Association of mobile health (mHealth) use with health status and COVID-19-related concerns by people with mobility impairments

PURPOSE

Mobile health (mHealth) technology has increased dramatically in the wake of the pandemic. Less research has focused on people with mobility impairing (PMI) disabilities. This study determined the prevalence of mHealth use among PMI adults during the COVID-19 escalation and examines demographic, health and COVID-19 concerns correlates.

METHODS

PMI adults (N = 304) completed an online survey investigating mHealth use and COVID-19 concerns related to food access in June of 2020. Smartphone and mHealth use were measured with an adapted version of the survey used in the Pew Internet & American Life project. Descriptive and multivariable analyses were conducted to determine associations of demographics, health status, and COVID-19 concerns with mHealth use. About two-thirds (N = 201) of the sample were mHealth users (owned a smartphone and engaged in health-promoting behaviors with the smartphone; e.g., sought online information, tracked health behaviors, used patient portals).

RESULTS

Having hypertension was associated with higher mHealth use, and having higher COVID-19 concerns about food access was associated with higher mHealth use. Those who used mHealth were also more engaged with smartphone apps for communication, services, and entertainment. Only the association between educational attainment and mHealth use remained significant after adjusting for other covariates in multivariable logistic regression models.

DISCUSSION

PMIs continue to need support in the use of mHealth technology to help maximize access to potentially important tools for rehabilitation and health management. There is a need to continue to investigate mHealth and its applications for people with disabilities.Implications for RehabilitationMany people with mobility impairing disabilities may be missing opportunities for mHealth rehabilitation and healthcare.COVID-19 has widened existing gaps in access and use of mHealth technology among people with mobility impairing disabilities.Focused education is needed to help people with disabilities exploit the full range of services of their smartphones to increase access to care, social connectivity, and other important goods and services to enhance rehabilitation and health management.

Socioeconomic inequalities in accumulation of multimorbidity in England from 2019 to 2049: a microsimulation projection study

BACKGROUND

There are socioeconomic inequalities in the prevalence of multimorbidity and its accumulation across the life course. Estimates of multimorbidity prevalence in English primary care increased by more than two-thirds from 2004 to 2019. We developed a microsimulation model to quantify current and projected multimorbidity inequalities in the English adult population.

METHODS

We used primary care data for adults in England from the Clinical Practice Research Datalink Aurum database between 2004 and 2019, linked to the 2015 English Index of Multiple Deprivation (IMD), to model time individuals spent in four health states (healthy, one chronic condition, basic multimorbidity [two or more chronic conditions], and complex multimorbidity [three or more chronic conditions affecting three or more body systems]) by sex, age, IMD quintile, birth cohort, and region. We applied these transition times in a stochastic dynamic continuous-time microsimulation model to Office for National Statistics population estimates for adults aged 30-90 years. We calculated projected prevalence and cumulative incident cases from 2019 to 2049 by IMD quintile, age group (younger than 65 years vs 65 years and older), and years to be lived without multimorbidity at age 30 years.

FINDINGS

Under the assumption that all chronic conditions were lifelong, and that once diagnosed there was no recovery, we projected prevalence of multimorbidity (basic or complex) increases by 34% from 53·8% in 2019 to 71·9% (95% uncertainty interval 71·8-72·0) in 2049. This rise equates to an 84% increase in the number of people with multimorbidity: from 19·2 million in 2019 to 35·3 million in 2049 (35·3 million to 35·4 million). This projected increase is greatest in the most deprived quintile, with an excess 1·07 million (1·04 million to 1·10 million) cumulative incident basic multimorbidity cases and 0·70 million (0·67 million to 0·74 million) complex multimorbidity cases over and above the projected cases for the least deprived quintile, largely driven by inequalities in those younger than 65 years. The median expected number of years to be lived without multimorbidity at age 30 years in 2019 is 15·12 years (14·62-16·01) in the least deprived IMD quintile and 12·15 years (11·61-12·60) in the most deprived IMD quintile.

INTERPRETATION

The number of people living with multimorbidity will probably increase substantially in the next 30 years, a continuation of past observed increases partly driven by changing population size and age structure. Inequalities in the multimorbidity burden increase at each stage of disease accumulation, and are projected to widen, particularly among the working-age population. Substantial action is needed now to address population health and to prepare health-care and social-care systems for coming decades.

FUNDING

University of Liverpool and National Institute for Health and Care Research School for Public Health Research.

The rationale for South Africa to prioritise mental health care as a critical aspect of overall health care

BACKGROUND

The publication of South Africa's National Mental Health Policy Framework and Strategic Plan 2023-2030 and the proposed National Health Insurance (NHI) make it timely to review that state of mental health services in the country, and to emphasize the importance of prioritising mental health as a pivotal component of holistic healthcare.

METHOD

We searched the published literature on mental health using Google Scholar, Pubmed, and Bing Chat, focusing on these words: epidemiology of mental health disorders, depression and anxiety disorders, mental health services, mental health facilities, human resources, financing and impact of COVID-19 on mental health in South Africa and beyond. We also searched the grey literature on mental health policy that is publicly available on Google.

RESULTS

We provided information on the epidemiology and economic impact of mental health disorders, the availability of mental health services, enabling policies, human resources, financing, and the infrastructure for mental health service delivery in South Africa. We detail the high lifetime prevalence rates of common mental disorders, as well as the profound impact of socioeconomic determinants such as poverty, unemployment, and trauma on mental health disorders. We note the exacerbating effect of the COVID-19 pandemic, and emphasize the pressing need for a robust mental health care system.

CONCLUSION

In addition to outlining the challenges, such as limited mental health service availability, a shortage of mental health professionals, and financial constraints, the review proposes potential solutions, including task-sharing, telehealth, and increasing the production of mental health professionals. The paper underscores the necessity of crafting a comprehensive NHI package of mental health services tailored to the local context. This envisioned package would focus on evidence-based interventions, early identification, and community-based care. By prioritising mental health and addressing its multifaceted challenges, South Africa can aspire to render accessible and equitable mental health services for all its citizens within the framework of the National Health Insurance.

Assessment of Health-Related Quality of Life in Children with Totally Corrected Tetralogy of Fallot in Sulaymaniyah, Iraq

PURPOSE

This study examined the health-related quality of life among children who have undergone surgery for tetralogy of Fallot (TOF) compared to healthy children.

DESIGN

Cross-sectional study.

METHODS

The study was carried out at Children's Heart Hospital and Primary Healthcare Centers in Sulaymaniyah, Iraq, between July 1, 2022, and November 1, 2022. The study involved 400 participants, comprised of 200 parents of healthy children and 200 parents with children with repaired TOF. Data collection involved utilizing a 5-point Likert Scale questionnaire administered through direct face-to-face interviews with the parents of the children.

FINDINGS

Children with surgically repaired TOF had markedly lower mean scores (P ≤ 0.001) in the overall dimension of QoL (Mean rank = 137) when compared to healthy children (Mean rank = 263). Furthermore, it was observed that children with repaired TOF had significantly lower mean scores (P < 0.001) across all subdimensions of QoL compared to their healthy counterparts. In the subject of children with repaired TOF, the impact of maternal education (illiterate and lower education) on overall QoL was found to be highly significant (P < 0.001). In addition, children with repaired TOF from lower socioeconomic status (SES) families had worse quality of life than those from medium and high SES families, with a p-value <0.001.

CONCLUSIONS

Repaired TOF children exhibited notable deficiencies across all dimensions of QoL compared to healthy children. Moreover, SES emerged as a significant determinant influencing the QoL outcomes of repaired TOF children.

CLINICAL EVIDENCE

Despite undergoing corrective surgery for TOF, the QoL in children with repaired TOF continues to be lower than that of their healthy counterparts. Notably, the economic and educational status of the family significantly impacts the way these children perceive and experience their QoL. This finding underscores the critical significance of factoring in socioeconomic elements when addressing the well-being of this particular group of children.

Commentary on the power of predictability: patterns of signals in early life shape neurodevelopment and mental health trajectories

As Davis and Glynn observe in the introduction to their review, early life adversity is a significant impediment to healthy child development. Whereas some theoretical accounts emphasize the sheer number of physical and psychosocial risk factors children experience (Evans, Li, & Whipple, Psychological Bulletin, 2013, 139, 1342), Davis and Glynn review a program of research that is aligned with models highlighting the types of adversity children encounter. They expand on accounts that differentiate threat from deprivation (McLaughlin & Sheridan, Current Directions in Psychological Science, 2016, 25, 239) to draw attention to the role of unpredictability in children's development.

