A comparative study: rural versus urban children as regard exposure to organophosphorus pesticides using cholinesterase enzyme activity

Background The uncontrolled long-term exposure to organophosphorus (OP) pesticides is hazardous to health especially in children. The present study aimed to determine the acetyl cholinesterase enzyme serum level in exposure and non-exposure children groups, to explore other clinical and laboratory outcomes of organophosphorus pesticides exposure on children living in rural versus urban areas, and to establish the hemotoxic alterations as a result of the exposure. A ninety clinically free children—forty-five from rural areas and forty-five children from urban areas—were assessed, and the clinical and laboratory effects of their exposure to organophosphorus pesticides were evaluated via measuring acetyl cholinesterase (AChE) enzyme activity. Results Significant differences between the two areas of residence were found in weight %, visits to the field, eating vegetables without washing, presence of insecticides at home, and previous organophosphorus pesticides toxicity of the patients and their families. Eye, respiratory, cardiac, nervous, muscle, gastrointestinal, and urinary symptoms were more common in the rural residence group which shows more exposure to pesticides. The mean level of the AChE enzyme was less in the rural residence group than the other one, and it showed significant correlations with the anemia indicating parameters. A weak positive correlation was found with platelets count. Conclusions Chronic organophosphorus toxicity that is more prevalent in rural areas may result in many transient neglected symptoms, unrevealed acetyl cholinesterase (AChE) enzyme deficiency, anemia, and thrombocytopenia. Acetyl cholinesterase enzyme serum level can be used as a screening test for organophosphorus pesticides exposure.

Investigation on form and energy use of the rural residences in Beijing and surrounding cold areas under the self-sufficiency perspective

As a design theory on energy-saving housing, Self-sufficiency house is suited to the environment conditions of cold rural areas in China. Investigation on the rural residence form and energy use is the important foundation to carry out the research and design practice on self-sufficiency house. Taking Beijing and its surrounding rural areas as target, the paper combs current situation and technical requirements of rural residence based on self-sufficiency perspective. After surveying general residential condition and data, it analyzes the form, function, energy use and heating technology of rural residence, which will provide basic data and reference for post-study.

Rural Versus Non-Rural Residence and Psychosocial Outcomes Among Caregivers of Patients with Dementia and Related Disorders

We used data on 718 dementia caregivers and multivariable linear regression to test associations between residential locale and psychosocial outcomes (grief, wellbeing, burden, quality of life [QOL], self-efficacy/mastery, and social networks). Rural residence (versus urban or suburban) was not associated with the psychosocial outcomes. However, for rural caregivers, greater self-efficacy/mastery was associated with lower grief (versus urban/suburban) and burden (versus suburban), and greater social network quality was associated with lower burden (versus suburban) and higher QOL (versus urban). Interventions targeting self-efficacy/mastery and social networks may be particularly effective at improving rural caregivers’ mental health and QOL.

Intimate partner violence and associated factors among reproductive age women during COVID-19 pandemic in Southern Ethiopia, 2020

Background World health organization (WHO) defines intimate partner violence (IPV) is physical, sexual, or emotional abuse by an intimate partner or ex-partner or spouse to a woman. From all forms of violence, ~ 1.3 million people worldwide die each year, accounting for 2.5% of global mortality. During the COVID-19 crisis, control and prevention measures have brought women and potential perpetrators together which increase the risk of IPV. Therefore, this study was aimed to assess the magnitude and associated factors of IPV against women during COVID-19 in Ethiopia. Methods Community based cross-section study was employed among 462 reproductive-age women to assess IPV and associated factors during COVID-19 pandemic. To select study participants one-stage cluster sampling technique was used. The data were entered into Epi data version 4.2 and exported to SPSS for analysis. Bivariate and multivariate analysis was used to check the association of dependent and independent variables and statistical significance was declared at P < 0.05. Result A total of 448 study subjects were responded making a response rate of 96.97%. Two- third (67.6%) of the respondent's age range was between 20 and 29 years. All of the participants heard about the pandemic of COVID-19 at the time of onset. The lifetime and the last twelve months prevalence of women with IPV was 42.19% and 24.11%, respectively. About 58 (12.9%) had experienced all three types of violence. Participants age ≥ 35 (AOR = 2.02; 95% CI: 1.99–4.29), rural residence (AOR = 3.04; 95% CI: 2.59–6.25), husband’s educational status of diploma and above (AOR = 0.35; 95% CI: 0.14–0.83), COVID-19 pandemic (AOR = 4.79; 95% CI: 1.13–6.86), and low social support (AOR = 3.23; 95% CI: 1.99–6.23) were independent predictors. Conclusions In this study two in five women undergo one type of violence in their lifetime. The occurrence of the COVID-19 pandemic has its impact on violence. Age ≥ 35, rural residence, husband’s educational status of diploma and above, history of child death, COVID-19 pandemic, and low social support were independent predictors of violence. This implies insight to concerned bodies like policymakers and stakeholders to design appropriate policies to avert this magnitude and making zero tolerance for violence in society.

