General Health Research Articles

Factor Structure, Reliability, and Construct Validity of the Wellness Inventory.

Wellness has been associated with various general medical and mental health outcomes; however, few empirically supported measures capture the breadth of the wellness construct. The first author had previously developed the Wellness Inventory through an iterative process with key stakeholders to establish face and content validity and examined the psychometric properties of the Wellness Inventory as a tool for assessing wellness across eight dimensions. The authors assessed the Wellness Inventory by using data from self-report online surveys in three samples of data collected from two groups of respondents: students and faculty members in a public university and behavioral health providers (N=3,446; 50% White and 43% female). Exploratory and confirmatory factor analyses and data from samples 1 and 2 were used to examine the factor structure and fit of the inventory. Data from sample 3 were used to assess test-retest reliability and convergent and discriminant validity. Factor analyses yielded a one-factor model comprising 54 items. A revised instrument based on this model revealed good fit to the data, internal consistency, and test-retest reliability and reasonable construct validity. The Wellness Inventory is a comprehensive and psychometrically valid tool for assessing wellness. The findings support a single dimension of wellness, suggesting wellness as a holistic, general construct. This inventory has implications for research on health promotion and prevention and clinical outcomes in both research and treatment.

Maternal EGCG intervention mitigates chronic hypertension during pregnancy in spontaneously hypertensive rats without adverse effects on pregnancy outcomes

Background: Chronic hypertension during pregnancy is a significant concern, associated with increased risks of maternal-fetal morbidity and mortality. Epigallocatechin gallate (EGCG), a compound known for its cardioprotective properties, has gained attention as a potential health supplement due to its favorable safety profile. Objective: This study aims to investigate the effects of maternal EGCG supplementation on elevated blood pressure and pregnancy outcomes in a rodent model of chronic hypertension, specifically using spontaneously hypertensive rats (SHR). Furthermore, the study explores the influence of maternal EGCG supplementation on the blood pressure of SHR offspring during early postnatal development. Methods: SHR dams received oral EGCG at 30 mg/kg body weight. Systolic blood pressure (SBP) monitored weekly throughout gestation period and until postpartum day 21. Pregnancy outcomes - litter size, pup viability, and birth weights - were recorded. SBP in weaned SHR offspring was monitored from 5 to 13 weeks of age to assess long-term effects of maternal EGCG treatment. Daily cage-side observations evaluated general health, behavior, and signs of toxicity. Plasma levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, and creatinine were analyzed to evaluate liver and kidney function. Results: EGCG treatment in SHR dams progressively reduced maternal SBP throughout gestation and the postpartum period. However, EGCG administration did not affect pregnancy outcomes (gestation duration, litter size, and birth weights). Markers of liver and kidney function (ALT, AST, urea, and creatinine) showed no signs of organ injury in EGCG-treated groups. Contrary to expectations, SBP in SHR offspring exposed to perinatal EGCG did not decrease compared to control groups, indicating maternal EGCG did not alter the offspring's hypertension predisposition. Conclusion: Maternal EGCG supplementation effectively lowered blood pressure in hypertensive dams without compromising pregnancy outcomes or causing liver and kidney damage. These findings suggest that EGCG may be a safe cardioprotective supplement during pregnancy. However, perinatal EGCG exposure did not alter the inherent genetic predisposition to hypertension in SHR offspring. Keywords: Theaceae; Camellia sinensis; green tea; catechins, EGCG; hypertension, pregnancy outcomes, perinatal, spontaneously hypertensive rats, chronic hypertension during pregnancy

General health and social outcomes 50 years after exposure to antenatal betamethasone: follow-up of a randomised controlled trial

