Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents

Objective To assess the subjective perception of residents on the built environment in hygienic cities and its relation to the self-rated health(SRH)status of residents,providing a basis for a better promotion on construction of health-supportive environments.Methods The online survey was adopted with the respondents recruited from residents living in Chaoyang District of Beijing in January 2021.With SRH level as the dependent variable,two-category logistic regression analysis was conducted to analyze the impact of the built environment in hygienic cities on the SRH status of residents.Results A total of 1,357 respondents were enrolled in this study.After controlling confounding factors,four aspects in the built environment in hygienic cities were detected remarkable influences on the SRH level of residents,including enough green space in the living area[odds ratio(OR)=1.395,95%confidence interval(95%CI):1.055–1.845],clean and hygienic living environment(OR=1.472,95%CI:1.107–1.956),residents’confidence in drinking water safety in the living area(OR=1.856,95%CI:1.354–2.544)and residents’confidence in food safety in the living area(OR=1.405,95%CI:1.027–1.921).Conclusion Regarding city construction,the government should focus more on the subjective perception of residents on built environments to build a supportive environment benefiting the health of residents.

Association between Self-Rated Health and Depressive Symptoms in Rural Chinese Adults:A Cohort Study Based on Propensity Score Matching

Health status is widely regarded as a correlate of depressive symptoms.However,health assessments based on clinical diagnosis in rural areas with poor medical conditions are very limited.Self-rated health(SRH)serves as a simple and convenient evaluation indicator,which may be used as an independent predictor of depressive symptoms.To confirm the relationship between SRH and depressive symptoms in rural adults,a longitudinal survey of rural households in China was conducted using the China Family Panel Studies(CFPS)from 2012 to 2016.Propensity score matching and logistic regression analysis were used to explore the association.After data cleansing,3,127 pairs(6,254 participants)aged 16 and older followed for 4 years were enrolled,of which the average age was(50.02±14.19)years old,and the proportions of male and female were 48.64%and 51.36%,respectively.The incidence rate of depressive symptoms within 4 years was 30.86%(95%CI:29.24–32.48)in the group with fair or poor SRH,and 21.59%(95%CI:20.14–23.03)in the group with good SRH.The difference between the two groups was statistically significant(χ^(2)=69.51,P<0.001).The results of univariate unconditional logistic regression analysis showed that there was a correlation between SRH and depressive symptoms in rural adults aged 30 and above(OR=1.65,95%CI:1.46–1.85,P<0.001).Thus,a simple and practical assessment tool based on SRH and other indicators should be established for early prevention and intervention in rural primary mental health care.

Social, Clinical and Psychometric Factors Affecting Self-Rated Oral Health, Self-Rated Health and Wellbeing in Adults: A Cross-Sectional Survey

Background: Many studies examined and reported oral and general health inequalities in clinical health, SROH and SRH. Objectives: The study aims to explore the social influences, gradients and predictors of self-rated oral health (SROH) and self-rated health (SRH) and wellbeing in Greek adults. Methods: Cross-sectional study, of men and women, aged 65 years and over (N = 743) in Greece. Descriptive and statistical analyses were performed for dentate and edentulous participants. For the association between socioeconomic exposures and binary outcomes, logistic regression was performed to estimate Odds Ratios and 95% Confidence Intervals (OR, 95% CI);levels of association and Cramer’s V were applied to calculate associations and p-values. Results: The objective socioeconomic measures, such as household income, education level and last main occupation were significant predictors and determinants of both SROH and self-rated health (SRH). For Satisfaction with life (SWL), there was a diversity in the results analogous to the dental status of the participants. Household income and SSS were predictors of SWL in dentate participants. In the total sample Household income, occupation and SSS, were predictors of SWL, while in edentulous participants only occupation and SSS were statistically significant (p < 0.05). Subjective social status was statistically significant for SROH, SRH and SWL (p < 0.01). More men than women reported their SROH and SRH as good. Household income and SSS were predictors of SWL, in dentate participants, thus the better the income and the higher the relative social status, the higher feeling of SWL was recorded. Place of residence had significant associations only with SWL. Household income, education, occupation and SSS had significant levels of association with SROH and SRH in dentate participants (p < 0.05). Conclusion: There are socioeconomic gradient inequalities in SROH and SRH in Greek adults living in Attica area. Subjective social status is a predictor of SROH, SRH and SWL. The need to prioritize interventions to eliminate disparities and inequalities in oral and general health and wellbeing of elders is evident.

