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Multiple long-term conditions and their association with quality of life and healthcare utilisation among adults in India: a cross-sectional analysis of WHO SAGE Waves 2 and 3

2026-08-18T02:01:04Z

Title: Multiple long-term conditions and their association with quality of life and healthcare utilisation among adults in India: a cross-sectional analysis of WHO SAGE Waves 2 and 3 Authors: Banstola, Amrit; Ahmed, Sayem; Shenoy, M Swathi; Gupta, Priti; Kondal, Dimple; Bhagat, Radhika; Goenka, Shifalika; Khunti, Kamlesh; Prabhakaran, Dorairaj; Mohan, Sailesh; Pokhrel, Subhash Abstract: Objectives: To examine the prevalence and disease-combination patterns of multiple long-term conditions (MLTCs) among adults in India and their associations with quality of life and healthcare utilisation. Design: Cross-sectional analysis of two nationally representative survey waves. Setting: Community-based household survey conducted across six Indian states (Assam, Karnataka, Maharashtra, Rajasthan, Uttar Pradesh and West Bengal), part of the WHO Study on global AGEing and adult health. Participants: 9116 adults aged 18 years and older in Wave 2 (2015) and 7885 adults in Wave 3 (2019–2020). Primary and secondary outcome measures: Quality of life, assessed with the 8-item WHO Quality of Life scale (WHOQoL-8, range 0–100), was the primary outcome. Outpatient visits and hospitalisations in the preceding 12 months were the secondary outcomes. Associations with MLTC were estimated using Tobit regression for quality of life and Poisson regression for healthcare utilisation, adjusting for sociodemographic, socio-economic and behavioural factors. Results: MLTC prevalence rose from 19.2% to 24.4% between waves and was highest among adults aged 60 years and older, women, urban residents and the wealthiest quintile. Hypertension–cataracts, hypertension–arthritis and hypertension–diabetes were the most prevalent dyads. Depression–chronic obstructive pulmonary disease (COPD) and depression–stroke combinations had the poorest quality of life. Physical and functional domains declined most as MLTC increased, while the financial domain remained stable. Compared with adults without chronic conditions, WHOQoL-8 scores fell in a stepwise pattern with one, two and three or more conditions (–2.6, –5.1 and –6.7 points in 2015; –3.3, –5.6 and –7.9 in 2019–2020; all p<0.001). The COPD–stroke combination had the highest outpatient use, and depression–angina the highest hospitalisation rate. Healthcare use rose incrementally with condition count (p<0.001). Conclusions: MLTC are rising in India and are associated with poorer quality of life and higher healthcare use. High-burden combinations, particularly depression–COPD, depression–stroke, COPD–stroke and depression–angina, warrant targeted interventions to improve quality of life and manage rising healthcare demands. Description: Data availability statement: Data may be obtained from a third party and are not publicly available. The SAGE India datasets underpinning this study are accessible from the International Institute for Population Sciences (IIPS) at: https://iipsindia.ac.in/content/SAGE-data. Access requires submission of a data-use request to IIPS and is subject to their terms and confidentiality conditions.; For the purposes of open access, the author has applied a Creative Commons Attribution (CC BY) Licence to any Accepted Author Manuscript version arising from this submission.

Trust in government moderates the association between fear of COVID-19 as well as empathic concern and preventive behaviour

