Health Characteristics Research Articles

Enhanced Antiglioma Effect by a Vitamin D3-Inserted Lipid Hybrid Neutrophil Membrane Biomimetic Multimodal Nanoplatform.

Glioblastoma, the most prevalent malignant brain tumor, is a lethal threat to human health, with aggressive and infiltrative growth characteristics that compromise the clinical treatment. Herein, we developed a vitamin D3-inserted lipid hybrid neutrophil membrane biomimetic multimodal nanoplatform (designated as NED@MnO2-DOX) through doxorubicin (DOX)-loaded manganese dioxide nanoparticles (MnO2) which were coated with a vitamin D3-inserted lipid hybrid neutrophil membrane. It was demonstrated that in addition to chemotherapy and chemo-dynamic therapy efficacy, NED@MnO2-DOX exhibited great power to activate and amplify immune responses related to the cGAS STING pathway, bolstering the secretion of type I interferon-β and proinflammatory cytokines, promoting the maturation of DC cells and infiltration of CD8+T cells into the glioma tissue, thereby reversing the immunosuppressive microenvironment of glioma from a "cold" tumor to a "hot" tumor. The biomimetic multimodal nanoplatform has potential as a multimodal strategy for glioma-targeted treatment, especially holding considerable promise for the development of innate immune therapy for glioma.

Characteristics of participants in the first fully online National Diabetes Prevention Programme: A quantitative survey

Background Diabetes prevention programmes (DPPs) are being implemented around the world to tackle the rise in type 2 diabetes. In 2021/22, the Health Service Executive(HSE) in Ireland piloted a fully online national diabetes prevention programme(NDPP). Characteristics and factors affecting participation may be different among people attending online DPPs compared to face-to-face programmes. The aim of this study was to describe the demographic, psychosocial and health characteristics of participants in the pilot of the online NDPP in Ireland. Methods A survey from the evaluation of the English NDPP was adapted for the Irish context with Patient and Public Involvement (PPI) input. The survey was sent (between April and June 2022) to all individuals who attended the initial assessment of the pilot NDPP (n=73). It contained questions on health status, co-morbidities, motivation to improve health, quality of life, self-efficacy, beliefs about the risk of diabetes, participation(e.g. recollection and understanding of invite, number of sessions attended), as well as demographic information. Results Response rate was 30.5% (n=22). Mean age of responders was 62 years (range 36–82 years) and over half were men (57.1%, n=12). The majority (81%, n=17) had attended 6 or more of the 14 sessions. Most (90.5% n=19) reported having family members or acquaintances with diabetes, had positive views of their current health status and high quality of life scores (71.4%, n= 15). Mental health scores were slightly higher than the national average. Over half (57.2%, n=12) were confident or very confident about participating in an online DPP. Almost all (95.2%, n=20) believed it was important to manage their risk of type 2 diabetes. Conclusions Participants in the online pilot NDPP had positive views of their general health and positive psychosocial characteristics affecting their decision to participate. These beliefs may be modifiable intervention targets to encourage participation among non-attenders in future programmes.

Demographics and Health Characteristics Associated With the Likelihood of Participating in Digitally Delivered Exercise Rehabilitation for Improving Heart Health Among Breast Cancer Survivors: Cross-Sectional Survey Study.

