Social Support and Longevity: Meta-Analysis-Based Evidence and Psychobiological Mechanisms

How is social support defined, categorized and measured in studies of work-related musculoskeletal disorders among hospital nurses: A scoping review

AIM

To summarize current literature on the definition, categorization and measurement of social support in studies of work-related musculoskeletal disorders among hospital nurses.

DESIGN

A scoping review.

DATA SOURCES

A literature search of four databases (CINAHL, Medline, Embase and Web of Science) was employed to map the evidence between January 2012 and April 2023 on the definition, categorization and measurement of social support in studies of work-related musculoskeletal disorders among nurses in hospital settings.

REVIEW METHODS

This review adopted Arksey and O'Malley's framework for conducting scoping reviews. Data extraction was reported using PRISMA Scoping Review guidelines and articles synthesized using a descriptive approach.

RESULTS

Fifteen studies met the criteria for inclusion in the review. Social support was distinctly defined in only two studies. Four main categories of social support identified were Co-worker, Supervisor, Family and Overall support. Eight tools were found to measure social support, and the most used tool was the Job Content Questionnaire.

CONCLUSIONS

The review identified that social support is often not explicitly defined. Furthermore, social support can be categorized and measured in different ways, using diverse tools. This variation may affect the understanding of social support and the approaches in measuring and providing social support in the workplace.

IMPACT

Studies should clearly define the social support category evaluated, to facilitate comparisons between studies of nurses with work-related musculoskeletal disorders. Healthcare managers should obtain feedback from nurses to ensure that the category of social support provided matches that which the nurse requires to ensure it helps the nurse from an organizational perspective. Healthy social relationships should be encouraged among nurses to promote nurses' well-being and by extension patient care.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public involvement.

Longitudinal analysis of lifetime stressors and depression: Exploring intersectionality and tailoring social support for better mental health in a community population cohort

AIMS

Health inequalities studies need to understand how individuals simultaneously defined by several socioeconomic factors differ from others when facing a series of stressors across the lifespan in the risk of major depression (MD). Theoretical efforts, as well as empirical studies, have suggested a pertinent role of social support in mental health outcomes. However, little is known about which forms of social support would alleviate the negative impact of MD vulnerability in self-rated mental health (SRMH) across different socioeconomic groups. We investigated 1) differential associations between lifetime stressors and MD across social groups and 2) explored diverse social support forms mediating the associations between MD vulnerability and SRMH.

METHODS

Data analyzed were from a large longitudinal population-based cohort. Multilevel analysis of individual heterogeneity and discriminatory accuracy was used to articulate MD vulnerability in different social groups defined by ethnicity, gender, and socioeconomic status (SES). Genetic predispositions were also included in the modeling process. These social groups were then regrouped based on their vulnerability level of MD. Mediation analyses were then applied to identify which social support forms mediate the effect of MD vulnerability on SRMH.

RESULTS

Higher levels of stressors were associated with higher risks of MD, and their associations varied by different social groups. The social groups (White men with medium SES or White women with high SES) had the lowest predicted incidence of MD, whereas White women with low SES reported the highest predicted incidence of MD. Two social support forms (guidance and opportunity for nurturance) significantly mediated the indirect paths between MD vulnerability and SRMH.

CONCLUSIONS

By applying an intersectional lens, the present study provides a novel quantitative instrument for documenting the associations of stress and depression in various social identities. The findings of the study suggest more focused intervention programs and strategies for risk reduction should focus on identified characteristics and pay particular attention to the combined effect of lifetime stressors and discovered social identities.

Blind spots in health perception: the underestimated role of social connection for health outcomes

BACKGROUND

Robust evidence indicates that having few or poor-quality social connections is associated with poorer physical health outcomes and risk for earlier death (Snyder-Mackler N, Science 368, 2020; Vila J, Front Psychol 12:717164, 2021).

AIM

This study sought to determine whether recent attention on social connection and loneliness brought on by the COVID-19 pandemic may influence risk perception and whether these perceptions were heightened among those who are lonely.

METHODS

Two waves of online survey data were collected. The first included data from 1,486 English-speaking respondents in the US, UK, and Australia, and a second sample of 999 nationally representative US adults, with a final sample of 2392 respondents from the US and UK.

RESULTS

Perceptions of risk have remained consistent, underestimating the influence of social factors on health outcomes and longevity, even among respondents who reported moderate-to-severe levels of loneliness.

CONCLUSIONS

Despite heightened awareness and discourse during the COVID-19 pandemic, public perception in the US and UK continues to significantly underestimate the impact of social factors on physical health and mortality. This underestimation persists regardless of individual loneliness levels, underscoring the need for enhanced public education and policy efforts to recognize social connection as a crucial determinant of health outcomes.

Social support and aging: psychometric analysis of the ENRICHD Social Support Instrument in a Chilean population over 50

BACKGROUND

Social support is relevant to studying well-being, quality of life, and health during aging, particularly in people over 50. Therefore, brief instruments that allow its measurement within the clinical evaluation and research processes are necessary. The ENRICH Social Support Scale (ESSI) is a brief and easy-to-use instrument that measures the perception of social support; however, its psychometric properties in people over 50 in the Chilean context have yet to be tested.

METHOD

This study had a non-experimental, longitudinal panel design in which a sample of 303 people over 50 years of age (M = 55.14 years, SD = 5.19; 52% women) were administered a survey incorporating sociodemographic variables, the ESSI and the Newsom Social Negativity Scale. 277 participants completed the follow-up survey (M = 56.75 years, SD = 5.15; 54% women). Confirmatory factor analysis (CFA), structural equation modeling (SEM), invariance analysis, and internal consistency tests were performed to determine the psychometric properties.

RESULTS

The six items from the scale load in a single-factor model obtained an excellent fit to the data and reliability coefficients (α = 0.902; ω = 0.904). The SEM analysis evidenced an inverse correlation between the ESSI and Newsom's social negativity scale, demonstrating evidence of construct validity. Furthermore, in the sex invariance analyses, the scalar level was reached, implying that the items' meanings are the same for men and women. Finally, the residual level was reached in the temporal invariance analyses, which means that the scale items are consistent in time.

CONCLUSIONS

The ESSI is a reliable and valid tool to be used in the Chilean context both in the clinical setting and in research on people over 50. The evidence obtained supports its usability to appropriately measure the perception of social support, which is relevant considering that it has been associated with reports of higher quality of life and lower mortality and morbidity during aging.

The Associations Between Social Support and Problematic Mobile Phone Use Among Children and Adolescents: A Three-level Meta-analysis

Numerous studies have investigated the relationship between social support and problematic mobile phone use among adolescents, yet a definitive consensus remains elusive. The high prevalence of problematic mobile phone use among children and adolescents requires urgent clarity on this issue. However, previous meta-analyses on this topic have primarily focused on college students, overlooking this association in younger age groups. The present study thus concentrated on children and adolescents, conducting a three-level meta-analysis to combine existing research findings and analyze various moderators to identify sources of research heterogeneity. A systematic literature search retrieved a total of 33 studies with 135 effect sizes for this meta-analysis, and 25,537 students (53.83% female, age range 7-19, grades range 3rd-12th) were included. The results showed a negative correlation (r = -0.139) between social support and problematic mobile phone use in children and adolescents. Age, social support measurement, sources of social support, and symptoms of problematic mobile phone use were found to have a significant moderating influence. Specifically, social support showed a stronger negative correlation with problematic mobile phone use in older adolescents compared to their younger counterparts. The correlation was more pronounced when using the Multidimensional Scale of Perceived Social Support than other scales. Family support exhibited a stronger negative correlation with problematic mobile phone use compared to other sources of support. Among the symptoms of problematic mobile phone use, the inability to control craving has the strongest negative correlation with social support. This meta-analysis suggested that providing more social support, particularly in the form of family support, during the development of children and adolescents may help alleviate problematic mobile phone use.

Virtual friendly visitor program: combatting loneliness in community dwelling older adults

Introduction

Loneliness is a critical public health issue affecting older adults, with significant impacts on their mental and physical health, including increased risks of depression, cognitive decline, and higher mortality rates, necessitating distinct approaches for each condition given their unique implications and the exacerbation of these issues during the COVID-19 pandemic. We examine the implementation and outcomes of a Friendly Visitor Program (FVP) designed to mitigate loneliness among older adults. The program involved social work student interns providing virtual visits to older adults using computers and tablets, with the goal of enhancing social interaction and support.

