Life skills, wealth, health, and wellbeing in later life

Cognition and Wealth Changes in Mid-to-later Life: A Latent Class Trajectories Approach Using the Health and Retirement Study

ObjectivesTo assess how cognitive trajectories from mid-to-later life relate to wealth change, overall and by mid-life income. Methods: Data were from participants (51-64 years) in the 2000-2018 U.S. Health and Retirement Study who were cognitively healthy at baseline (year 2000; unweighted n = 3821). Longitudinal latent class analyses generated cognitive and wealth trajectories, independently, and multinomial logistic regressions estimated the association between cognitive trajectories and wealth profiles, overall and by median income. Results: We identified three cognitive: cognitively healthy (CH), increasing cognitive impairment (ICI), and increasing dementia (ID) and four wealth profiles: stable wealth loss (SWL), delayed gradual wealth loss (DGWL), stable wealth gain (SWG), and gradual wealth gain (GWG). The ID group had higher probability of being in the SWL group and lower probability of SWG, which was more pronounced in respondents with greater median income. Discussion: Individuals with ID may be vulnerable to wealth loss, particularly for middle-class households.

Letting people flourish: defining and suggesting skills for maintaining and improving positive health

Background

The concept of "positive health" emerged from the need for a holistic and more dynamic perspective on health, emphasising the ability of individuals to adapt and self-manage. The positive health conversation tool helps understand how people score on six positive health dimensions. However, skills within these dimensions to maintain or improve health have not yet been described. This is important for enabling individuals to put health advice into practise. Therefore, this paper aims to define and suggest skills for maintaining and improving positive health.

Subsections

Suggestions for definitions of skills within the positive health dimensions are described using the functional, interactive, and critical health literacy framework. Additionally, executive functions and life skills were incorporated. Moreover, the environment's role in these individual skills was noted, mentioning organisational health literacy that emphasises organisations' responsibility to provide comprehensible health information to all individuals. We propose that health promotion interventions can incorporate the proposed skills in practical exercises while aligning intervention materials and implementation tools with end-users and implementers.

Discussion and conclusion

The suggested skills for maintaining and improving positive health are a first step towards a more comprehensive understanding and open to discussion. These skills may also be applied to other practical conversation tools for maintaining or improving health. Increasing positive health through the defined skills may be especially relevant to those with a lower socioeconomic position who also have limited health literacy and thereby may contribute to reducing health inequalities. Taken together, strengthening the defined skills may hopefully contribute to allowing people to flourish in life.

Youth focused life skills training and counselling services program-An inter-sectoral initiative in India: Program development and preliminary analysis of factors affecting life skills

OBJECTIVES

This paper describes the methodology of developing and implementation of a youth focused life skills training and counselling services programme (LSTCP) and assessment of factors associated with life skills of participants pre-training.

DESIGN

Development of all aspects of LSTCP (modules, methods and evaluation) was through a consultative process. Experiential learning based facilitation was decided as the approach for training participants. A quasi-experimental design with pre, post and follow-up assessment post-training was finalised. Data collection was done using specifically developed semi-structured self-administered questionnaire.

RESULTS

Multivariable logistic regression with life skills as outcome and various exposure variables was performed. About 2/3rd of participants had high level of life skills (68%). Increased score of extraversion (AOR = 1.57,95% CI = 1.32-1.85), agreeableness (AOR = 1.42,95% CI = 1.16-1.73), conscientiousness (AOR = 1.9,95% CI = 1.55-2.33), physical (AOR = 1.03,95% CI = 1.01-1.04), environmental (AOR = 1.02,95% CI = 1.004-1.03) and social quality of life (AOR = 1.01,95% CI = 1.006-1.02) were associated with high life skills score. Higher score of neuroticism (AOR = 0.66,95% CI = 0.53-0.79) was associated with low life skills score.

CONCLUSION

The results presented provide an opportunity to understand the evolution of factors affecting life skills during the follow-up of this study. This study throws light on development of LSTCP for apparently healthy population in a setting like India and its states.

