General Health Status Research Articles

Abstract 814: Bridging the gap: Informal caregivers' access to information on genetic testing for cancer risk

Abstract Introduction: Cancer risk genetic testing (referred to as genetic testing thereafter) benefits patients by allowing them to make informed behavioral and medical decisions to reduce cancer risk and by facilitating surveillance and earlier detection. Informal caregivers, who often serve as primary advocates for those at risk, play a pivotal role in supporting behavioral and medical decisions based on genetic testing information. Assessing caregivers’ knowledge of genetic testing can guide future interventions supporting informed decision-making to ensure that all groups benefit equally from advances in genetic testing. We examined the association between caregiving and knowledge of genetic testing as well as other individual and socioeconomic factors. Methods: Secondary data analysis was conducted using the 2020 Health Information National Trends Survey (HINTS 5 Cycle 4). HINTS is a nationally representative survey of adults in the civilian non-institutionalized US population. Exposure variable was caregiving (yes/no) assessed with the question “Are you currently caring for or making health care decisions for someone with a medical, behavioral, disability, or other condition?”. The outcome variable was genetic testing knowledge (yes/no) assessed with the question “have you heard of high-risk cancer genetic testing - e.g., BRCA 1/2". Weighted, multivariable logistic regression was used to estimate the association between caregiving and genetic testing knowledge adjusting for age, gender, race/ethnicity, marital status, education level, having a regular provider, rural-urban residence, and self-reported general health status. Results: A total of 3,136 participants aged ≥18 were included in the study, of whom 16.4% were caregivers and 35.9% had heard of genetic testing. In the adjusted analysis, there was no statistically significant difference between caregivers and non-caregivers in relation to genetic testing knowledge (P=0.7881). However, respondents who were ≥65 years old (aOR=0.54, 95% CI: 0.40-0.72) were less likely to have heard about genetic testing compared to those aged 18-49, as were respondents who had no regular provider (aOR=0.71, 95% CI: 0.53-0.95) compared to those with a regular provider. Compared to non-Hispanic White respondents, non-Hispanic Black (aOR=0.45, 95% CI: 0.31-0.66) or Hispanic respondents (aOR=0.44, 95% CI: 0.29-0.68) were less likely to have heard about genetic testing. Female respondents (aOR=2.02, 95% CI: 1.55-2.61) were twice as likely to have heard about genetic testing than their male counterparts. Conclusions: We found that about a third of Americans had heard about genetic testing; patients who were younger, female, White, and those who had access to a regular provider were more likely to be aware of testing. Interventions targeting under-resourced caregivers are urgently needed to promote equity in genetic testing and its benefits. Citation Format: Eric Adjei Boakye, Pranali G. Patel, Chaitali S. Dagli, Sarah Wagoner, Mrudula Nair, Nosayaba Osazuwa-Peters, Veronica Bernacchi, Samantha H. Tam. Bridging the gap: Informal caregivers' access to information on genetic testing for cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 814.

Malted sorghum as a maize substitute in broiler diets: effect on feed utilisation, growth performance and haemo-biochemical parameters

Sorghum is amongst the most drought-tolerant cereals in the driest rain-fed regions of the tropics and its utilisation in sustainable poultry production is limited by presence of phytochemicals. Thus, this study evaluated the effects of malting dietary sorghum on growth performance and haemo-biochemical parameters of Ross 308 broiler chickens. A total of 150 unsexed, 2 weeks-old chicks were evenly distributed into 15 replicated pens which were randomly allocated into three experimental diets and fed in two phase feeding. Three diets were formulated by completely replacing maize grain in commercial grower and finisher diets (CON) with red malted sorghum (RSD) and white malted sorghum (WSD). Broilers fed CON and WSD diets gained more weight compared to those fed RSD in week 3 and 5. The lowest feed conversion ratio (FCR) was observed in CON in week 4 and 6. The protein efficiency ratio was the lowest with broilers fed malted sorghum-based diets (MSD) through out the study. Protein intake was the highest in broilers fed WSD in week 3 and 5, but lowest in week 4 and 5 in broilers fed RSD. Diets affected white blood cells basophils, corpuscular (volume and haemoglobin), corpuscular haemoglobin concentration, creatinine, bilirubin, and enzymes (GTP and GOT). Overall, the results from the present study suggest that maize grains can be replaced with malted white sorghum grains in poultry diets, without any adverse effects on the birds’ growth performance and general health status.