Methods

The study utilized a qualitative narrative design for process evaluation and a longitudinal non-experimental, prospective research design for outcome evaluation, employing a three-level cross-classified longitudinal growth model to assess changes in loneliness among VFVP participants while also testing potential predictors of these changes.

Results

Findings indicated that the program was associated with reduced loneliness over time. Younger and White participants performed better in the program than older participants from other races and ethnicity. Satisfaction with visits and willingness to recommend the program were significant predictors of reduced loneliness. Unexpectedly, greater comfort with technology correlated with increased loneliness, suggesting overreliance on digital interactions may not substitute for in-person contact. Furthermore, improved social networks was associated with reduced loneliness, highlighting the importance of strong social networks.

Discussion

The study underscores the potential of friendly visitor interventions in addressing the challenges of lonely older adults and provides insights for optimizing such programs in the future.

A human working memory advantage for social network information

As a social species, humans live in complexly bounded social groups. In order to navigate these networks, humans rely on a set of social-cognitive processes, including social working memory. Here, we designed a novel network memory task to study working memory for social versus non-social network information across 241 participants (18-65 years) in a tightly controlled, preregistered study. We show that humans demonstrate a working memory advantage for social, relative to non-social, network information. We also observed a self-relevant positivity bias, but an 'other' negativity bias. These findings are interpreted in the context of an evolutionary need to belong to one's social group, to identify risks to one's social safety and to appropriately track one's social status within a complex network of social relationships.

The association between social support and prosocial behavior: A three-level meta-analysis

Numerous studies have examined the relationship between social support and prosocial behavior and have concluded that social support is an important factor in generating prosocial behavior. However, different studies have produced different conclusions, and the moderating effect on the relationship is not entirely clear. The current study uses a three-level meta-analysis method to clarify the relationship between social support and prosocial behavior, and explores the moderating variables that affect the relationship between the two variables. Through a systematic literature search, a total of 92 studies, 418 effect sizes, and 74,378 participants were obtained. The main effects test found a significant positive correlation between social support and prosocial behavior. Tests of the moderating effects indicated that the relationship between social support and prosocial behavior was moderated by year of publication, source of social support, measurement of social support and measurement of prosocial behavior. In summary, social support plays an important role in prosocial behavior, and exploring their relationship is beneficial to families, schools and society in guiding individuals' prosocial behavior.

Influences of sex and gender on the associations between risk and protective factors, brain, and behavior

Risk and protective factors for psychiatric illnesses are linked to distinct structural and functional changes in the brain. Further, the prevalence of these factors varies across sexes and genders, yet the distinct and joint effects of sex and gender in this context have not been extensively characterized. This suggests that risk and protective factors may map onto the brain and uniquely influence individuals across sexes and genders. Here, we review how specific risk (childhood maltreatment, the COVID-19 pandemic, experiences of racism), and protective factors (social support and psychological resilience) distinctly influence the brain across sexes and genders. We also discuss the role of sex and gender in the compounding effects of risk factors and in the interdependent influences of risk and protective factors. As such, we call on researchers to consider sex and gender when researching risk and protective factors for psychiatric illnesses, and we provide concrete recommendations on how to account for them in future research. Considering protective factors alongside risk factors in research and acknowledging sex and gender differences will enable us to establish sex- and gender-specific brain-behavior relationships. This will subsequently inform the development of targeted prevention and intervention strategies for psychiatric illnesses, which have been lacking. To achieve sex and gender equality in mental health, acknowledging and researching potential differences will lead to a better understanding of men and women, males and females, and the factors that make them more vulnerable or resilient to psychopathology.

Development and Validation of Chinese Version of Dental Pain Screening Questionnaire

INTRODUCTION

Dental pain is one of the most prevalent oral complaints. This study aimed to establish a Chinese version of Dental Pain Screening Questionnaire (DePaQ) to help classify patients into three groups of dental pain diseases (group 1, reversible pulpitis and dentine hypersensitivity; group 2, acute periapical periodontitis and irreversible pulpitis; and group 3, pericoronitis).

METHODS

The DePaQ was translated from English to Chinese. The clinical subjects (CS, n = 290) and nonclinical subjects (NS, n = 100) with dental pain were collected. The CS were randomly divided into two subsamples: CS1 (n = 203) and CS2 (n = 87). The Fisher discriminant functions of the final 13-item Chinese version of the DePaQ were obtained from the CS1 group, and discriminant validity was further verified in the CS2 and NS groups.

RESULTS

The discriminant functions of the final 13-item DePaQ obtained from the CS1 group were capable of correctly distinguishing 93.1% and 89.0% cases of the CS2 and NS groups, respectively. In the CS2 group, the sensitivity for groups 1, 2, and 3 was 88.0%, 80.0%, and 83.0%, respectively, and the specificity was 95.0%, 95.0%, and 86.0%, respectively. In the NS group, the sensitivity for groups 1, 2, and 3 was 82.0%, 80.0%, and 86.0%, respectively, and the specificity was 91.0%, 97.0%, and 90.0%, respectively.

CONCLUSIONS

The Chinese version of DePaQ could help classify the three groups of dental pain diseases and guide medical treatment.

Stay social, stay young: a bioanthropological outlook on the processes linking sociality and ageing

In modern human societies, social interactions and pro-social behaviours are associated with better individual and collective health, reduced mortality, and increased longevity. Conversely, social isolation is a predictor of shorter lifespan. The biological processes through which sociality affects the ageing process, as well as healthspan and lifespan, are still poorly understood. Unveiling the physiological, neurological, genomic, epigenomic, and evolutionary mechanisms underlying the association between sociality and longevity may open new perspectives to understand how lifespan is determined in a broader socio/evolutionary outlook. Here we summarize evidence showing how social dynamics can shape the evolution of life history traits through physiological and genetic processes directly or indirectly related to ageing and lifespan. We start by reviewing theories of ageing that incorporate social interactions into their model. Then, we address the link between sociality and lifespan from two separate points of view: (i) considering evidences from comparative evolutionary biology and bioanthropology that demonstrates how sociality contributes to natural variation in lifespan over the course of human evolution and among different human groups in both pre-industrial and post-industrial society, and (ii) discussing the main physiological, neurological, genetic, and epigenetic molecular processes at the interface between sociality and ageing. We highlight that the exposure to chronic social stressors deregulates neurophysiological and immunological pathways and promotes accelerated ageing and thereby reducing lifespan. In conclusion, we describe how sociality and social dynamics are intimately embedded in human biology, influencing healthy ageing and lifespan, and we highlight the need to foster interdisciplinary approaches including social sciences, biological anthropology, human ecology, physiology, and genetics.

Blue Zone Loma Linda: Assessing the Relationship Between Lifestyle and Oral Health

Objectives: Assess the relationship between lifestyle and oral health-related quality-of-life (OHRQoL) of residents in a blue zone, Loma Linda. Methods: A cross-sectional study was conducted using a questionnaire including demographics, lifestyle, and Oral Health Impact Profile (OHIP-14). Lifestyle cumulative scores ranged from 8-32, lower scores indicating greater conformity to Power 9® lifestyle, characterized by observing Sabbath, time with friends, volunteering, exercising, eating lots of plants, eating meat in moderation, drinking a lot of water, snacking on nuts, and eating an early dinner. OHIP-14 assessed OHRQoL, with scores from 0-56. Negative binomial regression was used, with significance of alpha = 0.05. Results: A total of 350 surveys were collected. Cumulative lifestyle showed a mean of 13.9. Spending time with friends was the most adhered to activity (96%) while the least followed was having early dinners (71.2%). Asians (Mean = 14.2) had significantly higher lifestyle scores than Whites (Mean = 13.7). The mean OHIP-14 was 7.01. Whites had lower OHIP-14 scores than Asians, indicating better OHRQoL. Race, nut consumption and exercise were significant predictors for increased OHRQoL (P < 0.05, in all instances). Conclusions: Loma Linda residents adhere well to the Power 9® lifestyle. There are significant predictors such as nut consumption and exercise for increased OHRQoL.

