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Postneonatal mortality (PNM), which differs from infant and perinatal mortality, has been observed in the past 25 years with respect to the health outcomes of children. While infant and perinatal mortality have been well-evaluated regarding racial differentials, there are no substantial data on PNM in this perspective. The purpose of this study was to assess whether or not social determinants of health adversely affect racial/ethnic PNM differentials in the USA.

A cross-sectional, nonexperimental epidemiologic study design was used to assess race as an exposure function of PNM using Cohort Linked Birth/Infant Death Data (2013). The outcome variable assessed PNM, while the main independent variables were race, social demographic variables (i.e. sex and age) and social determinants of health (i.e. marital status and maternal education). The chi-square statistic was used to assess the independence of variables by race, while the logistic regression model was used to assess the odds of PNM by race and other confounding variables.

During 2013, there were 4,451 children with PNM experience. The cumulative incidence of PNM was 23.6% (n = 2,795) among white infants, 24.3% (n = 1,298) among Black/African-Americans (AA) and 39.5% (n = 88) were American-Indian infants (AI), while 21.3% (n = 270) were multiracial, χ² (3) = 35.7, p < 0.001. Racial differentials in PNM were observed. Relative to White infants, PNM was two times as likely among AI, odds ratio (OR) 2.11 (95% confidence interval [CI] 1.61, 2.78). After controlling for the confounding variables, the burden of PNM persisted among AI, although slightly marginalized, adjusted odds ratio (aOR) 1.70, (99% CI 1.10, 2.65).

In a representative sample of US children, there were racial disparities in PNM infants who are AI compared to their white counterparts, illustrating excess mortality. These findings suggest the need to allocate social and health resources in transforming health equity in this direction.

This chapter shows the prevalence, trends and heterogeneity in maternal smoking around birth in the United Kingdom (UK), focussing on the war and post-war reconstruction period in which there exists surprisingly little systematic data on (maternal) smoking behaviours. Within this context, the authors highlight relevant events, the release of new information about the harms of smoking and changes in (government) policy aimed at reducing smoking prevalence. The authors show stark changes in smoking prevalence over a 30-year period, highlight the onset of the social gradient in smoking as well as genetic heterogeneities in smoking trends.

A growing body of research finds a consistently negative relationship between medical cannabis access and aggregate measures of opioid use. Nothing is currently known about the types of opioids that are being most impacted by cannabis access. Using the Callaway and Sant’Anna (2021) difference-in-differences (DID) estimator for the main analysis and data on all opioid shipments to every United States (US) pharmacy from 2006 to 2014, the authors found no evidence of overall change in the total number of morphine milligram equivalent (MME) units of opioids shipped to pharmacies, following the opening of medical cannabis dispensaries. However, across all opioids, the authors found a reduction in the highest MME dosage strengths (8.8% decrease in 50–89 MME doses and 11.3% decrease in 90+ MME doses). This decrease appears to be driven predominantly by commonly diverted opioids, where the authors found a reduction in the highest MME dosage strengths (12.2% in 50–89 MME doses and 13.8% in 90+ MME doses). Further, the authors see a 6.0% increase in low-to-moderate dose opioids (0–49 MMEs). This is consistent with patients using cannabis concomitantly with opioids in order to achieve a lower opioids dose.

Our objective was to evaluate the cost-utility of a health and social care integration programme for frail older adults in Buenos Aires, Argentina.

Based on a study of the programme’s effectiveness, a Markov model was conducted to assess its cost-utility. The active intervention was the health and social care integration programme, and the control was the best standard of care so far. The setting was the patients' home of residence. A third-party payer perspective and a lifelong time horizon were adopted. All transition probabilities, quality-adjusted life years (QALYs) and costs were estimated from the effectiveness study. A discount rate of 3.5% was applied to costs and benefits. Costs are expressed in international dollars (Int$), calculated according to the International Monetary Fund’s purchasing power parity rate. Different sensitivity analyses were performed. The model was built in Excel 365. Construct validity, verification during model construction and internal consistency of the results were assessed.

