BackgroundAn unhealthy lifestyle of college students is an important public health concern, but few studies have been undertaken to examine the role of socio-cultural differences.MethodsFor this cross-sectional comparative study, data on college students’ health-promoting lifestyles (HPL), as measured using the Health-Promoting Lifestyle Profile (HPLP-II) scale, and self-rated health status (SRH) as measured by Sub-Optimal Health Measurement Scale (SHMS V1.0) were collected from 829 college students.ResultsThe sample of 829 college students included 504 (60.8%) Chinese and 325 (39.2%) international students. Chinese students had higher scores in overall health-promoting lifestyle (HPL) (P < 0.001, eta squared =0.113) and in all the six subclasses than their international counterparts. In relation to health status evaluation, the two groups varied in physiological health (P < 0.001, eta squared = 0.095) and social health (P = 0.020, eta squared = 0.007) but there was no significant difference in psychological health subscale (P = 0.156, eta squared = 0.002). HPL was predicted by financial status among the Chinese group and by student’s major, age and level of education in the international group. Body mass index (BMI) and financial status emerged as predictors of the three subscales of SHMS V1.0 in the Chinese group and also of physiological and psychological subscales in the international group. Gender was associated with psychological health in both groups. Smoking status was a predictor of psychological health in both groups and also of social health in the international group. The level of education emerged as a predictor of social health in the international group.Regression analyses revealed a significant association between health status and healthy lifestyle (P < 0.001). In reference to participants with “excellent” lifestyle, participants with moderate lifestyle were at a 4.5 times higher risk of developing suboptimal health status (SHS) (OR: 4.5,95% CI:2.2-9.99) and those with a ‘general’ lifestyle were at a 3.2 times higher risk SHS (OR: 3.2, 95% CI: 1.5-7.18). Good and moderate HPLP-II levels of nutrition are associated with low risk of suboptimal health status (OR: 0,41 and 0,25, respectively). Participants in good and moderate HPLP-II levels of interpersonal relations are associated with higher risk of suboptimal health (OR:2,7 and 3,01 respectively) than those in excellent levels of HPLP-II.ConclusionCollectively, these findings provide a convincing body of evidence to support the role of socio-cultural factors as key determinants of the HPL and SRH of college students.

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BackgroundHyperglycemia is associated with an increased risk of developing atrial fibrillation (AF) and atrial flutter (AFL). Sodium-glucose transporter 2 inhibitors (SGLT2i) have been reported to prevent AF/AFL in some studies, but not others. Therefore, a meta-analysis was performed to investigate whether SGLT2i use is associated with lower risks of AF/AFL.MethodsPubMed, Scopus, Web of Science, Cochrane library databases were searched for randomized placebo-controlled trials comparing SGLT2i and placebo.ResultsA total of 33 trials involving 66,685 patients were included. The serious adverse events (SAEs) of AF/AFL occurrence were significantly lower in the SGLT2i group than the placebo group (0.96% vs. 1.19%; RR 0.83; 95% CI 0.71–0.96; P = 0.01; I2 25.5%). Similarly, the SAEs of AF occurrence was significantly lower in the SGLT2i group (0.82% vs. 1.06%; RR 0.81; 95% CI 0.69–0.95; P = 0.01; I2 10.2%). The subgroup analysis showed that the reduction in AF/AFL was significant only for dapagliflozin (1.02% vs. 1.49%; RR 0.73; 95% CI 0.59–0.89; P = 0.002; I2 0%), but not for canagliflozin (1.00% vs 1.08%; RR 0.83; 95% CI 0.62–1.12; P = 0.23; I2 0%), empagliflozin (0.88% vs 0.70%; RR 1.20; 95% CI 0.76–1.90; P = 0.43; I2 0%), ertugliflozin (1.01% vs 0.96%; RR 1.08; 95% CI 0.66–1.75; P = 0.76; I2 0%), and sotagliflozin (0.16% vs 0.10%; RR 1.09; 95% CI 0.13–8.86; P = 0.93; I2 0%).ConclusionsSGLT2i use is associated with a 19.33% lower SAEs of AF/AFL compared with the placebo. Dapagliflozin users had the lowest SAEs of AF/AFL incidence. Further studies are needed to determine whether canagliflozin, empagliflozin, ertugliflozin, and sotagliflozin similarly exert protective effects against AF/AFL development.