A Systematic Review and Meta-Analysis of the Association Between Physical Capability, Social Support, Loneliness, Depression, Anxiety, and Life Satisfaction in Older Adults

BACKGROUND AND OBJECTIVES

Physical capability, social support, loneliness, depression, and anxiety predict life satisfaction in older adults. Currently, no systematic review and meta-analysis have been conducted to investigate the strength of these associations globally. Therefore, this study quantified the strength of these associations.

RESEARCH DESIGN AND METHODS

A systematic literature search was conducted using MEDLINE, EMBASE, APA PsycINFO, Web of Science, and Scopus. We included observational studies assessing the association between physical capability, social support, loneliness, depression, and anxiety with life satisfaction in adults aged 65+.

RESULTS

In total, 10,552 articles were identified, of which 78 studies in 164,478 participants were included in the systematic review and 57 were included in the meta-analysis. Greater life satisfaction was significantly associated with greater physical capabilities (odds ratio [OR] = 2.64; 95% confidence interval [CI]: 2.01-3.45; p < .001, k = 35, n = 33,732), higher social support (OR = 3.27; 95% CI: 2.59-4.13, k = 20 studies, n = 13,228), reduced loneliness (OR = 3.30; 95% CI: 2.53-4.30, k = 11, n = 33,638), depression (OR = 4.76; 95% CI: 3.10-7.32, k = 24, n = 64,097), and anxiety (OR = 5.10; 95% CI: 2.21-11.78, k = 5, n = 43,368). The strength of associations did not vary between Western and Eastern countries, year of publication, or quality. Gender was a moderator: Loneliness was more strongly associated with life satisfaction in females. Age was also a moderator; the association between social support and life satisfaction weakened with increasing age.

DISCUSSION AND IMPLICATIONS

Improving the physical capabilities of older individuals, fostering social support, and alleviating feelings of loneliness, depression, and anxiety may help build life satisfaction in older individuals, which policy-makers and healthcare professionals should prioritize when implementing strategies.

Lower Perceived Social Support Associated With Greater Hopelessness in Patients After an Acute Ischemic Heart Disease Event

BACKGROUND

Hopelessness is present in up 52% of patients with ischemic heart disease (IHD) and is associated with increased morbidity and mortality. Lower perceived social support (PSS) has been associated with greater hopelessness in a pilot study of patients with IHD reporting moderate-severe hopelessness but has not been examined in a larger sample reporting none-severe levels of hopelessness and while controlling for covariates.

OBJECTIVE

The aim of this study was to determine the relationship between PSS and hopelessness in patients with IHD.

METHODS

Using a cross-sectional design, 178 participants were enrolled while hospitalized for an IHD event at 1 large hospital in the United States. Data collection occurred 2 weeks after hospital discharge using the State-Trait Hopelessness Scale, ENRICHD Social Support Inventory, Patient Health Questionnaire-9, a demographic form, and a medical record abstraction form. Linear models were used to assess the association between variables in unadjusted models and models adjusted for demographic and medical history.

RESULTS

Most participants were male (67%), married (67%), and non-Hispanic White (92%) and underwent coronary artery bypass surgery (61%). There was a moderate inverse correlation between PSS and state (r = -0.31, P < .001) and trait (r = -0.28, P < .001) hopelessness in unadjusted models. The relationships remained significant in adjusted models and did not differ by sex, type of IHD event, or marital status.

CONCLUSIONS

Lower PSS was associated with greater hopelessness in patients with IHD. Assessing PSS and hopelessness during hospitalization for an IHD event may enable clinicians to provide targeted interventions to reduce risk of hopelessness and improve secondary prevention in patients with IHD.

Epigenetic Aging Associations With Psychoneurological Symptoms and Social Functioning in Adults With Sickle Cell Disease

Objective: Sickle cell disease (SCD), the most common inherited blood disorder in the United States, is associated with severe psychoneurological symptoms. While epigenetic age acceleration has been linked to psychoneurological symptom burden in other diseases, this connection is unexplored in SCD. This study aimed to assess the association between epigenetic age acceleration and psychoneurological symptom burden in SCD. Methods: In this cross-sectional study, emotional impact, pain impact, sleep impact, social functioning, and cognitive function were assessed in 87 adults living with SCD. DNA methylation data were generated from blood specimens and used to calculate epigenetic age using five clocks (Horvath, Hannum, PhenoAge, GrimAge, & DunedinPACE). Associations between epigenetic age acceleration and symptoms were assessed. Results: The sample (N = 87) had a mean (SD) chronologic age was 30.6 (8.1) years. Epigenetic age acceleration was associated with several symptom outcomes. GrimAge age acceleration (β = -0.49, p = .03) and increased DunedinPACE (β = -2.23, p = .004) were associated with worse emotional impact scores. PhenoAge (β = -0.32, p = .04) and the GrimAge (β = -0.48, p = .05) age acceleration were associated with worse pain impact scores. Increased DunedinPACE (β = -2.07 p = .04) were associated with worse sleep impact scores. Increased DunedinPACE (β = -2.87, p = .005) was associated with worse social functioning scores. We did not find associations between epigenetic age acceleration and cognitive function in this sample. Conclusion: Epigenetic age acceleration was associated with worse symptom experiences, suggesting the potential for epigenetic age acceleration as a biomarker to aid in risk stratification or targets for intervention to mitigate symptom burden in SCD.

Which Social Variables Predict Diabetes Onset? Robust Findings in Two National Surveys

BACKGROUND AND OBJECTIVES

The role of social factors in diabetes onset has been obscured by wide variation in their conceptualization and operationalization. We apply 3 theoretical frameworks to categorize social relationship variables along several dimensions and identify which dimension(s) are robustly associated with incident diabetes in the older adult population.

RESEARCH DESIGN AND METHODS

The National Social Life, Health, and Aging Project (n = 2,365) and the Health and Retirement Study (n =11,824) provided longitudinal data from 57 to 90-year-old respondents over a 4- to 5-year period. Logistic regression models were used to test associations of 15 social variables measured identically in both data sets with diabetes onset measured as respondents' first report of a physician's diagnosis.

RESULTS

In both studies, not being married, experiencing strain in a spousal relationship, and feeling lonely were associated with increased risk for diabetes onset at follow-up. Inconsistent or null findings were observed for social support, social activity, network size, number of friends and relatives, living alone, and closeness to network members.

DISCUSSION AND IMPLICATIONS

Robust findings in 2 large-scale surveys support the importance of the valence dimension (i.e., positive and negative); specifically, alleviating negative aspects of social life might more effectively reduce risk for diabetes than augmenting positive ones. Findings were not aligned with social variables differing on the subjectivity dimension (i.e., structural, functional, and qualitative aspects of social connections). Future work needs consistent conceptualization and measurement of social factors to correctly identify and categorize risk factors for diabetes onset and other health conditions in older adults.

Socioeconomic and Health Characteristics as Predictors of Social Support in Elderly People with Visual Impairment: Evidence from Serbia

Background

Social networks and support have an independent and strong influence on health and quality of life at all stages of the life cycle, especially in the elderly. We aimed to determine the level of social support among the elderly population of the Republic of Serbia.

Methods

The survey is part of the fourth Health survey of the population of Serbia, which was conducted in 2019 by the Republic Institute of Statistics with the Institute for Public Health of Serbia "Dr. Milan Jovanović Batut" and the Ministry of Health of the Republic of Serbia. The research instrument was standardized questionnaires constructed in accordance with the European Health Interview Survey (EHIS, wave3) and the social support score (Oslo-3 Social Support Scale). For the purposes of this research, data on the population aged 65 and over were used.

Results

In terms of social support, 85.8% of respondents had bad , 13.9% moderate and 0.3% strong. Univariate regression analysis determined that respondents from the territory of Vojvodina had a 1.6 times higher chance of poor social support compared to respondents from southern and eastern Serbia. The probability of bad social support was 1.5 times higher in persons who were never married/cohabiting, persons with secondary education were at 1.6 times higher risk of poor social support compared to persons with higher education. Inactive persons had poor social support 1.4 times more often than employed persons, as well as persons with comorbidities (OR=1.218).

Conclusion

These researches are of great importance for public health because it provides valuable data for the creation of interventions that will intensify activities related to providing adequate social support to the elderly.