Strong evidence supports the benefits of exercise following both cardiovascular disease and cancer diagnoses. However, less than one-third of Australians who are referred to exercise rehabilitation complete a program following a cardiac diagnosis. Technological advances make it increasingly possible to embed real-time supervision, tailored exercise prescription, behavior change, and social support into home-based programs. This study aimed to explore demographic and health characteristics associated with the likelihood of breast cancer survivors uptaking a digitally delivered cardiac exercise rehabilitation program and to determine whether this differed according to intervention timing (ie, offered generally, before, during, or after treatment). Secondary aims were to explore the knowledge of cardiac-related treatment side-effects, exercise behavior, additional intervention interests (eg, diet, fatigue management), and service fee capabilities. This cross-sectional study involved a convenience sample of breast cancer survivors recruited via social media. A self-reported questionnaire was used to collect outcomes of interests, including the likelihood of uptaking a digitally delivered cardiac exercise rehabilitation program, and demographic and health characteristics. Descriptive statistics were used to summarize sample characteristics and outcomes. Ordered logistic regression models were used to examine associations between demographic and health characteristics and likelihood of intervention uptake generally, before, during, and after treatment, with odds ratios (ORs) <0.67 or >1.5 defined as clinically meaningful and statistical significance a priori set at P≤.05. A high proportion (194/208, 93%) of the sample (mean age 57, SD 11 years; median BMI=26, IQR 23-31 kg/m2) met recommended physical activity levels at the time of the survey. Living in an outer regional area (compared with living in a major city) was associated with higher odds of uptake in each model (OR 3.86-8.57, 95% CI 1.04-68.47; P=.01-.04). Receiving more cardiotoxic treatments was also associated with higher odds of general uptake (OR 1.42, 95% CI 1.02-1.96; P=.04). There was some evidence that a higher BMI, more comorbid conditions, and lower education (compared with university education) were associated with lower odds of intervention uptake, but findings differed according to intervention timing. Respondents identified the need for better education about the cardiotoxic effects of breast cancer treatment, and the desire for multifaceted rehabilitation interventions that are free or low cost (median Aus $10, IQR 10-15 per session; Aus $1=US $0.69 at time of study). These findings can be used to better inform future research and the development of intervention techniques that are critical to improving the delivery of a digital service model that is effective, equitable, and accessible, specifically, by enhancing digital inclusion, addressing general exercise barriers experienced by chronic disease populations, incorporating multidisciplinary care, and developing affordable delivery models.

Uso irregular de protetor solar e fatores associados em adultos e idosos: estudo de base populacional no Sul do Brasil

Introduction: The southern region leads skin cancer statistics in Brazil, with multiple factors related to this predisposition. Ultraviolet radiation is the main modifiable risk factor, and regular use of sunscreens has proven effective in reducing risk. Despite this, the prevalence of irregular sunscreen use has been higher than desired. Objective: To evaluate the association between irregular sunscreen use and sociodemographic, behavioral, and health characteristics in adults and older individuals. Method: A cross-sectional population-based study conducted in 2019 with adult residents in the urban area of Criciúma, state of Santa Catarina, Brazil. The outcome variable was irregular use of sunscreens. Exposure variables included sex, age, skin color, education, income, paid work, smoking, household registration in a Primary Health Care unit, access to supplementary health insurance, preventive medical and dental visits in the last year, walking in leisure time, commuting on foot or by bicycle, sufficient physical activity, personal history of cancer of any organ and the skin. To assess the association between irregular sunscreen use and these variables, crude and adjusted analyses were performed using Poisson Regression with a significance level of 5%. Results: In total, 820 individuals were studied. The prevalence of irregular sunscreen use was 52.8%. Factors associated with an increased prevalence of irregular sunscreen use were: male sex (PR 1.57; 95%CI 1.39-1.77), smoking (PR 1.19; 95%CI 1.03-1.37), being 60 years or older (PR 1.62; 95%CI 1.26-2.09), and lower education (inverse linear trend: p&lt;0.001). On the other hand, having supplementary health insurance (PR 0.84; 95%CI 0.71-0.99) and walking in leisure time (PR 0.76; 95%CI 0.64-0.90) were protective factors. Conclusion: This study allowed us to identify the profile of individuals at higher risk of irregular sunscreen use, representing a potential health benefit by better targeting strategies for preventing skin cancer in older populations and adults.

Heterogeneity in Prescription Opioid Misuse Motives by Age in Adolescents and Young Adults in the United States.

