Adverse Health Conditions Research Articles

Preventing and treating the adverse health conditions of androgenic-anabolic steroids: An online survey with 883 users in the United Kingdom

The use of use of androgenic-anabolic steroids (AAS) is associated with an increased risk of several health conditions. Health-related behaviours to prevent and treat these conditions include the use of needle exchange services, having blood tests to monitor one's health and seeking information and support from health professionals and other sources. This study investigates the prevalence of adverse health conditions and health behaviours in a cohort of AAS users from the United Kingdom taking part in an online survey, as well as behavioural factors impacting the likelihood of reporting a health condition in the last 12 months. The sample was composed of 883 adults (72.1 % males, 27.9 % females; Med age = 26, min = 16, max = 65). The most common health problems were dermatological (68.1 %) and neuropsychiatric (63.1 %) conditions. Although the majority of participants monitored their health with blood tests (86.4 %) and sought a General Practitioner (GP) to treat health problems (55.0 %), only a minority of LGBTQIA+ males sought a GP for information (12.8 %) or to treat health conditions (18.7 %). Participants who sought a GP for information about AAS were 74 % less likely to report a health condition in the last 12 months (OR = 0.26, 95 % CI 0.18 to 0.40, p < 0.001). These findings can be used to support research and interventions aiming to improve the access of AAS users to the health system by identifying health conditions and health-related behaviours adopted by subpopulations of AAS users.

Associations between Differential Aging and Lifestyle, Environment, Current, and Future Health Conditions: Findings from Canadian Longitudinal Study on Aging

Introduction: An aging population will bring a pressing challenge for the healthcare system. Insights into promoting healthy longevity can be gained by quantifying the biological aging process and understanding the roles of modifiable lifestyle and environmental factors, and chronic disease conditions. Methods: We developed a biological age (BioAge) index by applying multiple state-of-art machine learning models based on easily accessible blood test data from the Canadian Longitudinal Study of Aging (CLSA). The BioAge gap, which is the difference between BioAge index and chronological age, was used to quantify the differential aging, i.e., the difference between biological and chronological age, of the CLSA participants. We further investigated the associations between the BioAge gap and lifestyle, environmental factors, and current and future health conditions. Results: BioAge gap had strong associations with existing adverse health conditions (e.g., cancers, cardiovascular diseases, diabetes, and kidney diseases) and future disease onset (e.g., Parkinson’s disease, diabetes, and kidney diseases). We identified that frequent consumption of processed meat, pork, beef, and chicken, poor outcomes in nutritional risk screening, cigarette smoking, exposure to passive smoking are associated with positive BioAge gap (“older” BioAge than expected). We also identified several modifiable factors, including eating fruits, legumes, vegetables, related to negative BioAge gap (“younger” BioAge than expected). Conclusions: Our study shows that a BioAge index based on easily accessible blood tests has the potential to quantify the differential biological aging process that can be associated with current and future adverse health events. The identified risk and protective factors for differential aging indicated by BioAge gap are informative for future research and guidelines to promote healthy longevity.