Exercise Training Benefits Health-Related Quality of Life and Functional Capacity during Breast Cancer Chemotherapy: A Randomized Controlled Trial

PURPOSE

To examine the effectiveness of a supervised exercise training program (SETP) on health-related quality of life (HRQoL) and functional capacity in women with breast cancer (BC) undergoing chemotherapy.

METHODS

Ninety-three women with early-stage BC were randomly allocated to a SETP plus usual care (exercise, n = 47) or usual care alone (UC, n = 46). The SETP included three sessions per week, combining aerobic and resistance training, conducted concurrently over the chemotherapy. The EORTC Cancer Quality-of-Life-Questionnaire-Core-30 (QLQ-C30) and the BC-specific module (QLQ-BR23) were used to assess HRQoL. Functional capacity was analyzed by maximum voluntary handgrip strength (MVHS) and by the 30-s chair sit-to-stand test (30-s CST). These endpoints were assessed at baseline (t0); middle (t1; after 8 or 12 wk of t0); and at the end of chemotherapy (t2; after 20 wk of t0). Mean changes from baseline were assessed by an intention-to-treat approach.

RESULTS

Mixed linear model analyses showed that Exercise group experienced less deterioration in several domains of QLQ-C30 at t2, including in global health status/QoL (Δ = 9.39 units; P = 0.034), QLQ-C30 summary score (Δ = 8.08 units; P < 0.001), physical (Δ = 15.14 units; P < 0.001), role ( Δ = 21.81 units; P < 0.001), cognitive (Δ = 9.16 units; P = 0.032) and social functioning (Δ = 11.67 units; P = 0.038), compared with the UC group. Similarly, Exercise group exhibited significant lower levels of fatigue (Δ = -20.19 units; P < 0.001) and appetite loss (Δ = -13.69 units; P = 0.034), compared with the UC group. Significant between-group differences were observed on MVHS of the tumor/surgery upper limb side (Δ = 2.64 kg; P < 0.001) and contralateral limb (Δ = 2.22 kg; P < 0.001), and on the 30-s CST score (Δ = 3.56repetitions; P < 0.001), favoring the Exercise group. No differences were observed on QLQ-BR23 domains.

CONCLUSIONS

Exercise training was an effective complementary therapy to prevent the deterioration of HRQoL and functional capacity during chemotherapy in women with early-stage BC.

Long-term effects of surgically corrected menstrual outflow obstruction: A case-control study

OBJECTIVE

To enhance evidence-based knowledge on long-term sequalae in patients with surgically corrected obstructing Müllerian anomalies.

METHODS

This long-term case-control study included patients with menstrual outflow obstruction due to congenital anomalies of the uterus or vagina, who were at least 18 years old, and for whom 2 years had elapsed since the first surgery at the start of this study. The control group consisted of women without current gynecological problems. Patients underwent a surgical correction at the Radboud University Medical Center Nijmegen between 1980 and 2013. Of 78 patients approached, 38 (49%) were included in this study. The control group consisted of 54 females. The main outcome measures were pain and health state. The following questionnaires were used: Visual Analogue Scale pain scores, European Quality of Life-5 Dimensions questionnaire (EQ-5D-3L) and the adapted Endometriosis Health Profile questionnaire (EHP-30).

RESULTS

Patients had higher actual and maximum abdominal pain scores compared with controls (11 vs 0 [P = 0.007] and 48 vs 21 [P = 0.035], respectively). Based on the EQ-5D-3L scores, patients had more pain and discomfort (P = 0.005), more mood problems (P = 0.023), and a poorer subjective health state (P = 0.002) and self-rated health state (P = 0.031). Based on the EHP-30, patients had a significant poorer self-rated health state on four out of five subscales.

CONCLUSION

In this study, following surgically corrected menstrual obstruction, patients had statistically significant higher abdominal pain scores and a poorer self-rated health state compared with controls.

Cognitive-behavioral stress management program reduces postoperative psychological pressure and improves life quality in prostate cancer patients

OBJECTIVE

Cognitive-behavioral stress management (CBSM) improves mental status and quality of life (QoL) in cancer patients, while its impact on prostate cancer (PC) patients remains unknown. Thus, the study aimed at investigating the potency of CBSM program in ameliorating postoperative anxiety, depression, and QoL in PC patients.

METHODS

Totally, 160 postoperative PC patients were consecutively recruited followed by random assignments to either CBSM (N = 81) or usual care (UC) (N = 79) group as a 1:1 ratio. The patients received the corresponding interventions for 10 weeks then were followed up for 6 months.

RESULTS

CBSM group presented lower Hospital Anxiety and Depression Scale (HADS)-anxiety score and anxiety rate at month (M) 4 and M6 versus UC group (all P < 0.05), but not at M0, M1, and M2. Meanwhile, CBSM group exhibited a lower HADS-depression score versus UC group at M6 (P = 0.036) but no other timepoints; however, CBSM group showed no difference in depression rate versus UC group at any timepoints. Regarding the Quality-of-Life Questionnaire-Core30 (QLQ-C30) evaluation, CBSM group exhibited higher global health status scores at M1 (P = 0.010), M2 (P = 0.001), M4 (P = 0.029), and M6 (P = 0.015), higher functions score at M4 (P = 0.040) and M6 (P = 0.044), but a lower symptom score at M4 (P = 0.034) versus UC group; meanwhile, the above QoL indexes were not different at other timepoints between CBSM and UC groups.

CONCLUSION

CBSM serves as an effective caring program in relieving anxiety and depression as well as improving the QoL in postoperative PC patients.

Worldwide cohort studies to support healthy ageing research: data availabilities and gaps

BACKGROUND

Population ageing is a transforming demographic force. To support evidence-based efforts for promoting healthy ageing, a summary of data availabilities and gaps to study ageing is needed.

METHOD

Through a multifaceted search strategy, we identified relevant cohort studies worldwide to studying ageing and provided a summary of available pertinent measurements. Following the World Health Organization's definition of healthy ageing, we extracted information on intrinsic capacity domains and sociodemographic, social, and environmental factors.

RESULTS

We identified 287 cohort studies. South America, the Middle East, and Africa had a limited number of cohort studies to study ageing compared to Europe, Oceania, Asia, and North America. Data availabilities of different measures varied substantially by location and study aim. Using the information collected, we developed a web-based Healthy Ageing Toolkit to facilitate healthy ageing research.

CONCLUSIONS

The comprehensive summary of data availability enables timely evidence to contribute to the United Nations Decades of Healthy Ageing goals of promoting healthy ageing for all. Highlighted gaps guide strategies for increased data collection in regions with limited cohort studies. Comprehensive data, encompassing intrinsic capacity and various sociodemographic, social, and environmental factors, is crucial for advancing our understanding of healthy ageing and its underlying pathways.

e-Health Literacy Status of Individuals with Multiple Sclerosis in Turkey

Background: This research aims to compare e-health literacy of technology users and nonusers in people with multiple sclerosis (MS) and to investigate whether there are correlations between age, duration of MS, gender, marital status, and e-health total scores. Methods: This descriptive study was carried out with a web-based questionnaire. The questionnaire was sent to 300 patients with MS who were registered at Istanbul University-Cerrahpasa Medical Faculty Neurology Department. Results: A total of 156 people (mean age: 35.33 ± 10.47 years) participated in the survey. Smartphone 98.1% (n = 153) was the mostly used device. Rate of using Google and recommended websites about MS was 94.25% (n = 145) and 73.9% (n = 113), respectively. e-Health literacy of both the tablet and recommended websites users significantly differed from that of nonusers (p = 0.007 for both). Participants' e-health literacy total score was found to weakly, but significantly, correlate with their age, marital status, and education level (rho: -0.161, p = 0.044; rho: 0.172, p = 0.032; rho: -0.192, p = 0.016, respectively). Conclusions: With developments in digital technologies, it is important to identify the access status of people with MS to improve daily clinical management and implement further motor and cognitive rehabilitation. Therefore, determining the health literacy of individuals with MS and providing education on this subject will reduce the information pollution.

