Adult Life Research Articles

Immunosuppression in adult liver transplant recipients: a 2024 update from the Italian Liver Transplant Working Group.

Advances in surgical procedures and immunosuppressive therapies have considerably improved the outcomes of patients who have undergone liver transplantation in the past few decades. In 2020, the Italian Liver Transplant Working Group published practice-oriented algorithms for immunosuppressive therapy (IT) in adult liver transplant (LT) recipients. Due to the rapidly evolving LT field, regular updates to the recommendations are required. This review presents a consensus- and evidence-based update of the 2020 recommendations. The Italian Liver Transplant Working Group set out to address new IT issues, which were discussed based on supporting literature and the specialists' personal experiences. The panel deliberated on and graded each statement before consensus was reached. A series of consensus statements were formulated and finalized on: (i) oncologic indications for LT; (ii) management of chronic LT rejection; (iii) combined liver-kidney transplantation; (iv) immunosuppression for transplantation with an organ donated after circulatory death; (v) transplantation in the presence of frailty and sarcopenia; and (vi) ABO blood group incompatibility between donor and recipient. Algorithms were updated in the following LT groups: standard patients, critical patients, oncology patients, patients with specific etiology, and patients at high immunologic risk. A steroid-free approach was generally recommended, except for patients with autoimmune liver disease and those at high immunologic risk. The updated consensus- and evidence-based 2024 recommendations for immunosuppression regimens in adult patients with ABO-compatible LT address a range of clinical variables that should be considered to optimize the choice of the immunosuppression treatment in clinical practice in Italy.

Evaluating foliar insecticides and economic thresholds for Tychius picirostris (Coleoptera: Curculionidae) management in Oregon white clover seed production.

The clover seed weevil, Tychius picirostris Fabricius (Coleoptera: Curculionidae), is a major pest in Oregon white clover seed crops. Reliance on synthetic pyrethroid insecticides and limited availability of diverse modes of action (MoAs) has increased insecticide resistance selection in regional T. picirostris populations, emphasizing the need to evaluate novel chemistries and rotational strategies for effective insecticide resistance management (IRM). The efficacy of 8 foliar insecticide formulations for managing T. picirostris adult and larval life stages was determined in small and large-plot field trials across 2 crop years. In both years, bifenthrin (Brigade 2EC), the grower's standard, showed negligible adult and larval suppression. Insecticide formulations with isocycloseram and cyantraniliprole active ingredients reduced adult and larval populations when applied at BBCH 59-60 (prebloom) and BBCH 65-66 (full bloom) growth stages, respectively. While differences in T. picirostris abundance were observed among insecticide treatments, seed yield differences were not detected in large-plot trials. Larval abundance was correlated with reduced seed yield, and an economic threshold of ≥3 larvae per 30 inflorescences was determined as a conservative larval threshold to justify foliar applications of diamide insecticides. Additional commercial white clover seed fields were surveyed to compare larval scouting techniques, including a standard Berlese funnel and a grower's do-it-yourself funnel. Both larval extraction techniques were correlated and provided similar estimates of larval abundance. These findings demonstrate new MoAs, optimal insecticide application timing, and larval monitoring methods that can be incorporated into an effective T. picirostris IRM program in white clover seed crops.

Influence of prosthodontic rehabilitation and dietary advice on glycaemic control, nutritional status and oral health-related quality of life of older adults with type 2 diabetes.

