Adult Community Research Articles

Conflict Transformation in South Omo Zone Pastoralist and Agro-Pastoralist Community of Ethiopia

This study explores conflict transformation practices and actors through an analytical research approach. It reveals that various actors engaged in conflict and peace initiatives have primarily focused on activities cantered around conflict management, prevention, and resolution. This limited emphasis on conflict transformation is attributed to a lack of governmental attention to strategic planning in this regard. Sources of conflict identified include grievances, animal raiding, land disputes, fishing rights, and competition over water and pasture resources. Efforts aimed at conflict transformation encompass resilience-building, rangeland management, NGO interventions in peace dialogues, integration of pastoralism and agro-pastoralism with commercial agriculture, implementation of drought and conflict early warning systems, water resource management and development, range land rehabilitation, and provision of education to affected communities. While these activities have played a significant role in addressing conflicts and transforming relationships, they are deemed insufficient and inadequately executed for comprehensive conflict transformation. Nonetheless, they serve as vital drivers of peace. Although the current conflict transformation mechanisms in place have not resulted in significant changes in the conflict situation, the beginnings are promising and commendable. The government and other stakeholders are urged to engage in proactive conflict intervention mechanisms to effectuate conflict transformation and foster peace or mitigate its adverse impacts. Furthermore, the study advocates for the provision of informal peace education to all adult community members, with the possibility of formalizing this education as an existing conflict transformation option.

Factors influencing adoption of sexual and reproductive health intervention for adolescents in Ebonyi, Nigeria.

School and Community-embedded reproductive health interventions have been implemented in developing countries, with evidence that they led to improved sexual and reproductive health among adolescents. However, this type of intervention is rarely evaluated for its potential adoption and use. This study evaluated the constraints and enablers of the adoption of a school and community-embedded intervention that used community engagement, capacity building, partnerships and collaborations to deliver sexual and reproductive health services to adolescents. The intervention was implemented between 2019 and 2021 in six local government areas in Ebonyi State. The results on adoption presented here were collected four months into the mid-phase of the project, targeting adolescents, parents, adult family members, healthcare providers, local authorities, and community members. Sixteen in-depth interviews were conducted with policymakers, 14 with health service providers and 18 Focus Group Discussions (FGDs) with parents, community leaders and adolescents who were part of the implementation process. The coding reliability approach, a type of thematic data analysis was used, that involves early theme development and the identification of evidence for the themes. The adoption of school and community-embedded reproductive health intervention was strong among stakeholders at the early stages of the implementation process. Multi-stakeholder involvement and its multi-component approach made the intervention appealing, thereby enabling its adoption. However, at the later stage, the adoption was constrained by beliefs and norms about sexual and reproductive health (SRH) and the non-incentivisation of stakeholders who acted as advocates at the community level. The sustainability of the intervention may be threatened by the non-incentivisation of stakeholders and the irregular supply of materials and tools to facilitate SRH advocacy at the community level. The inclusive community-embedded reproductive health intervention was adopted by stakeholders because of the enablers which include timely stakeholder engagement. However, for it to be sustainable, implementers must address the non-incentivising of community-level advocates which serve as constraints.

Factors facilitating and hindering South Asian immigrant adults from engaging in exercise and physical activity - a qualitative systematic review.