Subjective social status and allostatic load among older people in England: A longitudinal analysis

BACKGROUND

Subjective social status has a known association with health, whereby better health outcomes are observed for those with higher perceived status. In this research, we offer new evidence on the status-health relationship using a rigorous methodological approach that considers both observed and unobserved confounders.

METHODS

We use 5 waves of data spanning 15 years from the English Longitudinal Study of Ageing and derive a measure of allostatic load with biomarkers as an objective measure of health. We apply 'within-between' panel regression models.

RESULTS

Models reveal the expected association between subjective status and health when comparing participants (the 'between' estimate), but no association when examining temporal variation within participants (the 'within' estimate). When controlling for personality traits including optimism, and parental education, the 'between' association between subjective status and allostatic load is reduced but does not disappear.

CONCLUSIONS

Person-level confounders play some role in explaining the observed link between subjective status and health. The exact nature of the link, including the role of psychological pathways and early-life confounders, remains a question for future research.

The effect of college degree attainment on neurodegenerative symptoms in genetically at-risk women

Using longitudinal data, the present study examined the association between college degree attainment and the manifestation of neurodegenerative symptoms among women (n = 93) at elevated genetic risk. The neurodegenerative symptoms investigated in this study are due to FXTAS (Fragile X-associated Tremor/Ataxia Syndrome), a condition with onset after age 50. Those at risk for FXTAS have a mutation of a single gene found on the X chromosome. FXTAS is characterized by intention tremor, gait ataxia, executive function deficits, memory issues, and neuropathy. College degree attainment has been shown to provide neuroprotective effects in the general population, delaying the development of neurodegenerative conditions such as Alzheimer's disease. For this reason, college degree attainment is a potentially salient resource for those at risk of FXTAS. The results of the present research indicated significantly more severe FXTAS symptoms in women who did not attain a college degree as compared with those who were college graduates, although the two groups were similar in age, genetic risk, household income, health behaviors, and general health problems. Furthermore, symptoms in those who did not attain a college degree worsened over the 9-year study period at a significantly faster rate than the college graduates. The association between college degree attainment and FXTAS symptoms was significantly mediated by depression, which was lower among the graduates than those who did not attain a college degree. Thus, the present research is an example of how a sociodemographic factor can mitigate neurodegenerative conditions in genetically at-risk adults.

Preventive Model of Formation of Health-save Competence of Student Youth with the Use of Natural Physiotherapy

Aim: The aim of the study is to determine the basic conceptual, methodological and organizational-methodological aspects of the process of forming health competence of students using natural physiotherapy, to formalize them in the form of a preventive model. Materials and Methods: The pedagogical experiment lasted during 2019-2021 in Sumy State Pedagogical University named after A.S. Makarenko. The pedagogical research was attended by 128 first- and second-year students majoring in «Physical Education», «Physical Therapy, Occupational Therapy» Sumy State Pedagogical University named after A.S. Makarenko. The research methods were as follows: analysis of special and scientific literature, pedagogical observation, pedagogical experiment, pedagogical testing, methods of statistical data processing. Results: In order to organize and systematize this theoretical and practical experience, we have developed a preventive model of forming health-save competence of students, which allows to form an idea of the determinants of health, ways to strengthen it, guide students to follow the rules of healthy living and application of a wide range of natural physiotherapeutic means. Conclusions: The pedagogical model of formation of health-save competence orients students on observance of rules and norms of a healthy way of life with application of natural physiotherapeutic means (physical exercises, water procedures, air, solar heat and light), systematizes and formalizes representations of integral, multilevel, integrative, interdisciplinary educational process in the conditions of educational institution.

The role of life skills in developing an authentic leadership attitude in public health students: a multicenter cross-sectional study in Poland

Background

Decision-making skills are considered crucial life skills that condition proper social functioning within groups (i.e., support authentic leadership skills and increasing one’s chances of success and wellbeing in life). Nonetheless, the number of scientific papers addressing the role of life skills in developing authentic leadership skills in public health students is limited. The aim of the present study was to develop a theoretical model to determine the role of selected life skills in developing authentic leadership skills in public health students.

