General Adult Population Research Articles

Leading by example: Experimental evidence that therapist lived experience disclosures can model the path to recovery for clients.

A common guideline for self-disclosure is that therapists should only share recovered personal experiences with clients (i.e., no longer distressing). However, theoretical rationale and empirical support for this claim is limited. Drawing on identity leadership theorizing, we investigated whether recovery disclosures are beneficial to the extent that they signal a therapist's aspirational prototypicality (i.e., embodiment of an aspirational identity for clients). Across two experimental studies (N = 545), we recruited clients, therapists and general population adults. Participants read a group therapy for depression vignette in which the therapist disclosed: nothing, professional experience with depression, current depression, recovered depression or recovered anxiety. Participants rated the prototypicality of the therapist, the extent to which they perceived the therapist positively, the therapist's expertness and the expected prognosis for therapy. Contrary to our hypotheses, the type of disclosure did not significantly affect positive perceptions, expertness or expected prognosis ratings. However, the therapist disclosing a recovered and relevant condition (recovered depression) was rated as significantly more aspirationally prototypical than the other therapists. Given prior evidence that group therapists are more effective when viewed as aspirationally prototypical, our findings suggest that recovery disclosures may represent one way therapists can signal their prototypicality and enhance their effectiveness.

Prevalence, Etiology and Outcomes of Native Pulmonary Regurgitation in the General Adult Population.

Pulmonary regurgitation (PR) after reparative intervention for congenital heart disease has been studied extensively. However, the burden, distribution of causes, and outcome of PR in adults is unknown. The study aimed to evaluate the prevalence, types, and outcomes of moderate/severe PR in adults in the community setting. A total of 398 adult residents of Olmsted County who had clinically indicated echocardiography 2004-2023 at Mayo Clinic, Rochester and had moderate or severe PR were identified retrospectively. Median age was 77 years, 48% were females, and 61 (51%) had severe PR. The age and sex-adjusted U.S. prevalence was 0.11% (vs 0.67% for ≥moderate tricuspid regurgitation). Moderate/severe PR was due to pulmonary hypertension in 77%, congenital/iatrogenic in 11%, primary pulmonary valve disease in 2% (88% due to carcinoid), and idiopathic isolated in 10%. In contrast, severe PR was due to congenital/iatrogenic disease in 52%, pulmonary hypertension in 39%, primary PR in 5% and isolated idiopathic in 3%. All-cause mortality rate per 100-person-year was 73 in primary (mostly carcinoid) PR, 16 in pulmonary hypertension-related PR (not different vs propensity matched patients without PR), and 6 in isolated idiopathic PR (not different vs matched patients without PR). Moderate or severe PR had a lower prevalence vs TR. The most frequent cause was pulmonary hypertension for ≥moderate PR and congenital/iatrogenic for severe PR. Mortality in patients with acquired ≥moderate PR appeared to be related to the underlying cause, with no excess mortality compared to matched patients without PR. Whether specifically severe PR confers excess mortality requires future investigation.

The efficacy of acupuncture for generalized anxiety disorder (GAD) in college students: Study protocol for a randomized controlled trial.

Generalized anxiety disorder (GAD) is the most common type of anxiety disorders. GAD usually occurs in adolescence or early adulthood, and the prevalence of GAD is higher among college-enrolled young adults than in the general adult population. However, there is a lack of evidence regarding the effectiveness of acupuncture in the treatment of GAD. This study's objective is to evaluate the efficacy of acupuncture in the treatment of GAD in college students and its stability. A total of 142 subjects will be recruited for the randomized controlled trial (RCT) of current undergraduate and graduate students with GAD and will be randomized into treatment and control groups. The treatment group will receive conventional acupuncture, while the control group will receive sham acupuncture using Streitberger needles. Both groups will be administered 8 acupuncture treatment (2 times per week for 4 weeks). The follow-up duration will be 2 months. The Hamilton Anxiety Scale (HAMA) will be used as the primary outcome of the study to measure the severity of anxiety disorder. The secondary outcomes of this study will be included the Pittsburgh Sleep Quality Index (PSQI) and Self-rating anxiety Scale (SAS). The study will also evaluate the success of blinding and the safety. Findings of this RCT will help evaluate the efficacy of acupuncture treatment for GAD in college students, potentially promoting it as an alternative treatment option. The protocol was registered at clinicaltrials.gov (Identifier: ChiCTR2400080688).