Exercise and physical activity are key components of management in patients with rheumatic musculoskeletal diseases (RMD), but people of the South Asian communities have a lower level of engagement with these activities compared to their Caucasian counterparts. The aim of this qualitative systematic review was to determine the barriers and facilitators of exercise and physical activity in South Asian communities who have migrated and live in western countries, particularly in those who have RMD. Qualitative studies, published in English between 1999 and 2021 and including evaluation of barriers and/or facilitators to exercise or physical activity behaviour in people of South Asian adult communities who have migrated and/or lived in western countries were identified from Embase, MEDLINE, CINAHL, PsycINFO, Google Scholar and manual searches. The studies were appraised using the CASP checklist. Inductive thematic synthesis was used to identify common and global themes. A total of 32 studies that discussed barriers and facilitators of physical activity in South Asian communities who have migrated and lived in western countries were used for this review but there were no studies identified that focussed specifically on those with RMD. Following appraisal of the reporting of the studies, 30 studies were included in the pooling of the results. The facilitators and barriers to physical activities were broadly categorized into 'extrinsic' and 'intrinsic' factors. Extrinsic factors such as 'opportunity' included environmental factors such as weather and safety; socioeconomic factors such as education, language and literacy, and support in the form of social, psychological and resources. Intrinsic factors included cultural factors, such as life stages and family influence, beliefs and knowledge, which impacted attitudes and skills. This review has synthesised evidence of barriers or facilitators and identified potentially modifiable factors influencing physical activity and exercise engagement, which could form the basis of evidence-based interventions to promote participation in healthy behaviour change. Provision of a safe, comfortable and culturally acceptable environment together with culturally-aligned cognitive strategies to facilitate acquisition of exercise-efficacy skills could help engagement. The systematic review was registered on PROSPERO, registration no. 289,235.

Connections between specific mental health diagnoses of schizophrenia, bipolar disorder and schizoaffective disorder and primary substance use

PurposeThis study aims to use the database of consumers referred to the dual diagnosis shared care service to examine those connections. The Eastern Dual Diagnosis Service, based in Melbourne, Australia, has established a database of consumers with co-occurring mental health disorders and problematic substance use. An examination of mental health and substance-use information obtained over a two-year period in the delivery of dual diagnosis shared care to consumers of mental health services is supporting an improved understanding of substance use and the connections to specific mental health diagnoses of schizophrenia, bipolar disorder and schizoaffective disorder.Design/methodology/approachThis research uses a quantitative approach to review the prevalence of primary substance use and mental health diagnoses for consumers referred to as dual diagnosis shared care. Reviewed are referrals from adult mental health community and rehabilitation teams operating within a mental health and well-being program between January 2019 and December 2020 inclusive.FindingsOf the 387 clients referred to the specialist dual diagnosis shared care, methamphetamine, alcohol and cannabis are associated with 89.4% of the primary mental health diagnosis (PMHD). The most common PMHDs are schizophrenia, schizoaffective disorder and bipolar disorder. The most common PMHD and substance-use connection was schizophrenia and methamphetamine. Nicotine was reported to be used by 84% of consumers and often occurred in addition to another problematic primary substance.Originality/valueImproved dual diagnosis data collection from a community-based clinical mental health service is increasing understanding of the mental health and substance-use relationship. This is now providing clarity on routes of investigation into co-occurring mental health and problematic substance-use trends and guiding improved integrated treatments within a contemporary mental health setting.

Where Should Senior Welfare Centers Stand in Older Adult Care in South Korea?

Senior Welfare Centers, the vital community facilities known mostly as leisure venues for older adults in South Korea, are expanding their roles as older adult care providers to respond to the aging population. However, their roles remain unclear, which makes it difficult to utilize their potential and establish a position in older adult care. This study conducted qualitative research to clarify and seek the role of Senior Welfare Centers by exploring their experiences in two major older adult care services, Community Care and Customized Care, through a focus group interview conducted with 13 Senior Welfare Center professionals. Using qualitative thematic analysis, the findings resulted in two main themes: (1) experiences of Community Care and Customized Care and (2) redefining the role of Senior Welfare Centers in older adult care. Nine subthemes presented limitations in the care system and possible strategies to ameliorate the care roles of Senior Welfare Centers. The findings indicate recommendations at the facility, client, and governmental levels for Senior Welfare Centers to reestablish their position in older adult care. The study recommends future research to study policies and care services maximizing strengths and potentials of Senior Welfare Centers to redesign optimized older adult care in South Korea.

"Infertility Isn't a Choice!": Conversations on Twitter about the Financial Burden of Oncofertility Care.