Social support receipt as a predictor of mortality: A cohort study in rural South Africa

The mechanisms connecting various types of social support to mortality have been well-studied in high-income countries. However, less is known about how these relationships function in different socioeconomic contexts. We examined how four domains of social support-emotional, physical, financial, and informational-impact mortality within a sample of older adults living in a rural and resource-constrained setting. Using baseline survey and longitudinal mortality data from HAALSI, we assessed how social support affects mortality in a cohort of 5059 individuals aged 40 years or older in rural Mpumalanga, South Africa. Social support was captured as the self-reported frequency with which close social contacts offered emotional, physical, financial, and informational support to respondents, standardized across the sample to increase interpretability. We used Cox proportional hazard models to evaluate how each support type affected mortality controlling for potential confounders, and assessed potential effect-modification by age and sex. Each of the four support domains had small positive associations with mortality, ranging from a hazard ratio per standard deviation of support of 1.04 [95% CI: 0.95,1.13] for financial support to 1.09 [95% CI: 0.99,1.18] for informational support. Associations were often stronger for females and younger individuals. We find baseline social support to be positively associated with mortality in rural South Africa. Possible explanations include that insufficient social support is not a strong driver of mortality risk in this setting, or that social support does not reach some necessary threshold to buffer against mortality. Additionally, it is possible that the social support measure did not capture more relevant aspects of support, or that our social support measures captured prior morbidity that attracted support before the study began. We highlight approaches to evaluate some of these hypotheses in future research.

Young adults' desired life tradeoffs: love first, sex last

Every human and non-human animal must make tradeoffs in investments in terms of time, energy, and resources. The aim of this study was to extrapolate from the types of investments in survival and reproduction that non-human animals make and translate these into human motivations. 16 potential goals were presented to 851 childless, 18-23-year-old adults from 11 world regions in an online study. Each young adult was asked to weight the importance of every goal to his or her ideal life. Weights had to sum to 100, requiring tradeoffs. Results revealed striking agreement across young adults with only four goals weighted above chance: Finding a beloved romantic partner, being physically and emotionally healthy, and earning money or resources. Having lots of sexual partners was the least important goal across all world regions for both sexes. Nevertheless, men more than women valued having many sexual partners, being talented outside work, being physically strong, and having a physically attractive romantic partner. Overall, there was cultural variation in some of the less important goals. Helping young adults achieve success requires understanding their own goals, rather than focusing on popularized depictions of what young adults desire.

Gender differences in relations between social comparison, social support, and sleep disturbance among midlife and older adults

Objective

To examine associations between sleep disturbance, social support, and social comparison among midlife and older adults, including the moderating role of gender.

Methods

Adults ages ≥40 years (N = 557, MAge = 57, 53% men) completed a cross-sectional survey including validated measures of sleep disturbance, perceptions of social support, and social comparison orientation.

Results

Sleep disturbance was negatively associated with social support (rs = -0.42 to - 0.33, ps = 0.001) and associations were stronger for men than women - particularly perceived support from friends (η 2  = 0.01). Sleep disturbance was also associated with upward comparison orientation (r = 0.12, p = 0.003), more strongly for women than men (η 2  = 0.01).

Discussion

Findings indicate that perceived support from friends (for men) and upward comparison (for women) may have particular influence on sleep among midlife and older adults. Additional work is needed to clarify the nature of these associations and their mechanism(s) of action, to inform potential treatment adaptations for this population.

The Use of Multifamily Discharge Preparation Groups in the Discharge Process of Patients with Schizophrenia

Background

After acute treatment, patients with schizophrenia return to their original living environment for further rehabilitation, which not only determines the quality of life of the patients and their families but also has an important impact on society. However, patients often find it difficult to adapt to changes in the environment when they are discharged from the hospital. This may be related to the incompleteness of China's mental health service system, as many services for schizophrenia patients are only in the treatment stage. In China, schizophrenia is traditionally associated with poor moral quality, and patients find it difficult to obtain support. Many patients have trouble reintegrating into the community after treatment. Schizophrenic multifamily teams gather families affected by the same illness and pain together to promote healing together in an environment that allows mutual sharing, understanding and transparency, maximizes the use of family resources for support, improves discharge readiness, and better deals with post-discharge recovery.

Methods

The multifamily group intervention method was used to improve the motivation of the patients' family motivation as well as the discharge readiness and self-efficacy of the patient.

Results

After the intervention, the motivation of the family and discharge readiness of the patient were improved compared with that of the baseline period; however, the improvement was not significant. The self-efficacy of the patients was significantly improved (P=0.042).

Conclusions

In the discharge preparation of schizophrenia patients, multifamily teams can be used to help patients and their families share resources, enhance support and prepare for discharge. Patients will have better support following discharge for recovery in the community. Additional consideration should be given to the impact of the environment on patient services, and the evaluation of the service process is key to continuously improving the service effect.

Public health impacts of air pollution from the spatiotemporal heterogeneity perspective: 31 provinces and municipalities in China from 2013 to 2020

Air pollution has long been a significant environmental health issue. Previous studies have employed diverse methodologies to investigate the impacts of air pollution on public health, yet few have thoroughly examined its spatiotemporal heterogeneity. Based on this, this study investigated the spatiotemporal heterogeneity of the impacts of air pollution on public health in 31 provinces in China from 2013 to 2020 based on the theoretical framework of multifactorial health decision-making and combined with the spatial durbin model and the geographically and temporally weighted regression model. The findings indicate that: (1) Air pollution and public health as measured by the incidence of respiratory diseases (IRD) in China exhibit significant spatial positive correlation and local spatial aggregation. (2) Air pollution demonstrates noteworthy spatial spillover effects. After controlling for economic development and living environment factors, including disposable income, population density, and urbanization rate, the direct and indirect spatial impacts of air pollution on IRD are measured at 3.552 and 2.848, correspondingly. (3) China's IRD is primarily influenced by various factors such as air pollution, economic development, living conditions, and healthcare, and the degree of its influence demonstrates an uneven spatiotemporal distribution trend. The findings of this study hold considerable practical significance for mitigating air pollution and safeguarding public health.

Structural changes in a Danish social housing area: The impact of forced permanent rehousing on contact frequency with general practitioner and use of antidepressants

There is a lack of knowledge about the health consequences of politically initiated forced permanent rehousing (FPR) of residents in social housing areas. This study investigates if FPR is associated with the contact frequency with general practitioner (GP) and the proportion of residents who use antidepressants. The study included 432 rehoused residents matched 1:2 with remaining residents and residents from a comparable neighbouring area without exposure to rehousing. For GP contact frequency, we conducted a difference-in-difference analysis while the proportion of residents who used antidepressants was investigated through descriptive statistics. We found high GP contact frequency in the three groups, but no significant differences. Further, we found a low proportion of residents who used antidepressants in all groups, but a small increase from baseline to follow-up. Our results thus suggest that FPR neither affected the rehoused residents' GP contact frequency nor the proportion who used antidepressants.

Social support and frailty progression in community-dwelling older adults

Objectives

Despite the growing evidence regarding the influence of social factors on frailty in older adults, the effect of social support remains unclear. This study aims to assess the association between social support and frailty progression (transition and incidence) in a sample of community-dwelling older adults.

Methods

Using a cohort study design, 1,059 older adults from the Berlin Initiative Study were followed up for 2.1 years. Multinomial and logistic regression analyses were performed to assess the association of social support using Oslo Social Support Scale-3 with frailty transition and incidence, respectively. Gender differences were explored using stratified analyses.

Results

At baseline, frailty prevalence in the study population [mean (SD) age 84.3 (5.6) years; 55.8% women] reached 33.1% with 47.0, 29.4 and 23.6% of the participants reporting moderate, strong and poor social support, respectively. Over the follow-up period, social support was not significantly associated with the frailty transition categories in the adjusted model. Conversely, the adjusted logistic regression analysis showed that participants with poor social support had twice the odds of becoming frail compared to those with strong social support (OR 2.07; 95% CI 1.08-3.95). Gender-stratified analyses showed comparable estimates to the main analysis but were statistically non-significant.

Discussion

Our study results underpin the role of social factors in frailty incidence and highlight social support as a potential target for frailty-preventing interventions in older adults. Therefore, it is important to adopt a biopsychosocial model rather than a purely biomedical model to understand and holistically improve the health of community-dwelling older adults.

