Adult Participants Research Articles

Risk Factors Associated with Gastritis among Adult Patients Attending at Capital Hospital in Mogadishu- Somalia

Background: Gastritis, an inflammatory disorder affecting the lining of the stomach, is a prevalent health concern across the globe, particularly in developing regions like Somalia. This study aims to investigate the primary risk factors linked to gastritis among adults receiving care at Capital Hospital in Mogadishu.  Methods: An unmatched case-control study was executed from June 1 to July 30, 2024, involving 63 adult participants, with 21 patients diagnosed with gastritis through endoscopic procedures and 42 controls. A semi- structured questionnaire was employed to gather data on socio-demographic characteristics, dietary patterns, lifestyle habits, medical histories, and medication usage. Statistical analysis was performed using SPSS version 26.  Results: The investigation revealed a gastritis prevalence of 78.8%, with acute cases constituting 48.9% and chronic cases 29.9%. Female participants were identified as having a protective effect against gastritis (Adjusted Odds Ratio [AOR]=0.05, p=0.023), whereas the routine use of non-steroidal anti-inflammatory drugs (NSAIDs) significantly raised the risk (Crude Odds Ratio [COR]=5.03, p=0.041). Interestingly, the presence of Helicobacter pylori was associated with a reduced risk of developing gastritis (COR=0.11, p=0.032). Other lifestyle and dietary factors did not show significant correlations.  Conclusions: The results underscore the protective influence of gender and the associated risks of NSAID intake regarding gastritis among Somali adults. The unexpected finding of H. pylori infection linked to lower gastritis risk deserves further exploration. There is an urgent need for targeted public health strategies to address the effects of gastritis in Somalia.

Service-policy gaps in the settlement journey of Arabic-speaking immigrant newcomer and refugee older adults in Edmonton, Canada.

Immigrant newcomers and refugees (INRs) are two migrant categories that experience consistent systemic barriers to settlement and integration in Canada as older adults. This paper explores the challenges experienced by Arabic-speaking INR older adults in Edmonton, Canada, during settlement and discusses policy and service implications. A qualitative description study using community-based participatory research principles was implemented to evaluate and support digital literacy in Arabic-speaking INR older adults. We included men and women aged 55 and older who identified as immigrants or refugees and spoke Arabic. Experiences of settlement challenges were consistently identified during data collection and engagement of INR older adult participants. A thematic sub-analysis of interviews with (10 individuals and one couple) of participants' narratives was completed in 2022 and was used to identify themes related to settlement barriers for this population. Two main themes were identified: (1) Limited English skills and digital literacy gaps create service barriers for INR older adults, and (2) Gaps in services and policies as basic needs remain unmet. We describe key challenges experienced by INR older adults, such as language barriers, precarious finances, poor access to health care services and lack of transportation and employment opportunities, which hinder successful integration into the new society. This study showcases the ongoing challenges with early settlement and integration that continue despite Canada's well-developed immigration settlement landscape. INR older adults often remain invisible in policy, and understanding their experiences is a first step to addressing their needs for resources that support healthy aging in the post-migration context.

Investigating the link between coronary artery calcification and atrial fibrillation: A systematic review and meta-analysis.

Both coronary artery calcification (CAC) and atrial fibrillation (AF) are associated with common risk factors, such as age, hypertension, diabetes, and dyslipidemia. Investigating their association may provide insights into shared pathophysiological mechanisms and overlapping risk profiles. A systematically search was performed covering various data bases including PubMed, Scopus, ISI, and Google Scholar from January 2000 until December 2023 for English-published articles. We focused on observational studies-cohort, case-control, and cross-sectional-that involved adult participants (aged 18 and older) and provided data on the any association between CAC and AF. We excluded studies if the full text was unavailable, the publication was not in English, there was insufficient numerical data or relative risk information. All the included articles (n = 14), were observational studies (n = 5 case-control and n = 9 cohort). All of the included papers (100%), reported a link between CAC and higher rate of major adverse cardiovascular events such as stroke and mortality in AF patients. The overall prevalence of AF across 5 studies was estimated to be 9.00% (95% confidence intervals [CI]: 2.00, 16.00), and 60% of the AF population were male. The overall proportion of AF in individuals with a coronary artery calcification score (CACS) of 0 is relatively high at 0.48 (95% CI: 0.32, 0.64), followed by CACS (1-99) which was 0.22 (95% CI: 0.16, 0.28), CACS (100-399) which was 0.17 (95% CI: 0.07, 0.28), and CACS (≥ 400) as 0.14 (95% CI: 0.07, 0.22). It can be concluded that there is a robust and consistent association between CAC and AF. Our systematic review underscores the importance of considering CAC as a potential factor in assessing the risk of AF, while also recognizing the multifactorial nature of this relationship.