The influence of WeChat education and care program on anxiety, depression, insomnia, and general state of health in parents of pediatric acute lymphoblastic leukemia patients

PurposeWeChat-based education and care program serves as a promising nursing method for relieving mental stress in parents of pediatric patients. This study purposed to explore the influence of the WeChat education and care program (WECP) on mental health, insomnia, and general state of health in parents of pediatric acute lymphoblastic leukemia (ALL) patients.MethodsTotally, 146 parents of 73 primary pediatric ALL patients were randomized into the WECP group (74 parents of 37 patients) and standard care (SC) group (72 parents of 36 patients) to receive a 6-month corresponding intervention. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), Athens insomnia scale (AIS), and 12-item general health questionnaire (GHQ-12) were assessed in parents of patients.ResultsSAS scores at the third month (M3) (P = 0.041) and M6 (P = 0.032) were reduced in WECP group versus SC group. SAS-defined anxiety rate at M6 (P = 0.035) was declined in WECP group versus SC group. SDS score at M6 was descended in WECP group versus SC group (P = 0.024). However, there was no discrepancy in SDS-defined depression rate at any time point between groups (all P > 0.05). AIS scores at M1 (P = 0.015) and M6 (P = 0.021), as well as GHQ-12 scores at M3 (P = 0.007) and M6 (P = 0.001) were decreased in WECP group versus SC group. By subgroup analyses, WECP exhibited good effects at M6 in mothers, but not in fathers.ConclusionWECP is a feasible and efficacy intervention to improve mental stress and health status among parents of pediatric ALL patients, especially in mothers.

Falta de conhecimento sobre os fatores de risco não ocupacionais da dor lombar entre profissionais de saúde ocupacional brasileiros: um estudo observacional transversal

INTRODUCTION: Low back pain (LBP) is highly prevalent and is one of the main causes of disability in Brazil and around the world. LBP presents a multifactorial etiology, being extremely common in workers. OBJECTIVE: This study aimed to verify the knowledge about the LBP risk factors, beliefs and attitudes about the management of LBP among health professionals (physiotherapists and ergonomists) working in the occupational area. MATERIALS AND METHODS: A cross-sectional observational study was conducted with 81 Brazilian occupational health professionals. Participants completed an electronic questionnaire comprising professional data, sociodemographics, items about LBP risk factors, and the Brazilian version of the Pain Attitudes and Beliefs Scale for Physiotherapists. Knowledge, beliefs and attitudes were analyzed using the chi-square test for LBP risk factors and the linear regression model for health professionals' beliefs and attitudes. RESULTS: Obesity (7.4%), sitting for more than 2 hours (8.6%), physical activity (9.9%), lack of psychosocial support at work (11.1%) and consuming alcohol (37.0%) presented the lowest rate of knowledge about LBP risk factors by professionals. Items about general health showed the lowest knowledge. A balanced biomedical and psychosocial orientation of beliefs and attitudes about managing LBP was observed. CONCLUSION: Brazilian occupational health professionals lack knowledge about non-occupational LBP risk factors, especially general health status. These professionals also have balanced biomedical and psychosocial concepts in managing LBP.

Fitness age outperforms body mass index in differentiating aging patterns and health risk profiles of healthy adults aged 51-80years.