Trends in the Link Between Perceived Social Support and Life Satisfaction in Adolescents (2013/14-2021/22): A Cross-National Study

Objectives

This repeated cross-sectional study aimed to (a) report trends in adolescents' perceived family, friend, classmate, and teacher support, (b) estimate the extent to which each source of support related to life satisfaction across space and time, and (c) ascertain whether sociodemographic factors moderated the relationship in question.

Methods

We relied on data pertaining to the 2013/14, 2017/18, and 2021/22 waves of the Health Behaviour in School-aged Children study. The examined sample covered 44 countries and regions (n = 716,083; M AGE = 13.6; SD AGE = 1.64; 50.7% female).

Results

The level of all sources of perceived social support slightly decreased over the examined period (all ω2 < .01). Family support involved the largest association with life satisfaction (β = 0.16); friend support, the lowest one (β = 0.03). These associations varied only tenuously across space and time. Sociodemographic factors moderated the link between perceived social support and life satisfaction to a negligible-to-weak extent.

Conclusion

Levels of perceived social support and their associations with life satisfaction subtly changed. Future research may attempt to pinpoint the macrosocial levers of these temporal dynamics.

Refugee health and physiological profiles in transitional settlements in Serbia and Kenya: Comparative evidence for effects of gender and social support

When armed conflict compels people to flee from their homelands, they embark on protracted journeys during which they experience wide ranging physical, social, and psychological challenges. Few studies have focused on refugee psychosocial and physiological profiles during the transitional phase of forced migration that often involves temporary sheltering. Transient refugees' experiences can vary substantially based on local socio-ecological conditions in temporary settlements, including the length of stay, living conditions, as well as the availability and accessibility of physical and social resources. In this study, we compared physiological and psychosocial data from refugees (N=365; 406 observations) in Serbia and Kenya, respectively, with divergent temporal (length of stay) and socio-ecological conditions. In Serbia, refugees resided in asylum centers (mean stay: 0.9 y); in Kenya they were living in Kakuma Refugee Camp (mean stay: 8.8 y), one of the world's largest camps at the time. We had limited ability to directly compare psychosocial measures and used meta-analytic techniques to evaluate predictors of refugee mental and physical health at the two sites, including based on perceived social support. Refugees in Serbia had higher fingernail cortisol (p < 0.001) and were less likely to have elevated C-reactive protein (CRP) levels (p < 0.01) than refugees in Kakuma. We found common gender differences in both settings; women had lower cortisol but higher EBV antibody titers and higher likelihood of having elevated CRP compared to men (all p < 0.01). Woman also reported poorer mental and physical health (p < 0.001). These physiological and health differences may reflect variation between men and women in their psychosocial and physical experiences of factors such as stress, violence, and trauma during their journeys and as transitional refugees. Finally, we also found that refugees with lower levels of perceived social support reported poorer physical and mental health (p < 0.001). Although our results are cross-sectional, they suggest that this intermittent phase of the refugee experience is a key window for helping enhance refugee well-being through an emphasis on interpersonal and community support systems.

From Social Stress and Isolation to Autonomic Nervous System Dysregulation in Suicidal Behavior

PURPOSE OF REVIEW

In this narrative review we wanted to describe the relationship of autonomic nervous system activity with social environment and suicidal spectrum behaviors.

RECENT FINDINGS

Patients with suicidal ideation/suicide attempt have higher sympathetic nervous system (SNS) and lower parasympathetic nervous system (PNS) activity in resting conditions and during acute stress tasks compared with patients without suicidal ideation/suicide attempt. Death by suicide and violent suicide attempt also are related to SNS hyperactivation. Similarly, a SNS/PNS imbalance has been observed in people with childhood trauma, stressful life events or feelings of loneliness and isolation. Social support seems to increase PNS control and resilience. Due to the importance of the social context and stressful life events in suicidal behavior, SNS/PNS imbalance could act as a mediator in this relationship and be a source of relevant biomarkers. Childhood trauma and stressful life events may impair the autonomic nervous system response in suicidal patients. Loneliness, isolation and social support may act as moderators in acute stress situations.

Psychogenic Aging: A Novel Prospect to Integrate Psychobiological Hallmarks of Aging

Psychological factors are amongst the most robust predictors of healthspan and longevity, yet are rarely incorporated into scientific and medical frameworks of aging. The prospect of characterizing and integrating the psychological influences of aging is therefore an unmet step for the advancement of geroscience. Psychogenic Aging research is an emerging branch of biogerontology that aims to address this gap by investigating the impact of psychological factors on human longevity. It is an interdisciplinary field that integrates complex psychological, neurological, and molecular relationships that can be best understood with precision medicine methodologies. This perspective argues that psychogenic aging should be considered an integral component of the Hallmarks of Aging framework, opening the doors for future biopsychosocial integration in longevity research. By providing a unique perspective on frequently overlooked aspects of organismal aging, psychogenic aging offers new insights and targets for anti-aging therapeutics on individual and societal levels that can significantly benefit the scientific and medical communities.

The Influence of Social Dynamics on Biological Aging and the Health of Historically Marginalized Populations: A Biopsychosocial Model for Health Disparities

Historically marginalized populations are susceptible to social isolation resulting from their unique social dynamics; thus, they incur a higher risk of developing chronic diseases across the course of life. Research has suggested that the cumulative effect of aging trajectories per se, across the lifespan, determines later-in-life disease risks. Emerging evidence has shown the biopsychosocial effects of social stress and social support on one's wellbeing in terms of inflammation. Built upon previous multidisciplinary findings, here, we provide an overarching model that explains how the social dynamics of marginalized populations shape their rate of biological aging through the inflammatory process. Under the framework of social stress and social support theories, this model aims to facilitate our understanding of the biopsychosocial impacts of social dynamics on the wellbeing of historically marginalized individuals, with a special emphasis on biological aging. We leverage this model to advance our mechanistic understanding of the health disparity observed in historically marginalized populations and inform future remediation strategies.

Socially-supported sleep in older adults aged 50 and older: a concept analysis

Introduction

The population of older adults is growing disproportionately, constituting 13% of the global population in 2022, and is expected to double by 2050. One of public health's priorities is healthy aging, the maintenance of functional ability aligned with well-being. As many as 50% of older adults report poor sleep quality, leading to an increased risk of morbidity and mortality. The quality and quantity of social relationships may broadly benefit sleep in older adults. However, the concept of socially-supported sleep is underdeveloped as a basis for intervention.

Methods

Existing literature was searched without time restriction in PubMed, CINAHL, PsycINFO, and Scopus ending in August 2022. Thematic analysis was used to determine the defining attributes, antecedents, and consequences of socially-supported sleep guided by Rodgers' evolutionary concept analysis.

Results

Twenty-nine articles written in English, peer-reviewed, and examined social support and sleep in participants aged ≥50 were included. The defining attributes reflect dimensions of sleep quality. The antecedents are safe and secure, belonging and connection, and warmth and comfort. The consequences of socially-supported sleep include improved regulatory capabilities, physical and emotional well-being, and quality of life.

Conclusion

Socially-supported sleep has the potential to inform interventions that promote sleep in older adults. Ongoing research is needed to address the antecedents and mechanisms through which socially-supported sleep may promote sleep quality for healthy aging.

Social Support, Health Behaviors, Self-Esteem, and Successful Aging in a Sub-Saharan African Sample of Older Adults: Test of a Sequential Mediation Model

Background and Objectives

Previous research demonstrates that social support facilitates successful aging across all cultures. However, the factors that potentially mediate the link between social support and successful aging remain unclear. This study examined whether a healthy lifestyle and self-esteem mediate the association between social support and successful aging. It was hypothesized that the relationship between social support (family, friends, and significant other) and successful aging would be serially mediated by both healthy lifestyle and self-esteem.

Research Design and Methods

Participants were 479 Nigerian retirees (53.4% female) aged 60 to 90 years (Mage = 64.81, SD = 6.86). They provided information on relevant demographic variables and completed the following measures: Fantastic Lifestyle Checklist (Fitness Appraisal), Rosenberg Self-esteem Scale, Multidimensional Scale of Perceived Social Support Scale, and Successful Aging Inventory. Three separate regression models (family, friends, and significant other dimensions of social support) were conducted using the Hayes PROCESS macro for SPSS with 5,000 bootstrap estimates.