Older Adults’ Perceptions, Experiences, and Preferences of a Gamified Cognitive Training Program

With cognitive plasticity being a “sluggish” process, regular long-term engagement in interventions like cognitive training is required to realize the potential that such interventions may confer for cognitive enhancement. A significant challenge associated with extended cognitive training studies is poor adherence and attrition. The current qualitative investigation therefore explored 66 older adult participants’ experiences of, and motivations during, a gamified cognitive training program to understand reasons for (non)adherence. Preferences regarding cognitive training were also explored to provide insight into how such programs might be designed and implemented to maximize motivation and long-term engagement. Using a qualitative description design drawing upon thematic analysis, findings revealed that participants were generally motivated by challenge, novelty, and opportunity to focus. In contrast, repetition, external factors, and negative mindsets detracted from the motivation of participants. Suggestions to improve cognitive training programs to promote long-term engagement included the addition of a large selection of games, an incentive system, mini daily challenges, reminder notifications, and social features. These findings may inform the design of cognitive training programs that accommodate the preferences and needs of older adults, which in turn, may promote adherence and improve intervention effectiveness.

The MapMe Body Scales: Validity and Reliability of a Biometrically Accurate, Photorealistic Set of Child Body Size Scales.

It is vital to identify children whose weight status means that they may benefit from medical or behavioural support, but adult visual judgements of child weight status are inaccurate, and children are seldom routinely weighed and measured. Consequently, there is a need for validated visual tools for use in training, communication, and interventions relating to child weight. This paper presents validation data for a set of innovative photo-realistic colour body size scales depicting boys and girls aged 4-5 and 10-11. Each age- and gender-specific scale consists of 7 figures based on three-dimensional (3D) scans of 388 children to accurately represent the change in body size caused by changing adiposity. To assess scale validity, 238 adult participants (105 men, 132 women, 1 non-binary individual) undertook two tasks: rating figure adiposity using a visual analogue scale and ranking figures in ascending order of adiposity (OSF Reference: gdp9j). Participants accurately estimated the relative adiposity of each figure, i.e., they were able to tell the difference between figures and correctly rank them by size. This demonstrates scale validity for use in body size tasks. One hundred and fifty-one participants also provided 3-day test-retest data, which demonstrates excellent short-term reliability. Overall, the MapMe child body size scales provide an anthropometrically accurate, valid, reliable, and usable tool for size-related tasks and communication with adults regarding child weight.

Association of oxidative balance score with all-cause mortality among individuals with chronic kidney disease: a cohort study