Adolescent (12-17 years) and young adult (18-25 years) prescription opioid misuse (POM) is linked to poor health outcomes. We investigated how POM motives vary across these ages and the potential links between motives and other substance use, mental health, and sociodemographic characteristics to help guide screening and prevention. Pooled 2015-2019 US National Survey on Drug Use and Health data were used, with 137,858 participants. Cross-tabulations estimated prevalence of individual motives and motive category by age. Mutually exclusive motive categories were no past-year POM, pain relief only, pain/sleep/relax (ie, some combination of only these motives), and any non-self-treatment motives (eg, get high, experiment). Logistic regression models evaluated links between motive category and sociodemographic, mental health, and substance use (eg, alcohol, cannabis, nicotine, other prescription misuse) outcomes by age group, versus reference groups of no past-year POM or pain relief only. Pain relief was the most common POM motive (estimated at >50% at all ages), but POM for non-self-treatment motives was the most common category after 14 years. POM for non-self-treatment motives had the highest adjusted odds ratios (aORs) of all substance use and mental health characteristics (eg, past-year substance use disorder aORs of 6.11 in adolescents [95% confidence interval (CI), 4.23-8.85] and 4.81 [95% CI, 4.01-5.77] in young adults, versus the pain relief only reference). POM for any non-self-treatment motives is linked to the highest prevalence of other substance use and mental health concerns, whereas POM for pain relief also signals a need for substance use and mental health screening.

In ovo sodium butyrate administration differentially impacts growth performance, intestinal barrier function, immune response, and gut microbiota characteristics in low and high hatch-weight broilers

BackgroundHatch weight (HW) affects broiler growth and low HW (LHW) often leads to suboptimal performance. Sodium butyrate (SB) has been shown to promote growth through enhanced intestinal health. This study investigated how broilers with different HW responded to in ovo SB injection and whether SB could enhance gut health and performance in LHW chicks. Ross 308 broiler eggs were injected on incubation d 12 with physiological saline (control) or SB at 0.1% (SB1), 0.3% (SB3), or 0.5% (SB5). Post-hatch, male chicks from each treatment were categorized as high HW (HHW) or LHW and assigned to 8 groups in a 4 × 2 factorial design. Production parameters were recorded periodically. Intestinal weight, length, and gene expression related to gut barrier function and immune response were examined on d 14 and 42. Cecal microbiota dynamics and predicted functionality were analyzed using 16S rRNA gene sequencing.ResultsSB treatments did not affect hatchability. HHW-control group exhibited consistently better weight gain and FCR than LHW-control group. SB dose-dependently influenced performance and gut health in both HW categories, with greater effects in LHW broilers at 0.3%. LHW-SB3 group attained highest body weight on d 42, exceeding controls but not significantly differing from HHW-SB3 group. LHW-SB3 group showed upregulation of gut-barrier genes CLDN1 in ileum, TJP1 in jejunum and anti-inflammatory cytokine IL-10 in both jejunum and ileum on d 14. Additionally, LHW-SB3 group upregulated mucin-producing MUC6 gene in ileum, while HHW-SB5 group increased pro-inflammatory IL-12p40 cytokine in caecum on d 42. LHW-SB3 group demonstrated shorter relative intestinal lengths, while HHW-SB5 had longer lengths. HHW-control group had higher bacterial diversity and growth-promoting bacteria while LHW-control group harbored the potential pathogen Helicobacter. SB reshaped gut microbiota biodiversity, composition, and predicted metabolic pathways in both HW categories. The LHW-SB3 group exhibited highest alpha diversity on d 14 and most beneficial bacteria at all timepoints. HHW-SB5 group presented increased pathogenic Escherichia-Shigella and Campylobacter on d 42.ConclusionsHW significantly affects subsequent performance and SB has differential effects based on HW. LHW chicks benefited more from 0.3% SB, showing improvements in growth, intestinal development, health, and gut microbiota characteristics.

Mental health and cannabidiol: an initial test

ABSTRACT Objective Cannabidiol (CBD) is a specific cannabinoid found in cannabis that has become increasingly popular in the United States and worldwide. Anecdotally, many CBD users report using it to help address negative emotional symptoms like anxiety and depression. However, little empirical research has, in fact, been conducted to understand the mental health characteristics of persons who use CBD compared to those who do not. To address this limitation, the current study examined differences in depression and anxiety among adults who currently use CBD compared with those that do not use CBD. Methods Participants were 1,116 adults (68.9% female, Mage = 21.4 years, SD = 3.6). Results Compared to individuals who do not use CBD, individuals who used CBD reported higher depression (p = 0.020, ηp 2=.006) and anxiety (p = 0.009, ηp 2=.007); however, the group differences were small in magnitude. Conclusion Overall, the current findings suggest that current CBD use is associated with higher levels of depression and anxiety, but these effects are small. Future prospective research is needed to explicate the interrelations between CBD use and depression and anxiety as well as other negative emotional states to better understand the time pattern and interplay between these factors.