Methods

The study was conducted from January 16 through February 28, 2018. In total, 653 students undertaking in-service training in Master’s degree programs qualified for the study, and complete data sets were obtained from 329 students (response rate 50.38%). The data were collected by means of a paper questionnaire. Four research tools were used in the study: The Authentic Leadership Self-Assessment Questionnaire, The Moral Foundations Questionnaire, The General Self-Efficacy Scale, and The Youth Leadership Life Skills Development Scale.

Results

Two subgroups were identified among the public health students in the study: 1) the extra life skills training group (N = 113) and 2) the no extra life skills training group (N = 216). Both groups of study participants did not differ significantly in terms of age (M (SD): 25.0 (3.89) vs. 25.0 (3.66); t = 0.068, P = 0.946). On the other hand, clear differences were observed in the case of the respondents’ participation in voluntary service. The respondents from the extra life skills training group declared participation in voluntary activities less frequently than the respondents from the second identified group (48.7 vs. 31.9%).

Conclusions

A verified theoretical model showed that course aimed at strengthening authentic leadership competences should be modular, should focus on self-improvement and critical reflection, and should be spread over time to enable and encourage each participant to grow and flourish at their own pace.

An Examination of the Latent Structure and Reproducibility of the Life Skills Scale for Sport in Botswana and Ghana

With the growing interest in sport-based positive youth development (PYD) programs across the African continent, there is a need to establish suitable measures to evaluate the success of these programs in fostering PYD. The Life Skills Scale for Sport (LSSS) was recently developed as a sport-specific measure of life skills development. Despite its good psychometric properties among British youth sport participants, cross-cultural evidence indicates differences in the conceptualization of the eight factors measured by the LSSS. To determine the suitability of the LSSS for use in the African youth sport context, this study examined the latent structure and reproducibility of scores produced by the scale in a sample of youth sport participants from Botswana and Ghana. Cross-sectional data from a sample of 495 youth athletes (male = 51.72%), aged 12-21 years (M = 16.76, SD = 1.58), from junior and senior secondary schools was used in this study. Confirmatory factor analysis and exploratory structural equation modeling were conducted, and conventional fit indices were used to assess model fit. Results on the original LSSS model indicated the need for model re-specification in the current sample. A re-specified LSSS, consisting of the original eight factors, but only 34 of the original 43 items, demonstrated improved fit and adequate internal consistency. Scores derived from the re-specified LSSS proved to be a valid estimate of life skills development in the current sample of youth sport participants. This has important implications for the utility of the LSSS in different cultures.

"It is really just brilliant to get credits for something that is so important to you!" Skills for Life: University students' perceptions of a planned dietary life skills course

OBJECTIVE

Universities have a role in educating and empowering students to become healthy and literate citizens of the 21st century society. The aim of this study was to explore university students' perceptions regarding the relevance and utility of a planned dietary life skills course.

DESIGN

Qualitative design including focus group discussions.

SETTING

A Norwegian university with participating undergraduate students from seven different disciplines.

METHOD

Data collection included 13 semi-structured focus group discussions involving 57 university students (35 women and 22 men aged 18-38 years). The focus group discussions were recorded and transcribed verbatim. To ensure in-depth knowledge of the research participants' thoughts and reflections, thematic analysis strategy was undertaken by a team of researchers.

RESULTS

When presented to the idea of a dietary life skills course as a university course, the students were mostly positive regarding its relevance and utility, however both motivators and barriers for attending were put forward. Some mentioned potential academic course benefits, such as enhanced CV, and a few mentioned potential societal benefits such as a healthy population and sustainable food consumption. Several motivators for attending the course were launched, such as increased knowledge and cooking skills, having dinner and expanded network. The students wanted to learn about food, nutrients and health, and how to cook simple, affordable, healthy and sustainable meals. Potential barriers for attending were mostly related to practicalities, such as potential lack of alignment with ordinary study programme or too demanding lectures.