BackgroundThe Oxidative Balance Score (OBS) is employed for evaluating the body’s overall level of oxidative stress. This study aimed to investigate the association between OBS and mortality in individuals with chronic kidney disease (CKD) using a cohort study design.MethodsWe used data from adult participants(≥ 20 years old) in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. CKD is diagnosed based on the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. OBS, which consists of 16 dietary factors and 4 lifestyle factors, categorized into pro-oxidants and antioxidants, with a total score range of 0 to 40 .The OBS was divided into four quartiles (Q1 to Q4), with Q1 (5–12), Q2 (13–18), Q3 (19–24), and Q4 (25–36). We excluded patients with missing data on OBS, CKD, and key covariates.Cox regression analysis were used to examine the relationship between OBS and all-cause mortality in CKD patients. Sensitivity analyses included subgroup analysis and multiple imputation.ResultsWe included a total of 3,984 patients with CKD. During an average follow-up period of 103 months, 1,263 cases (31.7%) of all-cause mortality were recorded. In the fully adjusted model, compared to Q1 the hazard ratios (HRs) and 95% confidence intervals (CIs) for Q4 were as follows: OBS 0.80 (0.68, 0.95) (p = 0.012), dietary OBS 0.78 (0.66, 0.92) (p = 0.003), and lifestyle OBS 0.83 (0.70, 0.99) (p = 0.038). Our sensitivity analyses further confirmed the robustness of these results.ConclusionsHigher OBS was negatively correlated with all-cause mortality risk in American adults with CKD.

Geometric Morphometric and Pattern Discrimination of Handwritten Numeral Characters Based on Local Ethnicities and Native Linguistic Disparities in Malaysia for Forensic Applications

Handwriting can be influenced by factors like culture and native language disparities; however, the specific research to discriminate handwritten numeral characters for forensic questioned document investigation involving the diverse ethnicities (Malay, Chinese and Indian) in Malaysian population remains unreported. Despite its application in forensic anthropology, utilization of the landmark based analysis using the Geometric Morphometric (GMM) technique for examining handwritten numeral character specimens appears sparse. Therefore, this present research that attempted to discriminate ethnicities background of 390 consenting adult participants in Malaysia based on the handwritten numeral characters (0-9) using GMM technique, merits forensic and scientific considerations. Results revealed that while there were universal ones, ethnic-specific handwritten numeral characters that may possibly be influenced by culture and native language (Malay, Chinese and Tamil languages) also prevailed. Significant differences (p < 0.0001) in ethnic-specific characters for the Malay, Chinese and Indian participants who attended the different national primary school settings in Malaysia were also observed. In conclusion, the discrimination of handwritten numeral characters for forensic examination of questioned documents among Malay, Chinese and Indian authors for the development of forensic intelligence is empirically supported.

Joining alone: factors that influence the musical participation of young adults after leaving school

Abstract When young people leave the musical world of their school environment, a lack of clear routes into adult musical engagement brings a risk of wasted ability, motivation and enjoyment, which arguably undermines the value of music education. This study explored the factors that influence continued musical participation among young British adults who had been actively engaged in school music. Musical participation is defined in this research as group music-making in either a formal or informal setting. Participants (n = 102) completed an online questionnaire or were interviewed (n = 6) about their past and present musical experiences along with future expectations for music-making. The stark headline finding was that while 87% of participants had intended to continue with music-making beyond school, only 48% had found groups to join. Nonetheless, 78% expected to continue with music-making in the future. Our research therefore suggests that any break from musical participation need not be permanent for individuals who have established strong musical identities through their early experiences. To conclude, we present a model of lifelong musical participation that illustrates the influences, motivations and choices that contribute to sustained musical engagement.

Does social capital enhance political participation in older adults? Multi-level evidence from the European Quality of Life Survey

This study explored the role of social capital for non-institutionalised and institutionalised political participation among older adults compared to younger age groups using European Quality of Life Survey data (EQLS) from 2016 and 33 countries (n = 36,908). Multilevel logistic regression analysis was employed to assess the association between individual- and country-level social capital and political participation. Findings revealed that, at the individual level, active associational engagement was positively related to both forms of political participation, while social trust and political trust were linked only to non-institutionalised participation—higher social trust and lower political trust were associated with a greater likelihood of participation. Country-level associational engagement was related to non-institutionalised political participation and country-level political trust with institutionalised participation. For older adults, active associational engagement had stronger individual and contextual effects on non-institutionalised political participation. These results enrich our understanding of political engagement in later life and highlight the unexplored potential for civic involvement among older adults.

Verbal and Spatial Working Memory Capacity in Blind Adults and the Possible Influence of Age at Blindness Onset: A Systematic Review and Meta-analysis.

