General Health Research Articles

Abstract A155: Perceived interpersonal racism in healthcare settings and cancer screening

Abstract Introduction: Black and Hispanic people frequently report that perceptions of their race or ethnicity underlie racist and discriminatory experiences in many settings. In the healthcare field, these interpersonal racist experiences can severely impact the decision to receive care and the general health of the patient. Previous studies assessing the role of perceived racial discrimination in the healthcare setting and cancer screenings struggled with low sample sizes that precluded meaningful conclusions. Also, a methodological issue not considered in prior studies is the large degree of uncertainty reported by racialized groups in their assessment of perceived racism and its relevance to the measurement of this construct. In response to these data limitations and newly available nationally representative Behavioral Risk Factor Surveillance System data, we assessed the relationship of perceived racial discrimination in the healthcare setting associated with timely cancer screening across racial/ethnic groups. Methods: Data was collected from the 2022 Behavioral Risk Factor Surveillance System, which is a nationally representative state level population-based household survey with 28 states and the District of Columbia administering the optional modules assessing perceived racial discrimination. Perceived racism in healthcare was measured with the question: “Within the past 12 months when seeking health care, do you feel your experiences were worse than, the same as, or better than for people of other races?”. The outcomes were USPSTF recommendation concordant up-to-date colorectal, cervical, and breast cancer screening. Survey weighted logistic regression models adjusted for age, sex, education, and state estimated prevalence differences stratified by race/ethnicity. Results: Colorectal, cervical, and breast cancer screening were lower in White persons who reported worse (aPD vs. "better": -11.6%, -15.8%, -19.3%) and uncertain (don’t know) experiences of racial discrimination (aPD vs. "better": -7.4%, -4.1%, -5.0%). Among Black people, colorectal and cervical screening were only lower in those reporting uncertain experiences (aPD vs. "better": -10.8% and -12.0%). Among Hispanic persons, breast cancer screening prevalence was lowest in those who reported uncertain and worse racial discrimination (aPD vs. “better”: -12.4% and -15.9%). Conclusions: In this large generalizable sample, perceived racial discrimination in the healthcare setting was associated with cancer screening for both White and Black persons, but in different ways. Worse interpersonal racism in the healthcare setting was associated with lower cancer screening in White persons; but being uncertain relative to other race groups was largely associated with worse cancer screening among Black persons. Uncertainty in self-reported, racist experiences must be considered in institutional efforts to measure and address racism in healthcare settings. Citation Format: Jessica Star, Priti Bandi, Kilan Ashad-Bishop. Perceived interpersonal racism in healthcare settings and cancer screening [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A155.

Abstract B074: Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities

Abstract Background: Up to 2.4 million people in the US live with chronic hepatitis B (HBV) infection (Wong et al., 2021). Foreign-born communities are most impacted, particularly those from Asia, the Pacific Islands, the Caribbean, and sub-Saharan Africa (Conners et al., 2023). Individuals with unmanaged HBV have a 15-40% lifetime risk of dying prematurely from cirrhosis or hepatocellular carcinoma (HCC) (McMahon, 2009). Low awareness, cultural norms, and misperceptions about HBV, HCC, and their connection contribute to low screening and care rates in affected communities. A more robust and comprehensive understanding of these barriers is needed to design effective awareness campaigns to improve HBV screening and care and prevent HCC. To this end, this study aimed to learn about existing knowledge and misconceptions about HBV and its relationship to HCC in high-risk communities, identify barriers to screening, and use the findings to develop effective communication strategies that raise awareness and dispel myths. Methods: Fifteen focus groups and two key informant interviews with community members, leaders, and public health experts were conducted to assess beliefs and attitudes about HBV and HCC and to identify preferred communication strategies. Results: The link between HBV and HCC remains poorly understood, and myths persist about the transmission and outcomes of both conditions. Multiple barriers to HBV and HCC screening exist, including concerns about insurance and immigration status, language barriers, cultural and religious beliefs, lack of general health literacy, lack of resources to cope with a positive diagnosis, widespread distrust of Western medicine, and fear of stigma and isolation. Ideas for effective communication methods included employing community health educators, primary care providers, ethnic media outlets and personal testimonials for delivery of information, and tailoring communications by community, age, and gender. These findings were used to create a suite of culturally and linguistically appropriate educational materials for use in each of twelve communities. Conclusions: Many challenges to increasing screening persist in groups most impacted by HBV and HCC, including a need for increased awareness about their connection. Community engagement is essential to overcoming these challenges, as are specific, targeted messaging and dissemination to improve the uptake of HBV screening and management. Behavioral and Social Science: Community-based Participatory Research Citation Format: Beatrice Zovich, Fiona Borondy-Jenkins, Suzanne Block, Kate Moraras, Thomas Chen, Chari Cohen. Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B074.

