Epidemiolgia (Basel, Switzerland)最新文献

{"title":"Modelling the Effects of Treatment Failure on the Minor Outbreak Duration for Carrier-Related Infectious Disease.","authors":"Pichaya Voottipruex, Nichaphat Patanarapeelert, Klot Patanarapeelert","doi":"10.3390/epidemiologia7030058","DOIUrl":"https://doi.org/10.3390/epidemiologia7030058","url":null,"abstract":"<p><p><b>Background:</b> The complex interplay between treatment interventions and asymptomatic carriers and its effect on the epidemic duration of an infectious disease is not fully understood. <b>Methods:</b> Here, we used Galton-Watson branching process and generating function technique to estimate the density functions of minor outbreak duration. Simulations were used to calculate the central tendency of outbreak duration and address how changing levels of treatment failure affect this estimated duration. <b>Results:</b><i>Streptococcus pyogenes</i> infection was used as a case study. Given the existence of the threshold, the change in mean duration as the probability of treatment failure increases is shown to be similar to the pattern driven by the basic reproduction number. In a supercritical regime, the mean duration tends to decrease as the probability of treatment failure increases. The distribution changes in tail behavior, from heavy- to light-tailed, if a large fraction of long extinction times develops to a major outbreak. <b>Conclusions:</b> Treatment failure elevates the probability of secondary transmissions by prolonging the overall infectious period, resulting in an extended the outbreak duration. The threshold of treatment failure identifies the maximum tolerable error for medical intervention. An unusually long period implies a critical early warning signal of a potential major outbreak that was successfully contained.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Pandemic Resurgence and Seasonal Patterns of Influenza Viruses and Respiratory Syncytial Virus in Arequipa, Peru (2021-2023).","authors":"Claudia Chipana-Ramos, Ynes Monroy Talavera, Luis Zamudio-Rodriguez, Lucia Villanueva-Sardon, Alexis Germán Murillo Carrasco, Ruy D Chacón, Yuma Ita-Balta","doi":"10.3390/epidemiologia7020057","DOIUrl":"https://doi.org/10.3390/epidemiologia7020057","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The coronavirus disease 2019 (COVID-19) pandemic profoundly disrupted global respiratory virus circulation, with sharp declines during 2020-2021, followed by a resurgence after the relaxation of public health measures. In South America, post-pandemic respiratory virus dynamics remain insufficiently characterized, particularly in ecologically diverse regions. Arequipa, a high-altitude city in southern Peru, has unique environmental conditions, including marked seasonal temperature variability, that may influence viral transmission. <b>Methods:</b> We performed a cross-sectional analysis of 21,784 nasopharyngeal swabs collected from symptomatic patients at four major hospitals between June 2021 and September 2023. All samples were tested for SARS-CoV-2 by RT-qPCR. Because routine screening for other respiratory viruses was implemented only in SARS-CoV-2-negative cases during the study period, a subset of SARS-CoV-2-negative samples was subsequently analyzed for influenza A virus (IAV), influenza B virus (IBV), and respiratory syncytial virus (RSV) using VIASURE assays. Viral circulation patterns were evaluated by year, month, and epidemiological week. Meteorological data were obtained from the SENAMHI-La Pampilla station. Logistic regression models were used to assess epidemiological and climatic predictors of viral detection. <b>Results:</b> SARS-CoV-2 positivity declined from 20.0% in 2021 to 8.8% in 2023. Conversely, detection of other respiratory viruses among SARS-CoV-2-negative samples increased from 0.8% in 2021 to 29.0% in 2023 (<i>p</i> < 0.01). Temporal increases in detection were observed during 2022-2023, particularly for IAV and RSV. In exploratory analyses, calendar year and relative humidity were associated with IAV and RSV detection, while age and temperature variables were associated with IBV. <b>Conclusions:</b> Climatic and demographic variables were associated with changes in viral detection for IAV, IBV, and RSV during the post-pandemic transition period in Arequipa. These findings describe patterns of viral detection within SARS-CoV-2-negative symptomatic patients and should be interpreted as surveillance-based observations rather than population-level estimates. Strengthened integrated epidemiological and genomic surveillance will be essential for vaccine planning and outbreak preparedness in the post-pandemic era.