Social demographic factors and leisure time physical activity influencing the self-rated health and happiness of Chinese people

Background and aims:The holistic definition of health is not merely the absence of disease or infirmity,but a state of complete physical,mental,and social well-being.However,related research on the influencing factor of self-rated health and happiness have generally remained separate.Therefore,this study aimed to 1)find individual level determinants of the two facets of health;and 2)investigate the covariance of the two facets of health within individual levels.Methods:Multivariate multilevel analysis of self-rated health and happiness at level 1,were nested within 10,968 people at level 2.Data were obtained from the 2015 Chinese General Social Survey.Results:Lower happiness and self-rated health were found in 1)females;2)the elderly;3)people with a lower educational level;4)people who were presently single;5)people with a lower self-rated economic status;6)people who resided in urban areas;and 7)people with sedentary lifestyles as compared to those in other categories of the same variable.After adjusting the related individual level determinants,the correlation coefficient of two facets of health at the individual level is 0.19,which indicates that no robust covariance was observed.Conclusions:The current study indicates the existence of disparity in the subjective physical and psychological dimensions of health among the elderly in China.Our findings emphasize the importance of paying attention to different aspects of health simultaneously in investigations and the benefits of leisure time activities.

Is the whole greater than the sum of the parts? Self-rated health and transdisciplinarity

Self-rated health (SRH)—a person’s subjective evaluation of his general health—is a more valid and powerful predictor of morbidity and mortality than any other combination of objective and self-reported measures. However, current theoretical frameworks fail to explain this association. Here, we sought to investigate SRH in relation to health outcomes from a transdisciplinary perspective. Using a selective review of epidemiological, clinical and qualitative SRH literature, we analyzed the relationships between this global subjective self-perception of health (the whole) and its directly measurable constituents (the parts). Although SRH often predicts major health outcomes, its underpinnings vary from person to person. Factors influencing individual’s health interact in complex ways evade reductionist methods assessing the parts, and may be best captured by global self-perceptions of health. The study of SRH from a transdisciplinary perspective exemplifies the notion that the whole is greater than the sum of its parts. Insight into individual’s experience of “health”, their association with physiological processes, and impact on the health/disease continuum may contribute to the development of individualized strategies for health care and promotion with aging. In particular, this should be most valuable for addressing non-communicable health conditions where cross-talk between health domains (biological, psychological, social, behavioral, spiritual) may significantly contribute to pathophysiology.

Self-Rated Health in University Students from Rio Branco in the Western Brazilian Amazon

The objective of this study was to determine the prevalence and associated factors of unsatisfactory self-rated health in university students. A cross-sectional study was conducted in graduate students of a Public University in the city of Rio Branco in the Western Brazilian Amazon. The overall prevalence of unsatisfactory self-rated health was 23.0%. After adjusting for gender and age, the factors associated with unsatisfactory self-rated health were as follows: sedentarism during leisure time (prevalence ratio (PR): 2.26;95% CI: 1.56 - 3.29), consuming meals only in restaurants (PR: 1.48;95% CI: 1.14 - 1.94), insomnia (PR: 1.86;95% CI: 1.50 - 2.30), headaches (PR: 2.17;95% CI: 1.52 - 3.09), and back pain (PR: 2.03;95% CI: 1.58 - 2.60). Thus, a high prevalence of unsatisfactory self-rated health was identified in this group of university students. The findings suggest immediate implementation of programs to promote healthy behaviors and to prevent headaches, back pain and insomnia.