CONCLUSION

Most students acknowledged the value of a dietary life skills course and thought that such a course could benefit their personal life. This encourages the offering of such courses at university level, tailored to consider both motivators and barriers for attending.

Validation and Factorial Invariance of the Life Skills Ability Scale in Mexican Higher Education Students

The objective of this study was to validate the Life Skills Ability Scale through internal consistency and construct validity in the context of higher education in Mexico. In study 1, the reliability and factor structure of the scale were evaluated with a sample of 525 higher education students (Mage = 19.94 years, SD = 3.85). In study 2, the factor invariance of the instrument was analyzed based on sample gender, which consisted of 707 higher education students (Mage = 20.03 years, SD = 4.19). The results showed adequate reliability and construct validity with a second order model and an eight-factor structure (teamwork, goal-setting, time management, emotional skills, communication, social skills, leadership, problem-solving, and decision-making). Likewise, there was measure equivalence between men and women. In conclusion, the Spanish version of the Life Skills Ability Scale in a Mexican context is a reliable and valid instrument that allows the assessment of life skills in higher education students.

Lebenskompetenzen als Ressourcen für die psychosomatische Behandlung

Zusammenfassung. Lebenskompetenzen stellen Fähigkeiten dar, aus denen eine salutogene Lebensführung resultiert. Dadurch können sie sowohl als Basis als auch als wichtiger Indikator für den therapeutischen Prozess dienen. Hier wird ein Selbsteinschätzungsinstrument vorgestellt, welches an N = 2 054 Patientinnen und Patienten der stationären psychosomatischen Behandlung erhoben wurde und dessen Konstrukt in zweifacher Erhebung exploratorisch und konfirmatorisch validiert wurde. Der Fragebogen LK-18 umfasst 18 Items, die sich in 6 Faktoren mit je 3 Items gliedern lassen. Diese sind Wohlbefinden, Selbstregulation, Engagement, Sinnerleben, Selbstwirksamkeit, sowie Sozialkontakte. Die Werte für Cronbachs α liegen zwischen .74 und .85, im Gesamtwert bei .91. Die RMSEA von .062 deutet auf eine akzeptable Modellpassung hin. Als externe Korrelate zeigen psychosomatische Symptombelastungen nach dem ICD10-basierten Symptomrating (ISR) und posttraumatische Störungen meist mittlere negative Korrelationen im Bereich -.22 bis -.69 ( p < .001). Die Ergebnisse demonstrieren die Validität des Fragebogens und seine Veränderungssensitivität, wodurch der Einsatz in der psychosomatischen Diagnostik als geeignetes Zusatzinstrument als sinnvoll erachtet werden kann.

Impact of night shifts on sleeping patterns, psychosocial and physical well-being among healthcare professionals: a cross-sectional study in a tertiary hospital in Saudi Arabia

BACKGROUND

Shift work and night shifts are very common in healthcare organisations worldwide. However, healthcare professionals doing shift work and night shifts are exposed to several stressors with psychological, social, physical and sleeping consequences. This study aimed to evaluate the effect of night shifts on the psychosocial, physical well-being and sleeping patterns of healthcare professionals in Saudi Arabia.

METHODS

We conducted an observational cross-sectional study from July to September 2019 at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Convenience sampling technique was used to recruit healthcare providers to participate in the study. The outcomes measured included the effect of working hours of healthcare workers on psychosocial and physical health, substance use, and sleep quality and patterns. Pearson's χ² test was used to compare proportions, and Student's t-test/Analysis of variance (ANOVA) was used to examine the mean differences among different demographic groups.