Association between serum uric acid levels and cardio-ankle vascular index stratified by circulating level of CD34-positive cells among elderly Japanese men: a cross-sectional study

Although serum uric acid (UA) has been reported to be positively associated with increased arterial stiffness as evaluated by cardio-ankle vascular index (CAVI), UA also has an antioxidative effect that prevents endothelial damage. Therefore, the status of endothelial repair induced by endothelial damage might affect the correlation between UA and CAVI. To clarify the correlation between UA and CAVI in relation to endothelial repair activity, we performed a cross-sectional study with 246 Japanese men aged 60–69 years undergoing a general health check-up. The analysis was stratified by the median circulating level of CD34-positive cells because circulating levels of CD34-positive cells could indicate the degree of endothelial repair activity. Independent of known cardiovascular risk factors, among participants with high circulating levels of CD34-positive cells (0.95 cells/μL ≤), UA was significantly positively correlated with CAVI (standardized parameter estimate β = 0.23, p = 0.009), but not among participants with low circulating levels of CD34-positive cells (< 0.95 cells/μL) (β = 0.07, p = 0.445). Independent of established cardiovascular risk factors, UA levels were significantly positively correlated with increased arterial stiffness only among participants with aggressive endothelial repair as evaluated by circulating levels of CD34-positive cells. These results might help clarify some background mechanisms related to endothelial activity.

Oral health problems among Flemish and Dutch nursing home residents assessed by non-dental caregivers using the novel Oral Health Section for inclusion in interRAI

Abstract Background and Objectives Oral health of older adults in nursing homes is poor, which can negatively affect general health and well-being. Most oral health problems are preventable with good oral hygiene and regular dental check-ups. Caregivers can help improve residents’ oral health through regular oral health assessments. The interRAI instrument used in Long-Term Care Facilities (LTCF) to evaluate older adults’ health and well-being, has the potential to integrate oral care into general care planning. The recently optimized Oral Health Section for inclusion in the interRAI instruments (OHS-interRAI) enables non-dental caregivers to identify residents requiring help with oral hygiene and/or a dental referral. This study reports the first data obtained using the OHS-interRAI, describing the oral health situation of older adults in Flemish and Dutch nursing homes. Research Design and Methods In this cross-sectional study, interRAI LTCF data, including OHS-interRAI data, were collected from October 2020 to January 2023 and analyzed from 417 and 795 persons aged 65 years or older in Flemish and Dutch nursing homes, respectively. Results Most common oral health problems were poor oral hygiene and compromised teeth. Differences in oral health were found between Flemish and Dutch residents. Flemish residents had significantly more problems with chewing, dry mouth, oral and denture hygiene, and tongue condition than their Dutch counterparts. They also had a higher need for help with oral hygiene (19.4% vs. 14.0%) and a dental referral (36.8% vs. 20.9%). Older adults in Flemish nursing homes (20.3%) had significantly fewer dental check-ups than those in Dutch nursing homes (73.5%). Discussion and Implications The use of the OHS-interRAI by non-dental caregivers identified at least one-third of the residents requiring help with oral hygiene and/or a dental referral. By means of trigger algorithms (Collaborative Action Points), the OHS-interRAI enables the integration of oral care into general care planning.