The loss of a sense, such as vision, forces individuals to adapt to their environment and its demands in a variety of ways. In the case of blindness, significant neurofunctional and cognitive changes have been documented. However, there is no clear consensus on the differences in performance between adult blind participants and sighted controls in cognitive processes such as working memory (WM). Two variables are important, including the cognitive task used to measure working memory and the age at which vision loss occurs. This review is aimed at exploring potential disparities in verbal and spatial WM performance between blind and sighted adults, as well as understanding how these differences may be influenced by the age of vision loss. A systematic search across PsycArticles, PsycInfo, Medline, and Web of Science databases identified 21 pertinent studies. The studies were categorized, and effect sizes were calculated through meta-analysis, distinguishing between verbal (auditory simple forward and backward span, complex span, and n-back) and visuospatial WM tasks (adapted Corsi-block and simple storage tasks, imagery tasks, and complex storage tasks). Visual sensory loss induces adaptations affecting WM function in blind participants. In the verbal domain, improved phonological processing and/or serial item position encoding might facilitate WM retrieval. In contrast, in spatial WM, an over-reliance on serial processing may hinder strategic grouping in blind individuals. This review highlights the need to further explore the role of age at the time of vision loss. Although evidence suggests that adaptations to serial processing may be more pronounced in early development, particularly in comparison to those who become blind in adulthood, the available data are limited. The study calls for further research to deepen our understanding of cognitive adaptations and their temporal dynamics in response to vision loss.

Effect of Age on Distortion Product Otoacoustic Emissions at Extended High Frequencies.

The inner ear is most susceptible to the aging effects. Distortion product otoacoustic emissions (DPOAEs) are a good indicator for interpreting the age effects but are usually recorded at up to 8000 Hz frequencies in routine audiologic testing. The present study was designed to assess and compare the DPOAEs at conventional frequencies and at extended high frequencies (EHFs) across different age groups. Extended high-frequency audiometry (9000-16000 Hz) and DPOAEs from 500-16000 Hz were recorded on 80 adult (160 ears) participants (15-55 years) with normal hearing sensitivity. The participants were categorized into 4 groups: group I (15-<25 years), group II (25-<35 years), group III (35-<45 years), and group IV (45-55 years). A statistically significant reduction in EHF thresholds was observed from group III onward. However, the thresholds were comparatively better for group III at frequencies 9000, 10000, and 11500Hz than group IV. No significant difference was observed for EHF DPOAEs in groups I and II (except at 16000 Hz) and III and IV. Distortion product otoacoustic emissions at conventional frequencies in group IV were significantly poorer than the other 3 groups. A weak negative correlation was observed between the DPOAE parameters and EHF thresholds. The effect of age was more pronounced on EHF DPOAEs than EHF thresholds for frequencies 9000, 10000, and 11500 Hz. Distortion product otoacoustic emissions at EHF started deteriorating below the age of 30 years and showed a rapid decline above 35 years. Extended high-frequency DPOAEs can be used as screening tools to assess the function of the basal part of the cochlea.

Association between overweight and central interleukin-6 in a nonclinical adult population.

Overweight is associated with low-grade systemic inflammation. However, its effect on neuroinflammation remains unclear. We examined the possible association between overweight and neuroinflammation using cerebrospinal fluid (CSF) in a nonclinical adult population in Japan. CSF and plasma levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), plasma levels of C-reactive protein (CRP), and leptin were measured in nonclinical adult participants (35 males and 34 females) who had no current or past history of neuropsychiatric diseases. We performed partial correlation analyses with sex and age as covariates between the body mass index (BMI) and the inflammatory markers and compared them between overweight and nonoverweight participants. The BMI significantly correlated with CSF levels of IL-6 (rs = 0.32, p = 0.009), plasma levels of CRP (rs = 0.30, p = 0.016), IL-1β (rs = 0.29, p = 0.019), IL-6 (rs = 0.25, p = 0.042), TNF-α (rs = 0.43, p < 0.001), and leptin (rs = 0.72, p < 0.001). Overweight participants (BMI ≧ 25) had significantly higher CSF levels of IL-6 (p < 0.001), plasma levels of IL-1β (p = 0.023), TNF-α (p < 0.001), and leptin (p < 0.001) than the nonoverweight participants. Overweight is associated with central IL-6, a marker for neuroinflammation, as well as systemic inflammation markers, even in a nonclinical population.