RESULTS

A total of 352 healthcare providers were involved in the study, of whom only 272 were night shift workers. The mean level of job satisfaction was higher among day shift workers than night shift workers: the mean scores were 3.82 (SD=0.93) and 3.48 (SD=1.04), respectively, p=0.007. Moreover, social life was more adversely affected among night shift workers compared with day shift workers: 3.95 (SD=1.11) and 3.61 (SD=1.25), respectively, p<0.030. Likewise, family life was more adversely affected among night shift workers than day shift workers, with a mean of 3.92 (SD=1.10) and 3.50 (SD=1.21), respectively, p<0.006. Around 71% of night shift workers reported having poor-quality sleep compared with 50% of day shift workers (p=0.001).

CONCLUSION

Quality of life is poor among night shift workers than day shift workers, particularly concerning sleep and social and physical outcomes. Further research is needed to investigate factors associated with the quality of sleep and the psychosocial and physical well-being of healthcare professionals working night shifts.

Re-activating life skills in cancer patients through expressive-creative workshops: A qualitative exploratory study

Background: Cancer strongly impacts on patients' lives, undermining their life skills. This research aimed to explore the perception of efficacy of participants in a series of expressive-creative workshops (ArtLab) designed to reactivate life skills in cancer patients.Methods:Quotations of two semi-structured focus groups with ten participants in ArtLab (Mean Age = 59; SD = 11.19) enrolled at [Fondazione IRCCS Istituto Nazionale dei Tumori] have been analyzed through a priori (top-down) thematic analysis which allowed us to identify life skills provided by WHO 1948: Emotional, Relational and Cognitive.Results:Thematic analysis showed ArtLab program's effectiveness, especially regarding Emotional and Relational life skills. Cognitive skills, instead, seemed to be only partially expressed. Sub-themes articulation for each life skill has been discussed.Conclusion:This study provides encouraging results with respect to the effectiveness of expressive-creative group workshops among cancer patients.

Life Skills Development Through Sport in Brazil: A Study Based on Self-Determination Theory

This study investigated whether a large sample of youth participants' life skills development through sport was impacted by demographic variables and/or variables based on self-determination theory. Participants were 461 Brazilian youth sport (325 boys; 136 girls) aged 10-17 years (M_age = 15.12, SD = 1.44). Participants completed a self-report research survey to assess demographic variables, coach autonomy support, basic need satisfaction, and sport motivation. We analyzed data using cluster analysis, a chi-square test and multivariate analysis of variance. We found that sport participants in the high life skills development cluster were older (p = .007) and had more years of sport experience (p = .032). Compared to the low life skills development cluster, sports participants in the high life skills development cluster displayed higher scores for coach's autonomy support (p = .001), autonomy satisfaction (p = .002), competence satisfaction (p = .001), relatedness satisfaction (p = .001), and identified regulation (p = .023). In practice, these findings indicate that coaches should seek to satisfy participants' three basic psychological needs and encourage an identified regulation form of motivation when trying to promote participants' life skills development through sport.

Optimism and longevity beyond age 85

BACKGROUND

Optimism is associated with health benefits and improved survival among adults aged >65. Whether or not optimism beyond age 85 continues to confer survival benefits is poorly documented. We examine the hypothesis that being optimistic at ages 85 and 90 is associated with improved survival.

METHODS

The Jerusalem Longitudinal Study (1990-2020) assessed comorbidity, depression, cognition, social and functional status, and 5-year mortality among a representative community sample, born 1920-1921, at age 85 (n=1096) and age 90 (n=533). Overall optimism (Op-Total) was measured using a validated 7-item score from the Scale of Subjective Wellbeing for Older Persons. The four questions concerning positive future expectations (Op-Future) and three questions concerning positive experiences (Op-Happy) were also analyzed separately. We determined unadjusted mortality Hazards Ratios, and also adjusted for gender, financial difficulty, marital status, educational status, ADL dependence, physical activity, diabetes mellitus, hypertension, ischemic heart disease, cognitive impairment and depression.