Evaluation of Hemoglobin Concentration in Male Patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major public health problem. This study was done to evaluate the changes of hemoglobin concentration in COPD patients in comparison to healthy person. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Bangladesh from July 2018 to June 2019. A total number of 160 male subjects, ages ranged from 30-70 years were included in this study. Among them, eighty (80) male COPD subjects were taken as study group (Group II) and eighty (80) age matched male healthy subjects were taken as control group (Group I). Hemoglobin concentration was estimated by cyanmethemoglobin method. Data were expressed as mean (±SD) and statistical significance of difference among the group was calculated by unpaired students' 't' test. The mean±SD of hemoglobin concentration of Group I and Group II were 13.79±1.08gm/dl and 11.63±1.33gm/dl respectively. The mean ±SD of hemoglobin concentration significantly lower in study group in comparison with control group. Patients with COPD with greater changes in hemoglobin concentration causes more frequent hospitalization and increased mortality and morbidity due to COPD related complications. So, assessment of this parameter is important for early detection and prevention of complication related to COPD for leading a healthy life.

Unconditional cash transfers, health and savings

This paper examines the relationship between a national unconditional cash transfers (UCTs) program, health and savings. We theoretically and empirically show that motives to save can be strong when cash transfers promote health outcomes. We first present a theoretical model that considers lifecycle-consumption savings decisions, where households derive utility from consumption and leisure time at working age, as well as old-age consumption and old-age longevity that positively depend on health spending. We then empirically examine the impact of Pakistan's Benazir Income Support Programme on various indicators of savings and provide suggestive evidence on how UCTs influence savings via health. We find that in the short and medium term, UCTs increase the probability that a household decides to save and have significant positive effects on the rates and amounts of household savings. The effects of UCTs are more pronounced on informal compared to formal savings. The results present exploratory and suggestive evidence that health is a mechanism through which UCTs transmit to savings. These findings are consistent with our theoretical predictions.

Aerobic exercise training effects on hippocampal volume in healthy older individuals: a meta-analysis of randomized controlled trials

We conducted a meta-analysis of randomized controlled trials investigating the effects of aerobic exercise training (AET) lasting ≥ 4 weeks on hippocampal volume and cardiorespiratory fitness (CRF) in cognitively unimpaired, healthy older individuals. Random-effects robust variance estimation models were used to test differences between AET and controls, while meta-regressions tested associations between CRF and hippocampal volume changes. We included eight studies (N = 554) delivering fully supervised AET for 3 to 12 months (M = 7.8, SD = 4.5) with an average AET volume of 129.85 min/week (SD = 45.5) at moderate-to-vigorous intensity. There were no significant effects of AET on hippocampal volume (SMD = 0.10, 95% CI - 0.01 to 0.21, p = 0.073), but AET moderately improved CRF (SMD = 0.30, 95% CI 0.12 to 0.48, p = 0.005). Improvement in CRF was not associated with changes in hippocampal volume (bSE = 0.05, SE = 0.51, p = 0.923). From the limited number of studies, AET does not seem to impact hippocampal volume in cognitively unimpaired, healthy older individuals. Notable methodological limitations across investigations might mask the lack of effects.

Development and validation of a stacking ensemble model for death prediction in the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

OBJECTIVE

This study aimed to develop and validate a mortality risk prediction model for older people based on the Chinese Longitudinal Healthy Longevity Survey using the stacking ensemble strategy.

MATERIAL AND METHODS

A total of 12,769 participants aged 65 or more at baseline were included. Ensemble machine learning models were applied to develop a mortality prediction model. We selected three base learners, including logistic regression, eXtreme Gradient Boosting, and Categorical + Boosting, and used logistic regression as the meta-learner. The primary outcome was five-year survival. Variable importance was evaluated by the SHapley Additive exPlanations method.

RESULTS

The mean age at baseline was 88, and 57.8 % of participants were women. The CatBoost model performed the best among the three base learners, the area under the receiver operating characteristics curve (AUC) reached 0.8469 (95%CI: 0.8345-0.8593), and the stacking ensemble model further improved the discrimination ability (AUC = 0.8486, 95%CI: 0.8367-0.8612, P = 0.046). Conventional logistic regression had comparable performance (AUC = 0.8470, 95 % CI: 0.8346-0.8595). Older age, higher scores for self-care activities of daily living, being male, higher objective physical performance capacity scores, not undertaking housework, and lower scores on the Mini-Mental State Examination contributed to higher risk.

CONCLUSIONS

We successfully constructed and validated a few death risk prediction models for a Chinese population of older adults. While the stacking ensemble approach had the best prediction performance, the improvement over conventional logistic regression was insubstantial.

Late-Life Metabolic Dysfunction-Associated Steatotic Liver Disease and its Association With Physical Disability and Dementia

BACKGROUND

The burden of metabolic dysfunction-associated steatotic liver disease (MASLD) is growing rapidly, including among older adults. The number of older adults is also rising with concomitantly increasing rates of age-related physical and cognitive dysfunction. However, data on whether MASLD affects physical and cognitive function in older adults is limited. As such, we aimed to identify whether prevalent MASLD influences the risk of incident physical disability or dementia in initially healthy older adults.

METHODS

A post-hoc analysis of participants from the ASPREE-XT cohort study, which recruited community-dwelling older adults without a history of cardiovascular disease, dementia, or independence-limiting functional impairment. The Fatty Liver Index (to identify MASLD) was calculated in those with complete data. Cox proportional-hazards models were used to investigate the outcomes of dementia and persistent physical disability in participants with MASLD vs those without.

RESULTS

Of the 9 097 individuals included (mean age 75.1 ± 4.2 years; 45.0% men), 341 (3.7%) developed persistent physical disability and 370 (4.1%) developed dementia over a median follow-up of 6.4 years (IQR 5.3-7.5 years). When adjusting for known contributors including age, gender, education, comorbidity, and functional measures, MASLD was associated with an increased risk of persistent physical disability (HR 1.41 [95% CI: 1.07-1.87]) and reduced risk of incident dementia (HR 0.63 [95% CI: 0.48-0.83]).

CONCLUSIONS

Prevalent MASLD is associated with reduced rates of incident dementia but increased risk of persistent physical disability in initially relatively healthy older adults. Understanding the mechanisms underlying these divergent results to allow appropriate risk stratification and counseling is important.

Common home hazards among healthy older aged adults and potential modifications required for age-friendly housing

INTRODUCTION

The creation of age-friendly home environments enables middle-aged and older aged people to live independently at home while adapting to age-related changes. Little is currently known about existing home hazards that may potentially hinder healthy older people as they age.

METHODS

Prospective cohort study of healthy adults who received an age-friendly home environment assessment conducted by an occupational therapist. Adults aged 60 and over, without significant disability, living in homes within metropolitan Adelaide, South Australia were recruited through community advertising.

RESULTS

Sixty age-friendly home environment assessments were conducted. Common areas where potential hazards were identified, and modifications recommended were bathrooms, toilets and backyards. Gardens were commonly identified as potentially requiring modifications in the future. Participants were more likely to consider moving to new housing if additional modifications were needed to their homes.

CONCLUSION

Affordable and accessible age-friendly housing is required to support an ageing population. Education on age-friendly housing for healthy middle and older aged people is required enabling proactive planning rather than awaiting health crises.

A longitudinal descriptive assessment of US college COVID-19 dashboards

BACKGROUND

The purposes of this study were to (1) longitudinally examine US college and university COVID-19 dashboard content and (2) explore county-level population health and COVID-19 community indicators where colleges with large undergraduate enrollments were located.

METHODS

We identified 10 colleges with the largest undergraduate enrollments. Next, we located all public and private two- and four-year nonprofit colleges (n = 58) in each respective county. We assessed active COVID-19 dashboards using established criteria from We Rate COVID Dashboards in March 2021 and February 2022.

RESULTS

In 2021 and 2022, two-thirds (n = 38/58) of colleges had an active COVID-19 dashboard. While most COVID-19 dashboards were easy to read, they were less likely to include updated daily infection rates and testing frequency details.

CONCLUSION

Overall quality, content, and features of COVID-19 dashboards varied greatly across colleges. Future COVID-19 dashboard designs should focus on providing evidence-based information with the goal of promoting and supporting informed decision making.