This study aimed to evaluate how the adolescent and young adult (AYA) cancer community utilized Twitter to discuss the financial challenges of oncofertility care and to advocate for change. Tweets related to oncofertility and finances (n = 166), collected over a 12-week time period encompassing AYA Cancer Awareness Week, were thematically analyzed. Conversations highlighted how the high cost of care contributed to already high emotional and social distress. Proposed actions included providing timely information more equitably, improving access to financial support, and continued advocacy of policy changes to improve access to oncofertility care. Future research can explore the potential impact on policy change and clinical care.

Knowledge, Attitude and Perception of Hypertension among Residents of Akpor Community in Rivers State: A Descriptive Cross-Sectional Study

Background: Hypertension, also known as high blood pressure, is a serious condition of public health concern. It is the leading modifiable risk factor for cardiovascular disease and premature death worldwide, and can increase the risk of heart, brain, kidney and other diseases. Aim: This study aimed at determining the knowledge, attitude, and perception of hypertension among residents of Akpor kingdom, a semi-urban community in Rivers State. Methods: The study adopted a descriptive cross-sectional study design in which 284 apparently healthy community-based adult male and female individuals were purposively selected in four semi-urban communities of Akpor kingdom in Obio-Akpor Local Government Area of Rivers State. A structured questionnaire consisting of socio-demographic characteristics and research questions on knowledge, attitude and perception of hypertension was self-administered to the participants after obtaining their informed consents. All other ethical procedures were followed in line with the Declaration of Helsinki. Data was analyzed using SPSS version 25. Descriptive statistics was used to present the data in frequency tables. Results: Majority of the respondents were males 154 (54.2%), married 195 (68.7%), and between the ages of 40 and 50 (41.5%). Majority 164 (57.8%) had good knowledge of hypertension while 18 (6.3%) had no knowledge of hypertension at all. The prevalence of hypertension was 62 (21.8%), while 102 (35.9%) were not aware whether or not they were hypertensive. Majority of the hypertensive respondents 48 (16.9%) knew their status through medical diagnosis in hospitals/clinics while 14 (4.9%) knew theirs through other means. Majority of the hypertensive respondents 34 (54.8%) had a positive attitude in seeking healthcare while 28 (45.2%) had a negative attitude. Regarding lifestyle modification, 16 (25.8%) had a negative attitude/perception of hypertension out of which 9 (14.5%) never engaged in any form of lifestyle modification, while 7 (11.3%) managed their condition through prayers and other religious practices. Conclusion: A substantial percentage of most adult community dwellers still have poor knowledge of hypertension and negative attitude towards seeking healthcare despite the seemingly increase in public health campaigns in our communities. There is need for all stakeholders to join hands and intensify campaigns that would educate the populace on facts about hypertension, its prevention and management

Unpacking interactions among student teams in a practice-based IPE setting: a qualitative evaluation study

ABSTRACT In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.

The Intuitive Eating Scale-3: Development and psychometric evaluation

Intuitive eating has been found to protect against disordered eating and preserve well-being. Yet, there are methodological (length), conceptual (inconsideration of medical, value-based, and access-related reasons for food consumption), and psychometric (item wording) concerns with its most common measure, the Intuitive Eating Scale-2 (IES-2). To address these concerns, we developed the IES-3 and investigated its psychometric properties with U.S. community adults. Across three online studies, we evaluated the IES-3's factorial validity using exploratory factor analysis (EFA; Study 1; N = 957; Mage = 36.30), as well as confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), bifactor-CFA, and bifactor-ESEM (Study 2; N = 1152; Mage = 40.95), and cross-validated the optimal model (Study 3; N = 884; Mage = 38.54). We examined measurement invariance across samples and time, differential item functioning (age, body mass index [BMI], gender), composite reliability, and validity. Study 1 revealed a 12-item, 4-factor structure (unconditional permission to eat, eating for physical reasons, reliance on hunger and satiety cues, body-food choice congruence). In Study 2, a bifactor-ESEM model with a global intuitive eating factor and four specific factors best fit the data, which was temporally stable across three weeks. This model also had good fit in Study 3 and, across Studies 2 and 3, and was fully invariant and lacked measurement bias in terms of age, gender, and BMI. Associations between latent IES-3 factors and age, gender, and BMI were invariant across Studies 2 and 3. Composite reliability and validity (relationships with disordered eating, embodiment, body image, well-being, and distress; negligible relationship with impression management) of the retained model were also supported. The 12-item IES-3 demonstrates strong psychometric properties in U.S. community adults. Research is now needed using the IES-3 in other cultural contexts and social identity groups.