RESULTS

Between ages 85-90 and 90-95 years, 33.2% (364/1096) and 44.3% (236/533) people died respectively. All mean optimism scores declined from age 85 to 90, with males significantly more optimistic than females throughout. All measures of optimism (Op-Total, Op-Future, Op-Happy) at age 85 and 90 were significantly associated with improved 5-year survival from age 85-90 and 90-95 respectively, in both unadjusted and adjusted models. Findings remained unchanged after separately excluding depressed subjects, cognitively impaired subjects, and subjects dying within 6 months from baseline.

CONCLUSIONS

These finding support the hypothesis that being optimistic continues to confer a survival benefit irrespective of advancing age.

Comparison of Behavioral Concerns Priorities among Iranian Adolescent Boys, Parents and Teachers: Reporting the Results of a Modified Delphi

Background

Adolescence is a time of risks and opportunities. This study aimed to investigate and prioritize the behavioral concerns of male adolescents.

Methods

A modified Delphi study (2018-2019) was conducted in two stages. In the first stage, adolescents' behavioral concerns were extracted based on seven qualitative interviews and a focus group. Then, a questionnaire was designed using the obtained data; also, two-round consensus-building approach (rating and ranking) through surveys were conducted among 90students, teachers and parents covered by the Health Departments of Tehran University of Medical Sciences, who had been selected using a stratified cluster random sampling method. Qualitative content analysis was used in the first stage and descriptive statistics in the second stage to analyze the data.

Results

In the first stage, eight categories emerged, including relational challenges with parents and other adults; poor interaction with peers; lack of adaptation to conditions; emotional dysregulation; self-esteem and sense of purposefulness issues; materialistic tendencies; cyberspace issues; and non-adherence to religious beliefs. Then 63 behavioral concerns were identified. In each round (rating/ranking), 29/27, 28/29, and 30/30, responses were received for students, parents and teachers, respectively. According to the specified scores given to different issues, ten top problems according to the viewpoint of different groups were extracted.

Conclusion

"lack of planning and prioritization skill", "insufficient skill for controlling crisis", and "lack of resilience" are the most important priority for male adolescents, teachers and parents, respectively. These findings can be used for planning programs based on the adolescents' behavioral concerns.

The Prospective Association of Social Integration With Life Span and Exceptional Longevity in Women

OBJECTIVES

Although stronger social relationships have been associated with reduced mortality risk in prior research, their associations with favorable health outcomes are understudied. We evaluated whether higher social integration levels were associated with longer life span and greater likelihood of achieving exceptional longevity.

METHOD

Women from the Nurses' Health Study completed the Berkman-Syme Social Network Index in 1992 (N = 72,322; average age = 58.80 years), and were followed through 2014 with biennial questionnaires. Deaths were ascertained from participants' families, postal authorities, and death registries. Accelerated failure time models adjusting for relevant covariates estimated percent changes in life span associated with social integration levels; logistic regressions evaluated likelihood of surviving to age 85 years or older among women who could reach that age during follow-up (N = 16,818).

RESULTS

After controlling for baseline demographics and chronic diseases, socially integrated versus isolated women had 10% (95% confidence interval [CI] = 8.80-11.42) longer life span and 41% (95% CI = 1.28-1.54) higher odds of surviving to age 85 years. All findings remained statistically significant after further adjusting for health behaviors and depression.

DISCUSSION

Better social integration is related to longer life span and greater likelihood of achieving exceptional longevity among midlife women. Findings suggest social integration may be an important psychosocial asset to evaluate for promoting longer, healthier lives.

Association of Noncognitive Life Skills With Mortality at Middle and Older Ages in England

IMPORTANCE

Noncognitive life skills are patterns of behavior, thoughts, and feelings that complement cognitive ability in promoting positive economic and educational outcomes. These positive attributes have been associated with favorable social and health outcomes at older ages, but their combined association with survival is not known.