Modulatory effects of low-intensity retinal ultrasound stimulation on rapid and non-rapid eye movement sleep

Prior investigations have established that the manipulation of neural activity has the potential to influence both rapid eye movement and non-rapid eye movement sleep. Low-intensity retinal ultrasound stimulation has shown effectiveness in the modulation of neural activity. Nevertheless, the specific effects of retinal ultrasound stimulation on rapid eye movement and non-rapid eye movement sleep, as well as its potential to enhance overall sleep quality, remain to be elucidated. Here, we found that: In healthy mice, retinal ultrasound stimulation: (i) reduced total sleep time and non-rapid eye movement sleep ratio; (ii) changed relative power and sample entropy of the delta (0.5-4 Hz) in non-rapid eye movement sleep; and (iii) enhanced relative power of the theta (4-8 Hz) and reduced theta-gamma coupling strength in rapid eye movement sleep. In Alzheimer's disease mice with sleep disturbances, retinal ultrasound stimulation: (i) reduced the total sleep time; (ii) altered the relative power of the gamma band during rapid eye movement sleep; and (iii) enhanced the coupling strength of delta-gamma in non-rapid eye movement sleep and weakened the coupling strength of theta-fast gamma. The results indicate that retinal ultrasound stimulation can modulate rapid eye movement and non-rapid eye movement-related neural activity; however, it is not beneficial to the sleep quality of healthy and Alzheimer's disease mice.

Temporal Trend in Uptake of the National General Health Checkups and Cancer Screening Program among Korean Women with Breast Cancer

PURPOSE

This study assessed the temporal trends of uptake of national general health and cancer screening among women with breast cancer in Korea between 2009 and 2016.

MATERIALS AND METHODS

We retrospectively analyzed the claims data from the Korean National Health Insurance Service database. Participants included 101,403 breast cancer patients diagnosed between 2009 and 2016. Information on participation in national screening programs, including breast cancer screening, general health, and gastric, colorectal, and cervical cancers, up to 2020 was collected. Screening participation rates within the first 2 and 5 years postdiagnosis were calculated by diagnosis year and fitted with joinpoint regression models to assess temporal trends.

RESULTS

Overall, the participation rate in breast cancer screening within 2 years postdiagnosis increased from 10.9% to 14.0% from 2009-2016, with an annual percentage change (APC) of 3.7% (p < 0.05). The participation rate in breast cancer screening was lower than that in general health checkup and screening for other cancers within 2 and 5 years postdiagnosis. A steady increase in screening trends was also observed for general health, gastric, colorectal, and cervical cancers, with APC of 5.3%, 5.7%, 6.9%, and 7.6% in the 2-year postdiagnosis rate, and APC of 3.6%, 3.7%, 3.7%, and 4.4% in 5-year postdiagnosis rate, respectively. The screening rate was highest among age groups 50-59 and 60-69 in 2009 and significant upward trends were observed in all age groups for general health checkup and gastric, colorectal, and cervical cancer screening.

CONCLUSION

Among female breast cancer survivors in Korea, the uptake rate of screenings for general health and various cancers, including breast, gastric, colorectal, and cervical cancers, has shown a gradual increase in recent years.

Association between Quality of Life and Visual Acuity in a Randomized Clinical Trial of Patients with Uveitis Taking Antimetabolites

PURPOSE

To evaluate how changes in visual acuity are associated with changes in quality of life (QoL) among patients with non-infectious uveitis taking antimetabolites.

METHODS

This secondary analysis of the multicenter First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial involves 216 participants randomized to methotrexate or mycophenolate mofetil. Vision-related (NEI-VFQ and IND-VFQ) and health-related (PCS and MCS SF-36v2) QoL and visual acuity were measured at baseline and 6-month primary endpoint.

RESULTS

Visual acuity was significantly associated and correlated with all QoL measures (Spearman correlation coefficients = 0.5, 0.5, 0.3, and 0.4 for NEI-VFQ, IND-VFQ, SF-36v2 MCS and PCS, respectively). All observed changes in QoL met or exceeded the minimal clinically important difference definition on each scale. Treatment group was not significantly associated with any QoL measure.

CONCLUSION

By adding insight beyond visual acuity, QoL provides a more comprehensive picture of the patient experience during uveitis treatment.Abbreviations and Acronyms: QoL = quality of life; VR-QoL = vision-related quality of life; HR-QoL = health-related quality of life; FAST = First-line Antimetabolites as Corticosteroid Sparing Treatment; NEI-VFQ = National Eye Institute Visual Functioning Questionnaire; IND-VFQ = Indian Visual Functioning Questionnaire; SF-36v2 = Medical Outcomes Study 36-Item Short Form Survey; PCS = physical component score; MCS = mental component score; 95% CI = 95% confidence interval; MCID = minimal clinically important difference.

Where's the BIPOC Blueprint for Healthy Youth Development? The Role of Scientific Omissions in Our Struggle for Science Translation and Racial Equity in the United States

Prevention Science seeks to advance the prevention research and to translate scientific advances into the promotion of healthy development for all youth. Despite tremendous progress creating a robust evidence-base and set of translational tools, elaborations and expansions for equity are required. Our collective errors of omission as prevention researchers have left prevention practitioners and policy-makers without sufficient information to identify strategies that have been demonstrated to prevent behavioral health problems in young people who identify as Black, Indigenous, or other People of Color (BIPOC). We first describe the current shortcomings of available evidence, and then we call for individual and collective action to conceptualize equity-enhancing prevention, sample more inclusively, and improve analytic approaches such that we can truly promote the healthy development of all youth.

Asian Hate, religion, and perceived changes in physical health: exploring the flip side of minority stress during the COVID-19 pandemic

OBJECTIVES

Prior research suggests that racism is associated with adverse mental health outcomes for Asians in the United States. Relatively less research has been conducted to examine the effects of racism on physical health, particularly the changes in physical health among Asians and Asian Americans. This study aims to fill in this gap in prior research.

DESIGN

Survey was conducted via Qualtrics in March 2023. A panel sample of 356 Asian and Asian American adults from across the US was collected. Ordinary Least Squares Regression was employed to examine the interrelationships among racism, religion, and perceived changes in physical health during the COVID-19 pandemic.

RESULTS

Contrary to conventional wisdom, more frequent experience with blatant racism was associated with a perceived improvement in physical health after controlling for subtle racism, anxiety, acculturation, and various sociodemographic variables. Interestingly, this robust relationship was more significant among Asians who attended religious services more frequently. Additional three-way interactions revealed that the interaction between blatant racism and religious service attendance on perceived changes in physical health was more significant for US-born Asians and Asians of Indian or Japanese ethnicity.

CONCLUSION

Racism exerts a significant influence on physical health outcomes among Asians and Asian Americans. However, this relationship was contingent upon the specific aspect of racism and intersected with religiosity, acculturation, and ethnic identity.

Early Longitudinal Change in Heart Failure Health Status Following Initiation of Canagliflozin

BACKGROUND

Sodium glucose co-transporter 2 inhibitor (SGLT2i) therapy improves health status in heart failure (HF). There is insufficient description regarding the timing, rate, and extent of the health status changes in heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) after initiation of SGLT2is.

OBJECTIVES

The authors sought to model the association of canagliflozin treatment with rates of change in HF symptom status in HFpEF and HFrEF.

METHODS

Study participants with HFrEF and HFpEF were treated with either canagliflozin 100 mg or placebo for 12 weeks. The Kansas City Cardiomyopathy Questionnaire Total Symptom Score (KCCQ-TSS) was assessed at baseline and at 2, 4, 6, and 12 weeks. Longitudinal modeling assessed slope of KCCQ change across the study.

RESULTS

Among 448 individuals with HF (181 with HFrEF and 267 with HFpEF), participants with HFpEF had lower baseline KCCQ-TSS scores than those with HFrEF (54 ± 21 vs 64 ± 20). Modeling demonstrated initial rapid improvement in KCCQ-TSS in both HF groups, with deceleration over the next 4 to 6 weeks. The rate of change was greater among HFpEF participants (0.7 points/day; 95% CI: 0.3-1.1 points/day) than HFrEF participants (ΔKCCQ-TSS/day = 0.5; 95% CI: 0.1-1.0 points/day) randomized to canagliflozin, but these differences were not statistically significant (0.2 points/day; 95% CI: -0.4 to 0.7 points/day; P = 056).

CONCLUSIONS

After canagliflozin therapy, regardless of EF, modeling shows the KCCQ-TSS improves rapidly with the greatest improvements occurring within the first weeks of treatment. These results have implications for clinical use of SGLT2is and may be useful in the design of trials examining impact of these agents on health status in HF. (A Study on Impact of Canagliflozin on Health Status, Quality of Life, and Functional Status in Heart Failure [CHIEF-HF]; NCT04252287).

Characterizing the Impact of Disorders of the Gut-Brain Interaction on Mental and Physical Health Functioning Among Spanish-Speaking Latino Adults Living in the United States

INTRODUCTION

Latino individuals are underrepresented in the disorders of the gut-brain interaction (DGBI) literature, and no work has explored how disorders of the gut-brain interaction affect health and well-being in this group.