This prospective clinical study aimed to determine the influence of oral prosthodontic rehabilitation with partial removable dentures and simplified dietary advice on glycaemic control, nutritional status and oral health-related quality of life (OHRQoL) of older adults with type 2 diabetes. Individuals with tooth loss who did not wear complete or partial dentures are more likely to be at nutritional risk, suggesting that using dental prostheses would benefit the re-establishment of an adequate nutritional status and potentially improve quality of life. Nutritional therapy is essential for diabetes prevention, treatment and management, favouring glycaemic control. The literature provides little evidence on the contribution of partial removable dentures to improving diabetes control, nutritional profile and satisfaction in older adults, especially those with type 2 diabetes. Older individuals diagnosed with type 2 diabetes mellitus, aged 60 years or older and needing oral rehabilitation with partial removable dentures were eligible for this prospective study. The primary outcome measure was glycaemic control, measured by glycated haemoglobin (HbA1c) levels. The Oral Health Impact Profile (OHIP-14) questionnaire and the Mini Nutritional Assessment short-form (MNA-SF) represented secondary outcome measures. These measures were assessed at baseline and 12 months of follow-up after prosthesis delivery, combined with simple dietary advice in pamphlet form. The data were analysed using the Wilcoxon matched-pairs test. Forty-four patients who met the inclusion criteria and required treatment with removable partial dentures were selected for this study, which was carried out for a year. During this period, seven participants declined to participate because they moved to another city. Hence, a final sample of 37 participants (16 men and 21 women, average age of 65.8 years, ranging from 60 to 83 years) were included in the study. No laboratory parameter (HbA1c levels) changed significantly during the investigation. The number of older adults at risk of malnutrition was significantly lower at 12 months than at baseline. Furthermore, nutritional status significantly improved 12 months after prosthodontic treatment combined with dietary advice, and the effect sizes were large. OHRQoL significantly improved after prosthodontic therapy combined with dietary advice. Prosthodontic treatment with partial dentures associated with simple dietary advice did not influence glycaemic control but improved the nutritional status and OHRQoL of older adults with type 2 diabetes.

Maternal α-casein deficiency extends the lifespan of offspring and programmes their body composition.

Early nutrition has significant effects on physiological outcomes during adult life. We have analysed the effect of maternal α-casein (CSN1S1) deficiency on the physiological fate of dams and their offspring. α-casein deficiency reduces maternal milk protein concentration by more than 50% and attenuates the growth of pups to 27% (p < 0.001) of controls at the point of weaning. This is associated with a permanent reduction in adult body weight (- 31% at 25weeks). Offspring nursed by α-casein deficient dams showed a significantly increased lifespan (+ 20%, χ2: 10.6; p = 0.001). Liver transcriptome analysis of offspring nursed by α-casein deficient dams at weaning revealed gene expression patterns similar to those found in dwarf mice (reduced expression of somatotropic axis signalling genes, increased expression of xenobiotic metabolism genes). In adult mice, the expression of somatotropic axis genes returned to control levels. This demonstrates that, in contrast to dwarf mice, attenuation of the GH-IGF signalling axis in offspring nursed by α-casein deficient dams is transient, while the changes in body size and lifespan are permanent. Offspring nursed by α-casein deficient dams showed permanent changes in body composition. Absolute and relative adipose tissue weights (p < 0.05), the percentage of body fat (p < 0.001) as well as adipocyte size in epididymal white adipose tissue are all reduced. Serum leptin levels were 25% of those found in control mice (p < 0.001). Liver lipid content and lipid composition were significantly altered in response to postnatal nutrition. This demonstrates the nutrition in early life programmes adult lipid metabolism, body composition and lifespan.

Adherence to the Gluten-Free Diet Role as a Mediating and Moderating of the Relationship between Food Insecurity and Health-Related Quality of Life in Adults with Celiac Disease: Cross-Sectional Study.

This cross-sectional study aimed to estimate the relationship between food insecurity (FI) and health-related quality of life (HRQoL) in patients with celiac disease (CD) and assess whether this relationship is mediated or moderated by adherence to the gluten-free diet (GFD). The results of 1162 samples of patients diagnosed with CD showed that 8.3% of individuals who have a combined score of less than 13 exhibited excellent or very good adherence to the GFD. Furthermore, moderate and fair to poor adherence to the GFD was demonstrated, respectively and 71.9% of the patients had poor HRQoL levels. A significant and moderate positive correlation between FI and GFD adherence (r = 0.489) was found, indicating that 24% of the variance in FI is shared with GFD adherence. The patients' gender, marital status, and monthly income made statistically significant contributions to the prediction (p < 0.05). Females had significantly lower HRQoL scores than males (B = -4.619, 95% CL: -6.08, -3.16) after holding all other variables constant. In conclusion, FI is mediated by GFD adherence to HRQoL. Moreover, a significant total effect relation was found between HRQoL and both FI and GFD adherence, suggesting that lowering symptoms and complications associated with CD may reduce the impact of FI on HRQoL.