The programme had an average cost of Int$18,768.22/QALY, and the control Int$42,609.68/QALY. In the incremental analysis, the programme saved Int$26,436.10 and gained 0.81 QALYs over the control. In the sensitivity analyses, in 99.96% of cases, the programme was less costly and more effective.

The cost savings can facilitate the scalability.

The health and social care integration programme for frail older adults was more effective and less costly than the best standard of care to date. This study contributes to the scarce evidence on the efficiency of integrated care strategies for frail older persons.

Normal-weight obesity (NWO), characterized by normal body mass index (BMI) but excess body fat, is a potential contributor to chronic diseases. This study aims to assess the relationship between this phenomenon and some metabolic factors in a population of Iranian employees.

This cross-sectional study was conducted on Iranian employees from the baseline data of Employees Health Cohort Study, Shiraz, Iran. Anthropometric measures, including weight, height, waist circumference and percentage of body fat, were obtained from the cohort database. The participants were divided into three groups: healthy, normal-weight obese and overweight/obese. Metabolic variables including blood pressure, fasting blood sugar, lipid profile, liver function enzymes and metabolic syndrome were assessed in relation to the study groups.

A total of 985 participants aged 25–64 years were included. Males with NWO had significantly higher alanine aminotransferase (ALT) levels compared to the healthy group in the fully adjusted model. Also, high-density lipoprotein (HDL) was significantly lower among females with overweight/obesity than healthy group when adjusted for age and energy intake. Furthermore, after adjusting for age and energy intake, both genders in the overweight/obese group showed significantly elevated systolic and diastolic blood pressure, while this was not observed for the NWO group. Lastly, metabolic syndrome was more prevalent in NWO as well as overweight/obesity.

These findings further encourage identification of excess body fat, even in normal-weight individuals, to prevent chronic metabolic diseases. Special attention should be paid to subgroups with sedentary occupations, as they may be at increased risk for NWO-related health issues.

This study aims to explore the link between prevalent risk factors for early childhood diarrhea, including hygiene, feeding, weaning practices and maternal education and the occurrence and severity of early childhood diarrhea in Saudi Arabia.

A case-control study was conducted, involving 98 mothers from the Eastern Region of Saudi Arabia (51 cases and 47 controls). Data were collected from both hospital and community sources. The collected data were statistically analyzed and depicted using descriptive statistics and frequency tables.

Demographic data revealed that 60% of mothers were housewives, 75% had normal deliveries and all babies were full term. In the study cohort, 44% of children aged one to two years. Four domains were compared: diarrheal management, hygiene, weaning and feeding practices. Diarrheal management was suboptimal in some cases: 29% increased fluid intake, 10% maintained adequate food intake, 50% sought medical advice, 58% were familiar with oral rehydration solutions and only 37% used them. Hygiene practices were deficient, with 35% using wipes or sanitizers, 64% handwashing before feeding and 52% adhering to the recommended 10-s duration. Controls exhibited better hygiene practices. Weaning practices were generally similar, with no significant differences between the two groups.

To the best of the authors’ knowledge, this is the first study to collectively report on the risk factors linked to early childhood diarrhea in Saudi Arabia. This study yields significant insights, highlighting the crucial role of managing diarrhea, educating mothers and implementing proper household practices in impacting the occurrence and severity of this perilous ailment.