Results

Controlling for age and sex, family support, significant other support, friends support, healthy lifestyle, and self-esteem were directly associated with successful aging. The association between family support and successful aging was mediated by healthy lifestyle; and this was also seen for friends' support and significant other support. The sequential path from social support to successful aging through healthy lifestyle, and then via improved self-esteem, was significant for family support and significant other support, but not friends support.

Discussion and Implications

Findings suggest that middle-aged to older adults who have strong support from their families and significant others may be more likely to engage in healthy behaviors and, in turn, experience higher levels of self-esteem, thereby aging well.

What influences life expectancy in people with dementia? Social support as an emerging protective factor

BACKGROUND

The aim of this study was to investigate the role of support from the social environment for the life expectancy in people with dementia beyond well-established individual demographic and clinical predictors over a period of up to 8 years.

METHODS

The analyses are based on data from 500 community-dwelling individuals in Germany who tested positive for dementia and were followed up for up to 8 years. Life expectancy was examined in relation to perceived social support as well as well-established socio-demographic (age, sex) and clinical predictors (cognitive status, functional status, comorbidities), using Cox regressions.

RESULTS

Greater support from the social environment reduced the risk of mortality (hazard ratio [HR]: 0.78; 95% confidence interval [CI]: 0.63-0.98), with the role of emotional support being particularly important. Furthermore, higher age was associated with an increased mortality risk (HR: 1.08; 95% CI: 1.05-1.11), while female sex (HR: 0.64; 95% CI: 0.48-0.85) and higher cognitive (HR: 0.96; 95% CI: 0.93-0.98) and functional status (HR: 0.91; 95% CI: 0.86-0.97) were associated with higher life expectancy.

CONCLUSION

Our study provides novel evidence that less support from the social environment, especially emotional support, is a risk factor for shorter life expectancy in people with dementia-beyond known clinical factors. Not only the clinical and caregiving needs but also their psychosocial needs of individuals with dementia should be emphasised.

Leveraging the interpersonal context of child development to promote family resilience: A universal prevention approach from preconception through early childhood

Significant mental health problems affect one in five youth in the United States; in tandem with the child mental health epidemic, parents in the United States report high and rising rates of burnout and mental health challenges of their own. Multiple well-established theoretical perspectives demonstrate the high degree of interdependence between children's and their parents' mental health, including intergenerational transmission, prenatal programming, attachment, and temperament and self-regulation theories. Drawing on these perspectives, we argue that a universal prevention approach that centers the development of psychopathology within the context of the parent-child dyad can promote resilience and arrest emerging mental health problems for children and their parents, during sensitive developmental windows (e.g., preconception through early childhood). Derived from this integrated theoretical framework, we review empirical support for the following targets to promote family resilience: screening for current and historical parent risk factors and resilience resources; strengthening healthy, reciprocal social ties; and supporting youth socioemotional skill acquisition. Our review of the literature highlights how improvements in these areas can have cascading benefits across development, for both parents and their children, as well as for future generations. We conclude with actionable, empirically-supported recommendations that can have profound impacts on these targets through changes in federal and state policies, community healthcare settings, and early childhood education and care programs. To achieve enduring, multigenerational impacts, societal and community-level policies, programs, and practices must interweave efforts to support child mental health with efforts to promote parent adjustment and wellbeing.

Relationships Among Heart Rate Variability, Perceived Social Support, and Hopelessness in Adults With Ischemic Heart Disease

BACKGROUND

Lower perceived social support is associated with hopelessness in patients with ischemic heart disease (IHD). Higher perceived social support is associated with higher heart rate variability (HRV) in adults following a stressful event, but the relationship between HRV and hopelessness has not been examined in patients with IHD. The purpose of this research was to evaluate the relationships among HRV, perceived social support, and hopelessness in patients with IHD.

METHODS AND RESULTS

Ninety-four participants were enrolled while hospitalized for an IHD event at a large hospital in the United States. Data collection occurred 2 weeks after hospital discharge and included the State-Trait Hopelessness Scale, ENRICHD Social Support Inventory, Patient Health Questionnaire-9, a demographic form, and a short-term HRV measurement taken at rest. Linear models were used to assess associations between variables in unadjusted and adjusted models. Most participants were men (67%), married (75%), and non-Hispanic White (96%) and underwent coronary artery bypass surgery (57%). There were inverse correlations between high frequency HRV and state hopelessness (r=-0.21, P=0.008) and root mean square of successive differences between normal heartbeats HRV and state hopelessness (r=-0.20, P=0.012) after adjusting for important covariates. High frequency and root mean square of successive differences between normal heartbeats did not show evidence of mediating the relationship between perceived social support and hopelessness.

CONCLUSIONS

There were significant inverse correlations between parasympathetic measures of HRV and hopelessness. Assessing high frequency and root mean square of successive differences between normal heartbeats during early recovery following an IHD event could provide promising evidence for understanding a possible precursor to hopelessness and targets for future interventions. Registration Information: clinicaltrials.gov. Identifiers: NCT03907891, NCT05003791.

Health Care Access and Quality of Life of Community-Dwelling Senior Citizens in Pampanga, Philippines

This study examined the association between healthcare access and quality of life (QOL) among senior citizens in Pampanga, Philippines. We conducted a cross-sectional study among 410 community-dwelling senior citizens aged 60 and above. Using validated scales, we assessed both healthcare access and QOL. Descriptive statistics were employed to characterize the senior citizens, and multiple linear regression was used to examine the association between healthcare access and QOL. Senior citizens, averaging 69 years old, were predominantly women, single/widowed, and with comorbidities. They reported high healthcare access (mean = 120.13) and moderate QOL (mean = 70.79). Environmental health scored highest in QOL domains, while social relationships scored lowest. Overall healthcare access was positively associated with overall QOL (B [unstandardized beta] = .22, 95% CI [confidence interval] 0.10, 0.33) and its domains. Significant associations with overall QOL were observed for accessibility (B = 1.95, 95% CI 0.98, 2.91) and affordability (B = -1.60, 95% CI -2.46, -0.74). Filipino senior citizens in Pampanga demonstrated high healthcare access and moderate QOL. The study highlights the importance of healthcare access in enhancing senior citizens' QOL, particularly regarding accessibility and affordability. Further research is needed to explore the nuanced relationships between healthcare access subscales and specific QOL domains.

Psychosocial Factors Associated with Lower Urinary Tract Symptoms One Year Postpartum

Pregnancy carries substantial risk for developing lower urinary tract symptoms (LUTSs), with potential lifelong impacts on bladder health. Little is known about modifiable psychosocial factors that may influence the risk of postpartum LUTSs. We examined associations between depressive symptoms, perceived stress, and postpartum LUTSs, and the moderating effects of perceived social support, using data from a cohort study of Expect With Me group prenatal care (n = 462). One year postpartum, 40.3% participants reported one or more LUTS. The most frequent LUTS was daytime frequency (22.3%), followed by urinary incontinence (19.5%), urgency (18.0%), nocturia (15.6%), and bladder pain (6.9%). Higher odds of any LUTS were associated with greater depressive symptoms (adjusted odds ratio (AOR) 1.08, 95% confidence interval (CI) 1.04-1.11) and perceived stress (AOR 1.12, 95% CI 1.04-1.19). Higher perceived social support was associated with lower odds of any LUTS (AOR 0.94, 95% CI 0.88-0.99). Perceived social support mitigated the adverse effects of depressive symptoms (interaction AOR 0.99, 95% CI 0.98-0.99) and perceived stress (interaction AOR 0.97, 95% CI 0.95-0.99) on experiencing any LUTS. Greater depressive symptoms and perceived stress may increase the likelihood of experiencing LUTSs after childbirth. Efforts to promote bladder health among postpartum patients should consider psychological factors and social support.

Characterizing the mechanisms of social connection

Understanding how individuals form and maintain strong social networks has emerged as a significant public health priority as a result of the increased focus on the epidemic of loneliness and the myriad protective benefits conferred by social connection. In this review, we highlight the psychological and neural mechanisms that enable us to connect with others, which in turn help buffer against the consequences of stress and isolation. Central to this process is the experience of rewards derived from positive social interactions, which encourage the sharing of perspectives and preferences that unite individuals. Sharing affective states with others helps us to align our understanding of the world with another's, thereby continuing to reinforce bonds and strengthen relationships. These psychological processes depend on neural systems supporting reward and social cognitive function. Lastly, we also consider limitations associated with pursuing healthy social connections and outline potential avenues of future research.