Sexual Well-Being and Aging Patterns: Findings of a Cluster Analysis among Older Adults in Portugal and Spain.

From a cross-cultural perspective, aging well may encompass pertinent challenges in terms of adjustment, sexual well-being, and satisfaction with life in the late years. Considering the paucity of empirical data concerning cultural diversity of experiencing aging, this study aims to help fill this gap by assessing the specific patterns of sexual satisfaction, adjustment to aging (AtA), and life satisfaction with life (SwL) of older adults in Portugal and Spain. This cross-national study included 326 older adults, age 65 and older, from Portugal and Spain. Five instruments were applied: (a) Adjustment to Aging Scale (ATAS); (b) Satisfaction with Life Scale (SwLS); (c) New Sexual Satisfaction Scale-Short (NSSS-S); (d) Mini-Mental State Exam; and (e) Sociodemographic, Health and Lifestyle questionnaire. K-means cluster analysis was employed to identify and characterize the clusters considering adjustments to aging, sexual satisfaction, and life satisfaction. One-way ANOVAs were conducted to analyze differences in sexual well-being among clusters. Findings indicated three clusters, which explained 77.7% (R-sq = 0.777) of the total variance: Cluster 1: "Most skilled" (n = 26, 8.0%), Cluster 2: "Least adjusted" (n = 115, 35.3%), and Cluster 3: "Aging strivers" (n = 185, 56.7%). Participants in Cluster 1 were mostly Portuguese, with high levels of AtA, sexual satisfaction, and SWL. Conversely, Cluster 2 included mostly Portuguese participants with moderate sexual satisfaction and lower levels of AtA and SwL. Participants from Cluster 3 were mostly Spanish, with moderate levels of AtA and reduced sexual satisfaction and SwL. This study innovates by exploring the elaborate interplay among sexual satisfaction, AtA, and SwL in a cross-cultural perspective, with implications for tailoring interventions, service planning, development, and evaluation of culturally diverse older populations.

Community-based exercises improve health status in pre-frail older adults: A systematic review with meta-analysis

BackgroundPre-frailty is associated with increased healthcare utilization. Over the past decade, public health interventions such as community-based exercises to target pre-frailty have been increasingly studied. However, the effects of community-based exercises on clinical outcome measures amongst community-dwelling older adults with pre-frailty remain unclear. This review aims to better understand the effects of community-based exercise on physical function, cognition, quality of life and frailty status in community-dwelling pre-frail older adults. A secondary objective was to investigate the optimal exercise parameters on clinical outcomes.MethodsSearches of MEDLINE, CINAHL, Google Scholar and Web of Science databases were conducted. Articles were included if they were randomized controlled trials (RCTs), and excluded if the participants consist of less than 50% pre-frail community-dwelling older adults. Meta-analyses (where possible) with either a fixed- or random- effect(s) model, standardized mean difference (SMD), odds ratio (OR) and tests of heterogeneity were performed. Multivariable meta-regression was performed to identify predictors of statistically significant outcome measures. The risk of bias was assessed using the modified Cochrane Risk-of-Bias tool.ResultsTwenty-two RCTs with 900 participants in the experimental group and 1015 participants in the control group were included. When compared to minimal intervention, community-based exercises significantly improved lower limb strength (10 RCTs, 384 participants in the experimental group and 482 participants in the control group) with SMD 0.67 (95% CI 0.29 to 1.04), and lower limb function (5 RCTs, 120 participants in the experimental group and 219 participants in the control group) with SMD 0.27 (95% CI 0.03 to 0.51). Those who have received community-based exercises were more likely to reverse from pre-frailty to healthy state (OR = 2.74, 95% CI 1.36 to 5.51) (6 RCTs, 263 participants in the experimental group and 281 participants in the control group). The frequency of exercise sessions was a significant predictor of the effect size for gait speed (P<0.05).ConclusionsCommunity-based exercise intervention is superior to minimal intervention for improving health status in pre-frail older adults. This has implications on the implementation of community-based exercise intervention by healthcare providers and policymakers.OtherNil funding for this review. PROSPERO registration number CRD42022348556.

Exposure to metal mixtures and telomere length in Bangladeshi children.