Identifying factors associated with disparities in accessing an Integrative Oncology program

Introduction: Integrative oncology (IO) programs provide patients with evidence-based complementary medicine therapies within a supportive and palliative cancer care setting. This study retrospectively examined characteristics of patients with lung cancer predicting utilization of a freely-provided IO consultation at two medical centers in Israel. Methods: Electronic medical files of 832 patients with lung cancer attending/not attending the IO consultation were searched for socio-demographic (age, gender, country of birth, place of residence, primary language spoken) and personal health (Body Mass Index; smoking; disability) characteristics; cancer-related parameters (primary tumor site, localized vs. metastatic); and reported pain- and emotional-related concerns. Results: Only 120 (14.4%) of eligible patients attended the IO consultation, with multivariate analysis finding a significantly lower likelihood of attendance among patients who were older (OR: 0.98, 95%CI=0.96-0.99; p=0.02); male (OR: 0.53, 95%CI=0.34-0.83; p=0.005); primarily non Hebrew-speaking (i.e., primarily Arabic or Russian speakers; OR: 0.34, 95%CI=0.14-0.82; p=0.016); without disability (OR: 0.52, 95%CI=0.33-0.92; p=0.025); and not reporting pain (OR=0.40,95%CI=0.17-0.98-; p=0.046). Conclusions: The present study suggests that age, gender and culture-related factors (reflected by the patient's primary language) may contribute to disparities in accessing a freely-provided IO consultation, as shown in a diverse population of patients with lung cancer from two medical centers in Israel. Further research is needed to better understand the role of these programs within a diverse, equitable and inclusive setting of effective and safe integrative care of oncology patients.

Inventory of the risks of contamination of milk from the neighbourhoods in traditional farms in the Poro region in Côte d'ivoire

This study, which highlights the situation of dairy farms as well as their development prospects, took place from May to October 2022 in the Poro region of Côte d'Ivoire. And focused on the sociodemographic, zootechnical and health characteristics of 45 traditional farms with a total of 360 dairy cows. Trade, the main activity for 51.1% of the owners, followed by agriculture 31.11%, for 88.88% of the indigenous Senufo herders and 93.33% are non-indigenous Fulani. Feed is pasture for 75.6% and 24.44% of farmers providing a feed supplement. The age of first calving is between 3 and 4 years old or 5 to 6 years old. Cows that calved the most at the age of 4 years by 46.51% compared to those calved 3 years ago 30.23%, 5 years 19.77% and 6 years 3.49% at the regional level. The frequency of milking per season varies significantly from 0.5 litres/day to 15 litres/day depending on the breeds observed (P&lt;0.05). The main parasitic diseases are Trypanosomiasis 28.88%, a bi-infection (Safa (foot-and-mouth disease), Bovine Nodular Cutaneous Skin Disease (BNCSD)) 20% and Contagious Bovine Pleuropneumonia (CBPP) 13.30%. For 80% of farmers, the prevalence of clinical mastitis is 60% and 20% estimate the prevalence of subclinical mastitis to be 40%. The milk is harvested by the Fulani and 33.33% sell the milk to wholesalers in each department of the Poro region. The amount of unsold milk 22.22% filtered for some, boiled (10 to 15 minutes). This study highlights a lack of hygiene during milking and on farms. It is therefore important to carry out mastitis screening actions in traditional dairy farms in the Poro region and to structure it.

(Fear of) SARS-CoV-2 infection and psychological distress: a population-based cohort study in southern Switzerland.