The effects of challenge or social buffering on cortisol, testosterone, and antler growth in captive red deer (Cervus elaphus) males

We equipped 17 captive red deer males (Cervus elaphus) with GPS collars to measure inter-individual distances throughout the 5-months of the antler growth period. We expected some individuals to associate regularly with others while others would not. We predicted that males aggregating with others within a socially stable environment (Associates) would benefit from a form of "social buffering" and would likely have lowered cortisol (C) and testosterone (T) concentrations. Males only irregularly joining social groupings would experience elevated levels of aggression; according to the "Challenge hypothesis", their T and C concentrations should increase. Interacting with a higher proportion of Associates did indeed reduce C concentrations. Conversely, avoiding Associates and challenging other males stimulated the T secretion. Admittedly, males avoiding regular proximity to others tended to develop the largest antlers. They probably benefited from frequent successful agonistic threats to conspecifics, resulting in elevated T concentrations. Regular association with tolerant, conspecifics and "social buffering" did not seem sufficient for producing larger antlers despite reducing C concentrations. Alternative social strategies were adopted within the same group of individuals and showed how the trade-off between these strategies could have an essential impact on C and T concentrations.

Sex differences in frailty among older adults

By definition, aging is a natural, gradual and continuous process. On the other hand, frailty reflects the increase in vulnerability to stressors and shortens the time without disease (health span) while longevity refers to the length of life (lifespan). The average life expectancy has significantly increased during the last few decades. A longer lifespan has been accompanied by an increase in frailty and decreased independence in older adults, with major differences existing between men and women. For example, women tend to live longer than men but also experience higher rates of frailty and disability. Sex differences prevent optimization of lifestyle interventions and therapies to effectively prevent frailty. Sex differences in frailty and aging are rooted in a complex interplay between uncontrollable (genetic, epigenetic, physiological), and controllable factors (psychosocial and lifestyle factors). Thus, understanding the underlying causes of sex differences in frailty and aging is essential for developing personalized interventions to promote healthy aging and improve quality of life in older men and women. In this review, we have discussed the key contributors and knowledge gaps related to sex differences in aging and frailty.

Hula as a physical activity and social support intervention for sustained activity in female breast and gynecologic cancer survivors

Background

Physical activity improves health and psychosocial functioning for people who have been diagnosed with cancer. Native Hawaiians face disparities for some cancers, including breast cancer. Delivering culturally grounded interventions has the potential to improve enjoyment and adherence to the intervention. We sought to test the adherence and impact of a 6 month randomized wait-list controlled trial of hula.

Methods

In this randomized wait-list controlled design people who had been diagnosed with breast or gynecologic cancers were invited to participate with other cancer survivors in a group based setting. Participants were randomized to begin hula immediately or after six months. Attendance was collected and heart-rate measured three times per session. In addition, demographic data, self-report psychosocial data, and biological data (findings will be reported elsewhere) were collected at three time points: baseline, 6 months, and 12 months. The study included six months of hula, twice per week, 60 min each session. In addition, participants committed to practice 60 min per week at home.

Results

Participants in the study (n = 42) attended, on average, 72% of the sessions. Significant increase in moderate physical activity (d = 0.50, p = 0.03) was observed in the intervention versus control group. For the measures of intra-individual changes pre-and post-intervention, an increase in total physical activity were seen in the intervention group (d = 0.69, p = 0.003), daily caloric intake decreased (d = -0.62, p = 0.007), and a reduction in waist circumference (d = -0.89, p = 0.0002) that was sustained six months after completion of the intervention. Psychosocially, cognitive functioning significantly declined from baseline to 12 months (d = -0.50, p = 0.03), with role functioning improving (d = 0.55, p = 0.02), social constraints increasing (d = 0.49, p = 0.03), and financial difficulties improving (d = -0.55, p = 0.02).

Conclusion

Sustainable physical activity is crucial to improve both the survival and quality of life of cancer survivors. Culturally grounded interventions, such as hula have the potential to increase the maintenance of physical activity. In addition, they create a support group where the benefits of people who have all experienced cancer can gather and garner those benefits of social support, too. This study was registered as a clinical trial through the National Cancer Institute (NCT02351479).

Clinical trial registration

Clinicaltrails.gov, NCT02351479.

Sex Moderates the Relationship Between Social Support and Cardiovascular Prevention Behaviors in Middle-aged and Older Adults

BACKGROUND

Most risk factors for cardiovascular disease (CVD) are modifiable, suggesting that the burden of CVD could be substantially reduced through cardiovascular screening and healthier lifestyle. People who have social support are more likely to adhere to cardiovascular prevention recommendations, but it is not clear whether the benefit of social support is equal for men and women.

PURPOSE

We investigated whether sex moderates the relationship between social support and adherence to cardiovascular prevention recommendations in a nationally representative sample.

METHODS

Participants were 17,287 adults (n = 10,264 middle-aged adults 40-64 years old and n = 7,023 older adults ≥ 65 years old) who participated in the National Health Survey of Spain in 2017. Social support was measured with the Functional Social Support Questionnaire of Duke-UNC. Adherence to cardiovascular screening recommendations was assessed based on self-reported testing of cholesterol, blood pressure, and blood sugar by a health professional in the past 12 months. Adherence to recommended health-related behaviors was assessed based on the guidelines of the European Society of Cardiology regarding diet, alcohol consumption, smoking, and physical activity.

RESULTS

Multiple regression models adjusted for socio-demographic and cardiovascular history and risk variables showed that social support was more strongly associated with adherence to cardiovascular prevention recommendations in men than in women. In particular, low social support levels were especially detrimental for both middle-aged men (screening: B = 0.13, 95% CI [0.06-0.20], p < .001; behaviors: B = 0.33 [0.26-0.41], p < .001) and older men (screening: B = 0.10 [0.04-0.17], p = .001; behaviors: B = 0.16 [0.08-0.25], p < .001), whereas older women had comparatively high adherence, which was unrelated to social support (screening: B = 0.02 [-0.03 to 0.08], p = .433; behaviors: B = 0.03 [-0.03 to 0.10], p = .342).

CONCLUSIONS

Social support is more strongly associated with cardiovascular prevention in men than in women, such that men who lack social support have the lowest adherence to cardiovascular screening and lifestyle recommendations.

Peer support interventions in patients with kidney failure: A systematic review

BACKGROUND

Peer support has been associated with improved health-related outcomes (e.g., psychological well-being and treatment adherence) among patients with serious, chronic conditions, including kidney disease. Yet, there is little existing research evaluating the effects of peer support programs on health outcomes among patients with kidney failure being treated with kidney replacement therapy.

METHODS

Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a systematic review using five databases to assess the effects of peer support programs on health-related outcomes (e.g., physical symptoms, depression) among patients with kidney failure undergoing kidney replacement therapy.

RESULTS

Peer support in kidney failure was assessed across 12 studies (eight randomized controlled trials, one quasi-experimental controlled trial, and three single-arm trials) with 2893 patients. Three studies highlighted the links between peer support and improved patient engagement with care, while one found peer support did not significantly impact engagement. Three studies showed associations between peer support and improvements in psychological well-being. Four studies underscored the effects of peer support on self-efficacy and one on treatment adherence.

CONCLUSIONS

Despite preliminary evidence of the positive associations between peer support and health-related outcomes among patients with kidney failure, peer support programs for this patient population remain poorly understood and underutilized. Further rigorous prospective and randomized studies are needed to evaluate how peer support can be optimized and incorporated into clinical care for this vulnerable patient population.

The Association Between Group Identity and Post-Traumatic Growth in the Post COVID-19 Era: The Mediating Effect of Social-Emotional Competence

Purpose

To investigate the impact of human-society relationships on individual post-traumatic growth (PTG) in the post COVID-19 era, this study examined the association between group identity (GI) and PTG, and explored the mediating role of social-emotional competence (SEC).

Patients and Methods

In this cross-sectional study, we surveyed 1203 high school students in an eastern region of China using the GI Scale, the SEC Scale, and the PTG Scale. We conducted correlation and mediation analyses using SPSS 23.0 and PROCESS software.