METHODS

This study sought to explore how disorders of the gut-brain interaction affect health factors in a sample of Latino individuals (N = 292; 80.80% female; M age = 37.65 years, SD = 11.98) with (n = 60) and without (n = 232) a disorder of the gut-brain interaction based on current Rome Foundation diagnostic criteria (Rome IV).

RESULTS

DGBI was associated with increased pain intensity, pain disability, cardiovascular risk, depressive symptoms, and anxiety/panic symptoms and lower physical health-related quality of life and mental health-related quality of life controlling for age, sex, and nativity.

DISCUSSION

Better understanding mental health and treatment-seeking behaviors among Latino individuals may help clinical gastroenterologists engage their Latino patients to a greater extent and thus provide higher quality of care.

A Comparison of Items and Constructs of Standardized Health-Related Quality of Life and Mental Well-Being Measures

OBJECTIVES

This study aimed to explore the internal constructs of the concepts being measured by EQ-5D-5L (a health-related quality of life measure that can produce preference-based utility values) and the 12-item General Health Questionnaire (GHQ-12, a mental well-being measure) and to understand to what extent the items of EQ-5D-5L and GHQ-12 associate with each other.

METHODS

We used data from 12 701 respondents participating in a Belgian survey in 2022. Correlation coefficients between GHQ-12 and EQ-5D-5L were calculated at both the aggregate and item levels. Multidimensional scaling, exploratory factor analysis, and regression models were performed to investigate the underlying constructs that are associated with the items.

RESULTS

Despite a moderate correlation (0.39) between the EQ-5D-5L and GHQ-12 total scores, only a trivial or weak correlation (<0.3) was observed between the first 4 EQ-5D-5L items and any GHQ-12 item. Multidimensional scaling and exploratory factor analysis showed the first 4 EQ-5D-5L dimensions were clustered together with EuroQol visual analog scale and positively phrased GHQ-12 items were close to each other, whereas EQ-anxiety/depression and negatively phrased GHQ-12 items were grouped with overall life satisfaction. In the regression models, not all GHQ-12 items had a significant coefficient to predict EQ-5D-5L responses.

CONCLUSIONS

To the best of our knowledge, we present the first comparison of items and underlying constructs of GHQ-12 and EQ-5D-5L. The results showed that GHQ-12 can only partially predict the responses of EQ-5D-5L and the 2 instruments measure different constructs. Researchers should carefully consider conceptual legitimacy while applying the mapping technique and consider sensitivity analyses for the mapping estimates.

Comparative analysis of health status and health service utilization patterns among rural and urban elderly populations in Hungary: a study on the challenges of unhealthy aging

The demographic transition poses a significant challenge for health systems, especially in Central and Eastern European (CEE) countries, where the healthcare needs of aging populations are on the rise. This study aimed to describe and compare the health status and utilization of health services among the elderly residing in urban and rural areas of the most deprived region in Hungary. A comprehensive health survey was conducted in 2022, involving a randomly selected sample of 443 older adults (≥ 65 years) in Northeast Hungary. Multivariable logistic regression models adjusting for age, sex, education, financial status, chronic diseases, and activity limitations were used to investigate the association between type of residence and health service use. Among the study participants, 62.3% were female, 38.3% attained primary education, 12.5% reported a bad or very bad financial situation and 52.6% lived in urban areas. Overall, 24% of the elderly rated their health as very good or good (27.8% in urban and 19.7% in rural areas), while 57.8% (52.6% and 63.5% in urban and rural areas) reported limitations in daily activities. Compared to urban residents, rural residents reported lower rates of dentist visits (p = 0.006), specialist visits (p = 0.028), faecal occult blood testing (p < 0.001), colorectal cancer screening with colonoscopy (p = 0.014), and breast cancer screening (p = 0.035), and a higher rate of blood pressure measurement (p = 0.042). Multivariable models indicated that urban residence was positively associated with faecal occult blood testing (OR = 2.32, p = 0.014), but negatively associated with blood pressure (OR = 0.42, p = 0.017) and blood glucose measurements (OR = 0.48, p = 0.009). These findings highlight the influence of residence on health service utilization among older adults in Hungary. Further comprehensive studies are needed to better understand the health needs of the elderly population and to develop policies aimed at promoting healthy aging in CEE countries.

Beyond diagnosis: Investigating factors influencing health-related quality of life in older people with type 2 diabetes in Slovenia

AIMS

To examine the present state of health-related quality of life (HRQOL) among elderly individuals with type 2 diabetes (T2D) receiving integrated care and identify risk factors associated with low HRQOL.

METHODS

A multi-centre cross-sectional survey among elderly individuals with T2D, treated in Slovenian urban and rural primary care settings was performed. HRQOL was investigated using EuroQol 5-dimension (EQ-5D) questionnaire and Appraisal of Diabetes Scale (ADS). Furthermore, socio-demographic, clinical, and laboratory data were collected. Low HRQOL was defined as EQ-5D utility score <10%. Statistical analysis was performed using univariate and multivariate binary logistic regression statistics.

RESULTS

Examining 358 people with median age of 72 (range 65-98) years and with a mean EQ-5D utility score of 0.80, the study found that lower HRQOL correlated with older age, higher body mass index (BMI), lower education, elevated depressive symptoms, increased challenges across all EQ-5D dimensions, and less favourable appraisal of diabetes. When considering age, gender, education, and HbA1c, the main predictors of low HRQOL were BMI (OR 1.35, 95% CI 1.04-1.76, p = 0.025) and ADS score (OR 1.63, 95% CI 1.13-2.35, p = 0.009).

CONCLUSIONS

To improve HRQOL, integrated care models should consider interventions that target mental health, obesity prevention, chronic pain management, diabetes education, self-management, and treatment plan personalisation.

Is it worth it? Greater risk aversion with lower life satisfaction among depressed individuals

Decisions of individuals with depression are often risk-averse. Risk-aversion may also extend to decisions regarding treatment, which may cause individuals to forgo or delay treatment. It is also well established that depression is associated with lower satisfaction with life. However, whether life satisfaction is associated with risk aversion for individuals with depression is not yet known. Three groups of participants (Depressed: n = 61; Chronic pain: n = 61; Comorbid depression and pain: n = 58) completed a clinical interview and several self-report questionnaires, including the Satisfaction with Life Scale (SWLS). Participants also completed two utility elicitation tasks: time trade-off (TTO), which measures utilities of health states without implied risks, and standard gamble (SG), which measures utilities of health states in the presence of risk (presented in this study as a hypothetical clinical trial described as having both potential harms and benefits). Risk aversion is defined as the difference in the utility ratings generated via SG and via TTO. For both TTO and SG, individuals evaluated their own depression or pain. When perfect health was used as a hypothetical benefit in TTO and SG tasks, satisfaction with life was not associated with risk preferences, for either depressed participants or participants with chronic pain (all ps ns). However, for participants with depression, when the hypothetical benefit was a more ecologically valid 'mild' depression in TTO and SG tasks, lower satisfaction with life was associated with greater risk aversion (p < .005; p < .03). For depressed individuals, therefore, lower satisfaction with life may be associated with risk aversion regarding treatments when benefits are seen as minor, which may result in treatment avoidance and, consequently, further worsening of both symptoms and life satisfaction.

Parenting Students and Indicators of Financial Stability, Health, and Academic Success: Findings from a Population-Based Sample of Public Urban University Students

Parenting students constitute a significant portion of the college population, with 22% of undergraduate students nationwide managing the dual responsibilities of parenthood and education. Single-parenting students face disproportionate challenges to achieving academic success. This study examines the health, financial, and academic aspects of parenting students attending a large, urban public university, specifically comparing single parents to their married or cohabiting counterparts and non-parenting students in New York City. We collected data from 2104 participants, including 142 single parents and 119 married or cohabiting parents, through a cross-sectional survey. Using adjusted regression models, we evaluated the associations between parenting status and financial, health, and academic factors. Our findings reveal that, in comparison to non-parents, single parents are significantly more likely to carry debt (adjusted odds ratio [aOR] 1.81), rely on food assistance (aOR 5.03), and achieve slightly lower GPAs (β - 0.11). Single parents also work more hours (aOR 1.66) and have an increased likelihood of facing debt (aOR 2.66), housing difficulties (aOR 2.80), food insecurity (aOR 2.21), and lower GPAs (β - 0.22) compared to their married or cohabiting peers. The disaggregation of single and married or cohabiting parents reveals significant disparities, emphasizing the vulnerability of single-parenting students in higher education. Targeted interventions addressing issues like food security and housing are essential to support the academic success of single parents.