BackgroundAntenatal corticosteroids are recommended for women at risk of preterm birth from 24 to 34 weeks’ gestation as they reduce neonatal morbidity and mortality, but evidence regarding their long-term effects on offspring is limited. This study assessed general health and social outcomes 50 years after antenatal exposure to corticosteroids.MethodsWe assessed 424 adult offspring of women who participated in the first randomised, double-blind, placebo-controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome. The first 717 mothers received two intramuscular injections of betamethasone (6 mg betamethasone sodium phosphate and 6 mg betamethasone acetate) or placebo given 24 h apart and the subsequent 398 received two injections of double dose betamethasone (12 mg betamethasone sodium phosphate and 12 mg betamethasone acetate) or equivalent volume of placebo. Follow-up included a health questionnaire and consent for access to administrative data sources. Outcome categories included mental health (depression, anxiety, bipolar affective disorder, schizophrenia and treatment or hospital admission for any mental health disorder), general health (chronic kidney disease, cancer diagnosis, bone fracture, oral health, allergies, functional difficulties and physical activity) and social outcomes (educational attainment, employment and criminal convictions). Investigators remained blinded to treatment allocation. Analyses were adjusted for gestational age at entry, sex and clustering.ResultsWe assessed 424 adult offspring (46% of survivors; mean [SD] age 49.3 [1.0] years; 212 [50%] female). There was no difference in mental health, general health and social outcomes between those exposed to betamethasone and those exposed to placebo, with the exception that osteoporotic site fracture in adulthood was more likely to have occurred in the betamethasone group compared with placebo (adjusted relative risk 1.57, 95% CI 1.00, 2.48, p = 0.05). No dose–effect relationship was evident and there was no difference in the proportion with at least one fracture. Follow-up rate and lack of in-person assessments were the main limitations.ConclusionsThere is no evidence that antenatal corticosteroids have clinically important effects on general health and social outcomes up to 50 years of age.

Civic Identity and Mental Health in Russia: The Role of Psychological Coping Strategies During Sanctions and Perceived Threat.

We explore the role of Russian civic identity in maintaining mental health in a challenging socioeconomic and political environment. The study was conducted on a sample of Russians in August 2022 after the beginning of the military conflict in Ukraine and the imposition of multiple sanctions on Russia. The sample included 384 respondents from 18 to 54 years old. The questionnaire included methods for assessing Russian civic identity, general psychological health, depression, and the psychological coping strategies in crisis situations. We explored whether Russian civic identity has direct, indirect, and total positive effects on general psychological health. The indirect effect was examined through psychological coping strategies, such as Reframing and Spiritual support. For depression reduction, the role of Russian civic identity was not significant as we did not find a statistically significant direct or total effect. However, we found a statistically significant indirect negative effect of civic identity on depression via a Reframing strategy. Thus, Russian civic identity may increase general psychological health and reduce depression through Reframing. Although the conflict is highly controversial geopolitically, our study findings may have important implications for other settings that may be involved in conflict or be under sanctions.

Metabolite and protein associations with general health in the population-based CHRIS study

Identifying biomarkers able to discriminate individuals on different health trajectories is crucial to understand the molecular basis of age-related morbidity. We investigated multi-omics signatures of general health and organ-specific morbidity, as well as their interconnectivity. We examined cross-sectional metabolome and proteome data from 3,142 adults of the Cooperative Health Research in South Tyrol (CHRIS) study, an Alpine population study designed to investigate how human biology, environment, and lifestyle factors contribute to people’s health over time. We had 174 metabolites and 148 proteins quantified from fasting serum and plasma samples. We used the Cumulative Illness Rating Scale (CIRS) Comorbidity Index (CMI), which considers morbidity in 14 organ systems, to assess health status (any morbidity vs. healthy). Omics-signatures for health status were identified using random forest (RF) classifiers. Linear regression models were fitted to assess directionality of omics markers and health status associations, as well as to identify omics markers related to organ-specific morbidity. Next to age, we identified 21 metabolites and 10 proteins as relevant predictors of health status and results confirmed associations for serotonin and glutamate to be age-independent. Considering organ-specific morbidity, several metabolites and proteins were jointly related to endocrine, cardiovascular, and renal morbidity. To conclude, circulating serotonin was identified as a potential novel predictor for overall morbidity.

Periodontal diseases in Africa.

Periodontal diseases, a group of complex conditions marked by an excessive immune response and periodontal tissue destruction, are a global health concern. Since 1990, the incidence of these diseases has doubled, with Western sub-Saharan Africa experiencing the highest burden. Accurate diagnosis and case identification are crucial for understanding the etiology, features of disease, research, treatment and prevention. Modern perspectives on periodontal disease classification are based on commonality among those affected. However, current literature is often plagued by methodological inconsistencies and focused on disease mechanisms in European populations. Health inequalities in low- and middle-income countries (LMICs) are exacerbated by these challenges, with sub-Saharan Africa, and Nigeria specifically, facing unique difficulties such as clinical personnel shortages and limited research infrastructure. This review explored disparities in periodontal disease research, care and outcomes in African populations. We highlighted these disparities and identified the factors contributing to inequities in periodontal health outcomes. We further demonstrated the critical need for inclusive and equitable healthcare and research practices tailored to the unique challenges faced by diverse populations and regions with limited resources. Addressing these disparities is essential for ensuring that advancements in healthcare are accessible to all, thereby improving global oral health and general health.