FACTORS ASSOCIATED WITH DEPRESSION, ANXIETY, AND STRESS AMONG FOOD INDUSTRY WORKERS: A SYSTEMATIC REVIEW

In 2021, food industry workers represented approximately one-tenth of the total labour force in Malaysia. There was an estimated 15% of working-age adults who experienced a mental disorder worldwide in 2019. To make the situation worse, service workers in food retail and food services face tremendous stress and mental health consequences during the COVID-19 pandemic. Various study found that worsening mental health and psychological distress have been accelerated substantially by the pandemic. An unsafe or unhealthy working environment can undermine mental health, as poor mental health can interfere with a person’s ability to work if left unsupported. This systematic review aimed to evaluate findings related to factors associated with depression, anxiety, and stress among food industry workers. Articles related to these factors were collected electronically from two different databases (EBSCOHOST and Scopus). An independent reviewers screened the titles and abstracts of the collected articles from each database, and then stored them in Google Sheet based on the inclusion and exclusion criteria. Next, the included articles were critically appraised to assess the quality of the studies using the Mixed Methods Appraisal Tool (MMAT). Out of the 292 articles identified, four were included in the final review. Sociodemographic characteristics, as well as biological, psychological, and occupational factors were found to be associated with common mental issues among food industry workers. By identifying the risk factors, specific interventions can be implemented by the employers and other relevant parties to prevent, promote, protect, and support the mental health well-being of food industry workers. These findings may be utilised to improve the implementation of key interventions directed to prevent, promote, protect, and support the mental health of food industry workers. Consequently, an enabling environment can be created to address mental health at work, as outlined by the World Health Organization (WHO). Employers may adapt or revamp their work environment to minimise exposure to psychological risks among their workers, which could prevent workers from experiencing adverse mental health conditions. Workers should also be equipped with awareness and skills, as well as opportunities to recognise and act early on mental health issues in order to promote and protect their mental health. Moreover, workers with pre-existing or ongoing mental health conditions should receive support to access job opportunities, or continue working, and thrive at work, since good mental health status at work can improve an individual’s performance and productivity.

Prevalence and Trends of Weakness Among Middle-Aged and Older Adults in the United States.

McGrath, R, FitzSimmons, S, Andrew, S, Black, K, Bradley, A, Christensen, BK, Collins, K, Klawitter, L, Kieser, J, Langford, M, Orr, M, and Hackney, KJ. Prevalence and trends of weakness among middle-aged and older adults in the United States. J Strength Cond Res 37(12): 2484-2490, 2023-Muscle weakness, which is often determined with low handgrip strength (HGS), is associated with several adverse health conditions; however, the prevalence and trends of weakness in the United States is not well-understood. We sought to estimate the prevalence and trends of weakness in Americans aged at least 50 years. The total unweighted analytic sample included 22,895 Americans from the 2006-2016 waves of the Health and Retirement Study. Handgrip strength was measured with a handgrip dynamometer. Men with weakness were below at least one of the absolute or normalized (body mass, body mass index) cut points: <35.5 kg, <0.45 kg/kg, <1.05 kg/kg/m 2 . The presence of any weakness in women was also identified as being below one of the absolute or normalized HGS cut points: <20.0 kg, <0.34 kg/kg, or <0.79 kg/kg/m 2 . There was an increasing trend in the prevalence of any weakness over time ( p < 0.001). The prevalence of weakness was 45.1% (95% confidence interval [CI]: 44.0-46.0) in the 2006-2008 waves and 52.6% (CI: 51.5-53.7) in the 2014-2016 waves. Weakness prevalence was higher for older (≥65 years) Americans (64.2%; CI: 62.8-65.5) compared with middle-aged (50-64 years) Americans (42.2%; CI: 40.6-43.8) in the 2014-2016 waves. Moreover, the prevalence of weakness in the 2014-2016 waves was generally higher in women (54.5%; CI: 53.1-55.9) than in men (50.4%; CI: 48.7-52.0). Differences existed in weakness prevalence across races and ethnicities. The findings from our investigation suggest that the prevalence of weakness is overall pronounced and increasing in Americans. Efforts for mitigating and better operationalizing weakness will elevate in importance as our older American population grows.

Dual task scheduling strategy for personalized multi-objective optimization of cycle time and fatigue in human-robot collaboration