Comparison of soluble dietary fibers from various quinoa microgreens: Structural characteristics and bioactive properties

Quinoa (Chenopodium quinoa Willd.) microgreens are widely consumed as healthy vegetables around the world. Although soluble dietary fibers exist as the major bioactive macromolecules in quinoa microgreens, their structural characteristics and bioactive properties are still unclear. Therefore, the structural characteristics and bioactive properties of soluble dietary fibers from various quinoa microgreens (QMSDFs) were investigated in this study. The yields of QMSDFs ranged from 38.82 to 52.31 mg/g. Indeed, all QMSDFs were predominantly consisted of complex pectic-polysaccharides, e.g., homogalacturonan (HG) and rhamnogalacturonan I (RG I) pectic domains, with the molecular weights ranged from 2.405 × 104 to 5.538 × 104 Da. In addition, the proportions between RG I and HG pectic domains in all QMSDFs were estimated in the range of 1: 2.34-1: 4.73 (ratio of galacturonic acid/rhamnose). Furthermore, all QMSDFs exhibited marked in vitro antioxidant, antiglycation, prebiotic, and immunoregulatory effects, which may be partially correlated to their low molecular weights and low esterification degrees. These findings are helpful for revealing the structural and biological properties of QMSDFs, which can offer some new insights into further development of quinoa microgreens and related QMSDFs as value-added healthy products.

Development and validation of Unsuccessful Disengagement Aging Scale (UDAS) for older adults

The present study aimed to develop a precise and reliable measure of unsuccessful disengagement among older adults, defined as involuntary withdrawal from societal roles and norms due to familial or societal pressure, resulting in the transfer of responsibilities to the younger generation. High scores on the Unsuccessful Disengagement Aging Scale (UDAS) were indicative of a greater degree of unsuccessful disengagement. The study was conducted in two parts: Study I involved a purposive sample of 200 participants, whereas Study II involved a purposive sample of 500 occupationally retired older adults aged between 65 and 85 years. The constructs of the study were measured using the UDAS, Depression Anxiety and Stress Scale, and Identity and Experiences Scale. In Study I, the UDAS was subjected to an Exploratory Factor Analysis, which revealed a clear four-factor solution with high factor loadings and internally consistent factors. This factor structure was confirmed through Confirmatory Factor Analysis in Study II. Construct validity was established through the UDAS's significant positive correlation with depression and non-significant correlation with assimilation identity style. Furthermore, the mean UDAS score of older adults suffering from chronic physical ailments such as hypertension, diabetes, cardiac problems, hepatitis, ulcers, liver problems, arthritis, and joint pain was significantly higher than that of healthy older adults, indicating the concurrent validity of the UDAS in distinguishing between ill and healthy older adults. Overall, the results indicated that the UDAS was a reliable and valid instrument for measuring unsuccessful disengagement in older adults.

Effects of HMB on Endurance Performance in a Healthy Population: A Systematic Review and Meta-Analysis

ABSTRACT

Fernández-Landa, J, Todorovic, N, Santibañez-Gutierrez, A, Ostojic, SM, Calleja-González, J, Sekulic, D, and Mielgo-Ayuso, J. Effects of HMB on endurance performance in a healthy population: a systematic review and meta-analysis. J Strength Cond Res 38(4): e202-e210, 2024-β-hydroxy-β-methylbutyrate (HMB) has been used extensively as a dietary supplement for athletes and physically active people. However, the ergogenic effect of HMB supplementation on endurance performance is still unclear. Therefore, this systematic review and meta-analysis (SRMA) aimed to assess HMB supplementation on endurance performance and V̇O 2 max . This SRMA followed PRISMA guidelines. Three electronic databases were searched (PubMed/Medline, Web of Science [WOS], and Scopus) from inception until April 3, 2023. In this SRMA, human experimental trials, controlled with a placebo group, assessing the effect of HMB supplementation on endurance performance in a healthy population were included. The quality of the studies was assessed by the Physiotherapy Evidence Database (PEDro) scale. The study protocol was registered in the Prospective Register of Systematic Review (PROSPERO): CRD42022341790. Eleven studies involving 279 participants met the inclusion criteria. The results displayed a significant improvement on endurance performance (pooled standardized mean difference [SMD] = 0.58 [0.28-0.87]) and V̇O 2 max (pooled SMD = 0.58 [0.21-0.95]) after HMB ingestion. Moreover, after the exclusion of the studies not evenly distributed around the base of the funnel plot, the results continued to be significantly positive in endurance performance (pooled SMD = 0.38 [0.22-0.53]) and V̇O 2 max (pooled SMD = 0.25 [0.09-0.42]). In conclusion, HMB (3 g·d -1 ) ingestion during 2-12 weeks significantly improves endurance performance and V̇O 2 max .

Pituitary volumes in patients with adjustment disorder

The pituitary gland plays an important role in the stress response mechanism. Given the direct link between adjustment disorder and stress, we hypothesized that there might be changes in the pituitary gland in these patients. The study comprised a patient group of 19 individuals with adjustment disorder according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, and 18 healthy controls. The mean pituitary gland volumes of the patient group were not statistically significantly different from those of the healthy control group (80.81 ± 1.82 mm3 in patients with adjustment disorder vs. 81.10 ± 7.04 mm3 in healthy controls, with a statistically nonsignificant difference of P > 0.05). This finding is contrary to our previous findings in anxiety-related disorders. In this regard, adjustment disorder is not similar to anxiety-related disorders in terms of pituitary gland volumes. We should also clearly state that our study is a pioneering study and that studies with large samples are needed to support our findings. The limitations of our study can be attributed to the small sample size, the utilization of a cross-sectional design, and the inclusion of patients using psychotropic drugs.

Evaluation of the demographic characteristics and general health status of earthquake survivors affected by the 2023 Kahramanmaraş earthquake; a section from Gaziantep Nurdağı district

BACKGROUND

An earthquake with a magnitude of 7.7 occurred in Pazarcık District of Turkey at 04.17 on February 6, 2023 and another earthquake of 7.6 occurred at 13.24 on the same day. This is the second largest earthquake to have occurred in Turkey. The aim of this study is to investigate the earthquake-related level of knowledge, attitudes and behaviours, general health and psychological status of survivors who were affected by the 2023 Kahramanmaraş Earthquake and who were living in Nurdağı District of Gaziantep after the earthquake.

METHODS

Data of 2317 individuals older than 18 years of age who were living in earthquake neighbourhoods, tents and containers in Nurdağı District of Gaziantep were examined. Variables were evaluated to find out the demographic characteristics and general health status of earthquake victims. General Health Questionnaire (GHQ-12) was used to find out psychological states of earthquake victims.

RESULTS

The rate of injuries was 14.2% and leg and foot injuries were the most common with 44.2%. The relationship between injury status; and age, marital status, and being trapped under debris was revealed (p < 0.05). Mean GHQ-12 score of the survivors was 3.81 ± 2.81 and 51.9% experienced psychological distress. In the evaluation with logistic regression, it was found that female gender, being injured in the earthquake, loss of first degree and second degree relatives (with a higher rate in loss of first degree relative), having a severely damaged -to be demolished house and having a completely destroyed house were correlated with higher level of psychological distress (p < 0.05).

CONCLUSION

General characteristics, injury prevalence and affecting factors of earthquake survivors were evaluated in the present study. Psychological distress was found in victims. For this reason, providing protective and assistive services to fight the destructive effects of earthquake is vital. Accordingly, increasing the awareness of people residing in earthquake zones regarding earthquakes is exceptionally important.

Use and Interest in Virtual Reality for Mental and Physical Health in a U.S. Population-Based Sample of Low-Income Veterans

Virtual reality (VR) represents a new way to deliver health interventions, but research is needed on experience and interest in using VR for health among important subgroups in the United States. This descriptive study examined these issues among low-income veterans in the United States. Data were analyzed from a nationally representative sample of 1,028 low-income veterans surveyed in late 2022-early 2023. The results showed that while only 10 percent of the sample had ever used a VR headset, 35 percent of veterans reported they would be "somewhat/very willing" to use VR for mental health or substance use problems. Veterans with higher levels of education (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI] = 1.07-1.47), lower mental health functioning (aOR = 0.96, 95% CI = 0.94-0.98), and previous VR experience (aOR = 5.30, 95% CI = 2.96-9.48) were significantly more willing to use VR to treat their mental health or substance use problems. These findings suggest many veterans are willing to use VR to improve their mental health, and they could benefit from greater exposure and education about VR-based interventions.