Physical fitness has been extensively shown to strongly associate with general health status and major health risks. Here we tested the ability of a novel estimate of fitness age (FitAge) to differentiate aging trajectories.This study aimed at (1) testing the ability of FitAge to differentiate aging patterns among decelerated, normal, and accelerated agers in selected health domains, (2) estimating the risk for developing major health issues depending on the aging trajectory, and (3) comparing FitAge to body mass index (BMI) categorization in differentiating healthy from unhealthy aging patterns.A total of 176 volunteers participated in this cross-sectional study. Participants underwent clinical screening and a comprehensive assessment of body composition, nutritional and health-related status, cognitive functioning, and haematochemical analyses with routine tests, oxidative stress, and inflammation markers. Scores for major health risks were also computed.FitAge outperformed BMI in estimating major health risk scores and was able to differentiate decelerated from normal and accelerated agers for health risk profile and several physiological domains. Body composition, immune system activation, and inflammation markers emerged as those variables flagging the largest differences between decelerated and accelerated aging patterns.The novel estimate of biological aging can accurately differentiate both in women and men decelerated from accelerated agers in almost all the domains scrutinized. Overall, decelerated aging is linked to positively oriented features which associate with reduced risk of developing major health issues.The present findings have potential relevance and practical implications to identify individuals at higher risk of accelerated aging according to their FitAge estimated via simple and cost-effective motor tests.

The obesity challenge in joint replacement: a multifaceted analysis of self-reported health status and exercise capacity using NHANES data - a population-based study.

Joint replacement is successful for end-stage osteopathy, with obesity linked to evaluated risk. But the impact of obesity on self-reported health and exercise capacity among joint replacement patients remains complex and requires investigation. This study utilizes data from the National Health and Nutrition Examination Survey (NHANES) to examine the relationship between obesity severity, demographic factors, medical comorbidities, and self-reported health status. The relationship between general health status and BMI was analyzed using multivariable regression, and further illustrated using a restricted cubic spline. Additionally, a bibliometric analysis and systemic review was done to frame the research within the broader context of existing knowledge and demographic specifics. Analysis of NHANES data involving 327 joint replacement patients yielded intriguing insights. The difference in self-reported health between BMI groups did not achieve conventional statistical significance (P=0.06), and multivariable analysis showed that even severely obese patients did not exhibit significantly elevated risk of poor/fair self-reported health compared to normal weight subjects. Among severely obese individuals (BMI>40), 40.63% still rated their health positively. However, stratified analyses indicated that obesity correlated with negative health reports across gender, age, and education strata. Notably, physical functioning emerged as a robust predictor of self-reported health, with those reporting no walking difficulties having significantly lower odds of poor/fair health (Odds Ratio=0.37, P=0.01). The study highlights the need for healthcare providers to consider individual physical abilities and comorbidities alongside obesity severity when discussing treatment options with joint replacement patients. It supports tailored interventions and informed shared decision-making. Future research could explore effective weight management strategies for obese individuals undergoing joint replacement.

Methanolic extract of Cleome droserifolia mitigates epinephrine-induced cardiac injury