Correlation analysis on the association of composite dietary antioxidant index with serum cotinine levels in the general adult population

Correlation analysis on the association of composite dietary antioxidant index with serum cotinine levels in the general adult population

The prevalence and determinants of health anxiety during the covid-19 pandemic: A systematic review and meta-analysis

The coronavirus disease 2019 (COVID-19) pandemic subjected the global population to a situation that aroused disproportionate Health Anxiety (HA). However, this association has not been explored in a systematic review or meta-analysis. The aim of this systematic review was to assess the prevalence and determining factors of HA in the general adult population during the COVID-19 pandemic. A systematic search was conducted across the databases MEDLINE, PsychINFO, Embase and Web of Science. Observational studies using the 18-item Short Health Anxiety Inventory to measure HA during the pandemic were included. A narrative synthesis and meta-analysis summarised HA levels in the general adult population, subgroups and by associated factors. Out of 4088 studies, 12 met the inclusion criteria. Meta-analyses revealed a mean HA score of 15.16 (SE = 0.415). Significantly higher HA levels were observed among females, unmarried individuals, and those with pre-existing health conditions. The HA score of 15.16 suggests elevated HA during the COVID-19 pandemic compared to pre-pandemic studies. Understanding which groups may be more affected by HA during pandemics and health crises will enable us to develop more tailored public health strategies to mitigate the psychological effects of future public health crises. Further research is needed to establish causal and longitudinal relationships.

Association between C-reactive protein and sarcopenia: The National Health and Nutrition Examination Survey

C-reactive protein (CRP), a clinical biomarker, is frequently used to evaluate the inflammatory status of the body. However, the association between CRP levels and sarcopenia among the general adult population in the USA is unknown. This study focused on assessing whether CRP levels were associated with sarcopenia. This cross-sectional study collected adult data of adults from the 2015 to 2018 National Health and Nutrition Examination Survey. Four-extremity total muscle mass was used to evaluate sarcopenia (appendicular lean mass). In addition, dual-energy X-ray absorptiometry was adopted to measure appendicular lean mass. The CRP levels were used to assess inflammation status. Odds ratios (OR) and 95% confidence intervals (95% CI) were determined using multivariable logistic regression to analyze the association between CRP levels and sarcopenia. A multivariable-adjusted restricted cubic spline model was built to plot OR curves at 4 knots. Among the 3710 participants involved in this study (average age, 39.4 [11.54] years; 1801 [48.5%] men), 352 (9.5%) displayed characteristics of sarcopenia, while 3358 (90.5%) did not. Compared with participates in the lowest quartile (Q1) of CRP level (Q1; ≤0.08 to ≤0.7), those in the highest quartile (Q4; ≤4.3 to ≤188.5) had an adjusted OR for sarcopenia of 2.74 (95% CI, 1.65–4.57; P < .001). Based on the multivariable restricted cubic spline model, CRP levels showed a nonlinear association with sarcopenia (P < .001). The adjusted OR of sarcopenia of 1.86 (95% CI, 1.37–2.51; P < .001) was determined by 2 piecewise regression models for those having the CRP level of 1.8. Based on subgroup analysis, CRP levels were related to sarcopenia in males (OR, 1.03; 95% CI, 1–1.05) and individuals aged <50 years (OR, 1.03; 95% CI, 1.01–1.05), drinking (OR, 1.02; 95% CI, 1–1.03), and body mass index ≥ 25 kg/m2 (OR, 1.02; 95% CI, 1–1.03). Our results indicated that CRP levels showed a nonlinear correlation with sarcopenia among adults in the US.