The increased adoption of collaborative robots into human dominated work cells improves production efficiency of hard-to-automate manufacturing tasks. System-centric task scheduling objectives aim to fully utilize all available agents, often physically burdening workers with schedules designed maximized efficiency. Therefore, the modeling and optimization of human fatigue, as one of the main contributors to efficiency decline and adverse health conditions, is significant to task scheduling in Human-Robot Collaboration (HRC). Furthermore, HRC teams often involve drastically different workers with differing capabilities and muscle strengths – with direct implication toward their personalized fatigue responses. As such, we present a dual scheduling strategy for personalized multi-objective optimization of cycle time and fatigue considering recovery in HRC. The scheduling strategy involves two fatigue minimization objectives which either minimize the team’s fatigue state or an individual worker’s fatigue state. This balances fatigue accumulation between workers, providing targeted rest and recovery to specific workers while maintaining production efficiency. We designed a custom NSGA-III genetic algorithm for simultaneously minimizing cycle time and fatigue. Our model and algorithm are applied to an HRC assembly case and show promising results in redistributing tasks between agents to minimize personalized fatigue.

Mental Health among Automobile industry workers in Chennai – A Cross-sectional study from a Single Industrial unit

Introduction: Working in a mentally healthy place is necessary for people. Adverse mental health conditions can lead to disruption in work which in turn causes absenteeism, low productivity, and financial constraints. This study intends to assess the levels of depression, anxiety and stress and to determine its associated factors among the workers in the automobile industry in Chennai. Methods: A cross-sectional study was conducted among 227 Automobile industry workers in Chennai, India. A semi-structured questionnaire was used to collect information about the socio-demographic and working details of the study subjects, while the Depression Anxiety Stress Scale (DASS -21) was used to assess mental health status. Descriptive variables were expressed as proportions, while Pearson's Chi-square test was used to study the association between dependent and independent variables. Results: A total number of 227 participants were included in the study. More than 80 % of the workers were permanent employees. The prevalence of Depression, anxiety and stress among the study subjects are 38.8%, 43.6 % and 26.9 %, respectively. Workers in the middle age group of 30- 39 years had a higher risk of developing depression, anxiety, and stress than those in the other age groups. For Depression, age, type of family, employment status, and working experience were statistically significant (p&lt;0.05). The sleeping hours, comorbidities, substance use, co-worker support, and supervisor support of the workers were the factors that showed no association with Depression, anxiety, and stress. Conclusion: There is a need for attention to be paid to the development of a healthy psychosocial workplace climate which should be supported by stronger workplace support.

About the associations of vitamin D deficiency and biomarkers of systemic inflammatory response with all-cause and cause-specific mortality in a general population sample of almost 400,000 UK Biobank participants

It is unknown whether the well-known association between vitamin D deficiency and mortality could be explained by the immune system modulating effects of vitamin D, which may protect from a systemic inflammatory response (SIR) to adverse health conditions. This study aims to investigate the interrelationships of vitamin D deficiency, biomarkers of SIR, and mortality. We used multivariate logistic regression with adjustment for 51 covariates to assess the associations of vitamin D deficiency with disadvantageous levels of nine biomarkers of SIR in the UK Biobank cohort. Furthermore, we tested with Cox regression and mediation analysis whether biomarkers of SIR and vitamin D deficiency were independently associated with mortality. We included 397,737 participants aged 37–73 years. Vitamin D deficiency was associated with disadvantageous levels of all blood cell count-based biomarkers, but not with C-reactive protein (CRP)-based biomarkers after adjustment for body weight. Vitamin D deficiency and all biomarkers of SIR were significantly associated with all-cause mortality and mortality from cancer, cardiovascular and respiratory disease. The strength of these associations was unaltered if vitamin D deficiency and biomarkers of SIR were put in the same model. This finding was further supported by the mediation analyses. This study showed that vitamin D deficiency is associated with disadvantageous levels of blood cell count-based but not CRP-based biomarkers of SIR. Vitamin D deficiency and systemic inflammation were independently and strongly associated with mortality. The potential of clinical interventions against both vitamin D deficiency and underlying causes of systemic inflammation should be explored.