Ethnopharmacological relevanceCleome droserifolia treatment has potent antioxidant, antimicrobial, and immunomodulatory potentials, which can help recover the general health status. Aim of the studyThis research aims to estimate the potential cardioprotective properties of the methanolic extract of Cleome droserifolia (MEC) against epinephrine-induced cardiac injury (MI) in rats. Materials and methodsThirty-six male Wistar rats were separated equally into 6 groups. The control group (Cont) received oral distilled water for 30 uninterrupted days and was administered subcutaneous saline on the 31st and 32nd days. The MEC 100 group received MEC 100 mg/kg, P.O., for 30 uninterrupted days and administered subcutaneous saline on the 31st and 32nd days. The MEC 200 group received MEC 200 mg/kg, P.O. for 30 uninterrupted days and subcutaneous saline was administered on the 31st and 32nd days. The epinephrine group (EP) received distilled water orally for 30 uninterrupted days and administered subcutaneous epinephrine (2 mg/kg, s.c.) divided into two doses (1 mg/kg, s.c) each on the 31st and 32nd days. MEC 100+Ep group received MEC 100 mg/kg, P.O., for 30 uninterrupted days and administered subcutaneous epinephrine (2 mg/kg, s.c.) divided into two doses (1 mg/kg, s.c) each on the 31st and 32nd days. The MEC 200+EP received MEC 200 mg/kg, P.O. for 30 uninterrupted days and administered subcutaneous epinephrine (2 mg/kg, s.c.) divided into two doses (1 mg/kg, s.c) each on the 31st and 32nd days. Electrocardiography (ECG), biochemical, oxidative stress, inflammatory mediators, histopathological, immunohistochemical analysis and the expression of phosphoinositide 3-kinases (PI3K) and protein kinase B (AKT) were assessed. ResultsMEC reversed epinephrine-induced lessening of heart rate, prolonged QT interval and ST displacement. Pretreatment with MEC significantly reduced serum aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) levels in MI rats. The MEC pretreatment promoted total antioxidant capacity (TAC), glutathione (GSH), and total oxidant status (TOS). In addition, it reduced interleukin-1β (IL-1β), interleukin-6 (IL-6), malondialdehyde (MDA), and tumour necrosis factor (TNF-α) in MI rats. Furthermore, MEC statistically reduced immunohistochemical promotion of nuclear factor–κB (NF-κB) and expression of AKT and PI3K in cardiac tissue and perfected histopathological changes. ConclusionThe MEC, rich in phenolic and flavonoid contents, had a cardioprotective effect on rats suffering from epinephrine-induced MI. Such effect was achieved via improving cardiac function, antioxidant status, attenuating ECG pattern and histological picture, as well as reducing IL-6, IL-1β, TNF-α and NF-κB, which its antioxidant and anti-inflammatory potential may partly arbitrate.

Burdening caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital, The Gambia.

Deinstitutionalization of persons living with mental illness has led to many patients residing in communities with family members and shifting the burden of care and caregiving from hospitals to homes. The aim of the study was to determine the burden on caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital (EFSTH). This was a descriptive cross-sectional study design with a sample consisting of 161 randomly selected caregivers of patients with schizophrenia. The GHQ-12 questionnaire was used to determine the general health status of the caregivers. The caregivers' burden was assessed using the Zarit Burden Scale. The data were collected using the researcher-administered method. The collected data were analyzed with IBM SPSS Version 20 using descriptive statistics, mean differences, and the general linear model (GLM). The main findings of this study were that caregivers experienced a significantly high level of burden. Most of them experienced high levels of physical (70%), psychological (93.2%), social (78.3%) and financial (55.3%) burdens. Employment status, specifically unemployment status and belonging to the Wolof ethnic group, was a significant predictor of the level of financial burden on the caregivers. Similarly, the total score for social burden was also significantly greater among unemployed caregivers. Educational level was a significant predictor of the total score on the psychological and physical burden scale. The caregivers of patients with schizophrenia at EFSTH are experiencing a high level of burden as a result of their caregiving role, which affects their health, and this calls for urgent intervention.

Objective and subjective measures of air pollution and self-rated health: the evidence from Chile.

The literature exploring individual differences in self-rated health has grown fast in recent years. Self-rated health (SRH) is a good indicator of general health status. This empirical study explores the association between outdoor air pollution and SRH in Chile. This type of analysis is infrequent in Latin America. We used objective and subjective air pollution measures. The first corresponds to PM2.5, and the latter to the perception of a high level of air pollution. Drawing on data from two independent and repeated nationwide surveys over the period 2006-2017 at the individual level in Chile, we performed repeated cross-sectional analyses for each year of survey application. Ordered Logit (OL) and Logit (L) multivariate models were used to investigate the association between SRH and air pollution measures, considering other socioeconomic and demographic covariates. We found that the higher isthe level of air pollution, the lower the SRH in Chile, regardless of whether air pollution is physically measured or perceived by respondents. The results were consistent over the years in the sign and significance of regression coefficients using two surveys and two forms of the outcome variable. Our findings add evidence that air pollution is a relevant determinant of SRH. In addition, they show that subjective measures of air pollution can be as reliable as physical measures in the analysis of the association between air pollution and human health.