It is widely recognized that the COVID-19 pandemic exerted an impact on the mental health of the general population, but epidemiological evidence is surprisingly sparse. We aimed to explore the association between serologically confirmed SARS-CoV-2 infection and psychological distress - assessed by symptoms of depression, anxiety and stress - in the general adult population in southern Switzerland, a region widely affected by the pandemic. We also investigated whether this association varied over time and between pandemic waves from late 2020 through 2021. We used data from 305 adults who participated in the Corona Immunitas Ticino prospective seroprevalence study in southern Switzerland, including results of the serological tests of SARS-CoV-2 infection collected in June 2021, and explored associations with depression, anxiety and stress scores as measured by the 21-item Depression, Anxiety and Stress Scale at three time points between December 2020 and August 2021, accounting for socio-demographic and health characteristics. In our sample, 84.3% of the participants (mean age of 51.30 years, SD = ±.93) were seronegative at baseline. Seropositive (i.e., infected) participants had a decreasing probability of being depressed and anxious through the COVID-19 pandemic waves compared to the seronegative (non-infected) participants. Further, seropositivity at baseline was also associated with more rapid decline in depressive, anxiety and stress symptomatology, and younger age and the presence of chronic diseases were independently associated with mild anxiety (OR = .97; P = 0.013; 95% CI = 0.95, 0.99; OR = 3.47; P = 0.001; 95% CI = 1.71, 7.04) and stress (OR = .96; P = 0.003; 95% CI = .94, .99; OR = 2.56; P = 0.010; 95% CI = 1.25, 5.22). Our results suggest that the MH consequences of the pandemic may not be due to the SARS-CoV-2 infection per se, but to fears associated with the risk of infection, and to the pandemic uncertainties.

Age Variation Among US Adults' Social Media Experiences and Beliefs About Who Is Responsible for Reducing Health-Related Falsehoods: Secondary Analysis of a National Survey.

We live in a digital age where social media has become an essential part of people's lives. It is also one of the leading platforms responsible for spreading health-related falsehoods. This study explores who adults of different age groups perceive as responsible for reducing health-related falsehoods on social media. Despite growing concern over older adults' exposure to false health information on social media, little research examines their beliefs on how to address the problem. This study examines how the age of US adults is associated with their reported experiences with health-related falsehoods on social media and their beliefs about who should be tasked with reducing such falsehoods. This study is a secondary analysis of data from the 2022 Health Information National Trends Survey, a nationally representative survey of US adults (18 years and older). Multivariable logistic regressions estimated how a respondent's age was associated with their self-reported social media use, their difficulty to detect health-related falsehoods on social media, their discussion of health information found on social media with medical providers, and their beliefs regarding who should be responsible for reducing health-related falsehoods on social media. Regression estimates were adjusted for respondents' sociodemographic and health characteristics. Daily social media use decreased with respondents' age. Respondents aged 50-64 years (b=0.515, P=.01) and 65-74 years (b=0.697, P=.002) were more likely than respondents aged 18-34 years to report they strongly agree that it is difficult for them to detect health-related falsehoods on social media. Compared to younger adults, older adults (65-74 years: b=0.818, P=.002; 75 years and older: b=1.058, P<.001) were more likely to believe medical providers should be responsible for reducing online falsehoods. In addition to ongoing efforts by social media platforms to detect and remove falsehoods, the findings suggest medical providers should be tasked with discrediting health-related falsehoods on social media for older adults. However, time during the clinical visit is limited. Future research is needed to discover new approaches and tools tailored to older adults to assist with filtering and discrediting health-related falsehoods on social media.

Paying the price: Financial hardship and its association with psychological distress among different population groups in the midst of Great Britain’s cost-of-living crisis

BackgroundGreat Britain has been experiencing a cost-of-living crisis since late 2021, with the cost of everyday essentials rising more quickly than the average household income. This study provides up-to-date information on levels of subjective and objective financial hardship during this crisis, differences across population subgroups, and associations with psychological distress. MethodsWe used data from a representative cross-sectional survey of adults (≥16y) in Great Britain (n=7,027) conducted January-March 2023. Subjective financial hardship was defined as reporting finding it quite/very difficult to manage financially these days and objective financial hardship as reporting having been in rent/mortgage arrears in the past 12 months. Past-30-day psychological distress was assessed with the K6 and categorised as no/low (scores ≤4), moderate (5-12), and severe distress (≥13). Covariates included sociodemographic characteristics, mental health history, smoking status, and alcohol consumption. ResultsOverall, 12.9% [95%CI=12.0-13.8%] reported subjective financial hardship and 6.5% [5.8-7.2%] objective financial hardship. Groups experiencing more hardship included non-binary people, ethnic minority groups, less advantaged social grades, those living in private rented or social housing, unemployed and seeking work or not in paid work for other reasons, those with more children in the household, those with a history of ≥1 mental health conditions, those who currently smoked and those who drank not at all or at very high levels. Subjective/objective financial hardship was associated with greater odds of experiencing moderate (ORadj=1.96 [1.59-2.42]/ORadj=1.86 [1.40-2.47]) or severe psychological distress (ORadj=4.11 [3.07-5.50]/ORadj=2.23 [1.52-3.29]). These associations between financial hardship and psychological distress were similar across all sociodemographic, mental health, smoking, and alcohol characteristics. ConclusionsIn the first quarter of 2023, around one in eight adults in Great Britain reported finding it difficult to manage financially and one in fifteen reported having been in rent or mortgage arrears in the past 12 months, with higher rates of financial hardship among disadvantaged groups. However, disadvantage did not appear to compound the psychological impact of financial hardship: people experiencing financial hardship were substantially more likely to report moderate or severe psychological distress regardless of their sociodemographic characteristics.