Economic evaluations often utilise individual-patient data (IPD) to calculate probabilities of events based on observed proportions. However, this approach is limited when interest is in the likelihood of extreme biomarker values that vary by observable characteristics such as blood glucose in gestational diabetes mellitus (GDM). Here, instead of directly calculating probabilities using the IPD, we utilised flexible parametric models that estimate the full conditional distribution, capturing the non-normal characteristics of biomarkers and enabling the derivation of tail probabilities for specific populations. In the case study, we used data from the Born in Bradford study (N = 10,353) to model two non-normally distributed GDM biomarkers (2-hours post-load and fasting glucose). First, we applied fully parametric maximum likelihood to estimate alternative flexible models and information criteria for model selection. We then integrated the chosen distributions in a probabilistic decision model that estimates the cost-effective diagnostic thresholds and the expected costs and quality-adjusted life years (QALYs) of the alternative strategies (‘Testing and Treating’, ‘Treat all’, ‘Do Nothing’). The model adopts the ‘payer’ perspective and expresses results in net monetary benefits (NMB). The log-logistic and Singh-Maddala distributions offered the optimal fit for the 2-hours post-load and fasting glucose biomarkers, respectively. At £13,000 per QALY, maximum NMB with ‘Test and Treat’ (−£330) was achieved for a diagnostic threshold of fasting glucose >6.6 mmol/L, 2-hours post-load glucose >9 mmol/L, identifying 2.9% of women as GDM positive. The case study demonstrated that fully parametric approaches can be implemented in healthcare modelling when interest lies in extreme biomarker values.

The COVID-19 pandemic has caused significant mortality and morbidity worldwide. However, the role of dietary patterns as a potential risk factor for COVID-19 has not been well established, especially in studies with large samples. Therefore, this study aims to identify and evaluate the association between major dietary patterns and COVID-19 among adults from Iran.

In this cross-sectional study, the authors included 9,189 participants aged 20–70 who participated in the Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd study (TAMIZ). They used factor analysis to extract dietary patterns based on a food frequency questionnaire (FFQ). Then, they assessed the relationship between these dietary patterns and the odds of COVID-19.

This study identified two major dietary patterns: “high protein and high fiber” and “transitional”. Participants in the highest tertile of the “high protein and high fiber” dietary pattern, which included vegetables, fruits, dairy and various kinds of meats such as red meat, fish and poultry, had a lower odds of COVID-19 compared with those in the lowest tertile. However, the “transitional” dietary pattern did not affect the risk of COVID-19.

In conclusion, a “high protein, high fiber” diet may lower the odds of COVID-19. This study suggests that dietary patterns may influence the severity and spread of future similar pandemics.

Competitiveness is an important personality trait that has been studied in various disciplines and has been shown to predict critical work outcomes at the individual level. Despite this, the role of competitiveness in groups and teams has received scant attention amongst organizational researchers. Aiming to promote future research on the role of competitiveness as both an adaptive and maladaptive trait – particularly in the context of work – the authors review competitiveness and its effects on individual and team stress and Well-Being, giving special attention to the processes of cohesion and conflict and situational moderators. The authors illustrate a dynamic multilevel model of individual and team difference factors, competitive processes, and individual and team outcomes to highlight competitiveness as a consequential occupational stressor. Furthermore, the authors discuss the feedback loops that inform the different factors, highlight important avenues for future research, and offer practical solutions for managers to reduce unhealthy competition.

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. Considering the restricted and enclosed nature of prisons and closed environments and the prolonged and close contact between individuals, COVID-19 is more likely to have a higher incidence in these settings. This study aims to assess the prevalence of COVID-19 among prisoners.

Papers published in English from 2019 to July 7, 2023, were identified using relevant keywords such as prevalence, COVID-19 and prisoner in the following databases: PubMed/MEDLINE, Scopus and Google Scholar. For the meta-analysis of the prevalence, Cochrane’s Q statistics were calculated. A random effect model was used due to the heterogeneity in COVID-19 prevalence across included studies in the meta-analysis. All analyses were performed in STATA-13.

The pooled data presented a COVID-19 prevalence of 20% [95%CI: 0.13, 0.26] and 24% [95%CI: 0.07, 0.41], respectively, in studies that used PCR and antibody tests. Furthermore, two study designs, cross-sectional and cohort, were used. The results of the meta-analysis showed studies with cross-sectional and cohort designs reported 20% [95%CI: 0.11, 0.29] and 25% [95%CI: 0.13, 0.38], respectively.

Through more meticulous planning, it is feasible to reduce the number of individuals in prison cells, thereby preventing the further spread of COVID-19.