. In contrast, alcohol use and irregular lifestyles are associated with poor sleep. Individual variability and cultural adaptation may moderate the impact of some traditionally harmful behaviors. Personalized, multidimensional interventions are recommended for promoting sleep health in women. Full article

Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance use) that disproportionately impact BSMM living with HIV (BSMM+), but the impact of the pandemic on HIV care engagement among BSMM+ in the US South has not been explored in depth. Methods: BSMM+ (n = 27) were recruited from a longitudinal cohort in Dallas and Houston, Texas. Participants with less-than-optimal HIV care engagement, previous experiences of intimate partner violence (IPV), and prevalence of self-reported substance use were purposively selected for in-depth interviews from June 2022 to August 2023. Interviews lasted 54 min on average and were audio-recorded, transcribed, and de-identified before applying a thematic analysis approach. Results: Over half of participants experienced a relationship with IPV, used illicit substances in the past 60 days, and were depressed. Interviews highlighted that, during the COVID-19 pandemic, heightened levels of depression, substance use, and IPV individually and synergistically inhibited ART adherence and HIV care engagement. Participants described how IPV served to worsen their mental health and substance use, which, in turn, were the core drivers of poor HIV care engagement. Conclusions: The findings suggest that the COVID-19 pandemic exacerbated the syndemics of IPV, mental health, and substance use, and these acted as barriers to HIV care engagement. Future adherence interventions should synergistically address syndemic factors to maximize effectiveness. Full article

Background: This study aimed to evaluate the association between physical activity and suicidal ideation in adult women and to examine the moderating effect of self-rated health status. Methods: This study utilized raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) from the 6th to the 8th cycle (2013–2021). Complex sample logistic regression analysis was performed to assess the association between physical activity and suicidal ideation, and stratified analysis was conducted to examine differences in effects according to self-rated health status. Results: The prevalence of suicidal ideation among participants was 5.5%. Stratified analysis revealed that the effect of physical activity on suicidal ideation varied by self-rated health status. Among women with good self-rated health, physical activity was associated with significantly reduced odds of suicidal ideation (OR = 2.116, 95% CI: 1.229–3.643). However, among those with fair or poor self-rated health, physical activity showed no significant protective effect (OR = 1.173, 95% CI: 0.902–1.525). Conclusions: This study demonstrates a significant association between physical activity and suicidal ideation, with self-rated health status playing a key moderating role. Suicide prevention strategies should incorporate interventions that promote physical activity while considering self-rated health status. Full article

Background: Frailty is a major public health concern among older adults, leading to increased morbidity and functional decline. Physical activity and psychological resilience have been identified as potential protective factors against frailty, yet their combined effects remain understudied in Saudi Arabia. Objective: This study aimed to examine the associations between physical activity, resilience, and frailty among older adults in Riyadh. Methods: A cross-sectional study was conducted with 240 elderly participants aged 60 years and above. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ), frailty was measured using the Fried Frailty Phenotype, and resilience was evaluated with the Connor–Davidson Resilience Scale (CD-RISC-10). Logistic regression analysis was performed to identify correlates of frailty. Results: Higher physical activity levels were significantly associated with greater resilience (r = 0.61, p = 0.002) and lower frailty (OR = 0.64, p = 0.002). Advancing age, multiple comorbidities, and poor self-rated health were positively associated with frailty, while greater grip strength was inversely associated with it (OR = 0.67, p = 0.002). Conclusions: Physical activity and resilience appear to be independently associated with reduced odds of frailty among older adults in Riyadh. These findings underscore the potential benefits of integrated physical and psychological health strategies in promoting healthy aging. However, due to the cross-sectional design, causal relationships cannot be inferred. Longitudinal and intervention-based studies are needed to further explore these associations. Full article

Background: Men who have sex with men (MSM) in Japan, and globally, face disparities in mental health and well-being, driven by stigma, exclusion, and minority stress. While social capital is known to enhance well-being, no previous research has examined the distinct roles of gay versus heterosexual social capital in relation to subjective happiness. Methods: We conducted a cross-sectional online survey of 1564 MSM in Greater Tokyo, using geosocial networking applications. Social capital was measured using an adapted Resource Generator to assess access to resources from MSM and heterosexual network members. Subjective happiness was assessed using the Japanese version of the Subjective Happiness Scale. Multivariable linear regression identified correlates of happiness. Results: Gay social capital was the strongest predictor of subjective happiness, exceeding the effects of self-rated health, education, employment, and age. High levels of heterosexual social capital were also associated with greater happiness but to a lesser extent. Unemployment, poor health, and attendance at gay cruising venues were negatively associated with happiness. Conclusions: These findings provide the first global evidence of the differential associations between gay and heterosexual social capital on subjective happiness. Community-based interventions that affirm identity and build peer connection may substantially improve well-being among MSM in Japan. Full article