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P5 Mental Health Platform: A Digital Solution to Monitor Anxiety and Depression Symptoms in the General Portuguese Population.","authors":"Patrícia Soares-Coelho, Luís Jesus, Mafalda Machado-Sousa, Liliana Amorim, Sónia Ferreira, Maria Picó-Pérez, Pedro Morgado","doi":"10.3390/epidemiologia7020056","DOIUrl":"https://doi.org/10.3390/epidemiologia7020056","url":null,"abstract":"<p><p><b>Background:</b> The prevalence of mental disorders, particularly anxiety and depression, has been increasing and is becoming a major public health concern in Portugal. Digital mental health solutions offer scalable and accessible tools for monitoring and managing mental health. 'P5 Mental Health' has been created as a platform to assess and monitor symptoms of anxiety and depression in the Portuguese population, and to offer strategies to promote well-being to support users. <b>Objective:</b> This study aims to (1) describe the P5 Mental Health platform, (2) evaluate its feasibility as a digital mental health monitoring tool, and (3) analyze trends in the prevalence and severity of anxiety and depression symptoms over a four-year period, particularly in response to major societal stressors. <b>Methods:</b> Between September 2020 and September 2024, 46,032 responses were collected from platform users. Anxiety and depression symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales. Longitudinal trends were analyzed across four time periods. Welch's ANOVA and Games-Howell post hoc tests were conducted to compare symptom severity across time, and ordinal logistic regression was used to examine the impact of time on symptom progression. <b>Results:</b> Anxiety and depression symptoms increased between 2020 and 2022, stabilized thereafter, and showed a slight decline in 2024. The proportion of users reporting moderate to severe anxiety (GAD-7 ≥ 10) rose from 30.87% in September 2020 to 66.30% in June 2022. Similarly, the prevalence of moderate to severe depressive symptoms (PHQ-9 ≥ 10) rose from 3.62% in March 2021 to 51.54% in August 2021. Despite a small decrease in 2024, symptom levels remained significantly higher than baseline levels recorded at the beginning (<i>p</i> < 0.001). A strong positive correlation was found between anxiety and depression symptoms (<i>r</i> = 0.739, <i>p</i> < 0.001), underscoring their high comorbidity. <b>Conclusions:</b> This study demonstrates the feasibility of the P5 Mental Health platform as a real-time mental health monitoring tool, particularly during periods of heightened social and economic stress. The findings highlight the need for sustained digital mental health interventions beyond crisis periods to ensure long-term engagement; however, future improvements should focus on increasing user engagement and adding personalized features to ensure long-term mental health management.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Performance Indicators for Malaria Control in Kinshasa from 2020 to 2023, the Democratic Republic of the Congo.","authors":"Bienvenu Bampenga Lutumbu, Kennedy Makola Mbanzulu, Germain Kieng Kapour, Madone Mandina Ndona, Josué Zanga, Jean Pierre Kambala Mukendi, Harry Kayembe, Andy Mbangama, Roger Wumba","doi":"10.3390/epidemiologia7020055","DOIUrl":"https://doi.org/10.3390/epidemiologia7020055","url":null,"abstract":"<p><strong>Background: </strong>In 2018, malaria remained a leading cause of morbidity and mortality in the Democratic Republic of the Congo, accounting for 44% of all outpatient visits and 22% of deaths. This led to the development of the strategic plan for 2020-2023. To meet the objectives of this renewed plan, a monitoring and evaluation program focusing on performance indicators was established. This study aimed to assess the malaria control performance indicators in Kinshasa.</p><p><strong>Methods: </strong>A descriptive cross-sectional study used the National Malaria Control Program dataset of the period 2020-2023 to analyze malaria data from 23 HZ (Health Zone) in Kinshasa. Diagnostic, therapeutic, and preventive use of LLINs (long-lasting insecticidal nets) and sulfadoxine-pyrimethamin-based IPT (intermittent preventive treatment among pregnant women) indicators were evaluated following the targeted thresholds established in the strategic plan for 2020-2023.</p><p><strong>Results: </strong>Malaria was present in all studied HZ from 2020 to 2023, with a heterogeneous distribution. The malaria incidence during the study period was 30%, with an upward trend in both suspected and confirmed cases, peaking in 2022 and showing no further fluctuations thereafter. The proportion of LLINs distributed to pregnant women during antenatal care visits was 62%, 61%, 45%, and 88% in 2020, 2021, 2022, and 2023, respectively. A total of 83.1% of suspected malaria cases were diagnosed using RDT (Rapid Diagnosis Test), and confirmed malaria cases received antimalarial treatment.