Enterosignatures define common bacterial guilds in the human gut microbiome

The human gut microbiome composition is generally in a stable dynamic equilibrium, but it can deteriorate into dysbiotic states detrimental to host health. To disentangle the inherent complexity and capture the ecological spectrum of microbiome variability, we used 5,230 gut metagenomes to characterize signatures of bacteria commonly co-occurring, termed enterosignatures (ESs). We find five generalizable ESs dominated by either Bacteroides, Firmicutes, Prevotella, Bifidobacterium, or Escherichia. This model confirms key ecological characteristics known from previous enterotype concepts, while enabling the detection of gradual shifts in community structures. Temporal analysis implies that the Bacteroides-associated ES is "core" in the resilience of westernized gut microbiomes, while combinations with other ESs often complement the functional spectrum. The model reliably detects atypical gut microbiomes correlated with adverse host health conditions and/or the presence of pathobionts. ESs provide an interpretable and generic model that enables an intuitive characterization of gut microbiome composition in health and disease.

Staff Knowledge, Attitudes, and Beliefs About Child Sugar-Sweetened Beverage Intake and Acceptability of a Pediatric Clinic-Based Beverage Screener.

Beverages are the leading source of sugar in children's diets and a modifiable risk factor for adverse health conditions. Electronic health record-based screeners could facilitate health systems' efforts to reduce child consumption of sugary beverages. Before implementing a sugar-sweetened beverage screener in the electronic health record within academic healthcare system, 228 pediatric and family medicine clinic staff completed an online educational training to familiarize them with the screener and its rationale. Pretraining and posttraining surveys were used to examine the association between staff knowledge of sugar-sweetened beverages and the acceptability of the screening workflow. Respondents displayed high levels of pretraining knowledge about health consequences of added sugar intake, but lower levels of pediatric beverage guideline knowledge. Knowledge improved from pretraining to posttraining surveys, with high acceptability of the screening process. Staff compliance with sugar-sweetened beverage screening was examined using electronic health record data. During the 6 months after screener implementation, 47% of eligible pediatric patients were screened, with some variation in compliance by age group and practice type. This study demonstrated that engaging nursing and frontline staff to screen pediatric patients for behavioral determinants of health is feasible. Ongoing outreach and refreshers may improve sustainability.

Trends in Quick-Service Restaurants near Public Schools in the United States: Differences by Community, School, and Student Characteristics.

More than one-third of children and adolescents consume foods from quick-service restaurants (QSRs) daily, which is associated with an increased risk of diet-related adverse health conditions. To examine trends in the proximity of top-selling QSR chains to all public schools across the United States between 2006 and 2018 by community-, school-, and student-level characteristics. This longitudinal study examined changes in the number QSRs between the 2006-2007 and 2017-2018 school years using data from National Center for Education Statistics, Infogroup US Historical Business Data, and the US Department of Agriculture's Economic Research Service. A mixed-model analysis of variance using census tract as a random effect and accounting for repeated measures by school was used to examine the proximity of QSRs near schools. Models adjusted for demographic characteristics and census tract population density. Data were analyzed in2021. During 2006, 9% of schools had QSRs within 400 m, and 25% of schools in the most populated areas had at least one QSR within 400 m. There were more QSRs near schools with a high percentage of poverty (12%), and near schools with high school students with the highest population of Black or African American (16%) and Hispanic or Latino (18%) students. By 2018, the percent of all public schools within 400 m of QSRs increased to 12%. The increase over time was greater near schools with a high percentage of poverty (16%) and near schools with high school students with the highest population of Black or African American students (22%) and Hispanic or Latino (23%) students. This is the first nationwide study to examine trends in QSR proximity to all public schools. QSRs were most likely to be located near schools with high school students, near schools with a high percentage of poverty, and near schools with a higher proportion of racial and ethnic minority students. Over time, there were greater increases in QSRs near these schools which may have important implications for children's health and diet-related disparities.