Perception of sleep during hospitalisation from the nurses’ and patients’ perspective: an exploratory qualitative study

Abstract Aim. To investigate how nurses and patients perceive sleep and point out the factors that negatively impact patients’ sleep during hospitalisation in selected departments in two hospitals in the Czech Republic. Material and methods. An exploratory qualitative study – thematic analysis. We obtained data from three group interviews involving 16 nurses and eight inpatients from selected departments in two hospitals. We conducted an exploratory qualitative study and thematic analysis. Results. The thematic analysis identified four main themes. Theme (1): Importance of sleep. Theme (2): Quality and organisation of nursing care. Theme (3): Experiencing intense emotions and feelings. Theme (4): Health. Conclusions. Hospitalisation often negatively affects patients’ sleep. Patients’ emotions, experiences, and the hospital environment are essential to achieve good sleep. Nurses and the entire health care system have great potential to improve hospitalisation conditions concerning sleep and the emotional mood of patients and thus indirectly influence the general health of patients and their recovery.

Mental health and sleep in the post-COVID-19 era among Thai undergraduate students

The purpose of this study was to examine mental health problems and sleep quality among undergraduate students in the post-COVID-19 era, as well as related factors. This cross-sectional study involved 627 undergraduate students from Chiang Mai University in northern Thailand between October and December 2022. Data were collected using a self-administered online questionnaire that included the General Health Questionnaire-12 (GHQ-12), the Center for Epidemiologic Studies-Depression Scale (CES-D), and the Pittsburgh Sleep Quality Index (PSQI). The study found that 57.9% of participants experienced mental health problems (95% CI: 54.0–61.8), 32.2% experienced depression (95% CI: 28.5–35.9), and 68.1% reported poor sleep quality (95% CI: 64.4–71.8). Multiple logistic regression analysis revealed that medical conditions, relationships with family members, relationships with friends or other people, having problems while studying at university, and self-perceived COVID-19 impact score were all associated with mental health problems and poor sleep quality (p < 0.05). Depression was associated with the field of study, relationships with family members, relationships with friends or other people, having problems while studying at university, and self-perceived COVID-19 impact score (p < 0.05). The findings highlight a significant occurrence of poor sleep and mental health issues, including depression, among undergraduate students in the post-COVID-19 era, underscoring the need for ongoing mental health monitoring and interventions to mitigate negative outcomes.

Mental Health Status of Patients Recovered from COVID-19 in Macau: A Cross-Sectional Survey.

Background/Objectives: The COVID-19 pandemic has led to a global health crisis, impacting physical, and mental well-being, particularly among those who have recovered from the illness. This study aimed to assess the mental health status of patients recovered from COVID-19 in Macau, focusing on the impact of sequelae of COVID-19, and identifying demographic factors associated with poor mental health. Methods: A cross-sectional online survey was conducted involving 494 adults who had recovered from COVID-19, with 426 participants included in the final analysis. Mental health was evaluated using the 12-item General Health Questionnaire (GHQ-12), with scores ≥3 indicating poor mental health. Results: This study revealed a high prevalence of poor mental health, affecting 71.8% of the respondents. Binary logistic regression identified experiencing COVID-19 sequelae (OR = 5.727, 95% CI: 2.973-11.031), being in the age groups of 26-45 (OR = 4.227, 95% CI: 1.754-10.185), or 61, and above (OR = 18.072, 95% CI: 3.590-90.962), being male (OR = 0.501, 95% CI: 0.257-0.979), being married (OR = 5.714, 95% CI: 1.919-17.016), and dissatisfaction with family relationships (OR = 2.957, 95% CI: 1.228-7.119) as significant risk factors for poor mental health. Conclusions: This study underscores the critical need for targeted psychological support for patients recovered from COVID-19 in Macau, particularly for those with sequelae, and those in vulnerable demographic groups. The findings suggest that specific age groups and individuals with sequelae may face higher mental health risks, indicating the necessity for prioritized interventions.

Impact of Reductive Stress on Human Infertility: Underlying Mechanisms and Perspectives.