Background/Objectives: Hypertension, diabetes, and cancer are three prevalent chronic conditions with distinct etiologies and significant global health impacts. This study aimed to explore the diverse impacts of different chronic illnesses on health behaviors and psychological well-being, with a focus on identifying and addressing the unique challenges faced by individuals with hypertension, diabetes, and cancer. It was hypothesized that health behaviors and psychological well-being would differ significantly among individuals with hypertension, diabetes, and cancer, reflecting the distinct demands and psychosocial impacts of each condition. Methods: The database of Americans’ Changing Lives, Wave 6, including 767 participants, was used (56.1% hypertension, 20.8% diabetes, and 19.9% cancer cases). Variables concerning physical and mental health issues were chosen. Descriptive statistics summarized the data. Chi-squared and t-tests assessed associations and group differences, with effect sizes reported. Logistic regression examined predictors of hypertension, diabetes, and cancer. Sensitivity analyses excluded outliers. Results: Hypertensive individuals are more likely to show cognitive impairment and unhealthy behaviors, including poor self-rated health, higher BMI, lower physical activity, and altered alcohol use. Risk increases with age, widowhood, retirement, hospital admissions, and poor mental health, while more emergency room or doctor visits slightly reduce it. People with diabetes experience greater depressive symptoms, hopelessness, and financial stress. They also tend to have poorer self-rated health, higher BMI, and less physical activity. Risk is higher for separated individuals and lower for females. Psychological distress is a key factor, while age, employment, and healthcare use show minimal influence. Cancer is linked to chronic stress, poorer perceived health, and mental health challenges. Risk is higher among older adults and those who keep house. Poor self-rated health, high BMI, low fruit and vegetable intake, and psychological distress increase risk, but healthcare use is not a strong predictor. Conclusions: While different chronic illnesses present distinct challenges to health behaviors and psychological well-being, they also share common features-such as increased stress and lifestyle disruptions-underscoring the importance of both tailored and cross-cutting interventions to effectively support individuals across conditions. Full article

Background/Objectives: Skipping breakfast is increasingly common among adolescents and has been associated with adverse health and academic outcomes. The average prevalence of breakfast skipping among adolescents is around 16%, although worldwide, it varies greatly across studies, ranging from 1.3 to 74.7%. This study aimed to assess the frequency of daily breakfast consumption and explore the factors associated with its omission in a stratified sample of Spanish adolescents. Methods: A cross-sectional study was conducted among 547 third-year secondary school students (aged 14–15) from both urban and rural areas in Castilla-La Mancha. Self-reported questionnaires were used to gather sociodemographic, psychosocial, and lifestyle data, including adherence to the Mediterranean diet (via the Kidmed questionnaire) and breakfast habits during school days. Descriptive, bivariate (Chi-square), and multivariate (binary logistic regression) analyses were conducted separately for boys and girls. Results: Findings showed a high prevalence of breakfast skipping one or more days (33.46%), with a significantly higher rate among girls (43.27%) than among boys (24.42%). Also, girls were more likely than boys to skip breakfast every day (14.18% vs. 6.87%, p < 0.001). In both groups, low adherence to the Mediterranean diet was strongly associated with skipping breakfast, along with higher screen time, shorter sleep duration, and being overweight/obese. Among girls, low olive oil consumption (OR 0.145 (CI 0.03–0.67) p 0.014) and poor Mediterranean diet adherence (OR 0.140 (CI 0.06–0.34) p < 0.001) were significant predictors. For boys, being overweight/obese (OR 2.185 (CI 1.06–4.52) p 0.035), low Mediterranean diet adherence (OR 0.136 (CI 0.06–0.32) p < 0.001), and not eating industrial pastries were associated factors (OR 0.413 (CI 0.20–0.88) p 0.022). Predictive models demonstrated good discriminatory power (AUC = 0.807 for girls; 0.792 for boys). Conclusions: Skipping breakfast is prevalent among adolescents, particularly girls, and is linked to poor dietary patterns and excess weight. These findings underscore the need for gender-specific nutritional interventions to promote regular breakfast consumption and improve dietary habits in adolescents. Full article