Sedentary pattern, brain health, and cognitive function in rural‐dwelling older adults: A population‐based study

AbstractBackgroundSedentary behavior is distinct from low moderate‐to‐vigorous physical activity and is associated with a range of adverse health conditions. Population‐based studies have rarely examined the associations of objectively‐measured sedentary parameters, structural brain markers, and cognition among older adults.MethodsThis population‐based study included 2019 rural‐dwelling older adults (age ≥60 years, 59% women) who were free of dementia derived from MIND‐China baseline participants. In 2018‐2020, sedentary behavior parameters were measured using accelerometers. We used a neuropsychological test battery to assess global and domain‐specific cognitive function (memory, language, attention, and executive function). Volumes of total brain tissue, white matter hyperintensities, total grey matter, total white matter, ventricles, and hippocampus were assessed on the magnetic resonance imaging in a subsample (n = 1009). We used the general linear models, restricted cubic splines, and mediation models to examine the associations of sedentary parameters, structural brain markers, and cognitive measures, and the isotemporal substitution models to estimate associations of replacing sedentary time with physical activity.ResultsIn the total sample, adjusting for multiple confounders and MVPA, longer mean sedentary bout duration was linearly associated with lower z‐scores of global cognition, memory, and language, whereas the linear association of greater total sedentary time with poorer global cognition, memory, and language existed only among long‐sedentary individuals (&gt;10.2 hours/day); Having more breaks per sedentary hour or replacing 30‐minute sedentary time with the same amount of physical activity was significantly associated with higher cognitive z‐scores (P&lt;0.05). In the MRI subsample, simultaneously or separately entering multiple structural brain markers into the mediation models substantially attenuated the associations between mean sedentary bout duration and cognitive z‐scores.ConclusionIn the rural‐dwelling Chinese older adults, the association of prolonged uninterrupted sedentary time with poor cognition is largely mediated by structural brain markers and frequent breaks in sedentary time are associated with brain health.

Status of Maternal Cardiovascular Health in American Indian and Alaska Native Individuals: A Scientific Statement From the American Heart Association.

Cardiovascular disease is the leading cause of pregnancy-related death in the United States. American Indian and Alaska Native individuals have some of the highest maternal death and morbidity rates. Data on the causes of cardiovascular disease-related death in American Indian and Alaska Native individuals are limited, and there are several challenges and opportunities to improve maternal cardiovascular health in this population. This scientific statement provides an overview of the current status of cardiovascular health among American Indian and Alaska Native birthing individuals and causes of maternal death and morbidity and describes a stepwise multidisciplinary framework for addressing cardiovascular disease and cerebrovascular disease during the preconception, pregnancy, and postpartum time frame. This scientific statement highlights the American Heart Association's factors for cardiovascular health assessment known collectively as Life's Essential 8 as they pertain to American Indian and Alaska Native birthing individuals. It summarizes the impact of substance use, adverse mental health conditions, and lifestyle and cardiovascular disease risk factors, as well as the cascading effects of institutional and structural racism and the historical trauma faced by American Indian and Alaska Native individuals. It recognizes the possible impact of systematic acts of colonization and dominance on their social determinants of health, ultimately translating into worse health care outcomes. It focuses on the underreporting of American Indian and Alaska Native disaggregated data in pregnancy and postpartum outcomes and the importance of engaging key stakeholders, designing culturally appropriate care, building trust among communities and health care professionals, and expanding the American Indian and Alaska Native workforce in biomedical research and health care settings to optimize the cardiovascular health of American Indian and Alaska Native birthing individuals.

With Teeth, Broken, or Fixed: The Challenges of Linking Periodontitis, Neuroepidemiology, and Biomarkers of Disease.

Periodontitis is a chronic inflammatory, bacterially-driven disease of the tooth-supporting tissues that shares several risk factors and elements of host response with Alzheimer's disease and related dementias (ADRD). Epidemiological studies have identified relatively consistent associations between adverse oral health conditions and ADRD. In this issue of the journal, a large study from the UK Biobank further explores these relationships along with MRI cognitive biomarkers. Despite its strength due to the large sample size, challenges in the study of periodontitis and neuroepidemiology markers include potential sampling bias, appropriate assessment of exposures, and the possibility of reverse causality.