2026-08-18T02:01:14Z

Title: Trust in government moderates the association between fear of COVID-19 as well as empathic concern and preventive behaviour Authors: Karakulak, Arzu; Tepe, Beyza; Dimitrova, Radosveta; Abdelrahman, Mohamed; Akaliyski, Plamen; Alaseel, Rana; Alkamali, Yousuf Abdulqader; Amin, Azzam; Lizarzaburu Aguinaga, Danny A; Andres, Andrii; Aruta, John Jamir Benzon R; Yıldırım, Ebrar; Sugimura, Kazumi; Okati-Aliabad, Hassan; Mishra, Sushanta Kumar; Park, Joonha; Pavlova, Iuliia; Tavitian-Elmadjan, Lucy; Prot, Franjo; Rasia, José; Rivera, Rita; Gindi, Shahar; Wendt, Guilherme W; Serapinas, Danielius; Silletti, Fabiola; Sharma, Prerna; Ferenczi, Nelli; Rudnev, Maksim; Shukla, Shanu; Šolcová, Iva Poláčková; Solomontos-Kountouri, Olga; Friehs, Maria-Therese; Chen, Bin-Bin; Bartoluci, Sunčica; Stanciu, Adrian; Steinmetz, Lorena Cecilia López; Stogianni, Maria; Borchet, Judyta; Fernández-Morales, Regina; Bosnar, Ksenija; Stuart, Jaimee; Sultana, Sadia; Suryani, Angela Oktavia; Tair, Ergyul; Carbonell, Marta Martín; Uka, Fitim; Valickienė, Rasa Pilkauskaitė; Walter, Brett; Edine, Wassim Gharz; Yu, Yue; Yunes, Maria Angela Mattar; Zanoni da Silva, Milene; Mastrotheodoros, Stefanos; Giordani, Rubia Carla Formighieri; Ayub, Norzihan; Bacikova-Sleskova, Maria; Baikanova, Raushan; Landabur, Rodrigo; Hapunda, Given; Bakkar, Batoul; Benitez, David; Bodnar, Ivanna; Manrique-Millones, Denisse; Khanna, Richa; Janovská, Anna; Bolatov, Aidos; Broche-Pérez, Yunier; Buzea, Carmen; Abdul Kadir, Nor Ba’yah; Lefringhausen, Katharina; Karl, Johannes; Cassibba, Rosalinda; Dimitrovska, Gordana Ristevska; Công Doanh, Dương; Dominguez Espinosa, Alejandra del Carmen; Kazmierczak, Maria; Gaete, Jorge; Gan, Yiqun; Giolo, Suely; Krauss, Steven Eric; Gjoneska, Biljana; Godoy, Juan Carlos; del Pilar Grazioso, Maria; Seisembekov, Telman; Malik, Sadia; Hancheva, Camellia; Hihara, Shogo; Husain, Mohd Saiful; Petrytsa, Petro; Michalek-Kwiecien, Justyna; Islam, Md Saiful; Javakhishvili, Nino; Jovanović, Veljko; Samekin, Adil; Orellana, Ligia María; Muhl, Camila; Kabir, Russell Sarwar; Katović, Darko; Kauyzbay, Zhumaly; Nemat, Arash; Pišot, Saša; Neto, Felix; Kawashima, Tinka Delakorda; Khosla, Meetu; Klicperová-Baker, Martina; Kozina, Ana; Orellana, Carlos Iván; Lewandowska-Walter, Aleksandra; Liang, Yun-Hsia; Makashvili, Ana; Peralta, Eddy; McGrath, Breeda; Mechili, Enkeleint A; Mejía, Marinés; Avanesyan, Hrant; Riyanti, Benedicta Prihatin Dwi; Mhizha, Samson; Miconi, Diana; Mohsen, Fatema; Yang, Pei-Jung; Skrzypińska, Katarzyna; Moreta-Herrera, Rodrigo; Muradyan, Maria; Musso, Pasquale; Assiotis, Marios; Thome, Luciana Dutra; Stefenel, Delia; Naterer, Andrej; Neto, Joana; Palacio, Luz Marina Alonso; Sudarnoto, Laura Francisca Abstract: With the COVID-19 pandemic, behavioural scientists aimed to illuminate reasons why people comply with (or not) large-scale cooperative activities. Here we investigated the motives that underlie support for COVID-19 preventive behaviours in a sample of 12,758 individuals from 34 countries. We hypothesized that the associations of empathic prosocial concern and fear of disease with support towards preventive COVID-19 behaviours would be moderated by trust in the government. Results suggest that the association between fear of disease and support for COVID-19 preventive behaviours was strongest when trust in the government was weak (both at individual- and country-level). Conversely, the association with empathic prosocial concern was strongest when trust in the government was high, but this moderation was only found at individual-level scores of governmental trust. We discuss how motivations may be shaped by socio-cultural context, and outline how findings may contribute to a better understanding of collective action during global crises. Description: Data availability: The data generated and/or analyzed during the current study are available on the Open Science Framework repository, https://osf.io/kws9x/46. The World Values Survey data are available at https://www.worldvaluessurvey.org/wvs.jsp {ref. 48]. Scores on HDI were extracted from https://hdr.undp.org/data-center/documentation-and-downloads [ref. 55]. Data about hospital beds per thousand were extracted from https://ourworldindata.org/grapher/hospital-beds-per-1000-people [ref: 75]. Data about government stringency level were extracted from https://covidtracker.bsg.ox.ac.uk/stringency-map [ref. 76]. The scores for daily new COVID-19 cases and deaths represent a 7-days rolling average per million people and were extracted from https://ourworldindata.org/explorers/coronavirus-data-explorer?uniformYAxis=0&pickerSort=asc&pickerMetric=location&Metric=Cases+and+deaths&Interval=7-day+rolling+average&Relative+to+Population=true&Color+by+test+positivity=false [ref. 77].; Code availability: We shared all data and material relevant for this study by using widely-known/standard file formats, and used open tools for data interpretation/re-use. The analysis outputs together with the codes for reproducing these analyses can be accessed under https://osf.io/kws9x/files/ [ref. 43].; Supplementary information is available online at: https://www.nature.com/articles/s44271-023-00046-5#Sec16 .