Understanding the Lifestyle Correlates with Chronic Constipation and Self-Rated Health

The objective of this study is to evaluate the healthy and unhealthy behaviors as risk factors for chronic constipation and self-rated health status. Eight hundred tenth students enrolled from a university in Miaoli city, Taiwan. Chronic constipation was assessed using Chinese questionnaire. Information of unhealthy and healthy lifestyles was interviewed by constructed questionnaire. Thirty-six percentage of university students were assessed as chronic constipation. Using multivariate logistic regression adjusted for age, sex, race and BMI, we found chronic constipation significantly correlated with frequency of consumption from snack, fast food, fried food, daily consumption of water, physical activity and junk food used as regular food. Moreover, these unhealthy behaviors significantly correlated with self-rated health status. Students with chronic constipation had poor self-rated health status. It is urgent to create healthy behaviors to reduce the risk for chronic constipation or upgrade self-rated health status in university students.

Modification in self-rated health in patients discharged by a geriatric rehabilitation ward

Self-rated health is a valuable outcome in geriatric rehabilitation besides objective results. The present work aims at measuring and analyzing overall health as it is perceived at admission into and at discharge from a geriatric rehabilitation ward. Overall health was self-appraised through a visual-analogue scale (VAS), spanning from 0 (worst) to 10 (best). We studied 1997 patients (70% females), aged 79 (standard deviation, s.d. 8.7) years;most were frail, either functionally, clinically and cognitively. 80% of patients were discharged to home after a length of stay lasting 47.5 (s.d. 22.7) days. At admission, 3/5 patients appraised favorably their overall health (VAS ≥ 6/10): at discharge, the proportion rose to 3/4, with a mean (s.d.) gain = 2 (2) points. The improvement in self-perceived health score positively correlates with the grade expressing clients’ overall satisfaction for the stay (p 0.001), and with discharge versus admission differences in: Barthel Index (BI) total score (p < 0.001), Tinetti total score, Mini Mental State Examination (MMSE), Geriatric Depression Scale (5?items GDS), pain (VAS 0 to 10). A Linear regression model predicting the changes in self-perceived health included changes in BI, MMSE, GDS, pain, dropping Tinetti test. Changes in self-rated health were positively correlated to functional gain adjusted for pre-morbid level, and to relative functional gain. By analysis of variance, health self-appraisal changed more favorably in patients discharged to home than for other social outcomes (all p < 0.001). As expected, trends in self-perceived health parallel improvements in objective functional gauges and subjective indicators.

Social integration: How is it related to self-rated health?

Social integration has well-established health benefits among older adults in observational studies. However, interventions designed to increase social integration have not improved health suggesting important knowledge gaps on how social integration influences health outcomes. This study developed a new measure of social integration, daily social contact, capturing the interpersonal nature of social integration and mobility of individuals, and providing a direct assessment of individuals’ real-time access to companionship and social support. The data used is the 2006-2007 American Time Use Survey (ATUS), which surveyed 25,191 individuals aged 15 years and older (n = 4378 aged 65 years and older). Generalized ordinal logistic regression analyses revealed positive, but non-parallel relationships between daily social contacts and the ordinal categories of self-rated health among older adults. This study may be used to identify populations that experience social exclusion, such that future research can determine more precisely how to intervene to improve health outcomes.

Preventing Health Anxiety:The Role of Self-Evaluation,Sense of Coherence,Self-Rated Health and Perceived Social Support