An evaluation of the impact of a national Minimum Unit Price on alcohol policy on alcohol behaviours.

In 2018, Scotland pioneered national legislation which set a Minimum Unit Price (MUP) of 50 pence (∼US$0.64, €0.59) per unit of UK alcohol sold (8g/10ml). To inform policy development, we examine the policy effect using the Alcohol Use Disorders Identification Test (AUDIT-C), employing longitudinal data for over 17200 individuals. The effect of MUP on AUDIT-C scores is inferred by employing difference-in-difference regression. Pre- and post-intervention alcohol behaviours of individuals from Scotland are compared to a matched 'control' from England. Drinking at hazardous and harmful levels could be identified, as well as the frequency of alcohol consumption, number of drinks and heavy episodic drinking. Estimates adjust for demographic, socioeconomic and health characteristics. Potential inequalities by gender, age and household income are examined. MUP led to an estimated 5.3% reduction in the number of drinks consumed on drinking occasions, though a statistically significant effect on overall reported AUDIT-C scores or drinking at hazardous levels was not detected, with few differential effects for subgroups. Differences in the findings of this research compared to other studies may be explained by differences in population coverage collected in the survey data, compared to more comprehensive, population-wide administrative data, as well as sample attrition.

Loneliness Among Older Caregivers: An Analysis of the 2020 California Health Interview Survey.

Aging and caregiving are each risk factors for loneliness, but little is known about loneliness among older caregivers. Using the 2020 California Health Interview Survey (N = 7638), this study examined the relationship between (1) caregiving status and loneliness among older adults; (2) sociodemographic, technology, health, and caregiving characteristics and loneliness among older caregivers; and (3) compared how these variables relate to loneliness among older caregivers of persons with dementia versus non-dementia conditions. Findings revealed that 15% of older caregivers experienced loneliness, with dementia caregiving significantly increasing this likelihood. Immigrant caregivers, frequent internet users, and those with poorer self-reported health were at higher risk of experiencing loneliness. Future interventions, such as online social programs that foster social engagement, must be thoughtfully designed to align with the unique situations of older caregivers.

Long-term cognitive effects of menopausal hormone therapy: Findings from the KEEPS Continuation Study.