Background/Objectives: The prevalence of heart failure with preserved ejection fraction (HFpEF) is expected to surpass that of heart failure with reduced ejection fraction (HFrEF), yet it remains under-researched. Compared to HFrEF, patients with HFpEF have similarly poor survival rates, physical impairments, and quality of life (QOL) and similar improvements following exercise training. However, Medicare currently excludes coverage for cardiopulmonary rehabilitation (CR) for HFpEF. The purpose of this study was to evaluate the impact of HF at baseline and the effects of CR in both subtypes. Methods: Ninety-nine patients (forty-three with HFrEF and fifty-six with HFpEF) who completed CR were included. Demographic data and outcome measures were assessed pre- and post-CR, including weight, body mass index (BMI), 5x-sit-to-stand (5xStS), timed-up-and-go (TUG), 6-minute walk test (6MWT), Ferrans and Powers Quality of Life (F&P QOL), waist circumference, BERG balance, and Patient Health Questionnaire-9 (PHQ-9). Independent and paired t-tests were performed with statistical significance set at p < 0.05. Results: At baseline, compared to patients with HFrEF, patients with HFpEF were older with a significantly lower 6MWT distance (350.6 m vs. 299.6 m), lower BERG balance scores (52/56 vs. 49/56, respectively), and a 5xSTS score indicating a fall risk (16.9 ± 6.5). Following CR, both groups had significant improvements in all functional and self-reported outcome measures (p < 0.001), with no significant differences between HF subtypes. Patients with HFpEF also had a significant improvement in waist circumference. Conclusions: Compared to patients with HFrEF, patients with HFpEF presented with similar or greater impairments and had similar or greater improvements following CR. These results underscore the effectiveness of CR for HFpEF management and the need for insurance coverage. Full article

Background/Objectives: Nearly three-quarters of American adults are overweight or obese, leading to serious health challenges. Poor nutrition is a major contributor, highlighting the need for effective nutrition education and cooking interventions. This study evaluated the impact of the Dinner Tonight Healthy Cooking School (DTHCS) on improving nutrition knowledge and cooking confidence among participants. Methods: A secondary data analysis was conducted on self-reported retrospective surveys collected from 7932 individuals across 64 Texas counties between September 2017 and March 2024. The surveys assessed changes in participants’ understanding of key nutrition concepts (rated using a four-point scale from poor to excellent) and their confidence in cooking healthy meals (rated using a four-point scale from none to high) before and after attending the program. Results: The findings showed significant improvements in both nutrition knowledge (from fair to good p < 0.001) and cooking confidence (from low to moderate p < 0.001) following program participation. Conclusions: These results highlight the vital role of nutrition and culinary education in addressing the growing obesity epidemic and reducing the risk of diet-related chronic conditions. Given the positive program outcomes, DTHCS has the potential to inform future studies and guide successful planning and implementation of community-based cooking programs for adults to promote healthier eating behaviors. Full article

Objectives: This study aimed to assess the social support level among perimenopausal women and explore its key influencing factors. Methods: From November 2022 to March 2023, a stratified multistage random sampling method was used to recruit 647 perimenopausal women from three communities in Tianjin, China. The participants completed the Social Support Rating Scale (SSRS), the Kupperman Menopausal Index (KMI), and a sociodemographic questionnaire. Nonparametric tests, correlation analysis, and stepwise regression analysis were conducted to explore key factors influencing social support. Robustness checks were performed using hierarchical regression analysis. Results: The overall social support level of perimenopausal women was moderately low (34.190 ± 10.007), with the lowest scores observed in the 46–50 age group (33.000 ± 9.666). Stepwise regression analysis showed that, compared to married women, single women reported significantly lower social support levels (β = −0.242, p < 0.001). Using public sector employees as the reference group, women in all other occupational categories (including self-employed, corporate employees, farmers, freelancers, and other professions) had significantly lower social support scores (β range: −0.196 to −0.232, all p < 0.05). Compared to those with good family relationships, women with average (β = −0.420, p < 0.001) and poor (β = −0.349, p < 0.001) family relationships reported significantly lower social support levels. In terms of menopausal symptoms, greater severity of palpitations (β = −0.140, p < 0.05) and dyspareunia (β = −0.143, p < 0.05) was associated with lower social support, while higher levels of neuroticism (β = 0.102, p < 0.05) and joint/muscle pain (β = 0.158, p < 0.05) were linked to greater social support. Conclusions: Social support levels among perimenopausal women were generally low, particularly among those aged 46–50 years. Marital status, occupational type, and family relationships were key influencing factors, and certain menopausal symptoms were closely related to social support, especially those that are difficult to discuss, such as palpitations and dyspareunia. These findings highlight the necessity of strengthening social support networks for perimenopausal women and provide scientific evidence for the development of targeted interventions and public health policies to enhance their well-being and promote healthy aging. Full article