Mental Health and Oral Health in a Nationally Representative Cohort

Evidence connects mental illness to other adverse health conditions, including oral health. However, longitudinal associations between mental and oral health remain understudied. We aimed to examine mental health–oral health associations prospectively in a nationally representative US cohort. Data were from the Population Assessment of Tobacco and Health (PATH) Study. The Global Appraisal of Individual Needs–Short Screener measured 3 types of mental health symptoms: internalizing, externalizing, and substance use problems. Six self-reported oral health conditions related to periodontal disease were evaluated: self-rated oral health, bleeding gums, loose teeth, tooth extraction, gum disease, and bone loss around teeth. Cross-sectional analysis within PATH Study wave 4 (2016 to 2018, n = 30,746) compared the survey-weighted prevalence of the 6 oral health outcomes according to severity of mental health problems. Prospectively, oral health outcomes were assessed 2 y later (wave 5, 2018 to 2019) according to wave 4 (baseline) mental health problems (n = 26,168). Survey-weighted logistic regression models controlled for confounders (age, sex, tobacco use, etc.) with imputation for missing values. All 6 adverse oral health conditions were greater in prevalence among participants with severe internalizing problems. Multiple conditions were also associated with severe externalizing or substance use problems. Longitudinally associations attenuated, but multiple associations of meaningful magnitude persisted, most with internalizing problems. For example, the adjusted odds ratio was 1.27 (95% CI, 1.08 to 1.50) for bleeding gums and 1.37 (95% CI, 1.12 to 1.68) for tooth extraction when we compared severe versus none/low internalizing problems. Providers should expect higher levels of oral disease among patients with adverse mental health symptoms. Independent of externalizing and substance use problems, symptoms of internalizing problems (related to depression and/or anxiety) are plausible risk factors for future oral disease. Better integration and coordination of mental and oral health treatment and prevention are recommended.

0373 Association of U.S. Military Burn Pit Smoke Exposure with Insomnia and Sleep Apnea Symptoms

Abstract Introduction Burn pits (BPs) have been widely used by the U.S. military for waste disposal. Due to the obviously toxic nature of the BP emissions, exposure may contribute to diverse adverse health conditions, including sleep apnea. To our knowledge, this is the first study to examine the association between self-estimated amount of BP emission exposure and self-reported sleep complaints. Methods We used an online health questionnaire of the VA/DoD Airborne Hazards and Open Burn Pit Registry administered between April 2014 and August 2022 to 320,231 Veterans and active-duty personnel (age 40.1±9.2 years, BMI 28.8±4.5 kg/m2, 11% female, 75% white). Outcomes included insomnia, short sleep duration &amp;lt; 6hrs, sleep apnea events, and snoring. The exposure variable was cumulative BP exposure that was calculated by multiplying the response (in hours) to a question about burn pit exposure by number of deployment days, summing across deployments, and categorizing by quartile. We employed separate logistic regression models to determine the association between cumulative BP exposure days and sleep outcomes using no BP exposure as the reference. We adjusted the models by age, BMI, sex, race, ethnicity, military branch and duty status. Results We observed higher odds of insomnia as the duration of BP exposure increased in each quartile (Q1-Q4 ORs:1.8-3.4, p&amp;lt;.001). The same trend was observed for shorter sleep duration (Q1-Q4 ORs:1.6-2.4, p&amp;lt;.001), sleep apnea (Q1-Q4 ORs:1.4-2.4, p&amp;lt;.0001) and snoring (Q1-Q4 ORs:1.3-1.8, p&amp;lt;.0001). Conclusion Higher levels of BP emission exposure was associated with a greater report of insomnia symptoms, shorter sleep duration, snoring and sleep apnea events. Future research will focus on examining the association of BP emission ­exposure and objective sleep data extracted from polysomnography reports in the Veteran Affairs electronic medical records. Support (if any) This work is supported by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413), Michael E DeBakey Veteran Affairs Medical Center Bridge Grant (PI: Nowakowski), and the VA Airborne Hazards and Burn Pit Center of Excellence Pilot Grant (PI: Nowakowski).