Antioxidants have a well-established effect on general health and are essential in preventing oxidative damage to cells by scavenging free radicals. Free radicals are thought to be neutralized by these substances, which include polyphenols, β-carotene, and vitamins C and E, reducing cellular damage. On the other hand, recent data indicates that consuming excessive amounts of antioxidants may have side effects. Apoptosis and cell signaling are two beneficial physiological processes that are affected by excessive supplementation. Other negative effects include paradoxical enhancement of oxidative stress and unbalanced cellular redox potential. Overdosing on particular antioxidants has been associated with increased medication interactions, cancer progression, and fatality risks. Additionally, the complex impacts they may have on fertility might be both useful and adverse, depending on the quantity and duration of usage. This review delves into the dual role of antioxidants and emphasizes the importance of employing antioxidants in moderation. Antioxidant overconsumption may disrupt the oxidative balance necessary for normal sperm and oocyte function, which is one of the potential negative effects of antioxidants on fertility in both males and females that are also investigated. Although modest usage of antioxidants is generally safe and useful, high levels of antioxidants can upset hormonal balance, impair sperm motility, and negatively impact the outcomes of assisted reproductive technologies (ART). The findings emphasize the need to use antioxidant supplements in a balanced way, the importance of further research to optimize their use in fertility treatments, and the importance of supporting reproductive health to avoid adverse effects.

Impact of perioperative high-protein nutritional support on the quality of life of patients with primary lung cancer: a Russian prospective multicenter comparative study (NUTRILUNC study)

BACKGROUND: Individuals over the age of 70 comprise over half of operable patients with stage 0–IIIA lung cancer. In the early postoperative period of this cohort, pain, fatigue, insomnia, and/or mood disturbances are the four most common symptoms, which can significantly diminish quality of life and functional status. Perioperative nutritional support in such patients, which enhances exercise tolerance, can have a positive impact on their quality of life and socialization. AIM: To assess the effect of perioperative nutritional support using high-protein oral nutrition supplements on the general health and quality of life of non-small cell lung cancer patients during the postoperative period. MATERIALS AND METHODS: Patients with primary non-small cell lung cancer (n=112, 69 males), aged 57.2±8.2, who were awaiting lung surgery and at risk of malnutrition (Nutritional Risk Screening Assessment 2002 score ≥3) were randomly assigned into two groups. Oral nutritional support (Nutridrink Compact Protein, Nutricia LLC) was administered to the study group (n=55) at a rate of 250 ml/d (36 g of protein, 612 kcal) for 14 days prior to and 14 days following the surgery, in addition to the standard diet. Control group patients (n=57) were provided a standard diet. The quality of life was assessed using the Quality of Life Questionnaire Core-30. Results are presented as mean ± standard deviation. Differences were considered significant at p ≤0.05. RESULTS: Throughout the entire observation period, the study group exhibited superior growth indicators in terms of general health status, physical, and role functioning than the control group (p 0.05). The study group patients exhibited a propensity toward improved emotional functioning, and by the end of the study, weakness and insomnia were less pronounced (p 0.05). Other indicators did not exhibit any significant variations. CONCLUSION: Нigh-protein perioperative oral nutrition supplements exert a positive impact on the quality of life of non-small cell lung cancer patients.

Knowledge, attitude, and experience of dentists toward child abuse and neglect. A cross-sectional study

ABSTRACT Context: Child abuse and neglect can be described as all kinds of physical, emotional, and sexual abuse, neglect, commercial and/or any other type of exploitation resulting in any potential of causing hurt or an actual form of harm to a child’s general health, growth, survival, and dignity. The dentist is in a position to identify physical signs of physical abuse in a child hence, it is important to gauge the knowledge level and perception regarding child abuse and neglect. Aim: The aim of the present study was to ascertain the knowledge, attitude, and experience regarding child abuse and neglect among dentists in India. Materials and Methods: This cross-sectional, descriptive, survey-based study was conducted on 100 dental practitioners all over India using a pre-validated questionnaire. The study was approved by the institutional ethics committee. Responses received were recorded in an Excel Worksheet and analyzed using descriptive statistics and Chi-square statistical tool using SPSS software (version 21.0). Results: We found that 85% of respondents reported child abuse cases of a physical and sexual nature and 87% had knowledge that law enforcement agencies are responsible for reporting such cases. Also, 56% believed that such cases could be reported using electronic mail while other sources were telephone, letters, or personal intervention. Only 12% were fearful of litigation and 24% were concerned about such exposure to a child. Conclusion: A total of 11% of dentists experienced barriers in reporting such cases while 17% reported with no barriers. Child abuse and neglect are often underreported due to various reasons. This survey has attempted to assess the knowledge, attitude, and experience about child abuse and neglect and has found a few prominent reasons for not reporting such incidents.