</p><p><strong>Conclusions: </strong>The objectives of the 2020-2023 strategic plan were only partially achieved, and no HZ reached 100% diagnosis by RDT, with only four HZs reaching at least 95% of the target. Thirty-four HZs were able to benefit from 95% treatment with antimalarial drugs.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Alterations in Hospitalized COVID-19 Patients: Hyperglycemia and Newly Detected Diabetes.","authors":"Alecsandra Andreea Budihoi, Bogdana Nasui, Alexandra-Ioana Roșioară, Nina Ciuciuc, Stefan Vesa, Tudor Calinici, Monica Popa","doi":"10.3390/epidemiologia7020054","DOIUrl":"https://doi.org/10.3390/epidemiologia7020054","url":null,"abstract":"<p><strong>Background and objective: </strong>The aim of this study is to describe the frequency of newly detected dysglycemia, including hyperglycemia and newly diagnosed diabetes mellitus, among hospitalized COVID-19 patients without previously known diabetes and to identify associated clinical and therapeutic factors, in an exploratory, descriptive manner.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study on 562 COVID-19 patients. Demographic and clinical data were collected at admission and during hospitalization. Newly diagnosed diabetes mellitus was defined based on plasma glucose values meeting international diagnostic criteria during hospitalization in patients without prior diabetes, while newly altered blood sugar referred to transient hyperglycemia or impaired fasting glucose not fulfilling diabetes criteria. Comparisons between groups were performed using appropriate statistical tests, with a <i>p</i>-value < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Out of the total number of 562 COVID-19 patients, 14 (2.49%) were classified as having newly diagnosed diabetes, and 27 (4.8%) as having newly altered blood sugar levels. The median age of the participants was 67.5 years (interquartile range: 59.75; 71.75). Newly diagnosed diabetes was more frequently observed among patients presenting with gastrointestinal symptoms, elevated inflammatory markers, and those receiving specific in-hospital treatments. Newly altered blood sugar levels were more commonly associated with dyslipidemia, respiratory symptoms at admission, oxygen therapy, and selected COVID-19 treatments. COVID-19 vaccination status was descriptively stratified by admission period.</p><p><strong>Conclusions: </strong>New interdisciplinary approaches may support the identification and monitoring of glycemic alterations in hospitalized COVID-19 patients, with potential implications for clinical management and public health strategies.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Drives Influenza Vaccination in People with Diabetes? Evidence from the National Health Surveys of 2020 and 2023 in Spain.","authors":"Tomás Chivato-Martín-Falquina, Jose J Zamorano-Leon, Ana Lopez-de-Andres, Lucia Fuentes-Arroyo, Rodrigo Jimenez-Garcia","doi":"10.3390/epidemiologia7020053","DOIUrl":"https://doi.org/10.3390/epidemiologia7020053","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Diabetes is associated with an increased risk of influenza-related complications; therefore, annual vaccination constitutes an essential preventive measure. The objective of this study is to analyze the evolution of influenza vaccination coverage among the population with diabetes in Spain between 2020 and 2023 and to identify factors associated with adherence, comparing it with a matched population without diabetes. <b>Methods</b>: A cross-sectional study was conducted using data from the European Health Survey in Spain 2020 and the Spanish National Health Survey 2023, applying 1:1 matching by age, gender, and place of residence. Multivariable logistic regression was applied to assess time trend and to identify adherence predictors. <b>Results</b>: Vaccination coverage among individuals with diabetes increased from 52.0% in 2020 to 65.9% in 2023 and was higher than that observed among the matched participants without diabetes in both periods. Older age and the presence of comorbidities, such as myocardial infarction or respiratory diseases, were associated with a higher likelihood of vaccination, whereas alcohol consumption and smoking were associated with lower adherence among subjects with diabetes. The year 2023 was independently associated with a higher probability of vaccination compared with 2020 (OR: 1.82; 95% CI: 1.56-2.12). <b>Conclusions</b>: Although influenza vaccination coverage among the Spanish people with diabetes has improved following the COVID-19 pandemic, it remains below recommended targets, highlighting the need to strengthen targeted strategies aimed at less adherent subgroups.