Telomere length is associated with chronic diseases and in younger populations, may represent a biomarker of disease susceptibility. As growing evidence suggests that environmental factors, including metals, may impact telomere length, we investigated the association between 17 metals measured in toenail samples and leukocyte relative telomere length (RTL), among 472 five- to seven-year-old children enrolled in the Bangladesh Environmental Research in Children's Health (BiRCH) cohort. In single exposure linear regression models, a doubling of arsenic (As) and mercury (Hg) (μg/g) were associated with a -0.21 (95%CI: -0.032, -0.010; p=0.0005) and -0.017 (95%CI: -0.029, -0.004; p=0.006) difference in RTL, respectively. In Bayesian Kernel Machine Regression (BKMR) mixture models, the overall metal mixture was inversely associated with RTL (P-for-trend <0.001). Negative associations with RTL were observed with both log2-As and log2-Hg, while an inverted U-shaped association was observed for log2-zinc (Zn) with RTL. We found little evidence of interaction among metals. Sex-stratification identified stronger associations of the overall mixture and log2-As with RTL among females, compared to males. Our study suggests that As and Hg may independently influence RTL in mid-childhood. Further studies are needed to investigate potential long-term impacts of metal-associated telomere shortening in childhood on health outcomes in adult life.

Improving Functional Status of Older Adults Through Health Literacy Media: A Systematic Review

Older age can be followed by an aging process that shows a decrease in physical function due to various degenerative problems that reduce immunity caused the older adults vulnerable to infectious diseases. Health literacy can improve the physical function of the older adults in using self management agents, social support, access to health services and increasing the quality of life of older adults. The aim of this paper is to obtain the existence evidence of health literacy impact in improving older adults health status and functional or physical well-being living in community-setting and clinical setting. This paper used some databases Proquest database, PubMed, Sage Journal, Scopus, Ebscohost, Science Direct, anf Taylor &amp; Francis. There are 11 articles published between 2014 - 2024 were reviewed using the PRISMA method. This review found that there are different types of health literacy media (print and digital) and there are combination of health literacy with physical activity interventions to deliver health information to older people. Standardized health literacy media in readability, and easy to use such as video/web/electronic, game-based, digital, and mobile-based and health literacy interventions combined with planned physical activities can increase knowledge, self-efficacy, cognitive function, quality of life, and reducing frailty score, fall risk, depression score.

Exploring for the Change in Change of Employment Status Over Time

The study seeks to explore for presence of dissimilar developmental paths in employment status of American individuals. The empirical longitudinal exercise is conducted with hybrid latent class growth model and latent class growth mixtures. For testing the hypothesis of heterogeneous subgroups within employment status data three mainstream modelling variants of growth modelling are tested and elaborated in terms of model performance. Progressive employment status based typology is found robust to alternative model specifications voting for presence of clustered growth patterns in experiencing employment status over time. The resulted employment status based typology describes three clusters of active, inactive and mediocre active participants in terms of moving between various stages of employment status for the age span of 18years to 35 years i.e., from adult to post adult prime working life years. The presented approach to understand and explore employment status is novel perspective compared to classic survey based employment status data.

Ionic Liquid 1-Octyl-3-Methylimidazolium (M8OI) Is Mono-Oxygenated by CYP3A4 and CYP3A5 in Adult Human Liver.

Environmental sampling around a landfill site in the UK previously identified the methylimidazolium ionic liquid, 1-octyl-3-methylimidazolium (M8OI), in the soil. More recently, M8OI was shown to be detectable in sera from 5/20 PBC patients and 1/10 controls and to be oxidised on the alkyl chain in the human liver. The objective of this study was to examine the metabolism of M8OI in humans in more detail. In human hepatocytes, M8OI was mono-oxygenated to 1-(8-Hydroxyoctyl)-3-methyl-imidazolium (HO8IM) then further oxidised to 1-(7-carboxyheptyl)-3-methyl-1H-imidazol-3-ium (COOH7IM). The addition of ketoconazole-in contrast to a range of other cytochrome P450 inhibitors-blocked M8OI metabolism, suggesting primarily CYP3A-dependent mono-oxygenation of M8OI. Hepatocytes from one donor produced negligible and low levels of HO8IM and COOH7IM, respectively, on incubation with M8OI, when compared to hepatocytes from other donors. This donor had undetectable levels of CYP3A4 protein and low CYP3A enzyme activity. Transcript expression levels for other adult CYP3A isoforms-CYP3A5 and CYP3A43-suggest that a lack of CYP3A4 accounted primarily for this donor's low rate of M8OI oxidation. Insect cell (supersome) expression of various human CYPs identified CYP3A4 as the most active CYP mediating M8OI mono-oxygenation, followed by CYP3A5. HO8IM and COOH7IM were not toxic to human hepatocytes, in contrast to M8OI, and using a pooled preparation of human hepatocytes from five donors, ketoconazole potentiated M8OI toxicity. These data demonstrate that CYP3A initiates the mono-oxygenation and detoxification of M8OI in adult human livers and that CYP3A4 likely plays a major role in this process.