Vitamin D Status in the Adult Population of Romania-Results of the European Health Examination Survey.

Vitamin D deficiency is recognized as a general health condition globally and is acknowledged as a public health concern in Europe. In Romania, a national program of examination of the status of vitamin D for high-risk groups has demonstrated a vitamin D deficiency prevalence of 39.83%. No national data on the status of vitamin D in the general adult population are available to date. We used the framework of the European Health Examination Survey to analyze vitamin D levels in a sample population of adults aged 25-64 years, from 120 family doctors' patients lists, by using a sequential sampling method. Data were weighted to the Romanian population. Vitamin D deficiency was defined as 25(OH)D < 20 ng/mL. In total, 5380 adults aged 25-64 years were included in this study. The overall prevalence of vitamin D deficiency is 24.8%. Predictors of vitamin D deficiency were found to be obesity, female sex, living in rural areas, lower education level, and lower socioeconomic status. Specific recommendations for vitamin D screening and supplementation should be issued for women by specialist boards. Further studies are needed to identify seasonal variation and to establish a correlation with nutritional surveys.

Ambulatory Routine Care in Oncology in Germany: Real-World Survival Data

Introduction: Survival data reported by randomised controlled trials are collected in a highly selected patient population and can thus only be transferred to a limited extent to real-world patients: the patients in routine care are mostly older, present with more comorbidities and a worse general state of health. This so-called efficacy-effectiveness gap typically results in inferior survival data in routine healthcare. Methods: Six prospective clinical tumour registries recruited a total of 11,679 patients receiving systemic therapy in haemato-oncological practices in Germany between 2006 and 2020. For these patients with advanced colorectal cancer, breast cancer, lung cancer, pancreatic cancer, renal cell cancer, and lymphatic neoplasms, overall survival was analysed. A comprehensive literature search was performed to identify suitable pivotal randomised controlled trials. Results: Median overall survival of patients treated in German routine care, with advanced colorectal, breast, lung, and pancreatic cancer, as well as with diffuse large B‐cell lymphoma and multiple myeloma, is not shorter than the respective survival data reported in trials. Patients with advanced renal cell carcinoma, chronic lymphocytic leukaemia, or indolent non-Hodgkin lymphoma showed slightly lower survival rates compared to clinical trials. Conclusions: Despite less favourable patient characteristics, survival data from patients with cancer treated in ambulatory routine care in Germany are in range with results from randomised controlled studies.

Exploring the Impact of Socio-Demographic, Health, and Political Factors on COVID-19 Vaccination Attitudes

This study examines the influence of socio-demographic, health, and political factors on attitudes towards COVID-19 vaccination during 2021-2022. Utilizing data from the General Social Survey (GSS), the research explores the relationships between COVID-19 vaccination status and variables such as confidence in medicine, political views, general health condition, income, education level, and marital status. The analysis employs logistic regression models and Chi-Square tests to assess these relationships. Key findings indicate that higher income and education levels, as well as more liberal political views, are positively associated with vaccination uptake. In contrast, marital status presents a more complex picture, suggesting further exploration is needed. The study highlights the multifaceted nature of vaccination decisions and underscores the importance of tailored public health strategies that address the specific needs and concerns of different demographic groups. The research also acknowledges challenges and limitations, including issues related to causality, confounding factors, data quality, generalizability, response bias, and multicollinearity. Overall, the study contributes valuable insights for policymakers and public health practitioners aiming to enhance vaccination campaigns and policies.

Public perception of participation in low-risk clinical trials in critical care using waived consent: a Canadian national survey.