Findings from Kronos Early Estrogen Prevention Study (KEEPS)-Cog trial suggested no cognitive benefit or harm after 48 months of menopausal hormone therapy (mHT) initiated within 3 years of final menstrual period. To clarify the long-term effects of mHT initiated in early postmenopause, the observational KEEPS Continuation Study reevaluated cognition, mood, and neuroimaging effects in participants enrolled in the KEEPS-Cog and its parent study the KEEPS approximately 10 years after trial completion. We hypothesized that women randomized to transdermal estradiol (tE2) during early postmenopause would show cognitive benefits, while oral conjugated equine estrogens (oCEE) would show no effect, compared to placebo over the 10 years following randomization in the KEEPS trial. The KEEPS-Cog (2005-2008) was an ancillary study to the KEEPS (NCT00154180), in which participants were randomized into 3 groups: oCEE (Premarin, 0.45 mg/d), tE2 (Climara, 50 μg/d) both with micronized progesterone (Prometrium, 200 mg/d for 12 d/mo) or placebo pills and patch for 48 months. KEEPS Continuation (2017-2022), an observational, longitudinal cohort study of KEEPS clinical trial, involved recontacting KEEPS participants approximately 10 years after the completion of the 4-year clinical trial to attend in-person research visits. Seven of the original 9 sites participated in the KEEPS Continuation, resulting in 622 women of original 727 being invited to return for a visit, with 299 enrolling across the 7 sites. KEEPS Continuation participants repeated the original KEEPS-Cog test battery which was analyzed using 4 cognitive factor scores and a global cognitive score. Cognitive data from both KEEPS and KEEPS Continuation were available for 275 participants. Latent growth models (LGMs) assessed whether baseline cognition and cognitive changes during KEEPS predicted cognitive performance at follow-up, and whether mHT randomization modified these relationships, adjusting for covariates. Similar health characteristics were observed at KEEPS randomization for KEEPS Continuation participants and nonparticipants (i.e., women not returning for the KEEPS Continuation). The LGM revealed significant associations between intercepts and slopes for cognitive performance across almost all domains, indicating that cognitive factor scores changed over time. Tests assessing the effects of mHT allocation on cognitive slopes during the KEEPS and across all years of follow-up including the KEEPS Continuation visit were all statistically nonsignificant. The KEEPS Continuation study found no long-term cognitive effects of mHT, with baseline cognition and changes during KEEPS being the strongest predictors of later performance. Cross-sectional comparisons confirmed that participants assigned to mHT in KEEPS (oCEE and tE2 groups) performed similarly on cognitive measures to those randomized to placebo, approximately 10 years after completion of the randomized treatments. These findings suggest that mHT poses no long-term cognitive harm; conversely, it provides no cognitive benefit or protective effects against cognitive decline. In these KEEPS Continuation analyses, there were no long-term cognitive effects of short-term exposure to mHT started in early menopause versus placebo. These data provide reassurance about the long-term neurocognitive safety of mHT for symptom management in healthy, recently postmenopausal women, while also suggesting that mHT does not improve or preserve cognitive function in this population.

Patients with Osteoporotic Vertebral Fractures in Denmark 2010-2018: A National Registry Analysis.

Register-based cohort study based on linked data from multiple national registries. To describe the sociodemographic and health characteristics of individuals in Denmark with osteoporotic vertebral fractures (OVF) and analyze time trends. The study compares labor market participation and comorbidities between OVF patients and a matched control group without these fractures. The incidence and characteristics of OVF patients in Denmark are not well-documented. Multiple national health and economic registries enable linking of individual patient data, providing new insights. We identified individuals with hospital-diagnosed vertebral compression fractures from 2010 to 2018 using the Danish National Patient Register. A control group was matched by sex, age, and municipality. Work status prior to OVF was categorized as employed, on paid sickness benefit, in early retirement, or on old-age pension. Comorbidities were analyzed based on hospital diagnoses within 10 years prior to the fracture. During 2010 to 2018, 20.262 individuals had a hospital contact with an OVF. Sixty-four percent were women and the mean age was 73.6 (SD 12.4) years. OVF incidence increased from 86 in 2010 to 142 per 100,000 persons in 2018. In 2018, the regional incidence ranged from 120 to 154 per 100,000. More than a fifth of the patients were working prior to the fracture, while 77% were in early retirement or old-age pension. The population with OVF had more comorbidities than the matched comparison group. The incidence of hospital-diagnosed OVFs has risen over the last decade, with regional differences. Notably, over 20% of OVF patients were still employed, highlighting the socioeconomic impact of this condition.

Trajectory of Multiple Chronic Conditions and Associated Factors Among Noninstitutionalized Adults Aged 60 Years or Older in Southern Brazil.