Cardiac programming in the placentally restricted sheep fetus in early gestation.

Fetal growth restriction (FGR) occurs in 8% of human pregnancies, and the growth restricted newborn is at a greater risk of developing heart disease in later adult life. In sheep, experimental restriction of placental growth (PR) from conception results in FGR, a decrease in cardiomyocyte endowment and an upregulation of pathological hypertrophic signalling in the fetal heart in late gestation. However, there is no change in the expression of markers of cellular proliferation nor in the level of cardiomyocyte apoptosis in the heart of the PR fetus in late gestation. This suggests that FGR arises early in gestation and programs a decrease in cardiomyocyte endowment in early, rather than late, gestation. Here, control and PR fetal sheep were humanely killed at 55 days' gestation (term, 150days). Fetal body and heart weight were lower in PR compared with control fetuses and there was evidence of sparing of fetal brain growth. While there was no change in the proportion of cardiomyocytes that were proliferating in the early gestation PR heart, there was an increase in measures of apoptosis, and markers of autophagy and pathological hypertrophy in the PR fetal heart. These changes in early gestation highlight that FGR is associated with evidence of early cell death and compensatory hypertrophic responses of cardiomyocytes in the fetal heart. The data suggest that early placental restriction results in a decrease in the pool of proliferative cardiomyocytes in early gestation, which would limit cardiomyocyte endowment in the heart of the PR fetus in late gestation. KEY POINTS: Placental restriction leading to fetal growth restriction (FGR) and chronic fetal hypoxaemia in sheep results in a decrease in cardiomyocyte endowment in late gestation. FGR did not change cardiomyocyte proliferation during early gestation but did result in increased apoptosis and markers of autophagy in the fetal heart, which may result in the decreased endowment of cardiomyocytes observed in late gestation. FGR in early gestation also results in increased hypoxia inducible factor signalling in the fetal heart, which in turn may result in the altered expression of epigenetic regulators, increased expression of insulin-like growth factor 2 and cardiomyocyte hypertrophy during late gestation and after birth.

Sex- and age-specific reference intervals of 16 steroid metabolites quantified simultaneously by LC-MS/MS in sera from 2458 healthy subjects aged 0 to 77 years

BackgroundReference intervals covering the whole life span for all the metabolites in the steroid hormone biosynthesis quantified by sensitive and robust analytical methods are sparse or not existing. ObjectiveTo develop a state-of-the-art LC-MS/MS method for simultaneous quantification of multiple steroid metabolites and to establish detailed sex- and age-specific reference intervals for 16 steroid metabolites. Materials and methodAn isotope diluted LC-MS/MS method was developed for simultaneous quantitation of 16 steroid hormones. Serum samples from cross-sectional cohorts of healthy infants, children, adolescents, and adults aged 0.17 months to 77 years (n = 2458) were analysed. ResultsWith this novel, specific, and sensitive LC-MS/MS method, it was possible to quantify progesterone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate, androstenedione, testosterone, dihydrotestosterone, 11-deoxycorticosterone, corticosterone, 11-deoxycortisol, cortisol, and cortisone in ≥90 % of the samples, while estrone sulfate, aldosterone and dehydroepiandrosterone were quantified in 77 %, 75 % and 60 % of the samples, respectively. 21-deoxycortisol was only detectable in 2.5 % of samples from healthy subjects. Sex- and age-dependent fluctuations observed in minipuberty, puberty and adulthood including the menopausal transition were modelled. This enabled us to establish valid reference intervals from birth to late adult life for both males and females. ConclusionDetailed sex- and age-specific reference intervals of multiple, simultaneously quantified steroid metabolites by a novel and specific LC-MS/MS method provides a valuable tool for clinical practice and for future research.