Is functional training functional? a systematic review of its effects in community-dwelling older adults

Abstract Background Age-related decline in physical and cognitive capacity increases older adults’ risk of disability, long-term care placement, and mortality rate. Functional training, which uses activities of daily living or simulated movements to complete activities as the intervention medium, could be more effective than rote exercise, which uses repetitive movements without added purpose, in preventing late-life disability in older people. With a growing number of studies in this area, systematically studying the effect of functional training is needed. The purpose of this systematic review was to examine the effects of functional training on the outcomes of activities of daily living, physical functioning, and cognitive function in community-dwelling older adults. Methods Literature published between January 2010 and April 2024 in 10 electronic databases were searched and screened. This timeframe was established to include studies published within the last 15 years. Each identified article was screened and reviewed by two authors independently. The methodological quality of the included studies was evaluated using the PEDro Scale. Key findings were synthesized according to participants’ characteristics and intervention types. Results The review included 32 studies. In the general community-dwelling older adult population (20 studies), studies that applied functional training as a single-component approach showed a positive effect on activities of daily living. However, the training effect on balance and mobility was not superior to that of other exercise programs. Moreover, the effect was mixed when functional training was combined with other intervention components. In older adults with mild cognitive impairment (5 studies), Simulated Functional Tasks Exercise, a single-component training, consistently demonstrated positive effects on the activities of daily living and cognitive functions. In older adults with dementia (4 studies) or frailty (3 studies), the effect was mixed across the single- and multi-component approaches. Conclusion Functional training alone is effective in preventing late-life disability in general community-dwelling older adults. When training activities challenge both motor and cognitive abilities, the effect seems to improve the performance of activities of daily living and cognitive functions in older adults with mild cognitive impairment. Additional studies of functional training in older adults with cognitive impairment or frailty are recommended.

Communicating on Vaccine Benefit-Risk Ratios: A Discrete-Choice Experiment among Health Care Professionals and the General Population in France.

We explored preferences around the benefit-risk ratio (BRR) of vaccination among the general adult population and health care sector workers (HCSWs). We estimated preference weights and expected vaccine uptake for different BRR levels for a vaccine recommended during an infectious disease emergence. In addition, we explored how far qualitative information about disease severity, epidemiological context, and indirect protection interacts with these preferences. This was a cross-sectional study, using a self-administered online questionnaire containing a single-profile discrete choice experiment among HCSWs and the general population in France (quasi-representative sample). The questionnaire was available from January 12 to April 27, 2023, for HCSWs and from April 17 to May 3, 2023, for the general population. BRR is represented as the number of vaccine-prevented disease events for 1 event related to a vaccine side effect. Results are reported in 4 groups: general population sample, non-HCSWs, non-university-degree HCSWs, and university-degree HCSWs. Among the 1,869 participants, 1,038 (55.5%) varied their vaccine decision among the different vaccine scenarios. Hypothetical vaccine acceptance among university-degree HCSWs increased when the vaccination BRR was 100:1, while non-university-degree HCSWs and non-HCSWs were more sensitive to qualitative information about the vaccine BRR than quantitative indicators. Among participants in the general population sample with varied decisions, expected acceptance increased by 40% sample if disease risk was high. Among serial vaccine nondemanders, high disease risk decreased their certitude to refuse hypothetical vaccination. Our results suggest that only university-degree HCSWs are sensitive to the notion of BRR, but not the general public. Given that previous research found speaking about BRR might reduce vaccine acceptance, this notion should be avoided in vaccine promotion. The notion of benefit-risk ratio (BRR) of vaccination appears to be taken into account in vaccine decisions by university-degree HCSWs, but not by the general public. Mentioning a favorable BRR could imply that the vaccine is not safe and reduce vaccine motivation.Mentioning qualitative attributes of BRR surrounding disease frequency and severity, and indirect protection effects, strongly affected theoretical vaccine decisions in all participants, irrespective of professional categories.Expected vaccine acceptance increased by 40% among the general population sample if disease risk was presented as high, and expected vaccine coverage exceeded 50% in scenarios with high disease risk.Among those refusing vaccination in all vaccine scenarios, only a high risk of developing the disease decreased their certitude to refuse vaccination. This further underlines the importance of disease risk perception on vaccine decision making, including among persons who a priori are unlikely to accept vaccination.