The prevalence of chronic conditions is increasing worldwide. The objective of this study was to describe the trajectory of the occurrence of multiple chronic conditions during 6 years of follow-up and investigate their association with demographic, socioeconomic, and behavioral health characteristics of older adults in Southern Brazil. We used data from a longitudinal study (the Como Vai? study) of noninstitutionalized adults aged 60 or older living in the urban area of Pelotas, Rio Grande do Sul. We assessed the number of chronic conditions based on a list of 24 conditions in 3 interviews, conducted in 2014, 2016-2017, and 2019-2020. We used group-based semiparametric modeling to identify groups of participants based on the number of chronic conditions. For associations with participant characteristics, we performed multinomial logistic regression and considered a low, moderate, and high burden of chronic conditions. Of the 1,451 older adults in the cohort, 1,098 (75.7%) were included in analysis. Almost one-third (30.9%) had a low burden (2.3 conditions), more than half (52.0%) had a moderate burden (5.6 conditions), and 17.1% had a high burden (9.7 conditions). Men (relative risk [RR] = 6.10; 95% CI, 3.64-10.22), those aged 80 years or older (RR = 2.33; 95% CI, 1.15-4.72), those with no education (RR= 4.78; 95% CI, 2.19-10.45), and former smokers (RR = 1.53; 95% CI, 0.96-2.44) had a higher risk of being classified in the high-burden group than in the low-burden group. Most older adults belonged to the group with a moderate number of chronic conditions. Several sociodemographic characteristics were associated with belonging to the trajectory with a greater number of conditions.

Understanding loneliness and its correlates among people with spinal cord injury

Purpose To conduct the first known comprehensive examination of loneliness and its correlates in a diverse sample of people with spinal cord injury (SCI). Methods A cross-sectional sample of 343 people with SCI provided responses to the 20-item UCLA Loneliness Scale–Version 3. We examined the relation of loneliness to measures of demographic, disability, physical health, and social characteristics. Results The majority (56%) of respondents had scores indicating high levels of loneliness. At least a quarter of respondents indicated that they often felt alone, left out, isolated, and lacking in companionship. At least a quarter rarely or never felt there were people who really understood them, with whom they could talk, and with whom they had a lot in common. In univariate analyses, loneliness was associated with several demographic, disability, and health characteristics suggesting potential risk factors. In multiple regression analyses, social characteristics (social integration, social support, satisfaction with social roles) were the most strongly associated with loneliness. Conclusions Our findings underscore the high prevalence of loneliness among people with SCI. Given the adverse health consequences of loneliness documented in the general literature, there is an urgent need for researchers, healthcare providers, and policy makers to address the loneliness crisis in this population.

Youth athletes and wearable technology

Wearable sensors have become integral tools for monitoring biomechanical and physiologic aspects of athletic training and performance. A prominent trend in fitness technology, wearable devices now measure a variety of health characteristics, including movement and posture, physiologic measures (eg, heart rate and energy expenditure), and fluid and electrolyte losses, to understand an athlete’s physiologic responses during activity. Sleep has proven integral to athletic performance, and sleep monitoring wearable devices (eg, watches, rings, and headbands) use various measures, such as actigraphy and pulse oximetry, to analyze sleep quality. Young athletes benefit from wearable devices during training sessions, where multimodal data are collected and analyzed to assess performance. Wearable devices are also useful for resistance training, biofeedback, and electrical muscle stimulation, providing athletes with tools to optimize their training regimens. Moreover, these devices play a crucial role in athlete safety by monitoring cardiac physiology, head impacts, and muscle rehabilitation after injury. We provide a comprehensive review of current wearable technology and its application in youth athletics, describe where and how these sensors are used to help enhance physiologic, biomechanical, and performance parameters, and discuss future directions for wearable devices to advance sports science and athlete management.

“We’re a Disease to Someone”: Embodying Safety and Freedom in a State Motorcyclists’ Rights Organization

ABSTRACT Public health and safety experts have advocated mandatory helmet laws as an important means to increase motorcyclists’ safety and public health for over 50 years. Despite these recommendations, some motorcyclists have successfully organized to challenge such laws. This is an ethnographic study of the largest state motorcyclists’ rights organization (SMRO) in the United States and its institutionalized opposition to mandatory helmet laws. I argue that in addition to its focus on individual freedom, the motorcyclists’ rights movement has characteristics of an embodied health movement in the sense that activists challenge expert understandings of health issues based on their personal experiences. Motorcyclists’ rights activists oppose mandatory helmet laws advocated by experts because they interfere with their understanding of freedom but also do not work to increase safety as they understand it. Exploring the embodied health characteristics of the motorcyclists’ rights movement helps us understand how the movement has been able to grow and maintain itself and the boundaries of embodied health movements. Other movements that combine a focus on both freedom and health and safety may exist and provide fruitful opportunities for future research.