Background:Components of Self,completed with the perceived social support determine the individual differences in theevaluation of a stressor and the behavioral responses toward it,such as health-related anxiety.The study set as a goal theanalysis of associations between the components of Self,such as self-evaluation,sense of coherence,perceived social support,and reported health-related anxiety in an adult sample.Methods:147 adults from the 18–73 age group(mean age 37.5)voluntarily completed the questionnaire through Qualtrics online platform containing the Short Health Anxiety Inventory,Core Self-Evaluation Scale,Social Support Assessing Scale,and one Health Self-Evaluation Item.Results:ANOVA foundrelevant differences in total scores and subscales’scores of the health anxiety scale depending on the positive self-evaluation.Linear regression shows that the analyzed variables were responsible for the prediction of a higher value on the“Perceivedprobability of becoming ill”subscale in a proportion of 45.6%and for the“Perceived consequence of illness”subscale in aproportion of 20.2%The predictive value of the linear regression model for the total score on the health anxiety scale was46.3%.Our findings show that negative Core Self-Evaluation is linked with perceived health anxiety.Conclusions:Selfevaluation,sense of coherence and perceived social support influence the perceived health and can explain the differences inthe reported health-related anxiety.

Association between sporting event attendance and self-rated health:an analysis of multiyear cross-sectional national data in Japan

Background:This study examined the extent to which sporting event attendance is associated with self-rated health.Drawing from an economic model of health production and psychological research on the health benefits of psychosocial resources,sporting event attendance was hypothesized to have a positive relationship with selfrated health.Methods:A two-level multilevel ordered logistic regression was used to analyze multiyear cross-sectional data collected from national surveys in Japan.Results:The results demonstrate that,controlling for the effects of personal and environmental characteristics,sporting event attendance positively correlates with self-rated health over a 12-year period.Specifically,when compared to individuals who did not attend any sporting event during the past year,those who attended a sporting event were 33%more likely to indicate a higher level of self-rated health.Conclusions:These findings provide evidence for a positive association between sport spectatorship and the perception of general health and contribute to the literature examining the relationship between sport spectatorship and health outcomes.

Determinants of self-rated private health insurance coverage in Jamaica

The purpose of the current study was to model the health insurance coverage of Jamaicans;and to identify the determinants, strength and predictive power of the model in order to aid clinicians and other health practitioners in understanding those who have health insurance coverage. This study utilized secondary data taken from the dataset of the Jamaica Survey of Living Conditions which was collected between July and October 2002. It was a nationally representative stratified random sample survey of 25,018 respondents, with 50.7% females and 49.3% males. The data was collected by way of a self-administered questionnaire. The non-response rate for the survey was 29.7% with 20.5% not responding to particular questions, 9.0% not participating in the survey and another 0.2% being rejected due to data cleaning. The current research extracted 16,118 people 15 years and older from the survey sample of 25,018 respondents in order to model the determinants of private health insurance coverage in Jamaica. Data were stored, retrieved and analyzed using SPSS for Windows 15.0. A p-value of less than 0.05 was used to establish statistical significance. Descriptive analysis was used to provide baseline information on the sample, and cross-tabulations were used to examine some non-metric variables. Logistic regression was used to identify, determine and establish those factors that influence private health insurance coverage in Jamaica. This study found that approximately 12% of Jamaicans had private health insurance coverage, of which the least health insurance was owned by rural residents (7.5%). Using logistic regression, the findings revealed that twelve variables emerged as statistically significant determinants of health insurance coverage in this sample. These variables are social standing (two weal- thiest quintile: OR = 1.68, 95% CI = 1.23 – 2.30), income (OR = 1.00, 95%CI = 1.00 – 1.00), durable goods (OR = 1.16, 95% CI = 1.12 – 1.19), marital status (married: OR = 1.97, 95% CI = 1.61 – 2.42), area of residence (Peri-urban: OR = 1.45, 95% CI = 1.199 – 1.75;urban: OR = 1.83, 95% CI = 1.40 – 2.40), education (secondary: OR = 1.57, 95% CI = 1.20 – 2.06;tertiary: OR = 9.03, 95% CI = 6.47 – 12.59), social support (OR = 0.64, 95% CI = 0.53 – 0.76), crowding (OR = 1.14, 95% CI = 1.02 – 1.28), psychological conditions (negative affective: OR = 0.97, 95% CI = 0.94 – 1.00;positive affective: OR = 1.11, 95% CI = 1.06 – 1.16), number of males in household (OR = 0.85, 95% CI = 0.77 – 0.93), living arrangements (OR = 0.62, 95% CI = 0.41 – 0.92) and retirement benefits (OR = 1.55, 95% CI = 1.03 – 2.35). This study highlighted the need to address preventative care for the wealthiest, rural residents and the fact that social support is crucial to health care, as well as the fact that medical care costs are borne by the extended family and other social groups in which the individual is (or was) a member, which explains the low demand for health insurance in Jamaica. Private health care in Jamaica is substantially determined by affordability and education rather than illness, and it is a poor measure of the health care- seeking behaviour of Jamaicans.