Daily Step Count and Depression in Adults

Recent evidence syntheses have supported the protective role of daily steps in decreasing the risk of cardiovascular disease and all-cause mortality. However, step count-based recommendations should cover additional health outcomes. To synthesize the associations between objectively measured daily step counts and depression in the general adult population. In this systematic review and meta-analysis, a systematic search of the PubMed, PsycINFO, Scopus, SPORTDiscus, and Web of Science databases was conducted from inception until May 18, 2024, to identify observational studies using search terms related to physical activity, measures of daily steps, and depression, among others. Supplementary search methods were also applied. All identified studies were uploaded to an online review system and were considered without restrictions on publication date or language. Included studies had objectively measured daily step counts and depression data. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology reporting guidelines. Two independent reviewers extracted the published data. Pooled effect sizes (correlation coefficient, standardized mean difference [SMD], and risk ratio [RR]) with 95% CIs were estimated using the Sidik-Jonkman random-effects method. Thirty-three studies (27 cross-sectional and 6 longitudinal [3 panel and 3 prospective cohort]) involving 96 173 adults aged 18 years or older (range of mean [SD] ages: 18.6 [0.6] to 91.2 [1.6] years) were included. Daily steps were inversely correlated with depressive symptoms in both cross-sectional and panel studies. Compared with fewer than 5000 steps/d, pooled SMDs from cross-sectional studies revealed that 10 000 or more steps/d (SMD, -0.26; 95% CI, -0.38 to -0.14), 7500 to 9999 steps/d (SMD, -0.27; 95% CI, -0.43 to -0.11), and 5000 to 7499 steps/d (SMD, -0.17; 95% CI, -0.30 to -0.04) were significantly associated with fewer depressive symptoms. Pooled estimates from prospective cohort studies indicated that participants with 7000 or more steps/d had reduced risk of depression compared with their counterparts with fewer than 7000 steps/d (RR, 0.69; 95% CI, 0.62-0.77). An increase of 1000 steps/d was associated with a lower risk of depression (RR, 0.91; 95% CI, 0.87-0.94). In this systematic review and meta-analysis of 33 observational studies involving 96 173 adults, higher daily step counts were associated with fewer depressive symptoms in cross-sectional and longitudinal studies in the general adult population. Further prospective cohort studies are needed to clarify the potential protective role of daily steps in mitigating the risk of depression during adulthood.

Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea.

This study compared the current smoking prevalence among adults with human immunodeficiency virus (HIV) infection to that of the general Korean population and analyzed changes in smoking prevalence and cessation rates from 2009 to 2020. The study included a total of 10,980 adults with HIV infection who underwent a health screening examination (NHIS-NHID), 1,230 individuals with HIV infection who participated in the Korea HIV/AIDS Cohort (KoCosHIV), and 76,783 participants from the Korea National Health and Nutrition Examination Survey (KNHANES). We estimated the current smoking prevalence and the quit ratio, defined as the ratio of former smokers to ever-smokers. In the NHIS-NHID and KoCosHIV studies, the prevalence of current and former smoking among adults with HIV was 44.2% (95% confidence interval [CI], 43.2 to 45.1) and 15.6% (95% CI, 14.9 to 16.3), and 47.7% (95% CI, 43.7 to 51.8) and 16.9% (95% CI, 11.8 to 22.0), respectively. In the KNHANES, these rates were 22.5% and 18.1%, respectively. The standardized prevalence ratio of current smoking among adults with HIV was 1.76 in the NHIS-NHID and 1.97 in the KoCosHIV. Furthermore, the likelihood of quitting smoking was lower among adults with HIV than in the general population (NHIS-NHID: 26.1%; 95% CI, 25.0 to 27.1; KoCosHIV: 26.2%; 95% CI, 20.2 to 32.1; KNHANES: 44.6%; 95% CI, 44.5 to 44.6). Among HIV-positive adults, there was a 1.53% decline in the current smoking rate and a 2.86% increase in the quit ratio. Adults with HIV were more likely to smoke and less likely to quit smoking than the general adult population. Tobacco screening and cessation strategies should specifically target this population.