Investigating the Relationship between the General Health of Mothers and their Maternal Performance following Vaginal Childbirth

Background Birthing parents need to use specialized skills as the first caregivers of the newborn. Several factors may affect maternal performance, the general health of the birthing parent (e.g., mother) being one of them. Yet, there is a paucity of research in this area, particularly in Iran, and evidence remains inconsistent. Consequently, this study aimed to determine any correlations between maternal performance and the general health of mothers following vaginal childbirth in the context of Iran. Methods This cross-sectional study was conducted with people identifying as mothers (n = 450) who had given birth (&lt; two months) and been referred for the vaccination of their newborn. The multi-stage sampling method was carried out from April 2022 to February 2023. Participants who met the inclusion criteria completed a demographic and obstetric information questionnaire, along with the Barkin maternal performance and general health questionnaire. To investigate the relationship between maternal performance and the general health of the mothers, an independent t-test analysis was conducted . The level of statistical significance was set at p &lt; 0.05. Results The mean age of participants was 26.78, and the mean total score of maternal performance was 91.04 (0 - 120). The highest and lowest scores related to the ‘maternal competence’ and the ‘maternal needs’ domains, respectively. Overall, 76.89% of participants had a favorable general health condition (a score of less than 3.5 is considered favorable). There was no statistically significant difference identified in terms of maternal performance scores between those with a favorable and those with an unfavorable general health status. Conclusion Although the results of the present study did not show a significant relationship between the general health of mothers and maternal performance, this research builds on a growing body of evidence in the context of Iran. Despite recording high maternal performance scores in this sample, it will be important to enhance and maintain good mental health in all childbearing people, particularly following vaginal childbirth, as it is this which will enhance care and outcomes overall.

Changes in Digestive Health, Satiety and Overall Well-Being after 14 Days of a Multi-Functional GI Primer Supplement

A recent review proposed a role for multi-functional food or supplement products in priming the gut to support both digestive and systemic health. Accordingly, we designed and eva-luated the effect of a multi-functional gastrointestinal (GI) primer supplement on participant-reported measures for digestive health, quality-of-life (e.g., energy/vitality and general health), and reasons for satiation (e.g., attitudes towards food and eating). In this single-arm clinical trial, 68 participants with mild digestive symptoms consumed the GI primer supplement daily for 14 days. Digestive symptoms were evaluated daily from baseline (Day 0) through Day 14. At baseline and Day 14, participants reported their stool consistency, reasons for satiation, and quality-of-life measures using validated questionnaires. At Day 14, participants reported significant improvements in all (13/13) digestive symptom parameters (p-values &lt; 0.05) and an increase in % of stools with normal consistencies. There were significant improvements (p-values &lt; 0.05) in energy/vitality and general health, and in specific attitudes towards food and eating (e.g., physical satisfaction, planned amount, decreased eating priority, decreased food appeal, and self-consciousness). Results suggest the GI primer supplement promotes digestive health, improves quality of life, and impacts attitudes towards food/eating. This study provides preliminary support for the gut priming hypothesis through which multi-functional digestive products may improve GI health.

Efficacy of Shugan Hewei formula combined with rabeprazole in refractory gastroesophageal reflux disease: randomized, double-blind, placebo-controlled trial

ObjectivesTo assess the efficacy of the Chinese herbal medication Shugan Hewei formula (SHF) combined with rabeprazole in patients with refractory gastroesophageal reflux disease (rGERD).MethodA total of 264 participants were randomly assigned to the treatment group (n = 132) receiving SHF granules (20 mg) combined with rabeprazole (10 mg) and the control group (n = 132) receiving placebo SHF granules (20 mg) combined with rabeprazole (20 mg). Both groups undergo 8 weeks of treatment and 2 weeks of follow-up.ResultsThe treatment group showed higher total clinical symptom efficacy and lower total symptom scores compared to the control group. The treatment group was superior to the control group in reducing rGERD major symptom scores, including heartburn, retrosternal pain, regurgitation and belching, and acid regurgitation. Additionally, treatment group (Z = 8.169, P < 0.001) and control group (Z = 9.800, P < 0.001) treatments were all significantly attenuated esophageal inflammation, demonstrating comparable efficacy. Patients with esophagitis grade A decreased from 40.34% to 17.23%, and those with grade B decreased from 11.76% to 3.78% in the treatment group. The results of the SF-36 scale showed that combination therapy was more effective in improving role limitations due to physical health, vitality, general health, total somato-physical health, and psychiatric mental health.ConclusionOur study reveals that the combined treatment of SHF with rabeprazole is more efficacious in managing patients with rGERD when contrasted with sole rabeprazole treatment.