The acceptability of waiver of consent for participation in clinical research in intensive care unit (ICU) settings is uncertain. We sought to survey the Canadian public to assess levels of support, comfort, and acceptability for waived consent for low-risk clinical trials. We performed a prospective cross-sectional survey of the Canadian public aged 18yr or older. The survey was conducted by Ipsos between 19 and 23 November 2020. The survey content was derived from a literature review and in consultation with a patient and family partnership committee. The survey focused on attitudes and beliefs on waived consent for participation in low-risk clinical trials in ICU settings. The survey contained 35 items focused on sociodemographics, general health status, participation in medical research, and levels of support and comfort with research and with waived consent. The survey used a case study of a low-risk clinical trial intervention in ICU patients. Analysis was descriptive. We included 2,000 participants, 38% of whom reported experience with ICU and 16% with medical research. Participation in medical research was more common among those with postsecondary education, those with chronic disease, and those who were employed in health care. Most (80%) would support a model of waived consent for low-risk clinical trials, citing medical benefits (36%) and low perceived risk (34%). Most (77%) were comfortable with personally participating in a low-risk clinical trial. Most (80%) believed waived consent approaches were acceptable. Half (52%) believed the waived consent process should provide information about the research and include the option of opting out. When asked whether participants should always give full informed consent, regardless of the practicality or level of risk, 74% and 72% agreed, respectively. There is public support for models of waived consent for participation in low-risk pragmatic clinical trials in ICU settings in Canada; however, this is not universal. This information can inform and guide education, ethics, policy, and legal discussion on consent models.

Gender differences in psychological help-seeking attitudes: a case in Türkiye.

Mental disorders pose a substantial public health challenge within the overall disease burden. This study aims to determine the factors associated with seeking psychological help among individuals experiencing depression according to gender differences in Türkiye. The study utilized microdata from Türkiye Health Survey conducted by the Turkish Statistical Institute in 2016, 2019, and 2022. Binary logistic regression analysis was employed to determine the factors associated with seeking psychological help. The study's findings reveal that variables such as survey year, age, education level, employment status, general health status, disease status, depression status, day service status in the hospital, daily activity status, tobacco use status, and alcohol use status are associated with the status of receiving psychological help. Gender-specific analysis indicated variations in the significance and impact of these variables among individuals seeking psychological help. In the development of preventive strategies for mental health protection, special attention should be given to factors associated with the psychological help-seeking behavior of both women and men. Prioritizing and addressing these factors will contribute to more effective mental health interventions.

Identify risk factors affecting participation of Turkish women in mammography screening for breast cancer prevention

PurposeCancer screening is a public health intervention aiming to reduce cancer-caused deaths. This study aims to determine the factors affecting the mammography screening time among women aged 40–69.MethodsThe micro dataset obtained from the Türkiye Health Survey conducted by the Turkish Statistical Institute (TurkStat) in 2019 and 2022 was used in the present study. Stereotype logistic regression was used to determine the variables affecting mammography screening and period for breast cancer prevention in women in Türkiye.ResultsGiven the results achieved from the analysis, it was found that factors such as age, marital status, general health condition, comorbidity, receiving psychosocial support, high blood lipid levels, and performing breast self-examinations affected women’s adherence to cancer screening programs.ConclusionSince adherence to mammography increases with age, it is recommended to pay importance to education for women approaching the age of mammography screening. Educated individuals are expected to have access to multiple sources of information as to cancer and to access this information more easily. In order to gain more insight into the recommended preventive measures and outcomes related to cancer, it is suggested to review policies, which will increase the educational level of women, and provide privileges in the field of education.

Comparative Evaluation of Bioavailability, Efficacy and Safety of MICROCORE NESC® with Calcium Carbonate and Calcium Citrate Malate in Osteopenic and Osteoporotic Patients: A Randomized Clinical Trial.