Internalizing Disorders as a Mediator of the Association Between Adverse Childhood Experiences and Perceived Medication Intolerance or Poly-Allergy.

There is a well-established link between adverse childhood events, mental health and physical health conditions. There is also a large literature showing the relationship between medication intolerance or allergies, and poor health outcomes. However, less is understood about the role of medication intolerance and adverse childhood events. Thus, the present study examines the relationship between adverse childhood events, internalizing disorders (depression, anxiety) and medication intolerance. Three hundred 49 participants (349) were recruited from 11 primary care practices and health networks located in a large, Midwestern metropolitan area. Seemingly unrelated linear and Poisson regression was used to determine whether internalizing disorders, such as depression and anxiety, mediate the relationship between Adverse childhood experiences (ACEs) and allergies to medications to account for error terms in regression equations that are correlated. Results indicated an association between ACEs and number of allergies to medication, whereby ACEs was associated with depression, anxiety and number of allergies, and depression was associated with number of allergies. Sensitivity analysis confirmed these findings. There was a small but significant indirect effect of anxiety on allergies to medication after bootstrapping. This study shows that inflammatory responses occurring because of trauma and depression may be increasing medication allergies. However, given the size of the sample, more research is needed to confirm these results. Implications for healthcare providers are discussed.

Addressing the needs of Ethiopia’s street homeless women of reproductive age in the health and social protection policy: a qualitative study

IntroductionGlobally, homelessness is a growing concern, and homeless women of reproductive age are particularly vulnerable to adverse physical, mental, and reproductive health conditions, including violence. Although Ethiopia has many homeless individuals, the topic has received little attention in the policy arena. Therefore, we aimed to understand the reason for the lack of attention, with particular emphasis on women of reproductive age.MethodsThis is a qualitative study; 34 participants from governmental and non-governmental organisations responsible for addressing homeless individuals’ needs participated in in-depth interviews. A deductive analysis of the interview materials was applied using Shiffman and Smith’s political prioritisation framework.ResultsSeveral factors contributed to the underrepresentation of homeless women’s health and well-being needs in the policy context. Although many governmental and non-governmental organisations contributed to the homeless-focused programme, there was little collaboration and no unifying leadership. Moreover, there was insufficient advocacy and mobilisation to pressure national leaders. Concerning ideas, there was no consensus regarding the definition of and solution to homeless women’s health and social protection issues. Regarding political contexts and issue characteristics, a lack of a well-established structure, a paucity of information on the number of homeless women and the severity of their health situations relative to other problems, and the lack of clear indicators prevented this issue from gaining political priority.ConclusionsTo prioritise the health and well-being of homeless women, the government should form a unifying collaboration and a governance structure that addresses the unmet needs of these women. It is imperative to divide responsibilities and explicitly include homeless people and services targeted for them in the national health and social protection implementation documents. Further, generating consensus on framing the problems and solutions and establishing indicators for assessing the situation is vital.

Enhancing immunology based health sciences education for addressing health inequities - in the context of COVID-19

Abstract Māori and Pacific peoples in Aotearoa/New Zealand and the Pacific Region, remain disproportionately and inequitably impacted and affected by a number of adverse health conditions. The global COVID-19 pandemic exacerbated pre-existing inequities in health for different groups, including Māori and Pacific peoples. The consideration of addressing health inequities for Pacific peoples in the context of immunologically relevant health conditions, was explored in the online learning setting for the health sciences students. This work employed use of a Pacific method and means of communication and dialogue, known as Talanoa, that was adapted for the online learning setting as a result of the COVID-19 pandemic. The Talanoa approach was utilised as a tool for students to try and gain better understanding of how to engage, communicate and tackle health inequities appropriately and effectively for Pacific peoples. Undergraduate health sciences students received instruction into the Talanoa approach for communication within the Pacific setting. Online opportunities for presentations and discussion pertaining to developing appropriate solutions to address health inequities for Pacific peoples were facilitated. Students were able to adopt and apply elements of Talanoa in their presentations, discussions and interactions in the online setting. This work highlights the importance of the inclusion of Talanoa, as a means for enhancing online immunology based health sciences education for addressing health inequities appropriately in the context of COVID-19. Wellington School of Medicine &amp; Health Sciences, University of Otago.