Intergenerational and informal learning in communities

Digital Drop-In is a pilot project that aims to provide an informal social environment where older adults can come together to enhance their digital skills through facilitated informal peer and intergenerational learning (IGL). This qualitative study explores the digital skills assistance provided by a small sample of secondary school students aged 15 to16 years to older adult participants in a series of pilot workshops in a secondary school in Ireland during Autumn 2023. Feedback solicited from participants following completion of the workshops yielded the following preliminary observations. First, from the perspectives of the students, all of whom had volunteered for the project, agreement that the learning experience was successful and that their motivation for volunteering was worthwhile. Second, from the perspective of the older adult participants, there was value in the personalised nature of the one-to-one learner-led exchanges by contrast with instructor-led offerings. Finally, from the perspective of the facilitator, guiding learner-led exchanges in informal social environments requires flexibility to meet the needs of individual learners. In Spring 2024, data are planned to be collected from both generations through an online survey instrument and generational focus groups.When complete, this study will contribute to the field of intergenerational research by exploring the perspectives of mid-teenagers involved in an intergenerational exchange to support the digital skills of older adult community members in Ireland. It has potential to offer a contribution to the field of informal peer learning by proposing the role of a facilitator to guide and support the digital skills knowledge exchange in informal social settings.

Polycyclic aromatic hydrocarbons exposure and arterial stiffness-related plasma miRNAs: A panel study

The underlying mechanisms between polycyclic aromatic hydrocarbons (PAHs) exposure and arterial stiffness are poorly understood. We carried out a panel study involving three repeated surveys to examine the associations of individual and mixture of PAHs exposure with arterial stiffness-related miRNAs among 123 community adults. In linear mixed-effect (LME) models, we found that urinary 9-hydroxyfluorene (9-OHFlu), 2-hydroxyphenanthrene (2-OHPh), 9-hydroxyphenanthrene (9-OHPh) at lag 0 day were positively linked to miR-146a and/or miR-222. The Bayesian kernel machine regression (BKMR) analyses revealed positive overall associations of PAHs mixture at lag 0 day with miR-146a and miR-222, and urinary 9-OHFlu contributed the most. In addition, an inter-quartile range (IQR) increase in urinary 9-OHFlu at lag 0 day was associated with elevated miR-146a and miR-222 by 0.16 (95% CI: 0.02, 0.30) to 0.34 (95% CI: 0.13, 0.54). Accordingly, exposure to PAHs, especially 9-OHFlu at lag 0 day, was related to elevated arterial stiffness-related plasma miRNAs.

A tale of two marital stressors: Comparing proinflammatory responses to partner distress and marital conflict