The need to study rural cancer outcome disparities at the local level: a retrospective cohort study in Kansas and Missouri

Background Rural residence is commonly thought to be a risk factor for poor cancer outcomes. However, a number of studies have reported seemingly conflicting information regarding cancer outcome disparities with respect to rural residence, with some suggesting that the disparity is not present and others providing inconsistent evidence that either urban or rural residence is associated with poorer outcomes. We suggest a simple explanation for these seeming contradictions: namely that rural cancer outcome disparities are related to factors that occur differentially at a local level, such as environmental exposures, lack of access to care or screening, and socioeconomic factors, which differ by type of cancer. Methods We conducted a retrospective cohort study examining ten cancers treated at the University of Kansas Medical Center from 2011 to 2018, with individuals from either rural or urban residences. We defined urban residences as those in a county with a U.S. Department of Agriculture Urban Influence Code (UIC) of 1 or 2, with all other residences defines a rural. Inverse probability of treatment weighting was used to create a pseudo-sample balanced for covariates deemed likely to affect the outcomes modeled with cumulative link and weighted Cox-proportional hazards models. Results We found that rural residence is not a simple risk factor but rather appears to play a complex role in cancer outcome disparities. Specifically, rural residence is associated with higher stage at diagnosis and increased survival hazards for colon cancer but decreased risk for lung cancer compared to urban residence. Conclusion Many cancers are affected by unique social and environmental factors that may vary between rural and urban residents, such as access to care, diet, and lifestyle. Our results show that rurality can increase or decrease risk, depending on cancer site, which suggests the need to consider the factors connected to rurality that influence this complex pattern. Thus, we argue that such disparities must be studied at the local level to identify and design appropriate interventions to improve cancer outcomes.

Fruit and Vegetable Intakes and Sleep in Linkage With Cognition Among Older Adults in China

Background: Identifying factors associated with cognitive impairment among older adults is critical. This study aims to examine associations of fruit and/or vegetable intake (FVI), sleep quality and duration, and their interactions with cognitive performance among older adults in China.Methods: We utilize nationwide datasets in 2008 and 2011 in China to examine associations between sleep quality and duration, FVI, and cognitive impairment. Interactions between sleep and FVI on cognitive performance are also examined. All analyses are further stratified by gender, age group, and urban-rural residence.Results: When all covariates are fully adjusted for in the cross-sectional analyses, frequent FVI is associated with a 29% lower risk of cognitive impairment compared with less frequent FVI, and daily sleeping durations of ≤6h and ≥10h are associated with a 13% and a 51% higher risk of cognitive impairment, respectively, as compared with the duration of 8h. Sleep quality is not significantly associated with cognitive impairment compared with fair/poor sleep quality when all covariates are adjusted, though it is associated with a 31% lower risk when only demographics are controlled for. Interaction analyses reveal that frequent FVI offsets the higher risk of cognitive impairment for poor sleep quality and excessive sleep durations. Subgroup analyses show a generally similar pattern for both sexes but a more pronounced association for young older adults than for oldest-old adults. The patterns of the interactions of FVI, sleep quality, and sleep duration with cognitive impairment differ by urban-rural residence. However, associations of good sleep quality, adequate sleep duration, and frequent FVI with the incidence of cognitive impairment over a 3-year follow-up period are mostly not significant. Conclusions: The positive association of good sleep quality, appropriate sleep duration, frequent FVI, with good cognitive is mainly cumulative or long-term. Frequent FVI could offset a higher risk of cognitive impairment for poor sleep quality and/or excessive sleep durations. The associations are similar for both sexes but are stronger in oldest-old adults and differ by urban-rural residence.

Geographic Disparities in Cardiovascular Death Among Patients with Myelodysplastic Syndromes