Osteoporosis is a skeletal disease characterized by loss of bone mass, reduced bone strength and increased bone fragility predisposing to fractures. This study was planned to evaluate the efficacy, safety and relative bioavailability of Microcore NESC® (Natural Egg Shell Calcium) in osteopenia and osteoporotic patients. This was a randomized, open label, parallel group interventional clinical trial which included 60 study participants with osteopenia and osteoporosis who were randomized into three groups (20 each). Group 1-Microcore NESC®, Group 2-Shelcal and Group 3-CCM with 12weeks treatment period. The participants were evaluated for relative oral bioavailability, bone mineral density (BMD), serum osteocalcin, change in VAS pain scale and quality of life-Questionnaires. There was significant improvement in the BMD T scores-post-treatment with MICROCORE NESC® and Shelcal. Higher percentage of improvement in calcium absorption as depicted by an increase in serum calcium levels (10.23%) in the MICROCORE NESC®-treated group when compared to Shelcal (7.7%) and CCM (7.2%). The relative bioavailability of MICROCORE NESC® with respect to Shelcal was 93%. MICROCORE NESC®, has shown a better oral relative bio availability of calcium (93%), better improvement of BMD T score compared to Shelcal and CCM. The general health status has improved to very good/excellent in 83% of patients in MICROCORE NESC®-treated group. Thus, MICROCORE NESC® can be considered a better and safe calcium supplement, as there are very few side effects observed without any clinically significant abnormalities in lab parameters.

Patient Characteristics and the Extent to Which Clinicians Involve Patients in Decision Making: Secondary Analyses of Pooled Data.

The occurrence of shared decision making (SDM) in daily practice remains limited. Various patient characteristics have been suggested to potentially influence the extent to which clinicians involve patients in SDM. To assess associations between patient characteristics and the extent to which clinicians involve patients in SDM. We conducted a secondary analysis of data pooled from 10 studies comparing the care of adult patients with (intervention) or without (control) a within-encounter SDM conversation tool. We included studies with audio(-visual) recordings of clinical encounters in which decisions about starting or reconsidering treatment were discussed. In the original studies, the Observing Patient Involvement in Decision Making 12-items (OPTION12 item) scale was used to code the extent to which clinicians involved patients in SDM in clinical encounters. We conducted multivariable analyses with patient characteristics (age, gender, race, education, marital status, number of daily medications, general health status, health literacy) as independent variables and OPTION12 as a dependent variable. We included data from 1,614 patients. The between-arm difference in OPTION12 scores was 7.7 of 100 points (P < 0.001). We found no association between any patient characteristics and the OPTION12 score except for education level (p = 0.030), an association that was very small (2.8 points between the least and most educated), contributed mostly by, and only significant in, control arms (6.5 points). Subanalyses of a stroke prevention trial showed a positive association between age and OPTION12 score (P = 0.033). Most characteristics showed no association with the extent to which clinicians involved patients in SDM. Without an SDM conversation tool, clinicians devoted more efforts to involve patients with higher education, a difference not observed when the tool was used. Most sociodemographic patient characteristics show no association with the extent to which clinicians involve patients in shared decision making.Clinicians devoted less effort to involve patients with lower education, a difference that was not observed when a shared decision-making conversation tool was used.SDM conversation tools can be useful for clinicians to better involve patients and ensure patients get involved equally regardless of educational background.

Factors associated with health professionals’ stress reactions, job satisfaction, intention to leave and health-related outcomes in acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organisations