Validation of On-Head OPM MEG for Language Laterality Assessment.

Pre-surgical localization of language function in the brain is critical for patients with medically intractable epilepsy. MEG has emerged as a valuable clinical tool for localizing language areas in clinical populations, however, it is limited for widespread application due to the low availability of the system. Recent advances in optically pumped magnetometer (OPM) systems account for some of the limitations of traditional MEG and have been shown to have a similar signal-to-noise ratio. However, the novelty of these systems means that they have only been tested for limited sensory and motor applications. In this work, we aim to validate a novel on-head OPM MEG procedure for lateralizing language processes. OPM recordings, using a soft cap with flexible sensor placement, were collected from 19 healthy, right-handed controls during an auditory word recognition task. The resulting evoked fields were assessed for hemispheric laterality of the response. Principal component analysis (PCA) of the grand average language response indicated that the first two principal components were lateralized to the left hemisphere. The PCA also revealed that all participants had evoked topographies that closely resembled the average left-lateralized response. Left-lateralized responses were consistent with what is expected for a group of healthy right-handed individuals. These findings demonstrate that language-related evoked fields can be elucidated from on-head OPM MEG recordings in a group of healthy adult participants. In the future, on-head OPM MEG and the associated lateralization methods should be validated in patient populations as they may have utility in the pre-surgical mapping of language functions in patients with epilepsy.

Pharmacokinetic interaction between single and multiple doses of darunavir, in combination with cobicistat or ritonavir, and single-dose dabigatran etexilate in healthy adults

ObjectiveDarunavir (DRV) is a P-glycoprotein (P-gp) inhibitor. Dabigatran etexilate, prodrug of the anticoagulant dabigatran, is a P-gp probe substrate. This study evaluated the effect of single and multiple doses of DRV, coadministered with cobicistat (COBI) or ritonavir (rtv), on the pharmacokinetics (PK) of single-dose dabigatran etexilate.MethodsThis was an open-label, fixed-sequence, single-center, 2-panel, phase 1 study in which healthy adult participants were equally divided over 2 panels. In panel 1, participants received single and multiple doses of DRV/COBI 800/150 mg coadministered with single-dose dabigatran etexilate 150 mg. In panel 2, participants received single and multiple doses of DRV 800 mg + rtv 100 mg coadministered with single-dose dabigatran etexilate 150 mg. Key PK parameters evaluated were maximum plasma concentration (Cmax) and area under the plasma concentration-time curve from time zero to infinity (AUCinf) for free and total dabigatran.ResultsOverall, 28 participants were enrolled and treated (n = 14 per panel). Dabigatran Cmax and AUCinf increased 2.64-fold after a single dose of DRV/COBI and 1.99- and 1.88-fold, respectively, after multiple doses of DRV/COBI. Dabigatran Cmax and AUCinf increased 1.64- and 1.72-fold, respectively, after a single dose of DRV + rtv and 1.22- and 1.18-fold, respectively, after multiple doses of DRV + rtv. In both panels, the most commonly reported adverse events were diarrhea and headache.ConclusionFindings of increased dabigatran exposure with DRV/COBI or DRV + rtv coadministration indicate an inhibitory effect of single-dose boosted DRV on P-gp, and a mixed inhibitory/inductive effect of multiple doses of boosted DRV on P-gp.Trial registrationClinicalTrials.gov, NCT04208061. Registered December 19, 2019

Somatosensory migraine auras evoked by bihemispheric cortical spreading depression events in human parietal cortex.