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term BMI Trajectories and Category Changes in Older Mexican Adults: A 20-Year Longitudinal Analysis.","authors":"Israel Rico-Alba, Horacio Marquez-Gonzalez, Jessie Nallely Zurita-Cruz","doi":"10.3390/epidemiologia7020051","DOIUrl":"https://doi.org/10.3390/epidemiologia7020051","url":null,"abstract":"<p><strong>Background/objectives: </strong>Body mass index (BMI) trajectories and transitions across adulthood are dynamic processes influenced by aging and social- and health-related factors, yet long-term patterns in older adults from middle-income countries remain insufficiently characterized. The objective of this study was to characterize long-term BMI trajectories and transitions, and to identify sociodemographic and clinical factors associated with adverse BMI patterns among Mexican adults aged ≥50 years followed over 20 years.</p><p><strong>Methods: </strong>This study used data from the Mexican Health and Aging Study (ENASEM), a nationally representative longitudinal cohort. Participants aged ≥50 years with repeated BMI measurements across survey waves were included. BMI trajectories and transitions between BMI categories were described, and multinomial regression models were used to examine factors associated with upward transitions and unstable high-BMI patterns.</p><p><strong>Results: </strong>Distinct BMI trajectory patterns were identified over the 20-year follow-up. Participants in stable normal-weight trajectories were younger, more frequently female, and had higher educational attainment and income. In contrast, those with stable overweight/obesity or fluctuating-adverse BMI patterns had higher baseline BMI and a greater prevalence of diabetes, hypertension, and multimorbidity. In multivariable analyses, age contributed to trajectory differences; however, sex, socioeconomic factors, baseline BMI, and chronic conditions remained independently associated with adverse BMI patterns.</p><p><strong>Conclusions: </strong>BMI trajectories in later life are heterogeneous and reflect the combined influence of aging, socioeconomic conditions, and chronic disease burden. Identifying groups at risk of adverse BMI patterns may support the development of targeted interventions to reduce obesity-related health consequences in older adults.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Survey on Water, Sanitation, and Hygiene (WaSH) in Uganda's Karamoja Sub-Region, Using a KAP Questionnaire Within a One Health Framework.","authors":"Davide Ceccarelli, Silvana Diverio, Pier Giorgio Lappo, Carlo Ruspantini, Simon Peter Losike, Alma Rosa Pareschi, Maria Luisa Marenzoni","doi":"10.3390/epidemiologia7020052","DOIUrl":"https://doi.org/10.3390/epidemiologia7020052","url":null,"abstract":"<p><strong>Background: </strong>The Karamoja sub-region of Uganda addresses significant challenges in water, sanitation, and hygiene (WaSH), deeply linked to public and environmental health and regional development.</p><p><strong>Objectives: </strong>This study applied a Knowledge, Attitudes, and Practices (KAP) survey within a One Health framework to assess WaSH conditions, hygiene behaviour, livestock management, and disease prevention in the Moroto and Napak districts.</p><p><strong>Methods: </strong>A total of 195 respondents were surveyed, providing insights into socio-demographic factors, hygiene practices, livestock management, and disease prevention.</p><p><strong>Results: </strong>Findings highlighted gender disparities, with women less likely to achieve good knowledge compared to men (OR = 0.04; <i>p</i> = 0.002), probably reflecting limited access to information in traditionally male-focused community settings, and their greater involvement in water collection tasks. Age significantly influenced WaSH knowledge, with older individuals (aged ≥ 30 years) showing higher odds of good knowledge (OR = 20.39; 95% CI: 2.74-151.83; <i>p</i> = 0.003), probably due to their roles in knowledge transmission within the community. Proximity to water sources shaped behaviours, with greater distances associated with improved attitudes (OR = 3.56; <i>p</i> = 0.002) but reduced hygienic practices (OR = 0.20; <i>p</i> = 0.01). Livestock ownership, particularly of small ruminants, strongly correlates with good hygiene knowledge (OR = 16.89; <i>p</i> = 0.02), probably due to interactions with veterinarians and authorities during vaccination campaigns. Integrated communication strategies, including community meetings, home visits, and radio outreach, were strongly associated with improved practices (e.g., home visits: OR = 30.78; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Despite progress, challenges such as water scarcity, waste management, and gender disparities persist. Improving water infrastructure, promoting equitable access, and integrating tailored communication strategies are essential for fostering sustainable development, health equity, and the empowerment of women in Karamoja.