Marital quality shares ties to inflammatory conditions like cardiovascular disease and diabetes. For decades, research has focused on marital conflict as a primary mechanism given its potential to trigger inflammatory responses. However, longitudinal evidence suggests that marital conflict declines over time, and little attention has been paid to the inflammatory aftermath of other types of marital exchanges. A spouse’s emotional distress is an important but overlooked marital context, as partners are exposed to each other’s upsetting emotions throughout adulthood. To directly compare reactivity in proinflammatory gene expression to these two marital stressors and to examine differences by age and marital satisfaction, 203 community adults ages 25–90 (N = 102 couples) provided blood samples and rated their negative mood before and after they 1) watched their partner relive an upsetting personal memory and, in a separate visit 1–2 weeks later, 2) discussed a conflictual topic in their relationship. Controlling for age, sex, race/ethnicity, BMI, alcohol use, smoking, and comorbidities, increases in proinflammatory gene expression were significantly larger after the partner’s upsetting disclosure than after marital conflict (B = 0.073, SE = 0.031, p = .018). This pattern paralleled emotional reactivity to the tasks, wherein negative mood rose more in response to the partner’s disclosure than to marital conflict (B = 4.305, SE = 1.468, p = .004). In sum, proinflammatory and mood reactivity to spousal distress exceeded reactivity to marital conflict, a well-established marital stressor. Findings reveal spousal distress as a novel mechanism that may link marriage to inflammation-related diseases, and even pose risks for both happy and unhappy couples across adulthood.

Lower Urinary Tract Symptoms in US Women: Contemporary Prevalence Estimates from the RISE FOR HEALTH Study.

We aimed to estimate the prevalence of a wide range of lower urinary tract symptoms (LUTS) in US women, and explore associations with bother and discussion with health care providers, friends, and family. We analyzed baseline data collected from May 2022 to December 2023 in the RISE FOR HEALTH study-a large, regionally representative cohort study of adult female community members. LUTS and related bother were measured by the 10-item Symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index, and discussion was assessed by a study-specific item. Of the 3000 eligible participants, 73% (95% CI 71%-74%) reported any storage symptoms, 52% (95% CI 50%-53%) any voiding or emptying symptoms, and 11% (95% CI 10%-13%) any pain with bladder filling, for an overall LUTS prevalence of 79% (95% CI 78%-81%). This prevalence estimate included 43% (95% CI 41%-45%) of participants with mild to moderate symptoms and 37% (95% CI 35%-38%) with moderate to severe symptoms. Over one-third of participants reported LUTS-related bother (38%, 95% CI 36%-39%) and discussion (38%, 95% CI 36%-40%), whereas only 7.1% (95% CI 6.2%-8.1%) reported treatment. Urgency and incontinence (including urgency and stress incontinence) were associated with the greatest likelihood of bother and/or discussion (adjusted prevalence ratios = 1.3-2.3), even at mild to moderate levels. They were also the most commonly treated LUTS. LUTS, particularly storage LUTS such as urgency and incontinence, were common and bothersome in the RISE study population, yet often untreated. Given this large burden, both prevention and treatment-related interventions are warranted to reduce the high prevalence and bother of LUTS.

Effects of short-term moderate intensity exercise on the serum metabolome in older adults: a pilot randomized controlled trial

BackgroundWe previously reported changes in the serum metabolome associated with impaired myocardial relaxation in an asymptomatic older community cohort. In this prospective parallel-group randomized control pilot trial, we subjected community adults without cardiovascular disease to exercise intervention and evaluated the effects on serum metabolomics.MethodsBetween February 2019 to November 2019, thirty (83% females) middle-aged adults (53 ± 4 years) were randomized with sex stratification to either twelve weeks of moderate-intensity exercise training (Intervention) (n = 15) or Control (n = 15). The Intervention group underwent once-weekly aerobic and strength training sessions for 60 min each in a dedicated cardiac exercise laboratory for twelve weeks (ClinicalTrials.gov: NCT03617653). Serial measurements were taken pre- and post-intervention, including serum sampling for metabolomic analyses.ResultsTwenty-nine adults completed the study (Intervention n = 14; Control n = 15). Long-chain acylcarnitine C20:2-OH/C18:2-DC was reduced in the Intervention group by a magnitude of 0.714 but increased in the Control group by a magnitude of 1.742 (mean difference −1.028 age-adjusted p = 0.004). Among Controls, alanine correlated with left ventricular mass index (r = 0.529, age-adjusted p = 0.018) while aspartate correlated with Lateral e’ (r = −764, age-adjusted p = 0.016). C20:3 correlated with E/e’ ratio fold-change in the Intervention group (r = −0.653, age-adjusted p = 0.004). Among Controls, C20:2/C18:2 (r = 0.795, age-adjusted p = 0.005) and C20:2-OH/C18:2-DC fold-change (r = 0.742, age-adjusted p = 0.030) correlated with change in E/A ratio.ConclusionsCorresponding relationships between serum metabolites and cardiac function in response to exercise intervention provided pilot observations. Future investigations into cellular fuel oxidation or central carbon metabolism pathways that jointly impact the heart and related metabolic systems may be critical in preventive trials.

