It is a matter of speculation whether the high prevalence of smoking among Hungarian Roma (HR) is related to genetic, gene-environmental interactions or cultural factors. Our aim is to compare the genetic susceptibility and possible effects of determinants associated with smoking behaviours in the Hungarian general (HG) and Roma populations. A complex health survey including three pillars (questionnaire, physical and laboratory examinations) was carried out (N_HG = 412 and N_HR = 402). Risk allele frequencies of ten single-nucleotide polymorphisms (SNPs) were compared, and their combined effect was estimated by computing unweighted and weighted genetic risk scores (GRS, wGRS). The effects of genetic and environmental factors were investigated in regression analyses after confounders were introduced. Socio-economic status (SES) was calculated based on the Kuppuswamy scale 2019. Risk allele frequencies of only four SNPs were found to be different between populations (p < 0.01). Median values of GRS did not differ, while the wGRS median was slightly higher among Roma individuals (5.2 vs. 4.9; p = 0.02). Roma individuals were more likely to be heavy smokers (OR_males = 2.05, 95% CI [1.47–2.86]; OR_females = 1.89, 95% CI [1.58–2.25]. Smokers have lower SES compared to never smokers (SES β_HR = −0.039, p = 0.023; β_HG = −0.010, p = 0.049). An inverse relationship was found between SES and smoking behaviours (p < 0.0001) and was found to be a better predictor of smoking behaviours than genetic susceptibility. Our study findings suggest that the high prevalence of smoking behaviours and nicotine-dependence were not revealed to have a genetic susceptibility among HR individuals; therefore, the highest efforts should be focused on targeting SES-related factors in the Roma population. Strengths of the study: This is the first study carried out to investigate and detect the most relevant factors and the possible genetic background of the extremely high prevalence of smoking based in the Roma population. Limitations of the study: No standard instrument has been used to assess the intensity of addiction to nicotine. Because of some participants’ unwillingness to define themselves as Roma, the overall HR population was not represented by the sample of this study.

Non-communicable diseases (NCDs) have become a major public health concern in Iraq, playing a significant role in the country’s morbidity and mortality rates. To offer a thorough overview of the patterns and the overall impact of NCDs on public health, this study aims to map the trends in the incidence, prevalence, and mortality rates of NCDs in Iraq between 2003 and 2021. Data from the Global Burden of Disease (GBD) Study 2021 were utilized. The focus was on Iraq from 2003 to 2021, a period marked by significant social and political changes. Using the GBD results tool, age-standardized prevalence, incidence, and mortality rates (ASPR, ASIR, ASMR) for 12 major NCDs were extracted and expressed per 100,000 population. Descriptive statistics with 95% uncertainty intervals were calculated, and trends were analyzed. The analysis revealed a nuanced trajectory of NCDs in Iraq between 2003 and 2021. The ASPR of all NCDs increased slightly (change %: 0.1, 95% UI: -2.2 to 2.4), with a notable decline in chronic respiratory diseases (change %: −14.4, 95% UI: (-30.9 to 6.1) and a significant rise in neoplasms (change %: 32.7, 95% UI: -5.9 to 81.3). The ASIR of diabetes and kidney diseases showed the largest increase (change %: 42.9, 95% UI: 28.4 to 59.3), while chronic respiratory diseases had the greatest decline (change %: −12.1, 95% UI: -36.8 to 22.5). Cardiovascular diseases remained the leading cause of mortality in both sexes, with ASMRs increasing slightly for males and decreasing for females over the period. Skin and subcutaneous diseases showed the highest increase in ASMR (change %: 48.2), while digestive diseases experienced the largest decline (change %: −21.4). The GBD 2021 study highlights progress in reducing NCD mortality in Iraq, especially among younger people. However, older males still face high death rates from cardiovascular diseases. Rising cases of cancer, diabetes, and kidney diseases signal the need for targeted interventions. Continued focus on risk factors and healthcare access is essential.

Objective This study was aimed to determine the relationship between job stress and work-related quality of life (WRQoL) among emergency medical technicians (EMTs) in Lorestan province, Western Iran. Design This was a cross-sectional study. Methods Totally 430 EMTs who had been engaged in their respective units for more than 6 months from all emergency facilities in Lorestan province were selected using single stage cluster sampling method. Data were collected from April to July 2019 using two standard questionnaires: job stress (Health and Safety Executive (HSE)) and WRQoL. The OR with 95% CI was used to declare the statistical association (p≤0.05). Results All participants were exclusively males, with a mean age of 32±6.87 years. The overall average score of job stress using the HSE scale was 2.69±0.43; while the overall quality of working life score was 2.48±1.01. The type of working shift was found to have a significant impact on the HSE-average score (F(3,417)=5.26, p=0.01); and on the WRQoL-average score (F(3,417)=6.89, p<0.01). Conclusion Two-thirds of EMTs working in governmental hospitals had job stress and a low quality of work-related life. Additionally, work shift was statistically significant associated with EMTs’ job stress and WRQoL.