Quantifying the Relationship Between Unilateral Induced Metamorphopsia and Stereopsis Impairment

Purpose

To investigate the relationship between unilateral metamorphopsia, characterized by visual distortions in one eye, and impaired stereopsis.

Methods

Utilizing both near and distance measurements through advanced testing systems, including 4K smartphones and an active shutter three-dimensional system, we simulated varying degrees of unilateral metamorphopsia in 30 healthy young adults aged between 21 and 29 years. Two types of contour-based stereotest symbols, lines and squares, were developed. Distortions were classified into six distinct patterns, each further divided into eight grades of severity. Participants were tasked with identifying visual targets, and their stereothresholds were determined under different conditions of induced distortion. Stereopsis was measured within a range of 2.9 to 1.0 log arcsec, at 0.2 log arcsec intervals. Stereopsis changes under different distortion scenarios were analyzed using the generalized estimating equations, with a sequential Bonferroni adjustment applied for pairwise comparisons.

Results

A direct and quantifiable correlation was observed between the severity of metamorphopsia and reductions in stereopsis. As the degree of visual distortion increased, notably in both frequency and amplitude, there was a corresponding decline in stereopsis. This relationship held true in both near and distance measurements of stereopsis. Statistical analyses further reinforced these findings, highlighting a significant detrimental effect of distortion components on stereoacuity.

Conclusions

The findings highlight the clinical significance of understanding the interplay between unilateral metamorphopsia and stereopsis. Early interventions in conditions leading to metamorphopsia might be critical to maintaining optimal stereopsis.

Haematology and biochemistry in healthy llamas at sea level

In the last years, there has been an increasing interest in llamas, not only as part of a productive system, but mostly as companion animals. Most reports regarding clinical biochemistry and haematology include few llamas and details about their health status are not available. The present study aims to provide haematological and biochemical parameters for llamas of known health status. Twenty-three non-pregnant females and seven males that live in Buenos Aires, Argentina (34°36'S, 58°22'W, at sea level) were studied. Llamas were clinically healthy, in good nutritional status. Animals were kept at grass and were fed hay bale or pellets and water ad libitum. Blood samples were collected by jugular venipuncture in spring. Packed cell volume, leucocyte count, differential white cell count, platelets count, urea, creatinine, total proteins, albumin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, glucose, calcium and phosphate were assessed. No significant differences were observed between males and females, except for platelet count and calcium, which was greater in males (P˂0.01). Values obtained for the different parameters were similar to those previously reported, except for monocytes, alkaline phosphatase, glucose and calcium, that were lower and lymphocytes and platelets count, that were higher in this study. In conclusion, different ambient and methodological conditions might affect some parameters. The parameters hereby presented are representative of llama's population living at sea level in South America.

Neurological Health in Sexual and Gender Minority Individuals

Despite representing a significant proportion of the U.S. population, there is a paucity of population-based research on the health status and health needs of sexual and gender minority (SGM) individuals in neurology. Compared with heterosexual peers, some SGM populations have a higher burden of chronic health conditions. In parallel, SGM individuals are more likely to experience stigma and discrimination producing psychological distress, which may contribute to and be compounded by reduced health care access and utilization. In this narrative review, we summarize the existing literature on common neurological health conditions such as stroke, headache, epilepsy, movement disorders, and traumatic brain injury through the lens of intersection of SGM identity. Special focus is attuned to social determinants of health and gender-affirming hormonal therapy. Given the limitations in the available literature, there is an urgent unmet need for datasets that include sexual orientation and gender identity information, as well as funding for research that will characterize the prevalence of neurological conditions, unique risk factors, and health outcomes in SGM populations. In the health care community, providers should address deficiencies in their professional training and integrate inclusive language into their clinical skillset to build trust with SGM patients. There is an opportunity in neurology to proactively engage SGM communities, collaborate to remove barriers to care, promote resilience, and develop targeted interventions to ensure high-quality, culturally competent care for SGM populations to improve neurological health for all.

The CEPH aging cohort and biobank: a valuable collection of biological samples from exceptionally long-lived French individuals and their offspring for longevity studies

The increasing aging of the human population is currently and for the coming decades a major public health issue in many countries, requiring the implementation of global public health policies promoting healthy and successful aging. Individuals are not equal in the face of aging and some can present exceptional healthspan and/or lifespan, which are notably influenced by both genetic and environmental factors. Research and studies on human aging, healthy aging and longevity should rely in particular on cohorts of long-lived individuals, also including biological samples allowing studies on the biology of aging and longevity. In this manuscript, we provide for the first time a complete description of the CEPH (Centre d'Etude du Polymophisme Humain) Aging cohort, an exceptional cohort recruited during the 90s to 2000s, including more than 1700 French long-lived individuals (≥ 90 years old) born between 1875 and 1916 as well as for some of them their siblings and offspring. Among the participants, 1265 were centenarians, including 255 semi-supercentenarians ([105-110] years old) and 25 supercentenarians (≥ 110 years old). The available anthropometric, epidemiologic and clinical data for the cohort participants are described and especially the collection of blood-derived biological samples associated with the cohort which includes DNA, cryopreserved cells and cell lines, plasma, and serum. This biological collection from the first cohort of centenarians in the world is an inestimable resource for ongoing and future molecular, cellular, and functional studies aimed at deciphering the mechanisms of human (successful) aging and longevity.

Cardiorespiratory fitness and submaximal exercise dynamics in normal-weight obesity and metabolically healthy obesity

PURPOSE

Cardiorespiratory fitness (CRF) is critical for cardiovascular health. Normal-weight obesity (NWO) and metabolically healthy obesity (MHO) may be at increased risk for cardiovascular disease, but a comparison of CRF and submaximal exercise dynamics against rigorously defined low- and high-risk groups is lacking.

METHODS

Four groups (N = 40; 10/group) based on body mass index (BMI), body fat %, and metabolic syndrome (MetS) risk factors were recruited: healthy controls (CON; BMI 18.5-24.9 kg/m2, body fat < 25% [M] or < 35% [F], 0-1 risk factors), NWO (BMI 18.5-24.9 kg/m2, body fat ≥ 25% [M] or ≥ 35% [F]), MHO (BMI > 30 kg/m2, body fat ≥ 25% [M] or ≥ 35% [F], 0-1 risk factors), or metabolically unhealthy obesity (MUO; BMI > 30 kg/m2, body fat ≥ 25% [M] or ≥ 35% [F], 2 + risk factors). All participants completed a V ˙ O2peak test on a cycle ergometer.

RESULTS

V ˙ O2peak was similarly low in NWO (27.0 ± 4.8 mL/kg/min), MHO (25.4 ± 6.7 mL/kg/min) and MUO (24.6 ± 10.0 mL/kg/min) relative to CON (44.2 ± 11.0 mL/kg/min) when normalized to total body mass (p's < 0.01), and adjusting for fat mass or lean mass did not alter these results. This same differential V ˙ O2 pattern was apparent beginning at 25% of the exercise test (PGroup*Time < 0.01).

CONCLUSIONS

NWO and MHO had similar peak and submaximal CRF to MUO, despite some favorable health traits. Our work adds clarity to the notion that excess adiposity hinders CRF across BMI categories.

CLINICALTRIALS

gov registration: NCT05008952.

Sex Differences in Postinjury Health Profiles Among U.S. Military Personnel Following Deployment-Related Concussion

Background: Women in the U.S. military are now authorized to serve in direct combat occupations. This may increase their risk of combat injuries, such as concussion, in future conflicts. Knowledge of sex differences in health profiles after concussion is paramount for military medical planning efforts. The purpose of this study was to assess sex-related differences in health profiles among U.S. military personnel following deployment-related concussion. Materials and Methods: We conducted a retrospective study of service members who sustained a concussion during combat deployment between 2004 and 2013. Postinjury diagnoses were abstracted from outpatient encounters in electronic health records for 24 months after concussion. We used hierarchical clustering to identify clusters, termed "health profiles," and logistic regression to determine whether sex predicted membership in the health profiles. Results: The study sample included 346 women and 4536 men with deployment-related concussion. Five postinjury health profiles were identified and classified as no morbidity, back pain, tinnitus/memory loss, posttraumatic stress disorder/postconcussion syndrome, and multimorbidity. Women relative to men had higher odds of membership in the back pain (odds ratio [OR] = 1.32; 95% confidence interval [CI] = 1.05-1.67) and multimorbidity profiles (OR = 1.44; 95% CI = 1.03-2.00) and lower odds than men in the tinnitus/memory loss profile (OR = 0.62; 95% CI = 0.42-0.91). Conclusions: Postinjury health profiles among U.S. service members differ by sex following deployment-related concussion, particularly with a higher burden of multimorbidity among women than men, which may require interdisciplinary care. Women also had higher odds of membership in the back pain profile and lower odds in the tinnitus/memory loss profile than men. To prepare for future military operations where women may have greater exposure to combat, continued research elucidating health-related sex differences after deployment-related concussion is imperative.