OBJECTIVES

To evaluate the association of the combination of 5 noncognitive life skills with mortality, and to explore the role of sociodemographic, health, cognitive, and behavioral factors in explaining associations.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study used data from wave 5 of the English Longitudinal Study of Ageing, conducted in 2010. Participants included adults 52 years and older. Associations of scores on 5 noncognitive life skills, including conscientiousness, perseverance, emotional stability, optimism, and control, with all-cause mortality were analyzed for a mean (SD) of 7.2 (1.3) years. Data analyses were completed in November 2019.

EXPOSURES

Response to wave 5 of the English Longitudinal Study of Ageing.

MAIN OUTCOMES AND MEASURES

Noncognitive life skills scores, including conscientiousness, perseverance, emotional stability, optimism, and control, were measured by questionnaire. The main outcome was all-cause mortality, and the associations with noncognitive life skills scores were analyzed using Cox proportional hazards regressions models to estimate hazard ratios per 1-SD increase in score.

RESULTS

A total of 7850 participants (mean [SD] age, 66.5 [9.0] years; 4333 [55.2%] women) were included. Combined life skill score was positively associated with survival, with a hazard ratio of 0.81 (95% CI, 0.72-0.90) per 1-SD increase in positive attributes after adjustment for age, sex, race/ethnicity, childhood socioeconomic status, educational attainment, baseline chronic disease, depressive symptoms, cognitive function, mobility impairment, social isolation, smoking, physical activity, alcohol intake, and fruit and vegetable consumption (P < .001). Excluding deaths during 24 months after baseline as a check for reverse causation showed the same pattern (adjusted hazard ratio, 0.79; 95% CI, 0.70-0.89; P < .001). Associations were maintained after each life skill was omitted in turn from the aggregate score, indicating that no single positive attribute accounted for the protective association.

CONCLUSIONS AND RELEVANCE

These findings suggest that noncognitive life skills are associated with survival at older ages. Whether training and education programs could enhance these attributes and influence mortality risk is not known, but fostering and maintaining life skills may be important in later life.

The Association of Optimism with Sleep Duration and Quality: Findings from the Coronary Artery Risk and Development in Young Adults (CARDIA) Study

Optimism is associated with better health outcomes with hypothesized effects due in part to optimism's association with restorative health processes. Limited work has examined whether optimism is associated with better quality sleep, a major restorative process. We test the hypothesis that greater optimism is associated with more favorable sleep quality and duration. Main analyses included adults aged 32-51 who participated in the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 3,548) during the fifth (Year 15: 2000-2001) and sixth (Year 20: 2005-2006) follow-up visits. Optimism was assessed using the revised Life-Orientation Test. Self-report measures of sleep quality and duration were obtained twice 5 years apart. A subset of CARDIA participants (2003-2005) additionally provided actigraphic data and completed the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Multivariate regression analyses were used to examine associations of optimism and sleep indicators. In cross-sectional analyses of 3548 participants, each standard deviation (SD) higher optimism score resulted in 78% higher odds of self-reporting very good sleep quality. Prospectively, a 1-SD higher optimism score was related to higher odds of reporting persistently good sleep quality across 5-years relative to those with persistently poor sleep [OR = 1.31; 95%CI:1.10,1.56]. In participant with supplementary data, each SD higher optimism score was marginally associated with 22% greater odds of favorable sleep quality [OR = 1.22; 95%CI:1.00,1.49] as measured by the PSQI, with possible mediation by depressive symptoms. Optimism was unrelated to objective actigraphic sleep data. Findings support a positive cross-sectional and prospective association between optimism and self-reported sleep behavior.

Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults

Background

Relationships among sexual activity, problems and concerns, and well-being among older adults have not been fully explored.

Aim

To investigate associations among sexual activity, problems and concerns, and experienced well-being in a representative sample of older adults.

Methods

In this cross-sectional analysis from the English Longitudinal Study of Ageing, sexual behavior, problems, and concerns were assessed via a self-completed questionnaire. Covariates included age, partnership status, socioeconomic status, smoking status, alcohol intake, limiting long-standing illness, and depressive symptoms. Data were analyzed using 1-way independent analysis of variance.