Alarming Signal from the Ear: Tinnitus, a Possible Epiphenomenon of Silent Hyperlipidaemia.

Background/Objectives: Over the past few decades, many studies have been conducted to explore the link between tinnitus and lipid metabolism, yielding inconsistent results. In our current study, we compared the prevalence of various lipid metabolism abnormalities in patients with chronic subjective idiopathic tinnitus (CSIT) to the official prevalence data of dyslipidaemia in the general adult Hungarian population. To counteract the distorting effect of the co-increase in both conditions with age, we also examined this relationship by age groups. Methods: A total of 231 adult patients, suffering from CSIT, who underwent rheological treatment at the Department of Otorhinolaryngology and Head and Neck Surgery of the Clinical Center (University of Debrecen, Debrecen, Hungary), were involved in a retrospective study. Total cholesterol, serum triglycerides, LDL-C, ApoB, HDL-C, ApoA, and Lp(a) were utilized. Results: For the aggregated data, we found that the occurrence of dyslipidaemia among our patients (78.35%) significantly exceeded the corresponding official data about the occurrence of dyslipidaemia in the whole adult Hungarian population (16.51%). This finding was supported by our age-specific approach and the results imply an association between CSIT and dyslipidaemia. This finding suggests an association between CSIT and dyslipidaemia. Conclusions: Considering the relationship between CSIT and dyslipidaemia suggested by our results, tinnitus could be an indicator of dyslipidaemia, even at a young age. Therefore, careful investigation of each tinnitus patient, along with a lipidological evaluation for those with CSIT, may be recommended. This approach could lower mortality from lipid-related diseases, particularly atherosclerosis and its complications, by serving as the first line of defence against a harmful and life-threatening lipid-related conditions.

Respiratory chronic health conditions and racial disparities associated with e-cigarette use: a cross-sectional analysis using behavioral risk factor surveillance data.

Chronic Obstructive Pulmonary Disease (COPD), mainly caused by cigarette smoking, is one of the leading causes of death in the United States (US) and frequent asthma attacks are often exacerbated by cigarette use. Electronic cigarettes (e-cigarettes) are often used to quit cigarette smoking. Prevalence of COPD, asthma, cigarette use, and e-cigarette use differs between racial/ethnic groups. The overall objective was to assess the associations between e-cigarette use and COPD and asthma and how race/ethnicity and cigarette smoking modifies these associations. Data were retrieved from the 2016-2018 and 2020-2021 Behavioral Risk Factor Surveillance System datasets, a national annual health survey representing the US general adult population. Frequency and weighted percentages or means and standard deviations were obtained. Rao-Scott Chi-square test, two-sample t tests, and logistic regression were used to evaluate binary associations between current e-cigarette use and lifetime diagnosis of COPD and asthma. Multivariable analyses using logistic regression were conducted to assess associations between variables. Interaction effects between e-cigarette use and race/ethnicity were assessed and stratified analyses were performed as indicated. All multivariate analyses were stratified by cigarette smoking status. Prevalence of e-cigarette use was 5.1%, COPD was 6.7%, and asthma was 9.2%. Individuals who currently smoked cigarettes among all racial/ethnic groups, excluding non-Hispanic (NH) American Indian/Alaska Native individuals, were more likely to report current asthma if using e-cigarettes compared to non-use (p < 0.05). Among individuals who never smoked, Non-Hispanic White (NHW), NH-Black and Hispanic individuals using e-cigarettes had greater odds of COPD compared to NHW, NH-Black and Hispanic individuals who did not use these products, respectively (p < 0.05). Among NHW, Hispanic, and NH-Other persons who currently used cigarettes, individuals currently using e-cigarettes had greater odds of COPD compared to NHW, Hispanic, and NH-Hispanic individuals who did not use e-cigarettes, respectively (p < 0.05). Among individuals who formerly used cigarettes, current e-cigarette use was associated with COPD and asthma. Among individuals who never used cigarettes, current e-cigarette use was associated with reporting current asthma. The association between e-cigarette use and COPD and asthma was dependent on smoking status and racial/ethnic groups. Further studies should be conducted to explore this association.