Cortical spreading depression (CSD) is associated with pronounced alterations in cerebral blood flow. These alterations can be captured using high-field functional magnetic resonance imaging (fMRI). While compelling clinical and experimental data suggest that CSD is involved in the pathogenesis of migraine aura, the mechanistic intricacies remain poorly understood. Here, we use visual stimulus-induced blood oxygen level-dependent (BOLD) fMRI responses to characterize spatiotemporal alterations in cerebral blood flow during spontaneous attacks with migraine aura. Six adult participants diagnosed with migraine with aura underwent BOLD fMRI scans with a visual stimulation paradigm, consisting of flickering checkerboard stimulation. Our results revealed that auras with somatosensory symptoms corresponded with bilateral alterations of stimulus-induced BOLD responses in the somatosensory cortex, exhibiting anterior-to-posterior propagation and absence of antecedent occipital abnormalities. These altered stimulus-induced BOLD responses were bilateral, despite a unilateral manifestation of aura symptoms, and had no relationship with positive or negative aura symptoms. The bilateral abnormalities in stimulus-induced BOLD responses completes our current knowledge on migraine aura.

Knowledge And Attitude Regarding Rabies Prevention Among Adults Residing Under The Field Areas Of Medical College Health Unit, Pangappara

ABSTRACT Rabies has been one among the most dreaded diseases to man since antiquity. The present study was intended to assess the knowledge and attitude regarding rabies prevention among adults residing under the field areas of Medical College Health Unit, Pangappara. The objectives of the study were to assess the knowledge and attitude regarding rabies prevention, to assess the practice regarding rabies prevention, to find out the correlation between knowledge and attitude and to find out the association between knowledge of adults regarding rabies prevention with sociodemographic variables. The research approach adopted for the study was quantitative and the data was collected from 408 participants. The study design was cross sectional design and participants were selected using cluster sampling technique. Socio demographic data and the knowledge were assessed using an interview schedule, attitude and practice were assessed using a five point Likert scale and a checklist respectively. Data analysis was carried out using both descriptive and inferential statistics. The results showed that 47.1% had good knowledge,28.4% had average knowledge and 24.5% had poor knowledge regarding rabies prevention and 38% of adults had positive attitude,36% had uncertain attitude and 26% had negative attitude towards rabies prevention,45.9% reported good practice after an animal bite. The study revealed that there was a moderate positive correlation between knowledge and attitude (r = 0.443 and p &lt; 0.05) and there was a significant association between knowledge of adults regarding rabies prevention with age, socio economic status and adults participation status in rabies prevention campaign. The study concludes the necessity for preventing the mortality by dog mediated Rabies.

Directionality in BiCROS hearing aids: an investigation of objective and subjective outcomes

Objectives To assess the effect of forward and omnidirectional microphone configurations in BiCROS versus monaural hearing aids on objective and subjective outcomes in different noise conditions. Design After fitting and a 4-week acclimatisation period, speech recognition and sound quality were measured using forward directional, omnidirectional, and unaided settings. Two noise configurations were used, surrounding noise and noise presented from the aided (better) ear. Subjective outcomes were assessed using the SSQ-b and BBSS questionnaires and participant interviews. Study sample Eighteen adult participants (mean: 74.6 y; range: 61–94 y; ten males, eight females) with mild to moderately severe SNHL in their better ear (PTA0.5–4khz > 20 dB HL) and limited usable hearing in their poorer ear (average PTA0.5–4khz > 100 dB HL). Results Significant improvement in speech recognition and sound quality for BiCROS and monaural directional settings over omnidirectional and unaided, in both noise configurations. There were no significant differences observed between monoaural and BiCROS directional settings. Conclusion Speech in noise recognition and sound quality scores demonstrated a significant directional benefit for both BiCROS and monaural directional fitting settings over omnidirectional and unaided conditions. Unique BiCROS-specific experiences were identified in a patient-oriented approach. These can inform the development of BiCROS-tailored tools.

Leveraging Chatbots to Combat Health Misinformation for Older Adults: Participatory Design Study.