Assessment of sublethal effects of permethrin on adult life characteristics and resistance dynamics in Aedes albopictus (Diptera: Culicidae)

Mosquitoes are regularly exposed to adverse effects of insecticides employed in field during vector control campaigns. Its primary goal is to eliminate the vector population; nevertheless, this practise typically ignores the residual impacts and long-term repercussions on the remaining population. Here, the current study analysed how sublethal exposure of insecticides alter the life qualities, genotypic and biochemical characteristics of mosquitoes. The resistance ratio value in Laboratory Resistant (Lab-R) larvae increased 10 times (0.010 mg/l to 0.108 mg/l) compared to Laboratory Susceptible (LabS) larvae. It also revealed that the surviving mosquitoes had 50% reduction in hatchability but had longer larval and pupal periods (15 days and 2 days), respectively. The survival rates decrease in female by 2 days but increase in male by 7 days which is of concern and necessitates additional study. Moreover, major role of monooxygenase was confirmed behind resistance development which was further supported by piperonyl butoxide assay where reduction in Tolerance Ratio (TR50) by 12-fold occurred and gene expression profile also showed high expression level of CYP6P12 gene. In resistant strain, cuticular thickness increased by 1.23 times and alteration at codon 1532 (ATC to TTC) on VGSC gene leads to mutation I1532F. The data gleaned from our work highlights the threat of sublethal insecticides on vector control techniques and offers ample evidence that the larval selection alters adult life qualities, metabolic properties and transgenerational features which contributes to the damage caused by resistance.

Association between malnutrition and cognitive frailty in older adults: A systematic review and meta-analysis

BackgroundTo systematically assess the association between cognitive frailty (CF) and malnutrition in older adults. Methods8 databases were retrieved up until April 2023 by two reviewers in dependently, and meta-analysis was performed by Stata 16.0 software. ResultsA total of 19 studies were meta-analyzed to assess the relationship between CF and malnutrition in older adults. The pooled prevalence of CF from 17 studies was 23 %, and the pooled prevalence of malnutrition among patients with CF from 12 studies was 57 %. Data from 13 studies on the association between CF and malnutrition unveiled a high risk of CF in older adults with malnutrition (OR = 3.77, 95 % CI: 2.49–5.69). ConclusionThe prevalence of malnutrition is high in older adults with CF, and there is a significant delve into targeted treatment and preventive measures to ameliorate the quality of life of older adults.

Adolescent behavioral problems, preterm/low birth weight children and adult life success in a prospective Australian birth cohort study

BackgroundPreterm and/or low birthweight (PT/LBW) is predictive of a range of adverse adult outcomes, including lower employment, educational attainment, and mental wellbeing, and higher welfare receipt. Existing studies, however, on PT/LBW and adult psychosocial risks are often limited by low statistical power. Studies also fail to examine potential child or adolescent pathways leading to later adult adversity. Using a life course framework, we examine how adolescent problem behaviors may moderate the association between PT/LBW and a multidimensional measure of life success at age 30 to potentially address these limitations. MethodsWe analyze 2044 respondents from a Brisbane, Australia cohort followed from birth in1981–1984 through age 30. We examine moderation patterns using obstetric birth outcomes for weight and gestation, measures of problem behaviors from the Child Behavioral Checklist at age 14, and measures of educational attainment and life success at 30 using multivariable normal and ordered logistic regression. ResultsAssociations between PT/LBW and life success was found to be moderated by adolescent problem behaviors in six scales, including CBCL internalizing, externalizing, and total problems (all p < 0.01). In comparison, associations between LBW and educational attainment illustrate how a single-dimensional measure may yield null results. ConclusionFor PT/LBW, adolescent problem behaviors increase risk of lower life success at age 30. Compared to analysis of singular outcomes, the incorporation of multidimensional measures of adult wellbeing, paired with identification of risk and protective factors for adult life success as children develop over the lifespan, may further advance existing research and interventions for PT/LBW children.