Restless legs syndrome among blood donors: A systemic review and meta-analysis.

Restless legs syndrome (RLS), with adverse health outcomes, has been linked to blood donation, but evidence published thus far has not been rigorously analysed. This systematic review aggregates existing evidence on RLS among blood donors and identifies associated factors worthy of further investigation. MEDLINE and EMBASE were searched for articles published through 16 December 2023. Eleven studies from eight countries were selected from 142 publications. The pooled prevalence of RLS was calculated using a random-effects model, with heterogeneity assessed by the Cochran Q and I2 statistics. Meta-regression and sensitivity analyses explored sources of heterogeneity and the robustness of findings. Eleven studies, involving 20,255 blood donors, were included. The pooled prevalence of RLS among blood donors was 10.30% (95% confidence interval [CI]: 5.54%-16.30%), which was significantly higher than in the general adult population (3.0%, 95% CI: 1.4%-3.8%). Meta-regression identified the year of study and geographical region as significant sources of heterogeneity. From the five studies that used logistic regression analyses, female sex and older age stand out as associated factors. No publication bias was detected, and sensitivity analysis confirmed the robustness of results. Our findings suggest a high burden of RLS among blood donors, underscoring the need for further research with standardized criteria, appropriate design and analytical methodologies to better understand the impact of RLS on individual donors and the global blood supply.

Association between waist-to-hip ratio and risk of myocardial infarction: a systematic evaluation and meta-analysis

BackgroundMyocardial infarction(MI) is one of the most serious health threats. Despite the increasing number of clinical methods used to predict the onset of MI, the prediction of MI is still unsatisfactory and necessitates new methods.ObjectiveTo systematically review observational studies from the past two decades on the association between waist-to-hip ratio (WHR) and MI risk.MethodsOriginal literature on the correlation between WHR and MI was searched in PubMed, Embase, Web of Science, Cochrane Library, Science Direct, CNKI, and Wanfang up to January 31, 2024. Two researchers independently screened, extracted data, and assessed quality using the Newcastle-Ottawa Scale (NOS) and Revman5.3. Meta-analysis with Stata 16.0 calculated the combined Odd ratio (OR) for WHR and MI risk. Heterogeneity was assessed with the I2 statistic to select the appropriate effects model. Subgroup analysis, meta-regression, sensitivity analysis, and funnel plots tested for heterogeneity and publication bias.ResultsA total of 22 observational studies were included, involving 709,093 participants. The meta-analysis showed that an elevated WHR was significantly associated with an increased risk of MI, with a pooled odds ratio (OR) of 1.98 [95% Confidence interval (CI): 1.75–2.24] and high heterogeneity (I2 = 91.5%, P &amp;lt; 0.0001). Subgroup analysis revealed a stronger association between WHR and MI in women (OR: 1.99, 95% CI: 1.43–2.77) compared to men (OR: 1.74, 95% CI: 1.36–2.22). Regional analysis indicated that the association between WHR and MI risk was highest in Asian populations (OR: 2.93 95% CI: 1.61–5.33), followed by American (OR: 1.73, 95% CI: 1.45–2.08) and European populations (OR: 2.19, 95% CI: 1.49–3.22). Sensitivity analysis demonstrated that the results remained stable after excluding one study.ConclusionIn the general adult population, a higher WHR is a potentially significant association for MI and has predictive value for MI.

Public Valuations of Managing Compromised Molars: A Discrete Choice Experiment.