Older adults, a population particularly susceptible to misinformation, may experience attempts at health-related scams or defrauding, and they may unknowingly spread misinformation. Previous research has investigated managing misinformation through media literacy education or supporting users by fact-checking information and cautioning for potential misinformation content, yet studies focusing on older adults are limited. Chatbots have the potential to educate and support older adults in misinformation management. However, many studies focusing on designing technology for older adults use the needs-based approach and consider aging as a deficit, leading to issues in technology adoption. Instead, we adopted the asset-based approach, inviting older adults to be active collaborators in envisioning how intelligent technologies can enhance their misinformation management practices. This study aims to understand how older adults may use chatbots' capabilities for misinformation management. We conducted 5 participatory design workshops with a total of 17 older adult participants to ideate ways in which chatbots can help them manage misinformation. The workshops included 3 stages: developing scenarios reflecting older adults' encounters with misinformation in their lives, understanding existing chatbot platforms, and envisioning how chatbots can help intervene in the scenarios from stage 1. We found that issues with older adults' misinformation management arose more from interpersonal relationships than individuals' ability to detect misinformation in pieces of information. This finding underscored the importance of chatbots to act as mediators that facilitate communication and help resolve conflict. In addition, participants emphasized the importance of autonomy. They desired chatbots to teach them to navigate the information landscape and come to conclusions about misinformation on their own. Finally, we found that older adults' distrust in IT companies and governments' ability to regulate the IT industry affected their trust in chatbots. Thus, chatbot designers should consider using well-trusted sources and practicing transparency to increase older adults' trust in the chatbot-based tools. Overall, our results highlight the need for chatbot-based misinformation tools to go beyond fact checking. This study provides insights for how chatbots can be designed as part of technological systems for misinformation management among older adults. Our study underscores the importance of inviting older adults to be active co-designers of chatbot-based interventions.

Psychological, psychosocial and physical barriers preventing nature-based intervention participation in adults with mental health disorders: A scoping review.

Nature-based interventions (NBIs) are becoming a common mental health care referral option; however, little is known about the barriers to participation. Research reveals a concentration of evidence on the practical barriers with a paucity of guidance on the personal barriers as experienced by service users. This review explores what is known on the psychological, psychosocial and physical barriers as disclosed by adult mental health service users and the various stakeholders involved in NBI. Nine of the 104 articles screened met the inclusion criteria. The review identified a total of 47 barriers in which the majority were standalone barriers unique to the individual article or participant that generated them. However, other barriers suggest a level of universality with the greatest array of barriers identified in the psychosocial category. The review highlights an urgent need for further research on the psychological, psychosocial and physical barriers to NBI participation.

Association between the neutrophil-to-lymphocyte ratio and cancer in adults from NHANES 2005–2018: a cross-sectional study

Inflammation plays a crucial role in cancer development. The neutrophil-to-lymphocyte ratio (NLR), a measure of inflammation, is obtained from a complete blood count. However, little is known about the association between NLR and cancer in the general adult population in the United States. This study aimed to evaluate whether NLR is associated with cancer in American adults. This retrospective cross-sectional study included 28,016 adult participants from the National Health and Nutrition Examination Survey (NHANES) dataset spanning 2005 to 2018. Data on demographics (age, sex, race, marital status, Poverty-Income Ratio, education level), lifestyle factors (smoking, alcohol consumption, body mass index), medical conditions (hypertension, diabetes, cardiovascular disease), and laboratory parameters (hemoglobin, platelet count, alanine aminotransferase, creatinine, albumin, and lactate dehydrogenase), were collected. Logistic regression analysis was used to investigate the research objectives. Of the total 28,016 participants, 2639 had cancer. The mean age was 49.6 ± 17.6 years, and 50% were male. A positive association between NLR and cancer risk was observed after multivariate adjustment (OR = 1.20, 95% confidence interval (CI) = 1.05–1.36, p = 0.006). Similar patterns were observed in subgroup analyses (all p-values for interaction > 0.05). A higher NLR was directly correlated with an increased risk of developing cancer in adults.