Results

The results indicated that GI was a significant positive predictor of PTG (β=0.219, p<0.001), and that the pathway between GI and PTG was partially mediated by SEC (Effect=0.074, 95% CI= [0.045,0.104]).

Conclusion

GI can have both direct and indirect effects on PTG, with the latter mediated by SEC. These findings hold important theoretical and practical implications for promoting PTG and enhancing mental health in the post COVID-19 era.

Interpersonal Stressors and Resources for Support: Associations with Lower Urinary Tract Symptoms and Impact Among Women

Background: This study utilizes Coronary Artery Risk Development in Young Adults (CARDIA) data to examine whether women's perceived emotional support and interpersonal stressors are associated with lower urinary tract symptoms (LUTS) and their impact on quality of life. Materials and Methods: Emotional support was assessed at baseline/year 0 (1985-86), year 2 (1987-88), year 15 (2000-01), and year 20 (2005-06); interpersonal stressors were assessed at years 15 and 20. In 2012-13, LUTS and impact were assessed. LUTS/impact category (a composite variable ranging from bladder health to mild, moderate, and severe LUTS/impact) was regressed on trajectory groups of emotional support from years 0 to 20. Separately, LUTS/impact was regressed on mean emotional support and interpersonal stressors across years 15-20. Analyses were adjusted for age, race, education, and parity (n = 1104). Results: In comparison to women whose support trajectory from years 0 to 20 was consistently high, women whose support decreased from high to low had over twice the odds (odds ratio [OR] = 2.72; 95% confidence interval [CI] = 1.76-4.20) of being classified into a more burdensome LUTS/impact category. Mean support and interpersonal stressors across years 15-20 were independently associated with lower odds (OR = 0.59; 95% CI = 0.44-0.77) and greater odds (OR = 1.52; 95% CI = 1.19-1.94), respectively, of being classified into a more burdensome LUTS/impact category. Conclusions: In the CARDIA cohort, quality of women's interpersonal relationships, assessed between 1985-86 and 2005-06, was associated with LUTS/impact assessed in 2012-13. Additional research collecting LUTS/impact data at multiple time points is needed to test potential bidirectional associations of emotional support and interpersonal stressors with LUTS/impact, as well as potential mechanisms of association.

Social Safety Theory: Conceptual foundation, underlying mechanisms, and future directions

Classic theories of stress and health are largely based on assumptions regarding how different psychosocial stressors influence biological processes that, in turn, affect human health and behavior. Although theoretically rich, this work has yielded little consensus and led to numerous conceptual, measurement, and reproducibility issues. Social Safety Theory aims to address these issues by using the primary goal and regulatory logic of the human brain and immune system as the basis for specifying the social-environmental situations to which these systems should respond most strongly to maximize reproductive success and survival. This analysis gave rise to the integrated, multi-level formulation described herein, which transforms thinking about stress biology and provides a biologically based, evolutionary account for how and why experiences of social safety and social threat are strongly related to health, well-being, aging, and longevity. In doing so, the theory advances a testable framework for investigating the biopsychosocial roots of health disparities as well as how health-relevant biopsychosocial processes crystalize over time and how perceptions of the social environment interact with childhood microbial environment, birth cohort, culture, air pollution, genetics, sleep, diet, personality, and self-harm to affect health. The theory also highlights several interventions for reducing social threat and promoting resilience.

Liposaccharide-induced sustained mild inflammation fragments social behavior and alters basolateral amygdala activity

RATIONALE

Conditions with sustained low-grade inflammation have high comorbidity with depression and anxiety and are associated with social withdrawal. The basolateral amygdala (BLA) is critical for affective and social behaviors and is sensitive to inflammatory challenges. Large systemic doses of lipopolysaccharide (LPS) initiate peripheral inflammation, increase BLA neuronal activity, and disrupt social and affective measures in rodents. However, LPS doses commonly used in behavioral studies are high enough to evoke sickness syndrome, which can confound interpretation of amygdala-associated behaviors.

OBJECTIVES AND METHODS

The objectives of this study were to find a LPS dose that triggers mild peripheral inflammation but not observable sickness syndrome in adult male rats, to test the effects of sustained mild inflammation on BLA and social behaviors. To accomplish this, we administered single doses of LPS (0-100 μg/kg, intraperitoneally) and measured open field behavior, or repeated LPS (5 μg/kg, 3 consecutive days), and measured BLA neuronal firing, social interaction, and elevated plus maze behavior.

RESULTS

Repeated low-dose LPS decreased BLA neuron firing rate but increased the total number of active BLA neurons. Repeated low-dose LPS also caused early disengagement during social bouts and less anogenital investigation and an overall pattern of heightened social caution associated with reduced gain of social familiarity over the course of a social session.

CONCLUSIONS

These results provide evidence for parallel shifts in social interaction and amygdala activity caused by prolonged mild inflammation. This effect of inflammation may contribute to social symptoms associated with comorbid depression and chronic inflammatory conditions.

Correlated evolution of social organization and lifespan in mammals

Discerning the relationship between sociality and longevity would permit a deeper understanding of how animal life history evolved. Here, we perform a phylogenetic comparative analysis of ~1000 mammalian species on three states of social organization (solitary, pair-living, and group-living) and longevity. We show that group-living species generally live longer than solitary species, and that the transition rate from a short-lived state to a long-lived state is higher in group-living than non-group-living species, altogether supporting the correlated evolution of social organization and longevity. The comparative brain transcriptomes of 94 mammalian species identify 31 genes, hormones and immunity-related pathways broadly involved in the association between social organization and longevity. Further selection features reveal twenty overlapping pathways under selection for both social organization and longevity. These results underscore a molecular basis for the influence of the social organization on longevity.

"When you hear the noise, you know it's love": Family Support in American Indian Communities

Family relationships are an important source of emotional and instrumental support. In American Indian (AI) communities, families often provide support for women during childbirth and childrearing. The present study sought to gain insight into the influence of family during the pregnancy, childbirth, and childrearing experiences of AI women from a Gulf Coast tribe. A qualitative descriptive research design was used, and 31 interviews were conducted with women from the tribe. The average age of participants was 51.17, and the majority of women had 2 to 3 children. Data was analyzed using a content analysis approach. Themes that emerged include: Influence of Childhood on Participant's Families and Parenting Styles, Significance of Family Emotional Closeness, Significance of Family Physical Closeness, Importance of Taking Care of Family Members, Importance of Family in Childbirth, and Generational Shifts in Caregiving. Results of the study may influence health interventions for this community, and results should encourage health care providers to consider positive implications of including family and community supports in care.

Assessment of socio-relational self-efficacy in breast cancer patients: Italian validation of the social relationship coping efficacy scale (SRCE-I)

BACKGROUND

Social relationship coping efficacy (SRCE) represents the ability to maintain or enhance social relationships in the context of serious illness. The purpose of the current study was to confirm the factor structure, psychometric properties, and utility of the Italian version of the SRCE scale.

METHODS

181 breast cancer patients completed the SRCE-Italian (SRCE-I), the Cancer Behavior Inventory-Brief/Italian (CBI-B/I), quality of life (QOL) measures (EORTC QLQ-C30; EORTC QLQ-BR23), and the Hospital Anxiety and Depression Scale (HADS).

RESULTS

The SRCE-I was internally consistent (Cronbach alpha = .95) and factor analysis confirmed that the SRCE-I was a unidimensional construct. In terms of validity, the SRCE-I was correlated with QOL (EORTC QLQ-30, Social Functioning, r = .33, Emotional Functioning, r = .57, and Global Health/Quality of Life; r = .54) and scales of the EORTC QLQ-BR23 (e.g., Future Perspective, r = .38; Breast Symptoms, -.31). SRCE-I was also correlated negatively with the HADS (r = -.72) and positively with the CBI-B/I (r = .79), a measure of coping efficacy (all ps < .001). Mediation analyses confirmed the utility of the SRCE-I scale as a mediating mechanism in enhancing social functioning and QOL.

CONCLUSIONS

The SRCE-I is a structurally sound, reliable, and valid measure that assesses the ability to maintain or enhance social support and mitigate the loss of social support. The SRCE-I can be used as a screening measure to assess low efficacy for maintaining social support or as a measure to detect the change in efficacy for enhancing social support in interventions to improve the QOL of patients.