Salivary Metabolic Pathway Alterations in Brazilian E-Cigarette Users.

In recent years, the use of electronic cigarettes (e-cigs) has increased. However, their long-term effects on oral health and saliva remain poorly understood. Therefore, this study aimed to evaluate the saliva of e-cig users and investigate possible biomarkers. Participants were divided into two groups: the Electronic Cigarette Group (EG)-25 regular and exclusive e-cig users-and Control Group (CG)-25 non-smokers and non-e-cig users, matched in sex and age to the EG. The clinical analysis included the following parameters: age, sex, heart rate, oximetry, capillary blood glucose, carbon monoxide (CO) concentration in exhaled air, and alcohol use disorder identification test (AUDIT). Qualitative and quantitative analyses of saliva included sialometry, viscosity, pH, and cotinine concentrations. Furthermore, the EG and CG salivary metabolomes were compared using gas chromatography coupled with mass spectrometry (GC-MS). Data were analyzed using the Mann-Whitney test. The MetaboAnalyst 6.0 software was used for statistical analysis and biomarker evaluation. The EG showed high means for exhaled CO concentration and AUDIT but lower means for oximetry and salivary viscosity. Furthermore, 10 metabolites (isoleucine, 2-hydroxyglutaric acid, 3-phenyl-lactic acid, linoleic acid, 3-hydroxybutyric acid, 1,6-anhydroglucose, glucuronic acid, valine, stearic acid, and elaidic acid) were abundant in EG but absent in CG. It was concluded that e-cig users had high rates of alcohol consumption and experienced significant impacts on their general health, including increased cotinine and CO concentration in exhaled air, decreased oximetry, and low salivary viscosity. Furthermore, they showed a notable increase in salivary metabolites, especially those related to inflammation, xenobiotic metabolism, and biomass-burning pathways.

Supervised machine learning-based categorization and prediction of uranium adsorption capacity on various process parameters

Existing uranium poses significant dangers to the environment and the general population's health. Within the scope of this study, machine learning techniques were utilized to assess the characteristics that influence uranium adsorption. The adsorbent material, pH, temperature, solid-liquid ratio (SLR), and initial concentration (Ci) values were imported as the feature to evaluate using ML models in this study. The finding concluded that the Convolutional Neural Network (CNN) model performed excellently by attaining an accuracy of 98%, which is very high in classifying low and high levels of adsorption predictions. The Random Forest model was also the best performer for Qe prediction, with the lowest MSE value of 334.45 and the highest Squared-R score of 0.92 for the uranium adsorption process. Permutation Importance analysis indicated that initial concentration had the strongest impact on Qe. Knowing that a good interaction between uranyl ions and adsorbent surface would result in more active sites for trapping radioactive metal, optimizing this parameter can be quite helpful for designing new materials capable of capturing uranium species strongly from solutions. ML model excels at predicting Qe in uranium adsorption and can directly accommodate large datasets and non-linear input parameter-Qe interactions. As noted, the innovation poised to drive ML research has been made possible by recent technological developments in machine learning and can improve while offering new ways of addressing difficult environmental problems.

Impact of substance type and patient characteristics on the choice of treatment setting for substance use disorder in Belgium