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Ecological Study on the Mortality Impact of the COVID-19 Pandemic According to Country Development Status and Pandemic Years.","authors":"Murat Razi, Manuel Graña","doi":"10.3390/epidemiologia7020050","DOIUrl":"https://doi.org/10.3390/epidemiologia7020050","url":null,"abstract":"<p><p>The COVID-19 pandemic caused stark global mortality disparities, influenced by a complex interplay of demographic, economic, and health factors. This ecological study investigates associations between country macroscopic variables and COVID-19 accumulated mortality ratio (AMR) across 174 countries and may serve as a preparation for new pandemics.</p><p><strong>Methods: </strong>The study applies bidirectional stepwise multiple linear regression. To ensure statistical validity, we conducted diagnostic tests for multicollinearity and heteroscedasticity, applying robust M-estimation where necessary to minimize root mean squared error. The analysis covered six distinct stratifications based on development status (developed, developing, least developed, and combinations), and incorporated temporal analyses across three specific annual periods: 21 January 2020-20 January 2021; 21 January 2021-20 January 2022; and 21 January 2022-10 January 2023.</p><p><strong>Data: </strong>AMR per country values, accumulated between 21 January 2020 and 10 January 2023, and data on the prevalence of health conditions, and socioeconomic descriptive variables were extracted from Our World in Data (OWID) and other public data sites, like the World Bank.</p><p><strong>Results: </strong>The percentage of population aged over 65 years has the most consistent association with increased AMR globally. Obesity prevalence and income inequality (Gini index) were positively associated with AMR regardless of country development status. Conversely, the study finds a consistent negative correlation with diabetes prevalence, while the prevalence of respiratory diseases is a significant association only for developed nations. Socioeconomic factors were significantly associated with AMR, but this influence is stronger in developed countries than in the developing and least developed countries.</p><p><strong>Conclusions: </strong>While population aging is the primary association with increased AMR, the mortality impact of comorbidities and socioeconomic factors is heavily conditioned by a country's development stage, pointing to the necessity of development-status-aware public health strategies for incoming pandemics.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating How University Students Adapt to Stress: Psychometric Validation of a Psychological Instruments Battery.","authors":"Clara Simães, Catarina Morais, Liliana Fontes, Adérito Seixas, Rui Gomes","doi":"10.3390/epidemiologia7020049","DOIUrl":"https://doi.org/10.3390/epidemiologia7020049","url":null,"abstract":"<p><p><b>Background</b>: In modern society, increased awareness of stress stems mainly from the pressures of competitive environments, where the pursuit of academic and professional success places substantial demands on individuals, who must adapt. Drawing on the Transactional Model and the Interactive Model of Human Adaptation to Stress, this paper presents a battery of instruments designed to comprehensively assess university students' adaptation to stress. <b>Methods</b>: Data were collected from two academic years, using two independent samples of students: a calibration sample (<i>n</i> = 561) and a validation sample (<i>n</i> = 370) to test the psychometric properties of the instruments. The evaluation protocol included the Stress Questionnaire for Students (SQS), the Primary and Secondary Cognitive Appraisal Scale (PSCAS), the Reduced Coping Inventory (Coping-R), and the Academic Achievement Expectations (AAE). <b>Results</b>: Psychometric validation analyses indicated the best versions of the instruments' battery. Namely, an 18-item version and a six-factor structure for the SQS, a 10-item version and a five-factor structure for the PSCAS, a 12-item version and a four-factor structure for the Coping-R, and a five-item, one-factor structure for the AAE. <b>Conclusions</b>: The proposed instruments can serve as a compound resource for screening for academic stress experiences in university students, and as an original tool to understand the entire process of stress adaptation.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}