PurposeTo assess the caregiving burden and its associated factors among Eritrean families of persons living with schizophrenia.MethodsA cross-sectional study was conducted for 146 caregivers with their respective known patients with schizophrenia of Saint Mary's Neuropsychiatric National Referral Hospital (SMNNRH). Data were collected using Pai and Kapur's Family Burden Interview Schedule (FBIS), the Positive and Negative Syndrome Scale (PANSS) and self-prepared sociodemographic sheet. Data were analysed using SPSS V.21. Descriptive statistics, independent t-tests, one-way analysis of variance (ANOVA) and multiple regression analysis was employed to analyse the data.ResultsIn this study, 84 (57.5%) were males and 62 (42.5%) were females. The mean age was 33.96+10.37 (median=31) for the patients and 46.76+13.96 (median=48) for the caregivers. Total mean objective score was 29.47+6.67. Family caregivers who were single (F=3.224, p<0.005, effect size (ES)=0.064), had educational level at elementary (F=5.647 p=0.001, ES=0.11), had low monthly income (t=7.727, p<0.001, ES=0.01) and were dissatisfied with family support (t=2.889, p<0.01, ES=0.01) experienced greater burden relative to the counterparts. Caregiver's age (β=0.156; p<0.05), duration of caregiving (β=0.131; p<0.05), monthly household family income (β=−0.298; p<0.001), history of self-injury (β=0.151; p=0.05), positive scale (β=0.344; p<0.001), negative scale (β=0.278; p<0.001) and general psychopathological scale (β=0.146; p<0.01) emerged as significant predictors of objective burden.ConclusionsFamily caregivers of a person living with schizophrenia experience a significant burden of care. Our findings highlight that there is a need of strengthening social and psychological support to reduce the caregiving burden.

BackgroundRecurrence after atrial fibrillation (AF) ablation is still common.ObjectiveThis study aimed to evaluate the predictive abilities of AF duration and early recurrence (ER) to discriminate high-risk patients for recurrence.MethodsWe enrolled 1,763 consecutive patients with AF who were scheduled to receive the index radiofrequency catheter ablation (RFCA) from January 2016 to August 2021 in Dalian, China. Long AF duration (LAFD) was considered if the course of AF lasted for ≥ 12 months. ER was defined as any atrial tachycardia (AT) or AF event longer than 30 s occurring within a 3-month post-RFCA.ResultsLate recurrence occurred in 643 (36.5%) of the 1,763 patients at a median of 35 months after RFCA. Multivariate analysis identified LAFD (hazard ratio (HR): 1.80, 95% confidence interval (CI): 1.38–2.35, p &lt; 0.001) and ER (HR: 2.34, 95% CI: 1.82–3.01, p &lt; 0.001) as strong independent predictors of late recurrence in non-paroxysmal AF. Similarly, LAFD (HR: 1.48, 95% CI: 1.20–1.84, p &lt; 0.001) and ER (HR: 3.40, 95% CI: 2.68–4.30, p &lt; 0.001) were significantly associated with late recurrence in paroxysmal AF. Receiver operating curve analyses revealed that the CAAP-AF (CAD, Atrial diameter, Age, Persistent or longstanding AF, Antiarrhythmic drugs failed, Female) had the highest predict power [area under ROC curve (AUC) 0.586]. The addition of ER and LAFD to the CAAP-AF score significantly improved risk discrimination for late recurrence after AF ablation from 0.586 to 0.686.ConclusionLong AF duration and ER were independently associated with late recurrence. The prediction performance of the CAAP-AF model for recurrence was improved by the addition of LAFD and ER.