BackgroundSpecialised addiction treatment centers (SAC) and general mental health centers (GMHC) both offer care to people with substance use disorders (SUD) in Belgium, but these sectors often operate in parallel, with little collaboration. This fragmented system may lead to inefficiencies, particularly in the treatment of individuals with dual diagnoses. Despite the recognized challenges, there is limited understanding of the factors that influence whether patients with SUD are treated in SAC or GMHC. ObjectivesThis observational study has two main objectives:1.To examine whether and how the primary substance of abuse influences the choice of either SAC or GMHC.2.To assess whether other factors (e.g. sociodemographics, institution or person who orientated the patient to treatment) play a significant role in determining the type of center where the patient is treated. MethodsThe study used routinely collected data from treatment centers in Belgium from 2019 (Belgian Treatment Demand Indicator). Logistic regression evaluated the weight of drug use and sociodemographic variables for people entering treatment for SUD for the first time (n = 8322). A random forest algorithm was used to study all patients' orientation toward both sectors, across all treatment episodes (n = 29,658). ResultsThe study found that the primary substance significantly influences sector choice. Patients using illicit substances like cannabis, opiates, cocaine, and stimulants are 6–12 times more likely to be treated in an SAC than those using alcohol. Factors such as income source and referral source (e.g. self-referral, general practitioner, etc) also significantly impact patient orientation. ConclusionThese findings highlight the need for better integration between SAC and GMHC to adequately address the complex needs of people with SUD, especially with dual diagnosis.

Development of a Frailty Prediction Model Among Older Adults in China: A Cross-Sectional Analysis Using the Chinese Longitudinal Healthy Longevity Survey.

To identify the risk factors associated with frailty among older adults in China and develop a predictive model for assessing their frailty risk. Secondary cross-sectional analysis. The 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) provided data for this study. A total of 9006 participants were included in the analysis. Their general demographic, socioeconomic status and health behaviour risk factors were collected in the CLHLS. Frailty was assessed using the Frailty Index. A visual nomogram model was constructed based on independent predictors identified using multivariate analysis. The nomogram's discrimination and calibration capabilities were evaluated using the C-statistics and calibration curves. A 1000-times resampling enhanced bootstrap method was performed for internal validation of the nomogram. The results showed that living in rural settings, having a primary education level, having a spouse, having basic living security, smoking, drinking, exercising and social activities were protective factors against frailty. Increasing age, being underweight or obese, adverse self-assessed economic status and poor sleep quality were risk factors of frailty. The AUC values of the internal validation set were 0.830. The calibration curve was close to ideal. The Brier score was 0.122. The above results showed that the nomogram model had a good predictive performance. A simple and fast frailty risk prediction model was developed in this study to help healthcare professionals screen older adults at high risk of frailty in China. The frailty risk prediction model will assist healthcare professionals in risk management and decision-making and provide targeted frailty prevention interventions. Screening high-risk older adults and early intervention can reduce the risk of adverse outcomes and save medical expenses for older adults and society, thereby realising cost-effective planning of health resources and healthy ageing. No patient or public contribution. This study was a cross-sectional, secondary analysis of the CLHLS data.

Precarious employment and associations with socio-demographic characteristics and self-reported health in Wales, UK

ObjectivesThe study's aim was to explore the prevalence of precarious employment (PE) in Wales prior to the COVID-19 pandemic and examine associations with PE domains across socio-demographics and self-reported health. Study designA cross-sectional design was used to explore the prevalence of PE in Wales prior to the COVID-19 pandemic, in February 2020. MethodsData were collected from a national household survey carried out in May/June 2020, with a sample of 1032 residents in Wales. PE was determined using the Employment Precariousness Scale. Associations between experiencing PE and socio-demographic/health characteristics were examined using Chi-squared tests and logistic regression models (multinomial and binary). ResultsOverall, before the pandemic, one in four respondents (26.5%) was in PE, with the most prevalent domains, wages, and disempowerment being experienced by at least 50% of respondents. Worse perceived treatment at work was twice as likely in those reporting pre-existing conditions (adjusted odds ratio [aOR]: 2.45 95% confidence interval [CI]: [1.33–4.49]), poorer general health (aOR: 2.33 95% CI: [1.22–4.47]), or low mental wellbeing (aOR: 2.81 95% CI: [1.34–5.88]). Those with high wage precariousness were three times more likely to report low mental wellbeing (aOR 3.12 95% CI [1.54–6.32]). ConclusionsThe creation and provision of secure, adequately paid job opportunities has the potential to reduce the prevalence of PE in Wales. Targeting such employment opportunities to those people currently unwell would have better population health gains.

Multi-domain predictors of grip strength differentiate individuals with and without alcohol use disorder.