There is limited evidence to support optimal patient-centered management for compromised first permanent molars (cFPM) in children. Based on an online discrete choice experiment (DCE), this study elicits UK adult general population preferences and calculates willingness to pay (WTP) for pathways to manage cFPM. The DCE was designed with information from semistructured interviews and literature reviews, as well as focus groups with an expert panel of dentists, citizens, and policy makers. A statistically optimal D-efficient design generated 18 choice tasks, split across 2 blocks. Each respondent answered one block of 9 tasks to reduce survey fatigue. Choice tasks varied across 5 attributes: type of treatment, provider of care, who makes the management decision, number of future visits avoided, and cost. An opt-out was included (no treatment). Conditional logit models (fixed effects) were used for data analysis, and marginal WTP for each attribute level was calculated. An overall 430 respondents completed the DCE. Respondents valued children receiving care as compared with not. Restoring a cFPM was valued equally to spontaneous or orthodontic gap closure. In contrast, having a partial gap, prosthetic replacement with a bridge, or a full unit gap was valued less than restoration or full gap closure. General dentists were preferred to dentists with enhanced skills, but there was no evidence of a preference for general dentists over specialists in pediatric dentistry. Respondents preferred to be wholly or partly involved in the decision-making process as opposed to the dentist making the decision alone. Respondents preferred less costly treatments and the avoidance of future dental work. Dental care service providers must consider service user preferences for health and nonhealth outcomes in any service redesign. Furthermore, the results provide marginal WTP estimates that can be used to value dental care services.

Preferences for the delivery of early abortion services in Australia: a discrete choice experiment.

Background Abortion is a common procedure in Australia; it is estimated that the rate is between 15 and 17 per 1000 women. Surgical and medical abortion options are available; however, the use of medical abortion is not as common as in other similar countries. The aim of this study is to understand preferences for the provision of early abortion services in Australia. Methods We conducted a survey of 821 members of an online panel representative of the Australian adult general population. The survey consisted of a discrete choice experiment including 16 choice tasks and a number of follow-up questions. A mixed logit model was used to analyse the responses to the discrete choice experiment. Results Respondents preferred services that provided surgical abortion compared with early medical abortion (EMA). They preferred consultations with a specialist gynaecologist compared with a general practitioner (GP); consultations with a GP were preferred to those with a nurse practitioner. Face-to-face consultations were preferred to telehealth. For EMA, respondents preferred to collect medication from the doctor's surgery rather than from a pharmacy or to receive it by post. Overall, respondents preferred lower-cost services. There were no differences in preferences between respondents with or without experience of abortion or between genders. Conclusions Respondents prefer abortion services with low out-of-pocket costs. Their reluctance to use a nurse-led service may reflect the general public's lack of understanding of and familiarity with the training and expertise of nurse practitioners. Similarly, the safety and benefits of EMA relative to surgery, including EMA delivered by telehealth, need to be emphasised.

Healthy Lifestyle Changes Improve Cortisol Levels and Liver Steatosis in MASLD Patients: Results from a Randomized Clinical Trial.

Background: Steatotic liver disease associated with metabolic dysfunction (MASLD) affects up to about 30% of the general adult population and is closely related to obesity and the metabolic syndrome. Cortisol, a stress-related hormone contributing to hepatic fat accumulation and insulin resistance, also promotes progression of the disease. The study aims to investigate the impact of lifestyle modifications on cortisol levels and hepatic steatosis in patients with MASLD. Methods: In a 16-week three-arm randomized trial, 42 patients were randomly assigned to three groups who received dietary advice (CG), dietary advice combined with aerobic exercise (AE + DA), or dietary advice with high-intensity interval training (HIIT + DA). Before the start, after 2 months of intervention, and at the end of the project, medical evaluations, routine biochemical assessments, and psychological questionnaires were analyzed. At baseline and at the end of 4 months, hepatic steatosis was evaluated by Fibroscan®. Results: In the study population, severe hepatic steatosis (74%) and obesity (98%) were prevalent at the beginning of the study. A statistically significant (p-value = 0.001) reduction in circulating cortisol levels was observed over time in the two groups doing exercise, especially in HIIT + DA (p-value = 0.006). Hepatic steatosis, assessed by Fibroscan®, disappeared in 10 participants (CAP value < 248, p-value = 0.003). CAP values and waist circumference decreased in all groups, statistically significantly in the AE + DA group (p-value = 0.005; p-value = 0.04, respectively). Conclusions: The study emphasizes the benefits of combining diet and exercise in managing MASLD. HIIT + DA significantly decreased cortisol levels, while AE + DA was the most potent intervention for reducing hepatic steatosis.