The association between alcohol consumption and Parkinson's disease (PD) risk remains unclear, whereas smoking has an inverse relationship with the disease. This study systematically reviewed and meta‐analyzed 16 studies (2014–2024) from PubMed, Scopus, Web of Science, MEDLINE, and the Cochrane Library to assess the relationship between alcohol intake and PD risk, examining sex differences, dose–response patterns, smoking interactions, and genetic factors. Alcohol consumption was classified as low, moderate, or heavy, considering beverage type, sex, smoking status, and gene–environment interactions. Random‐effects meta‐analyses were used to evaluate sex‐stratified and subtype‐specific associations. PD progression, Mendelian randomization (MR), and gene–environment results were narratively synthesized. Sex‐stratified analyses showed inverse associations between alcohol consumption and PD risk versus non‐drinkers (lifetime relative risk [LRR] = −0.35 to −0.62), with significant effects in women and no association in low‐level drinkers. Subtype analyses indicated protective effects for liquor (RR = −0.12) and wine (RR = −0.16), but not for low‐level drinkers. Combined alcohol and smoking exposure produced the greatest PD risk reduction (LRR = −0.37), with pooled estimates confirming an inverse association (LRR = −0.20, I ² = 90.1%). However, MR and gene–environment studies showed inconsistent evidence. Light‐to‐moderate alcohol consumption, particularly wine and liquor, may reduce PD risk, with the strongest effects when combined with smoking. These findings highlight the combined effects of sex, genetic susceptibility, and lifestyle factors. Further longitudinal and MR studies stratified by sex and genotype are needed to elucidate the mechanisms; however, smoking cannot be recommended due to its detrimental effects. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

COVID-19 accounts for more than half a billion deaths globally. The clinical manifestations may vary in due course. Despite several studies aimed at determining the extent to which the disease's severity and mortality remain high when combined with other comorbidities, more research is required. Therefore, this review aimed to measure the pooled prevalence of coronary artery disease (CAD) among COVID-19 patients, specifically those with a history of CAD. Additionally, we aim to assess the association between mortality due to CAD and the severity of COVID-19 among hospitalized patients. A comprehensive search in PubMed, Web of Science, the Cochrane Library, and the WHO COVID-19 database was conducted. English studies with original data on CAD, mortality, and ARDS among COVID-19 patients were included. PRISMA guidelines were followed. Among the 2007 identified articles, 76 studies met the inclusion criteria. The pooled prevalence of CAD among COVID-19 patients was 14.4%(95% CI: 12.7–16.2). The highest prevalence was observed in European studies at 18.2%(95% CI: 13.3–24.2), while the lowest was in Asian studies at 10.4% (95% CI: 6.4–16.3). Participants with concurrent CAD at the time of hospital admission had twice the odds of mortality due to COVID-19 (2.64 [95% CI: 2.30–3.04]) with moderate heterogeneity (I2 = 45%, p < 0.01). Hospitalized COVID-19 patients with CAD had a 50% higher risk of ARDS (95% CI: 0.62–3.66), but this difference was not statistically significant. Although our analysis revealed evidence for a relationship between concurrent CAD at the time of hospital admission and mortality from COVID-19, however, global variation in health infrastructure, limitations of data reporting, and the effects of emerging variants must be considered in future investigations.

Cancer is one of the biggest health burdens for women in the Middle East and North Africa (MENA), with the incidence of breast, cervical and colorectal cancer on the rise. Although preventive measures such as the HPV vaccination and population-based screening are available, access to them remains very unequal. Women in rural, low-income and refugee communities face additional barriers, cultural stigmatisation, low health literacy, gender norms and fragile health systems, leading to delayed diagnoses and poorer outcomes. This review summarises the results of 724 peer-reviewed publications to assess the current situation of cancer screening in MENA and Mediterranean countries. The studies were classified into four dimensions: cancer type (breast, cervical, colorectal), behavioural constructs (awareness, uptake, education), vulnerability factors (e.g., migrants, refugees, low-literacy groups), and geography (indigenous MENA populations versus diaspora and Mediterranean immigrant communities). The results show large inequalities in access and participation due to fragmented policies, socio-cultural resistance and infrastructure gaps. Nevertheless, promising approaches are emerging: community-led outreach, mobile screening programmes, AI-assisted triage and culturally appropriate digital health interventions. Comparisons between the local and diaspora populations make it clear that systemic and cultural barriers persist even in well-equipped facilities. Closing the screening gap requires a culturally sensitive, digitally enabled and policy aligned approach. Key priorities include engaging religious and community leaders, promoting men’s engagement in women’s health and securing sustainable funding. With coordinated action across all sectors, MENA countries can build inclusive screening programmes that reach vulnerable women and reduce preventable cancer mortality.