Grip strength is considered one of the simplest and reliable indices of general health. Although motor ability and strength are commonly affected in people with alcohol use disorder (AUD), factors predictive of grip strength decline in AUD have not been investigated. Here, we employed a data-driven analysis predicting grip strength from measurements in 53 controls and 110 AUD participants, 53 of whom were comorbid with HIV infection. Controls and AUD were matched on sex, age, and body mass index. Measurements included commonly available metrics of brain structure, neuropsychological functioning, behavioural status, haematological and health status, and demographics. Based on 5-fold stratified cross-validation, a machine learning approach predicted grip strength separately for each cohort. The strongest (top 10%) predictors of grip were then tested against grip strength with correlational analysis. Leading grip strength predictors for both cohorts were cerebellar volume and mean corpuscular haemoglobin concentration. Predictors specific to controls were Backwards Digit Span, precentral gyrus volume, diastolic blood pressure, and mean platelet volume, which together significantly predicted grip strength (R2=0.255, p= 0.001). Unique predictors for AUD were comorbidity for HIV infection, social functioning, insular volume, and platelet count, which together significantly predicted grip strength (R2=0.162, p= 0.002). These cohort-specific predictors were doubly dissociated. Salient predictors of grip strength differed by diagnosis with only modest overlap. The constellation of cohort-specific predictive measurements of compromised grip strength provides insight into brain, behavioural, and physiological factors that may signal subtly affected yet treatable processes of physical decline and frailty.

Flight Hours and Depression in Flight Attendants During the COVID-19 Pandemic

INTRODUCTION: Flight attendants are constantly exposed to high-stress environments that could lead to the development of depression. The COVID-19 pandemic brought out new risk factors that could affect flight attendants’ mental health, such as reduced flight hours and fear of the disease itself, which other studies have shown was associated with depression. We aimed to find out whether reduced flight hours, fear of COVID-19, and other factors were associated with depression in flight attendants during the COVID-19 pandemic. METHODS: This cross-sectional study was conducted at the Directorate General Civil Aviation Medical Center Indonesia and Garuda Sentra Medika in 2022. We included flight attendants who were still employed before and after the start of the pandemic. Data were collected using several questionnaires, including the General Health Questionnaire-12 to screen for depression and Fear of COVID-19 for fear levels. RESULTS: We obtained data from 159 respondents, of whom 25.2% of them had depression. Multivariate analysis showed that the reduction of flight hours 1 yr after the start of the pandemic and fear of COVID-19 were found to significantly increase the likelihood of depression by 2.3 times and 3.9 times, respectively. DISCUSSION: During the pandemic, depression was found to be highly prevalent among flight attendants and was associated with the reduction of flight hours and fear of COVID-19. Sutrisno AB, Agustina A, Sosrosumihardjo D, Sugiharto A, Zulaecha SI, Khoe LC. Flight hours and depression in flight attendants during the COVID-19 pandemic. Aerosp Med Hum Perform. 2024; 95(11):826–830.

Can the APACHE II score be used to assess the risk of mortality in the elderly with hip fractures?

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim &amp;lt;/strong&amp;gt;Various predictive models have been developed to help identify patients with hip fractures with greater or lower probability of survival. The aim of this study was to establish the capacity of the APACHE II score to predict the survival of patients with hip fracture, in people aged over 65 years, and compare it with the existing score used to predict the survival of these patients.&amp;amp;nbsp;&amp;lt;/p&amp;gt; &amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Methods &amp;lt;/strong&amp;gt;This was a prospective, cohort study conducted in a tertiary care teaching hospital including 410 consecutive patients with hip fracture aged &amp;amp;ge;65 years. As part of the preoperative preparation, general health of the patients was classified according to the ASA score. The Charlson Comorbidity Index (CCI), the Nottingham Hip Fracture Score (NHFS), the POSSUM-P and the APACHE II scores were analysed.&amp;amp;nbsp;&amp;lt;/p&amp;gt; &amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Results &amp;lt;/strong&amp;gt;The sensitivity and specificity of the P-POSSUM score were 78.3 and 73.0, respectively, which was better than the APACHE II whose sensitivity and specificity were 56.6 and 89.7. The area beneath the ROC curve for P-POSSUM was 0.809, and for APACHE II, 0.803. However, there was no statistically significant difference between the APACHE II and P-POSSUM scores. The P-POSSUM and APACHE II scores were statistically significantly better than ASA, the Nottingham score and CCI.&amp;amp;nbsp;&amp;lt;/p&amp;gt; &amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Conclusion &amp;lt;/strong&amp;gt;This study showed that POSSUM-P and APACHE II can be used to predict mortality in elderly people with hip fractures.&amp;amp;nbsp;&amp;lt;/p&amp;gt;