Introduction: Acquired somatic mutations in hematopoietic stem cells lead to myelodysplastic syndromes (MDS) and are also associated with accelerated atherosclerosis. In subjects without MDS, these mutations constitute a potent cardiovascular risk factor: clonal hematopoiesis (CH). In a previous analysis, we demonstrated that an MDS diagnosis was an independent risk factor for cardiovascular disease (CVD) compared to propensity matched non-cancer controls. CVD is the most common non-cancer cause of death in MDS, and rural residence has been independently associated with many CVD risk factors. However, there are no studies examining the association of geographic disparities and cardiovascular death in patients with MDS. Methods: We identified adult patients diagnosed with MDS between 2001 and 2016 using the Surveillance, Epidemiology, and End Results (SEER) database. MDS risk was classified as low, intermediate or high, using International Classification of Diseases for Oncology 3 rd Edition (ICDO-3) codes. Rural and urban populations were categorized using the US Department of Agriculture's Rural-Urban Continuum Codes (RUCC). Primary cause of death reported to State Registries (SEER COD recode) was used to estimate cause-specific survival, calculated from date of MDS diagnosis to date of CVD-related death. Cases with missing data on any key variable were excluded from analysis. SEER*Stat version 8.3.9 was used to calculate incidence rates. Chi-square and t-test were used to compare categorical and continuous variables, respectively. Survival analyses employed the Kaplan-Meier method and log-rank tests. Multivariable Cox-proportional hazards repression estimated the association of rural residence with CVD death adjusting for age, sex, race, ethnicity, MDS risk, and geographic location. SAS version 9.4 was used for statistical analysis. Results: We included 52,750 patients with MDS, 56.8% were male and 84.8% were white. Low, intermediate and high histologic risk were seen in 18.7%, 64.4% and 16.9% respectively. Most patients were from urban areas (88%), however the estimated incidence rate for MDS was 6.7 per 100,000 per population at risk in both urban and rural populations. The rural MDS population was younger (median age 75 vs 77 years, p&lt;0.004) and had a higher proportion of whites (90.5% vs 84%, p&lt;0.001), but no difference in MDS risk distribution was noted by rurality (Table 1). Unadjusted analyses revealed a trend towards lower overall survival in the rural MDS population (24 vs 25 months, p=0.051). After adjusting for age, sex, race, ethnicity, MDS risk and area of residence, rural subjects with MDS had a 12% increased hazard (HR 1.12, 95%CI 1.03 - 1.22) for CVD-related death compared to urban subjects (Figure 1). Further, the adjusted HR for CVD-related death was 1.23 (CI95% 1.01 - 1.50) for those who lived in the most rural areas (RUCC codes 8 and 9, less than 2,500 urban population). Among young MDS patients (age&lt;65), those residing in rural areas had a higher proportion of CVD-related death (6% vs 4.7%, p=0.031) and significantly shorter CVD-specific survival compared to urban patients (Figure 2). MDS histologic risk was also a significant factor in the multivariable model (Table 2). Compared to low risk MDS, patients with intermediate and high risk had adjusted HR for CVD-related death of 1.17 (95%CI 1.11 - 1.24) and 1.2 (95%CI 1.09 - 1.32), respectively. Other factors significantly associated with increased hazard for CVD-related death in the adjusted model were advancing age and male sex. Discussion: In a large population-based study, we found that rural area of residence is significantly associated with a higher burden of CVD-related death in subjects with MDS, after adjusting for demographic risk factors and MDS risk classification. Although aging is an important issue in rural areas, the geographical disparities in CVD-related death among MDS patients are not explained by age alone and the difference was notable in young MDS patients. These findings should prompt hematologists caring for patients with MDS from rural areas to rigorously evaluate and address CVD risk factors. As novel treatments improve cancer-specific survival in MDS, marginalized populations with different CVD risk profiles may be disproportionally affected by the cardiovascular risk from CH, which should be considered when developing MDS surveillance programs. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Influence on attitudes and lifestyle due to lockdown amidst COVID-19 pandemic: a perception-based analysis among Bangladeshi residents

Background Countrywide lockdown or stay-at-home order has been implemented to slow down the transmission of emergent coronavirus. However, the influence on attitudes and lifestyle due to lockdown amidst the coronavirus disease 2019 (COVID-19) pandemic has been poorly understood. The present study aimed to investigate the influence on attitudes and lifestyle due to lockdown amidst the COVID-19 pandemic among Bangladeshi residents. Methods A cross-sectional survey carried out involving 1635 community dwellers across eight divisions in Bangladesh conducted from April 15, 2020 to May 10, 2020. A structured questionnaire incorporating socio-demographic, attitudes towards lockdown and adverse lifestyle amidst lockdown measures was employed to collect data using the Google Forms. Multiple regression analyses were executed to determine the associated factors of positive attitudes towards lockdown and adverse lifestyle. Results The mean scores of attitudes towards lockdown were 67.9 (SD = 8.4) out of 85 with an overall correct rate (positive attitudes) of 79.9%; whereas the mean scores of adverse lifestyle amidst lockdown were 16.1 (SD = 4.8) out of 34 with an overall rate of 47.4%. The factors associated with more positive attitudes towards lockdown included being female, divorced, higher educated, and students. Conversely, being male, having no formal education, and rural residence were associated factors of adverse lifestyle amidst the COVID-19 pandemic. Conclusions The findings reflect how the COVID-19 lockdown has preciously impacted the attitudes, and lifestyle of Bangladeshi citizens, which will contribute to promoting appropriate measures during a subsequent zonal or complete lockdown.