Insomnia trajectories predict chronic inflammation over 2 years at the transition to adulthood.

Insomnia in adolescents is an important public health concern, as its impacts on both their current and future physical and mental health has been discussed. However, few longitudinal studies have examined insomnia and chronic inflammation at the transition from adolescence to adulthood. This study aimed to examine the predictive effects of insomnia and insomnia trajectories on inflammation in college students by using a prospective design. Using data from the College Student Behaviour and Health Cohort Study, which was conducted between April 2019 and April 2021, with an interval of 6 months. We investigated the associations between insomnia trajectories from Year 1 to Year 3 and five inflammatory biomarkers (C-reactive protein [CRP], tumour necrosis factor [TNF]-α, interleukin [IL]-6, IL-1β, IL-10) at Year 3. The association of insomnia symptoms at baseline, Wave 1 or Wave 2 with inflammatory biomarkers at Wave 4 were also assessed. A total of 312 college students (males: 51.6%) aged 16-26 years (mean [SD] 18.82 [1.22] years) were analysed. We identified two insomnia trajectory classes: increasing insomnia (n = 63 [20.2%]) and decreasing insomnia (n = 249 [79.8%]). Generalised linear model analysis revealed that insomnia symptoms at Wave 1 were associated with significantly elevated CRP and TNF-α levels at Wave 4. Increasing insomnia trajectories predicted consistently higher levels of CRP, TNF-α and IL-10. However, after adjusting for potential confounders, these associations were significantly attenuated. Overall, the findings suggest that insomnia symptoms affect chronic inflammation at the transition to adulthood. Our study needs to be replicated in larger cohorts to further explore how inflammation interacts with insomnia to increase the susceptibility to adverse health conditions.

Perceived barriers and facilitators to health behaviors in European childhood cancer survivors: A qualitative PanCareFollowUp study.

Healthy behaviors, that is, engaging in regular physical activities, maintaining a healthy diet, limiting alcohol consumption, and avoiding tobacco and drug use, decrease the risk of developing late adverse health conditions in childhood cancer survivors. However, childhood cancer survivors may experience barriers to adopting and maintaining healthy behaviors. This study aimed to assess these barriers and facilitators to health behavior adoption and maintenance in childhood cancer survivors. A focus group ( n = 12) and semi-structured telephone interviews ( n = 20) were conducted with a selected sample of European and Dutch childhood cancer survivors, respectively. The Theoretical Domains Framework (TDF) was used to inform the topic guide and analysis. Inductive thematic analysis was applied to identify categories relating to barriers and facilitators of health behavior adoption and maintenance, after which they were deductively mapped onto the TDF. Ten TDF domains were identified in the data of which "Knowledge," "Beliefs about consequences," "Environmental context and resources," and "Social influences" were most commonly reported. Childhood cancer survivors expressed a need for knowledge on the importance of healthy behaviors, possibly provided by healthcare professionals. They indicated physical and long-term benefits of healthy behaviors, available professional support, and a supporting and health-consciously minded work and social environment to be facilitators. Barriers were mostly related to a lack of available time and an unhealthy environment. Lastly, (social) media was perceived as both a barrier and a facilitator to healthy behaviors. This study has identified education and available professional support in health behaviors and the relevance of healthy behaviors for childhood cancer survivors as key opportunities for stimulating health behavior adoption in childhood cancer survivors. Incorporating health behavior support and interventions for this population should therefore be a high priority.