Headache/migraine-related stigma, quality of life, disability, and most bothersome symptom in adults with current versus previous high-frequency headache/migraine and medication overuse: results of the Migraine Report Card survey

BackgroundHigh-frequency headache/migraine (HFM) and overuse of acute medication (medication overuse [MO]) are associated with increased disability and impact. Experiencing both HFM and MO can potentially compound impacts, including stigma; however, evidence of this is limited. The objective of this report was to evaluate self-reported stigma, health-related quality of life (HRQoL), disability, and migraine symptomology in US adults with HFM + MO from the Harris Poll Migraine Report Card survey.MethodsUS adults (≥ 18 yrs., no upper age limit) who screened positive for migraine per the ID Migraine™ screener completed an online survey. Participants were classified into “current HFM + MO” (≥ 8 days/month with headache/migraine and ≥ 10 days/month of acute medication use over last few months) or “previous HFM + MO” (previously experienced HFM + MO, headaches now occur ≤ 7 days/month with ≤ 9 days/month of acute medication use). Stigma, HRQoL, disability, and most bothersome symptom (MBS) were captured. The validated 8-item Stigma Scale for Chronic Illnesses (SSCI-8) assessed internal and external stigma (scores ≥ 60 are clinically significant). Raw data were weighted to the US adult population. Statistically significant differences were determined by a standard t-test of column proportions and means at the 90% (p < 0.1) and 95% (p < 0.05) confidence levels.ResultsParticipants (N = 550) were categorized as having current (n = 440; mean age 41.1 years; 54% female; 57% White, not Hispanic; 24% Hispanic; 11% Black, not Hispanic) or previous (n = 110; mean age 47.2 years; 49% female; 75% White, not Hispanic; 13% Hispanic; 4% Black, not Hispanic) HFM + MO. Compared to those with previous HFM + MO (21%), adults with current HFM + MO were more likely to experience clinically significant levels of stigma (47%). Men with current HFM + MO (52% compared to men with previous HFM + MO [25%] and women with current [41%] or previous [18%] HFM + MO), non-Hispanic Black (51% compared to White, not Hispanic [45%] and Hispanic [48%] current HFM + MO groups and White, not Hispanic previous HFM + MO [12%]), current HFM + MO aged 18–49 years (50% compared to those with current HFM + MO aged ≥ 50 years [33%] and those with previous HFM + MO aged 18–49 [34%] and ≥ 50 years [4%]), and employed respondents (53% current and 29% previous compared to those not employed [32% current and 12% previous]) reported higher rates of clinically significant stigma. Those with current HFM + MO were more likely to have worse HRQoL and disability due to headache/migraine. Respondents aged ≥ 50 years with current HFM + MO were more likely than respondents aged 18–49 years with current HFM + MO to indicate that their overall quality of life (66% vs. 52%) and their ability to participate in hobbies/activities they enjoy were negatively impacted by headache/migraine (61% vs. 49%). Pain-related symptoms were identified as the MBS.ConclusionsTogether these data suggest that current and previous HFM + MO can be associated with undesirable outcomes, including stigma and reduced HRQoL, which were greatest among people with current HFM + MO, but still considerable for people with previous HFM + MO.Graphical abstract

Social Robots for Meaningful Seated Activities: Acceptance & Use by Older Adults.

Healthy aging requires the maintenance of good physical and cognitive activity. However, as they age, older adults often experience a decline in physical and cognitive activity, leading to a more sedentary lifestyle. Some older adults may not have a choice but to become increasingly sedentary as they age due to injury or deteriorated physicality. As such, they require assistive technologies to aid in their daily lives and activities to maintain healthy cognitive function. Social Robots are a newer form of assistive technology, specifically designed for social interactions and gameplay. As with other assistive technologies, compliance barriers to their acceptance and use for meaningful, seated activities among older adults are expected. To better explore this phenomenon, improve quality of life and understand what drives older adults to accept and use newer forms of technology like social robots, this conceptual paper conjoins two theoretical frameworks: The Activity Theory of Aging (ATA) and the Unified Theory of Acceptance and Use of Technology (UTAUT). As social robots hold great promise for improving the quality of life for older adults, exploring what driving factors could enable their greater acceptance and use is essential to furthering this field of study within Australia.