Spanish Adaptation of the Mentalization Questionnaire (MZQ) in Community Adolescents and Adults.

Despite the role of mentalization in mental health outcomes and prevention, psychometrically-evaluated screening measures for mentalization remain sparse. One widely-used mentalization questionnaire is the Mentalization Questionnaire (MZQ; Hausberg et al., 2012), which we aimed to adapt and validate for use in Spanish. We adapted the MZQ to European Spanish and evaluated its psychometric properties in both adolescent (n = 389, ages 12-19, M = 14.5) and adult community samples (n = 382, M = 48). Confirmatory factor analysis resulted in a unidimensional structure including all items. This model had better goodness of fit than the original and other adaptations. Invariance analysis showed the same structure in adolescents compared by sex and age, and additionally in the adult versus adolescent samples. Evidence for convergent and discriminant validity was found. Internal consistency values in both adolescents and parents were fair and in the adolescent sample the MZQ scores remained moderately stable after re-test. The Spanish adaptation of the MZQ presents similar evidence of reliability and validity in the adolescent and adult samples. The results support this being a suitable version for evaluating mentalization in the general population.

An exploration of the social determinants of the health and well-being among older African immigrants living in San Diego. A socio-ecological approach

Background As immigration continues to be a global phenomenon, the number of aging immigrants will increase. There is a knowledge gap in the United States on the social determinants of health among older immigrants, especially the older refugee population. We aimed to explore the social determinants of health among older African immigrants living in San Diego, California, and to suggest strategies that can inform the design of health-promoting interventions. Methods We employed a qualitative approach using semi-structured interviews with 11 participants (nine females and two males). We used deductive thematic analysis to explore and analyse the factors that influence their health and well-being based on the five levels of the socio-ecological model (individual, interpersonal, organizational, community, and public policy). Results Participants were aged between 62 and 90 years; eight participants had arrived as refugees. Thematic analysis resulted in the following themes within the five levels: individual (pre-migration and migration experiences and impact on health, aging-related health decline, sedentary lifestyle, side effects of medications,language barrier); interpersonal (social support and social participation); organizational (access to healthcare and support services, transportation, - disruption to services due to COVID-19, perception of healthcare and support services); community (social, emotional and practical support, connecting older adults to services) and public policy (financial barriers, immigration policies and legal status). Conclusions Given the distinct linguistic and cultural backgrounds coupled with the unique health needs of our study participants, there is a need for diverse and complementary interventions that seek to build a sense of community and social support for older adults. Such interventions ought to be co-developed with immigrant communities and local organizations to ensure cultural acceptability and effectiveness. Crucially needed are immigration policies that consider the unique situation of older immigrants from low-income backgrounds to ensure equitable access to health and social care services.

Self-Care Practices and Health-Seeking Behaviors Among Older Adults in Urban Indian Slums: A Mixed Methods Study.