Attachment, Mate-Retention Strategies, and Intimate Partner Violence Victimisation: A Two-Wave Study in Brazil and the United Kingdom

2026-08-18T02:01:16Z

Title: Attachment, Mate-Retention Strategies, and Intimate Partner Violence Victimisation: A Two-Wave Study in Brazil and the United Kingdom Authors: Nascimento, Bruna; Shishane, Kwanele; Adair, Lora; Ferenczi, Nelli; Cao, Xiancai; Ackah, Maame Ama Akwama; May, Matthew Abstract: The current study examined whether individual differences in attachment orientation, mate-retention tactics (benefit-provisioning and cost-inflicting strategies), and COVID-19-related stressors (impact, uncertainty, and perceived risk) were associated with IPV victimisation across two time points, one month apart, in Brazil and the UK (N = 1416 at Wave 1; N = 353 at Wave 2). Linear mixed-effects models controlled for age, sex, ethnicity, and relationship length. IPV victimisation did not significantly change over time, and COVID-19-related variables were not associated with any form of IPV. Brazilian participants reported higher psychological IPV than UK participants, although no country differences emerged for physical or sexual IPV. Cost-inflicting mate-retention strategies were positively associated with all forms of IPV in both countries, with consistently stronger associations in the UK. Attachment avoidance was positively associated with all forms of IPV in Brazil but was negatively associated with psychological and sexual IPV in the UK. Attachment anxiety and benefit-provisioning strategies were associated with psychological IPV in Brazil only. These findings suggest that associations between attachment, mate-retention strategies, and IPV victimisation may vary across cultural contexts, underscoring the value of culturally sensitive approaches to IPV research and intervention. Description: Data Availability Statement: The full data can be obtained by contacting the corresponding author at nascimento.brunads@gmail.com.

Effects of cephalexin treatment on DNA replication dynamics in Escherichia coli

2026-08-16T02:01:07Z

Title: Effects of cephalexin treatment on DNA replication dynamics in Escherichia coli Authors: Grigoryan, Iren; Krawiel, Dominika; Dunbar, Emma L; Peros, Stelinda; McCarthy, Ronan R; Rudolph, Christian J Abstract: ... Description: Availability of data and materials: The datasets generated and analysed during the current study are available via the Brunel Figshare repository: https://doi.org/10.17633/rd.brunel.31999347.