Metaverse for mental health disorders:Opportunities and challenges

Several articles on the mental health impact of the metaverse and the need to balance its potential benefits with the risks of metaverse use has recently published.The metaverse consists of a combination of immersive technologies and artificial intelligence algorithms.The metaverse differs from the preceding digital psychiatric interventions due to its complex structure and interactions between components.The diverse functions of the metaverse ensure that it may have a substantial impact on mental health.However,the evidence for its efficacy in treating mental health disorders is limited to a few trials.The mental health benefits of immersive technologies are well-documented and suggest that metaverse-based psychiatric treatment may be similarly efficacious.The mental health risks of the metaverse are largely unknown,and it is not clear whether they will be greater than other digital psychiatric interventions.Much more research is needed to determine whether metaverse-based psychiatric treatment will meet the standards of appropriate mental healthcare.

Ultra‑High Sensitivity Anisotropic Piezoelectric Sensors for Structural Health Monitoring and Robotic Perception

Monitoring minuscule mechanical signals,both in magnitude and direction,is imperative in many application scenarios,e.g.,structural health monitoring and robotic sensing systems.However,the piezoelectric sensor struggles to satisfy the requirements for directional recognition due to the limited piezoelectric coefficient matrix,and achieving sensitivity for detecting micrometer-scale deformations is also challenging.Herein,we develop a vector sensor composed of lead zirconate titanate-electronic grade glass fiber composite filaments with oriented arrangement,capable of detecting minute anisotropic deformations.The as-prepared vector sensor can identify the deformation directions even when subjected to an unprecedented nominal strain of 0.06%,thereby enabling its utility in accurately discerning the 5μm-height wrinkles in thin films and in monitoring human pulse waves.The ultra-high sensitivity is attributed to the formation of porous ferroelectret and the efficient load transfer efficiency of continuous lead zirconate titanate phase.Additionally,when integrated with machine learning techniques,the sensor’s capability to recognize multi-signals enables it to differentiate between 10 types of fine textures with 100%accuracy.The structural design in piezoelectric devices enables a more comprehensive perception of mechanical stimuli,offering a novel perspective for enhancing recognition accuracy.

Mediating role of health literacy in the relationship between social isolation and psychological distress among pre-frail older adults

BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The social isolation of pre-frail older adults can impact their psychological distress.AIM To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty.METHODS This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over.Social isolation,health literacy,and psycholo-gical distress were comprehensively measured using the Lubben Social Network Scale-6,12-item Short-Form Health Literacy Questionnaire,and the Kessler Psy-chological Distress Scale-10.Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool.Descriptive statistical analyses,correlation analyses,and bootstrap mediation tests were used to assess associations between the variables.RESULTS The results showed that social isolation had an effect on health literacy among pre-frail older adults(β=0.240,P<0.001),social isolation impact on psycho-logical distress pre-frail older adults(β=-0.415,P<0.001);health literacy was identified effect on psychological distress among pre-frail older persons(β=-0.307,P<0.001).Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty,with a mediation effect of-0.074,accounting for 17.83%of the total effect.