The aim of this study is to identify (1) the extent of work-related stress and (2) stressors associated with cognitive and behavioral stress reactions, burnout symptoms, health status, quality of sleep, job satisfaction, and intention to leave the organization and the profession among health professionals working in acute care /rehabilitation hospitals, psychiatric hospitals, nursing homes, and home care organizations.BackgroundHealth professionals are faced with various stressors at work and as a consequence are leaving their profession prematurely. This study aimed to identify the extent of work-related stress and stressors associated with stress reactions, job satisfaction, and intention to leave and health-related outcomes among health professionals working in different healthcare sectors (acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organizations).MethodsThis study is based on a repeated cross-sectional design, which includes three data measures between 2017 and 2020 and 19,340 participating health professionals from 26 acute care / rehabilitation hospitals, 12 psychiatric hospitals, 86 nursing homes and 41 home care organizations in Switzerland. For data analysis, hierarchical multilevel models (using AIC) were calculated separately for hospitals, nursing homes, and home care organizations, regarding health professionals’ stress symptoms, job satisfaction, intention to leave the organization / profession, general health status, burnout symptoms, and quality of sleep.ResultsThe main findings reveal that the incompatibility of health professionals’ work and private life was significantly associated (p < 0.05) with their stress reactions, job satisfaction, intention to leave, and health-related outcomes in all the included work areas. The direct supervisor’s good leadership qualities were also associated with health professionals’ job satisfaction regarding all work areas (B ≥ 0.22, p = 0.000). In addition, a positive perceived bond with the organization (B ≥ 0.13, p < 0.01) and better development opportunities (B ≥ 0.05, p < 0.05) were associated with higher job satisfaction and a lower intention to leave the organization and profession among health professionals. Also, a younger age of health professionals was associated with a higher intention to leave the organization and the profession prematurely in all the included work areas. High physical (B ≥ 0.04, p < 0.05) and quantitative demands (B ≥ 0.05, p = 0.000) at work were also associated with negative health-related outcomes.

Depression Symptoms Amongst Older Brazilian and Chinese Women Submitted to Different Social Distancing Measures Rigidness During COVID-19 Outbreak.

It is plausible that depression symptoms and disrupting sleep quality were differently affected according to the rigidity of social distancing during the COVID-19 outbreak. To describe and compare depression symptoms and sleep quality amongst older Brazilian and Chinese women who were submitted to different social distancing measures (less rigid (Brazil) versus more rigid (China)). This observational cross-sectional study assessed urban older women who underwent home confinement with less (Brazil; n=1015) or more (China; n=644) rigidity. Socio-demographic correlates, general health information, depression symptoms [Geriatric Depression Scale (GDS- 15)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were assessed through interviews. 1659 older women (66.74 ± 5.48 years old; 38.8% Chinese; 61.2% Brazilian) were included for analysis. 22% of Brazilians and 19.6% of Chinese women presented depression symptoms. The frequency of bad sleepers was 56.4% and 37.7% amongst Brazilian and Chinese older women, respectively. After adjusting for socio-demographic variables, general health status, and PSQI global score, Chinese women had a significantly higher score of depression symptoms (3.88 ± 0.13) compared to the Brazilians (3.26 ± 0.10; p < 0.001). The frequency of poor sleep quality was very high regardless of the country. After adjusting for confounders and sleep quality, older Chinese women had a significantly superior score of depression symptoms exacerbating psychological distress by confinement rigidness.

ВЗАИМОСВЯЗЬ СОСТОЯНИЯ ЗДОРОВЬЯ НАСЕЛЕНИЯ И ПРИБЫЛЬНОСТИ В ПРОДОВОЛЬСТВЕННОЙ СФЕРЕ

The aim of the study is to develop theoretical provisions of the dependence of the general integrated state of health of the population on the total aggregate profit indi-cator of the food business. The subject of the study is the mechanism of the relation-ship between the state of health and profitability of the food business. A number of literary sources devoted to the gen-eralization of the state of health and economic development of the country are considered. The theoretical dependence of the integral indicator of health status on the total cumulative rate of total profit of the agro-industrial complex, the food industry and food retail is proved. The variants of changing the state of health with different parameters of its parabolic dependence on the total profitability of the food business are considered. A conditional numerical example of the dependence of the state of health in the form of a cubic parabola on the change in the total cumulative rate of profit of the food business is presented and analyzed. It is concluded that the main task of establishing and achieving health indicators (the general goal) is not only market, but also state provision with appropriate parameters of the overall total profitability of the food food business. It is proved that the growth of profitability (profitability) of food sales affects the change in the health status of the population in terms of eating disorders and metabolic disorders.