Main Outcome Measure

Enjoyment of life was assessed with the pleasure subscale of the CASP-19 (Control, Autonomy, Self-realization, and Pleasure), a validated measure of quality of life specific to older age.

Results

Data on sexual activity and enjoyment of life were available for a total of 3,045 men and 3,834 women (mean age 64.4 years in men and 65.3 years in women). Men and women who reported any sexual activity in the past year had significantly higher mean enjoyment of life scores compared with those who were not sexually active (men, 9.75 vs 9.44 [P < .001]; women, 9.86 vs 9.67 [P = .003]). Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life. Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101). Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.

Conclusion

This is among the first studies to show that well-being is higher among older adults when they are sexually active. Preferences regarding the expression of sexual activity differed between the sexes. Further longitudinal research is needed to confirm a causal association between sexual activity and well-being.

Smith L, Yang L, Veronese N, et al. Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults. Sex Med 2019;7:11–18.

Reprint of: Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series

Facets of positive psychological well-being, such as optimism, have been identified as positive health assets because they are prospectively associated with the 7 metrics of cardiovascular health (CVH) and improved outcomes related to cardiovascular disease. Connections between psychological well-being and cardiovascular conditions may be mediated through biological, behavioral, and psychosocial pathways. Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being. Further, workplaces are using well-being-focused interventions to promote employee CVH, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies. Given the relevance of psychological well-being to promoting CVH, this review outlines clinical recommendations to assess and promote well-being in encounters with patients. Finally, a research agenda is proposed. Additional prospective observational studies are needed to understand mechanisms underlying the connection between psychological well-being and cardiovascular outcomes. Moreover, rigorous intervention trials are needed to assess whether psychological well-being-promoting programs can improve cardiovascular outcomes.

Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series

Facets of positive psychological well-being, such as optimism, have been identified as positive health assets because they are prospectively associated with the 7 metrics of cardiovascular health (CVH) and improved outcomes related to cardiovascular disease. Connections between psychological well-being and cardiovascular conditions may be mediated through biological, behavioral, and psychosocial pathways. Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being. Further, workplaces are using well-being-focused interventions to promote employee CVH, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies. Given the relevance of psychological well-being to promoting CVH, this review outlines clinical recommendations to assess and promote well-being in encounters with patients. Finally, a research agenda is proposed. Additional prospective observational studies are needed to understand mechanisms underlying the connection between psychological well-being and cardiovascular outcomes. Moreover, rigorous intervention trials are needed to assess whether psychological well-being-promoting programs can improve cardiovascular outcomes.

The Life Skills of Older Americans: Association with Economic, Psychological, Social, and Health Outcomes

Studies of children and adolescents indicate that success in life is determined in part by attributes such as conscientiousness, emotional stability and sense of control, independently of childhood socioeconomic status and cognitive ability. Less is known about the role of these characteristics at older ages. This study investigated the relationship of five life skills - conscientiousness, emotional stability, persistence, optimism and sense of control - with a range of outcomes in 8,843 participants (mean age 72.57 years) in the Health and Retirement Study, a representative study of older Americans. More life skills were associated with greater wealth and income, better emotional wellbeing, stronger social relationships, less loneliness, better health, fewer chronic illnesses and impaired activities of daily living, better mobility and less obesity, after controlling for childhood socioeconomic status and current cognitive ability. Longitudinally, more life skills predicted emotional wellbeing, less loneliness and more prosocial behavior, better health and mobility over a 4 year period. Associations were independent of gender, ethnicity, family background, education and cognitive ability. The number of attributes was important rather than any single life skill. Life skills continue to matter at advanced ages, and fostering these characteristics in older adults may pay dividends in terms of later life health and wellbeing.

Sleep, Health and Wellness at Work: A Scoping Review

Many occupational factors may interfere with sleep. Sleep disturbances can, in turn, endanger the health and safety of workers. This rapid review of the literature identifies the main factors that alter the quantity and quality of sleep, indicates the effects these alterations have on the wellbeing of workers and suggests some health promotion measures.