Less Favorable Nutri-Score Consumption Ratings Are Prospectively Associated with Abdominal Obesity in Older Adults

Nutri-Score is a front-of-package (FOP) labeling designed to assist consumers in selecting healthier options at the point of purchase and ultimately enhance their health. This study aims to evaluate the association between the Nutri-Score system and incident abdominal obesity (AO) in community-dwelling older adults. A prospective cohort of 628 individuals aged ≥ 60 were recruited in Spain between 2008-2010 and were reexamined between 2015-2017. Dietary intake was evaluated utilizing a validated computerized dietary history. Food was categorized based on the Nutri-Score system into five levels from A (green, representing the best quality) to E (red, representing the poorest quality). A five-color Nutri-Score dietary index (5-CNS DI) in g/day/kg was calculated for each participant. AO was determined by a waist circumference (WC) of ≥102 cm for men and ≥88 cm for women. Logistic regression models were adjusted for the main potential confounders. During a mean six-year follow-up, 184 incident cases of AO occurred. The odds ratio (OR) and 95% confidence interval (CI) for AO, when comparing the highest and lowest quartiles of the 5-CNS DI, were 2.45 (1.17-5.14), with a p-value for trend of 0.035. In sensitivity analyses, the OR was 2.59 (1.22-5.52, p-trend: 0.032) after adjustment for WC at baseline, and 1.75 (0.74-4.18, p-trend: 0.316) after adjustment for ultra-processed food consumption. In conclusion, less favorable food-consumption ratings in the Nutri-Score are associated with incident AO in the elderly. These findings support the use of this FOP system to potentially improve metabolic health.

Living in public rental housing is healthier than private rental housing a 9-year cohort study from Japan Gerontological Evaluation Study

Housing tenure is an important aspect to determine health. However, even though renters tend to have more socioeconomic disadvantages than homeowners, mortality risk between private and public renters compared with homeowners remains unclear. Japanese public rented housing, such as the Urban Renaissance Agency, has been developed for supplying an adequate living environment since 1950s. This study aimed to examine the mortality risk among older Japanese residents living in private and public rented houses compared with those living in owner-occupied houses using 9-year follow-up data. This study drew upon a 9-year follow-up of participants in the Japan Gerontological Evaluation Study, a population-based cohort study of Japanese independent adults aged ≥ 65 years. Mortality from 2010 to 2019 was analyzed for 44,007 respondents. Housing tenure was defined by a questionnaire. Cox regression models were used for calculating the hazard ratio for mortality. Bonferroni correction was used to account for multiple testing between rental houses. Overall, 10,638 deaths occurred during the follow-up period. Compared with housing owners, all rental housing groups had a significantly higher risk of mortality. Among renters, participants who lived in public rental housing had the lowest risk of mortality even after adjusting for sociodemographic characteristics, health status, social status, and environmental status. Multiple testing among renters with Bonferroni correction showed that public renters had 0.80 times (95% CI 0.72-0.89) lower mortality risk than private renters. Although Japanese older adults living in public rental housing had a higher mortality risk than homeowners, this risk was lower than that among private renters. A positive neighborhood environment based on well-planned urban development may have contributed to this result. The results suggest that planned urban development lowers the risk of mortality in older renters in Japan.

Profiles of well-being in French older adults and associations with successful aging and personality: findings from the SHARE project

Maintaining the well-being of the older adults is a primary concern in gerontology. This study determined different profiles of well-being (WB) and compared the profiles in terms of successful aging (SA), personality, and sociodemographic variables. The study sample consisted of 856 adults aged 65-98 years. WB was taken into account in an eudemonic and hedonic approach. SA was measured by assessing the three distinct components of Rowe and Kahn's model (Successful aging. Gerontol 37(4):433-440. 10.1093/geront/37.4.433, 1997), personality by the Big Five Inventory, and sociodemographic variables. Latent class analyses (LCA) determined the number of WB profiles, and ANOVAs and Chi2 tests to compare them. The LCA revealed three WB profiles: Profile 1 (9.35%, n = 80), Profile 2 (37.38%, n = 320), and Profile 3 (53.27%, n = 456) in which participants reported lower, intermediate, and higher WB scores. Our results confirm that a high level of WB (Profile 3) can be linked to the components of SA and socio-demographic characteristics (age, marital status, level of education, income). This raises questions about the injunctions concerning healthy aging that older people integrate. It's also interesting to note that the intermediate profile (profile 2) can be either close to the "lower WB" profile (Profile 1) in terms of openness, conscientiousness, and agreeableness or to the "higher WB" profile (Profile 3) in terms of extraversion. However the three profiles do not have the same level of neuroticism. These results also showed the importance of adapting the support offered to older people according to their health status and/or individual characteristics.

Parameterization of Biomechanical Variables through Inertial Measurement Units (IMUs) in Occasional Healthy Runners

Running is one of the most popular sports practiced today and biomechanical variables are fundamental to understanding it. The main objectives of this study are to describe kinetic, kinematic, and spatiotemporal variables measured using four inertial measurement units (IMUs) in runners during treadmill running, investigate the relationships between these variables, and describe differences associated with different data sampling and averaging strategies. A total of 22 healthy recreational runners (M age = 28 ± 5.57 yrs) participated in treadmill measurements, running at their preferred speed (M = 10.1 ± 1.9 km/h) with a set-up of four IMUs placed on tibias and the lumbar area. Raw data was processed and analysed over selections spanning 30 s, 30 steps and 1 step. Very strong positive associations were obtained between the same family variables in all selections. The temporal variables were inversely associated with the step rate variable in the selection of 30 s and 30 steps of data. There were moderate associations between kinetic (forces) and kinematic (displacement) variables. There were no significant differences between the biomechanics variables in any selection. Our results suggest that a 4-IMU set-up, as presented in this study, is a viable approach for parameterization of the biomechanical variables in running, and also that there are no significant differences in the biomechanical variables studied independently, if we select data from 30 s, 30 steps or 1 step for processing and analysis. These results can assist in the methodological aspects of protocol design in future running research.

Who chooses "healthy" meals? An analysis of lunchtime meal quality in a workplace cafeteria

BACKGROUND

The workplace can play an important role in shaping the eating behaviors of U.S. adults. Unfortunately, foods obtained in the workplace tend to be low in nutritional quality. Questions remain about the best way to approach the promotion of healthy food purchases among employees and to what extent health promotion activities should be tailored to the demographic characteristics of the employees. The purpose of this study was to (1) assess the nutritional quality of lunchtime meal purchases by employees in cafeterias of a large organization, (2) examine associations between lunchtime meal quality selection and the demographic characteristics of employees, and (3) determine the healthfulness of foods and beverages offered in the cafeterias of this organization.

METHODS

A cross-sectional analysis was conducted using secondary data from a food labeling study implemented in three worksite cafeterias. Demographic data was collected via surveys and meal data was collected using a photo capture system for 378 participants. The Healthy Eating Index 2015 (HEI-2015) was used to determine meal quality and a total score for the menu of options available in the cafeterias during the study period. Summary statistics were generated, and the analysis of variance (ANOVA) was used to compare the HEI-2015 scores between groups.

RESULTS

The mean HEI-2015 total score for the menu items offered (n = 1,229) in the cafeteria during the study period was 63.1 (SD = 1.83). The mean HEI-2015 score for individual lunchtime meal observations (n = 378) was 47.1 (SD = 6.8). In general, HEI-2015 total scores were higher for non-smokers, individuals who self-identified as Asian, had higher physical activity levels, scored higher on numeracy and literacy assessments, and reported higher education levels, incomes, and health status.

CONCLUSIONS

The overall HEI-2015 scores indicate that the menu of options offered in the cafeterias and individual meal selections did not align with the Dietary Guidelines for Americans, and there were significant associations between average lunchtime meal quality scores and several demographic characteristics. These results suggest that healthy eating promotion activities in workplaces may need to be tailored to the demographic characteristics of the employees, and efforts to improve the food environment in the workplace could improve meal quality for all employees.