Background/Objectives: With the gradual acceleration of population aging in China, the health problems among middle-aged and older adults have become a key social topic. Among this segment of the population, symptoms of depression are common, and cancer has the potential to aggravate such psychological diseases. Under this background, the present study investigates depression in middle-aged and older cancer patients and the various factors that influence depression. Methods: Data from 356 participants (aged ≥ 45, cancer-diagnosed, CES-D score ≥ 10) were extracted from CHARLS 2020. Depressive symptoms were assessed using CES-D, with SPSS 29.0 employed for ANOVA and binary logistic regression to identify associations between cancer, covariates, and depression. Results: The number of depressive symptoms was 161 (45.2%). Binary logistic regression showed that “gender”, “retired status”, “social status”, “life satisfaction”, “self-rated health”, and “sleep duration” were the main factors. “Female”, “not retired”, “unsocialized”, “satisfied”, “very poor self-rated health”, and “sleep < 6 h” were found to exacerbate depressive symptoms in middle-aged and older cancer patients. Conclusions: Depressive symptoms are more severe in middle-aged and older cancer patients than in other groups and are influenced by various factors. Consequently, greater attention should be paid to the mental health of these patients in their daily lives, and targeted measures should be taken to improve their mental health considering all aspects of family and society. These measures may alleviate the psychological harm that these patients suffer in the process of cancer and its treatment. Full article

Background/Objective: Chronic sleep deprivation can lead to adverse health effects and therefore represents a public health burden While caffeine is a widely used stimulant, the relationship between caffeine consumption and sleep remains uncertain. Moreover, many studies might be subject to methodological bias, as invasive sleep measurements may themselves serve as confounders. The aim of the SleepSmart study was to assess the impact of caffeine consumption through coffee and energy drinks, utilizing both smartwatch data and questionnaire responses. Methods: The SleepSmart study is an observational cohort study conducted at LMU Hospital Munich, Germany, from July 2024 to January 2025. The study investigated two intervention groups: (1) coffee and (2) energy drink consumption. Each intervention lasted 1 week, with days 1 to 3 serving as a reference period (water consumption to adjust for increased fluid intake) and days 4 to 6 serving as the intervention period (consumption of an equivalent of 240 mg of caffeine per day, 3 h before bedtime). Data was collected through self-administered questionnaires and wearable devices. The primary endpoint was sleep duration. Objective measures of sleep (duration of light/deep sleep, duration of wake phases, heart rate) and self-assed quality of sleep (Pittsburgh Sleep Quality Index) served as secondary endpoints. Results: For the primary endpoint, we did not find a significant difference in average sleep duration (baseline [hours] 6.7, coffee 6.9, energy drink 6.7, p-value 0.183). Similarly, secondary endpoints related to sleep measures showed no significant changes in the duration of light/deep sleep (coffee [min]: 242.2, reference coffee [ref_C] 255.7 I energy drink: 237.5, reference energy drink [ref_E] 261.3), time awake (coffee 22.7, ref_C 23.4 I energy drink 21.3, ref_E 18.9), time to fall asleep/wake up (coffee 4.2, ref_C 4.0 I energy drink 4.4, ref_E 2.7), or average heart rate (coffee [bpm] 62.2, ref_C 62.1 I energy drink 62.6, ref_E 62.3)—neither between the two intervention groups nor compared to the reference period. However, self-assessed sleep quality revealed a decrease in perceived sleep quality, with reports of poor sleep increasing by 8% after coffee consumption (rather bad/very bad sleeping quality: 29.7%) and 20% after energy drink consumption (46.6%), compared to baseline data (21.6%). Conclusions: The SleepSmart study introduces wearable sleep tracking as an innovative, low-interference method for objectively recording sleep data. While wearable data did not indicate significant sleep deterioration in the group of young, healthy adults, caffeine appeared to negatively impact the subjective perception of sleep in the study cohort. Full article