Decoding the nexus:branched-chain amino acids and their connection with sleep,circadian rhythms,and cardiometabolic health

The sleep-wake cycle stands as an integrative process essential for sustaining optimal brain function and,either directly or indirectly,overall body health,encompassing metabolic and cardiovascular well-being.Given the heightened metabolic activity of the brain,there exists a considerable demand for nutrients in comparison to other organs.Among these,the branched-chain amino acids,comprising leucine,isoleucine,and valine,display distinctive significance,from their contribution to protein structure to their involvement in overall metabolism,especially in cerebral processes.Among the first amino acids that are released into circulation post-food intake,branched-chain amino acids assume a pivotal role in the regulation of protein synthesis,modulating insulin secretion and the amino acid sensing pathway of target of rapamycin.Branched-chain amino acids are key players in influencing the brain's uptake of monoamine precursors,competing for a shared transporter.Beyond their involvement in protein synthesis,these amino acids contribute to the metabolic cycles ofγ-aminobutyric acid and glutamate,as well as energy metabolism.Notably,they impact GABAergic neurons and the excitation/inhibition balance.The rhythmicity of branchedchain amino acids in plasma concentrations,observed over a 24-hour cycle and conserved in rodent models,is under circadian clock control.The mechanisms underlying those rhythms and the physiological consequences of their disruption are not fully understood.Disturbed sleep,obesity,diabetes,and cardiovascular diseases can elevate branched-chain amino acid concentrations or modify their oscillatory dynamics.The mechanisms driving these effects are currently the focal point of ongoing research efforts,since normalizing branched-chain amino acid levels has the ability to alleviate the severity of these pathologies.In this context,the Drosophila model,though underutilized,holds promise in shedding new light on these mechanisms.Initial findings indicate its potential to introduce novel concepts,particularly in elucidating the intricate connections between the circadian clock,sleep/wake,and metabolism.Consequently,the use and transport of branched-chain amino acids emerge as critical components and orchestrators in the web of interactions across multiple organs throughout the sleep/wake cycle.They could represent one of the so far elusive mechanisms connecting sleep patterns to metabolic and cardiovascular health,paving the way for potential therapeutic interventions.

A Comprehensive Survey on Federated Learning Applications in Computational Mental Healthcare

Mental health is a significant issue worldwide,and the utilization of technology to assist mental health has seen a growing trend.This aims to alleviate the workload on healthcare professionals and aid individuals.Numerous applications have been developed to support the challenges in intelligent healthcare systems.However,because mental health data is sensitive,privacy concerns have emerged.Federated learning has gotten some attention.This research reviews the studies on federated learning and mental health related to solving the issue of intelligent healthcare systems.It explores various dimensions of federated learning in mental health,such as datasets(their types and sources),applications categorized based on mental health symptoms,federated mental health frameworks,federated machine learning,federated deep learning,and the benefits of federated learning in mental health applications.This research conducts surveys to evaluate the current state of mental health applications,mainly focusing on the role of Federated Learning(FL)and related privacy and data security concerns.The survey provides valuable insights into how these applications are emerging and evolving,specifically emphasizing FL’s impact.

Relationship between the use of smart medical services and mental health status

In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.

Health anxiety and work loss in patients diagnosed with serrated polyposis syndrome:A cross sectional study

BACKGROUND Serrated polyposis syndrome(SPS)is a polyposis condition with neoplastic potential,but its psychological impact is not well understood.AIM To assess health anxiety prevalence in a regional Australian cohort of SPS patients and explore factors influencing it,including workforce impacts of regular surveillance.METHODS This cross-sectional study screened patients aged 18-65 undergoing colonoscopy in a regional gastroenterology practice between January 2015 and June 2022.Eligible SPS patients were invited to participate.Data included the Short Health Anxiety Inventory,employment status,and previous demographic and medical findings.RESULTS Health anxiety was found in 21.57%of SPS patients,with anxious patients being significantly more concerned about surveillance(OR=7.70).Patients lost an average of 11.04 work hours per colonoscopy.CONCLUSION Health anxiety in SPS patients aligns with rates in other gastroenterology populations.Identifying it may improve management,though further research is needed to better understand prevalence and care improvements.