The Awareness of Dental Erosion and Its Causes and Protective Factors Among a General Adult Population of Trinidad and Tobago

The Awareness of Dental Erosion and Its Causes and Protective Factors Among a General Adult Population of Trinidad and Tobago

Measures of social connectedness in adult populations: a systematic review

BackgroundPoor social connectedness has been identified as a risk factor for poor mental health but there is a lack of standardisation in how it is measured. This systematic review aimed to identify suitable measures of social connectedness for use in UK adult general populations.MethodsSearches were undertaken in two stages to identify: (1) measures of social connectedness from review articles and grey literature and (2) studies reporting on the psychometric properties of the identified measures. Grey literature and five databases were searched: MEDLINE, Embase and PsycINFO; CINAHL and Web of Science. Studies based on UK adult general populations (16–65 years) or other English language speaking countries with similar cultures (US, Canada, Ireland, Australia and New Zealand) were included. Psychometric evidence was extracted relating to six general domains: conceptual model, content validity, reliability, construct validity, scoring and interpretability, and respondent burden and presentation. A narrative synthesis summarised these psychometric properties.ResultsStage (1) 2,396 studies were retrieved and, 24 possible measures of social connectedness were identified; stage (2) 6,218 studies were identified reporting on psychometrics of identified measures and 22 studies were included. These studies provided psychometric evidence for 10 measures, and we did not find psychometric studies for the other identified measures. Six measures (6/10, 60%) reported assessing loneliness and four (4/10, 40%) reported assessing social support but there was a degree of overlap between the assessments of each concept. There was good evidence of reliability across measures, 90% (9/10) had adequate internal consistency, but evidence of content validity was only available for one scale. Five measures (5/10, 50%) reported on at least half of the psychometric criteria, and these were: UCLA-3 (for loneliness), and MSPSS, F-SozU K-6, SPS-10 and SPS-5 (for social support).ConclusionsThis review identified ten social connectedness measures, and identified UCLA-3, MSPSS, F-SozUK-6, SPS-10, and SPS-5 as having the most robust psychometric properties for the UK adult population. Further testing is required to establish content validity, and to clarify the definition and conceptualisation of social connectedness, to enable standardisation in the approach to measuring social connectedness.

The Relationship Between Psychopathology, Personality Traits, and a History of Traumatic Brain Injury.

To determine whether history of traumatic brain injury (TBI) is associated with psychopathology, and, in particular, substance use disorder (SUD) in young adults with a history of athletic participation. Observational study. University in the northeastern United States. A large (n = 534) and mixed sex (57% female) sample of varsity and club sport athletes older than 18 years. None. The Ohio State University Traumatic Brain Injury ID assessment and the Structured Clinical Interview for the diagnostic and statistical manual of mental disorders, fifth edition. Twenty-five percent of participants reported no history of head injuries, 32% reported 1 head injury, and 43% reported more than 1 head injury. Thirty-eight percent of participants had been diagnosed with 1 or more concussions. Twenty-eight percent of participants had a current psychiatric diagnosis and 49% had at least 1 lifetime diagnosis. Head injuries and concussions were significantly associated with the presence of lifetime psychiatric diagnosis and symptoms or diagnosis of alcohol or SUD. More head injuries were associated with symptoms of post-traumatic stress disorder. Higher number of self-reported head injuries and diagnosed concussions were associated with a lifetime history of psychopathology, and specifically, with alcohol and substance use disorders. These relationships are similar to those seen in the general population of adults. The relationships also raise several interesting questions about recovery from head injuries in young adult athletes.