Self-Management Using eHealth Technologies for Liver Transplant Recipients: Scoping Review.

Liver transplantation has become increasingly common as a last-resort treatment for end-stage liver diseases and liver cancer, with continually improving success rates and long-term survival rates. Nevertheless, liver transplant recipients face lifelong challenges in self-management, including immunosuppressant therapy, lifestyle adjustments, and navigating complex health care systems. eHealth technologies hold the potential to aid and optimize self-management outcomes, but their adoption has been slow in this population due to the complexity of post-liver transplant management. This study aims to examine the use of eHealth technologies in supporting self-management for liver transplant recipients and identify their benefits and challenges to suggest areas for further research. Following the Arksey and O'Malley methodology for scoping reviews, we conducted a systematic search of 5 electronic databases: PubMed, CINAHL, Embase, PsycINFO, and Web of Science. We included studies that (1) examined or implemented eHealth-based self-management, (2) included liver transplant recipients aged ≥18 years, and (3) were published in a peer-reviewed journal. We excluded studies that (1) were case reports, conference abstracts, editorials, or letters; (2) did not focus on the posttransplantation phase; (3) did not focus on self-management; and (4) did not incorporate the concept of eHealth or used technology solely for data collection. The quality of the selected eHealth interventions was evaluated using (1) the Template for Intervention Description and Replication guidelines and checklist and (2) the 5 core self-management skills identified by Lorig and Holman. Of 1461 articles, 15 (1.03%) studies were included in the final analysis. Our findings indicate that eHealth-based self-management strategies for adult liver transplant recipients primarily address lifestyle management, medication adherence, and remote monitoring, highlighting a notable gap in alcohol relapse interventions. The studies used diverse technologies, including mobile apps, videoconferencing, and telehealth platforms, but showed limited integration of decision-making or resource use skills essential for comprehensive self-management. The reviewed studies highlighted the potential of eHealth in enhancing individualized health care, but only a few included collaborative features such as 2-way communication or tailored goal setting. While adherence and feasibility were generally high in many interventions, their effectiveness varied due to diverse methodologies and outcome measures. This scoping review maps the current literature on eHealth-based self-management support for liver transplant recipients, assessing its potential and challenges. Future studies should focus on developing predictive models and personalized eHealth interventions rooted in patient-generated data, incorporating digital human-to-human interactions to effectively address the complex needs of liver transplant recipients. This review emphasizes the need for future eHealth self-management research to address the digital divide, especially with the aging liver transplant recipient population, and ensure more inclusive studies across diverse ethnicities and regions.

Association Between Metabolic Syndrome and Health-Related Quality of Life in Older Adults: Findings from the IRanian Longitudinal Study on Ageing.

Objectives: There are some studies without consensus on the association between metabolic syndrome (MetS) and health-related quality of life (HRQoL) and few studies among elderly participants; therefore, the aim of this study is evaluating the association between MetS and HRQoL between elderly participants after adjusting for possible confounding factors. Methods: A cross-sectional analysis was conducted with the data from baseline phase of the IRanian Longitudinal Study on Ageing. The MetS diagnosis was conducted based on the National Cholesterol Education Program Adult Treatment Panel III guidelines. The participants were 3452 subjects aged ≥60 years with and without MetS. The Prospective Epidemiological Research Studies in Iran version of the SF-12 questionnaire was used to examine subjects' perspectives on their well-being and general health level. The association between MetS and HRQoL was evaluated through multivariable linear regression model after adjusting for possible covariates. Results: MetS independently had an inverse association with subscales of HRQoL including physical functioning, physical problems, general health, social functioning, and emotional problems, even after fully adjusting for studied confounding factors. An inverse association was also observed between MetS and both mental component summary and physical component summary in the fully adjusted model. Conclusion: Older adults with MetS had a relatively worse physical and mental HRQoL in comparison with individuals without MetS. Independent of any underlying factors, the inverse association of MetS with HRQoL emphasizes the necessity of routine screening and treatment of MetS in older populations.