Background Effective self-care is crucial for maintaining health among older adults in resource-constrained communities. This study examined self-care practices, health-seeking behaviors, and associated factors among older adults in urban slums in India. Materials and methods A mixed methods study was conducted among 432 adults aged ≥65 years. Participants were selected through multistage random sampling from five slum areas. Self-care practices, health-seeking behaviors, demographic information, chronic conditions, self-efficacy, and health literacy were assessed through interviews. The qualitative data was explored through in-depth interviews with 30 participants. Results Inadequate health literacy (194, 45%) and low self-efficacy (162, 37.5%) were common. While 324 (75%) had an adequate diet and 378 (87.5%) took medications properly, only 86 (20%) monitored diabetes complications. Only 194 (45%) of the patients underwent recommended cancer screening, and 324 (75%) of the patients saw doctors ≥twice a year. Age, sex, education, income, comorbidities, self-efficacy, and health literacy had significant associations. Alongside facilitators such as social support, barriers such as limited healthcare access and suboptimal prevention orientation emerged. Conclusion Suboptimal prevention orientation and overreliance on secondary care instead of self-care among elderly people are problematic given the limited use of geriatric services. Grassroots health workers can improve health literacy and self-efficacy through home visits to enable self-care. Healthcare access inequities for vulnerable groups merit policy attention.

From pregnancy to the postpartum: Unraveling the complexities of symptom profiles among trauma-exposed women

BackgroundMany women experience new onset or worsening of existing posttraumatic stress disorder (PTSD) symptoms during pregnancy and the early postpartum period. However, perinatal PTSD symptom profiles and their predictors are not well understood. MethodsParticipants (N = 614 community adults) completed self-report measures across three methodologically similar longitudinal studies. Mixture modeling was used to identify latent subgroups of trauma-exposed women with distinct patterns of symptoms at pregnancy, 1-month, and 3-month postpartum. ResultsMixture modeling demonstrated two classes of women with relatively homogenous profiles (i.e., low vs. high symptoms) during pregnancy (n = 237). At 1-month postpartum (n = 391), results suggested a five-class solution: low symptoms, PTSD only, depression with primary appetite loss, depression, and comorbid PTSD and depression. At 3-months postpartum (n = 488), three classes were identified: low symptoms, elevated symptoms, and primary PTSD. Greater degree of exposure to interpersonal trauma and reproductive trauma, younger age, and minoritized racial/ethnic identity were associated with increased risk for elevated symptoms across the perinatal period. LimitationsOnly a subset of potential predictors of PTSD symptoms were examined. Replication with a larger and more racially and ethnically diverse sample of pregnant women is needed. ConclusionsResults highlight limitations of current perinatal mental health screening practices, which could overlook women with elevations in symptoms (e.g., intrusions) that are not routinely assessed relative to others (e.g., depressed mood), and identify important risk factors for perinatal PTSD symptoms to inform screening and referral.

Factors Associated with Frailty in Older Adults in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis.

Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them.

Perceived Stress Mediates Associations Between Grit and Health-Related Quality of Life.

Grit, characterized by passion and perseverance in the pursuit of long-term goals, may be associated with enhanced quality of life and reduced levels of perceived chronic stress. We hypothesized that reduced levels of perceived stress may mediate the association between facets of grit (i.e., Perseverance and Consistency) and healthy functioning. We conducted two studies, one with college students and one with community adults, to test this hypothesis (cumulative N = 600). In both studies, facets of grit were assessed using the Short Grit Scale, levels of perceived chronic stress were assessed via the Perceived Stress Scale, and health-related quality of life was measured using selected questions from the Medical Outcome Study Short Form-36. Consistent with our hypothesis, perceived stress levels significantly mediated the relation between Grit-Perseverance and health-related quality of life in both college students and community adults. Our data suggest that individuals with high Grit-Perseverance experience lower perceived stress, which may result in improved health-related quality of life. Additionally, perceived stress partially mediated the relation between Grit-Consistency and health-related quality of life, but only in community adults. These novel findings suggest that the association between Grit-Perseverance and perceived chronic stress may differ for college students and community adults. Overall, our work indicates that perceived stress may be a key mediator through which facets of grit are related to healthy functioning in college students and community adults.