Research on the Evaluation of an Age-Friendly Layout of Medical Service Facilities in Wuhan City Based on Accessibility

Accessibility is an important indicator for measuring the level of medical facility services in cities. Traditional studies on healthcare accessibility for the elderly have typically focused on the capabilities of emergency services while overlooking the daily independent healthcare needs of the elderly. Taking Wuhan City as an example, the Gaussian two-step floating catchment area method is used in this study to measure the accessibility of urban elderly residents with respect to general hospitals, specialized hospitals, and community health service centers. It also analyzes the appropriateness of the medical facility layout for the elderly in Wuhan City. The research findings indicate the following: (1) The accessibility evaluation method for urban medical facilities established with the Gaussian two-step floating catchment area model can accurately assess the supply–demand relationship between the elderly and various levels of medical facilities. (2) The overall coverage of medical service facilities in Wuhan City is relatively high, but there are significant differences in accessibility for elderly residents in different areas. (3) The appropriateness of daily healthcare access for elderly residents in the central urban areas of Wuhan City is mainly influenced by the layout of general hospitals, while, in the peripheral areas, it is mainly influenced by the layout of specialized hospitals and community health service centers. (4) Improving the appropriateness of urban medical facilities for elderly individuals requires differentiated improvement measures tailored to the characteristics of different zones.

National Addiction Workshop: A Virtual Adaptation to Support Competency Development in Opioid Use Disorder Management.

Accessible, manualized, skill-based training ready for wide dissemination is needed to prepare healthcare staff to meet the needs of people impacted by the opioid epidemic. A 2-day workshop and simulation training was designed by an interprofessional substance use disorder (SUD) specialty care team, adapted to a virtual platform, manualized, and offered to healthcare staff and trainees from a large healthcare system. The workshop was offered 6 times over the course of 10 months with a total of 177 participants from across the United States enrolled in the training. Interactive experiential learning strategies including games designed to test knowledge, small-group case discussions, video demonstrations of skills, patient panels, and 3 simulations of a patient with chronic pain who developed opioid use disorder in the context of long-term opioid therapy were utilized in efforts to build skills and confidence managing SUDs in primary care and general mental health settings. Of those who completed the post-workshop survey, most found both content and training structure useful, particularly content related to medication management, stigma, and collaborative care. In addition, overall confidence scores in assessing, diagnosing, and treating SUD increased. Skill building exercises, such as interprofessional team simulations, were highlighted as most beneficial. The workshop received national attention leading to a partnership with the healthcare system's simulation center for wider dissemination. Expanding access to SUD treatment requires training healthcare staff to effectively change attitudes, increase knowledge, and improve key skills. This 2-day interprofessional workshop was well-received by participants who reported high acceptability and satisfaction scores and demonstrated improved confidence in the management of SUDs. This type of manualized, collaborative, skill-based learning experience can foster staff preparedness and willingness to conceptualize SUD as a chronic condition amenable to treatment in different healthcare settings.

Personalized sleep and nutritional strategies to combat adverse effects of night shift work: a controlled intervention protocol

Abstract Background Working during the night interferes with the timing of normal daily activities and is associated with an increased risk of chronic diseases. Under controlled experimental conditions, interventions focusing on sleep and nutrition can mitigate the short-term adverse effects of shift work. However, it is unclear how these results translate to real-life, how they can be targeted to individual conditions, and how they relate to long-term health. Therefore, the current study aims to implement a personalized sleep and nutritional intervention among night shift workers in the field. Methods A non-blinded controlled intervention study is used, consisting of a run-in period, an intervention of 3 months, post-intervention measurements, and a follow-up after 12 months. Three study arms are included: sleep intervention, nutritional intervention, and control group (n = 25 each). Participants are healthy 18–60-year male night shift workers, with at least one year of experience in night shift work. Information from the run-in period will be used to personalize the interventions. The main outcomes are sleep measurements and continuous interstitial glucose levels. Furthermore, general health biomarkers and parameters will be determined to further evaluate effects on long-term health. Discussion This study aims to mitigate negative health consequences associated with night shift work by introducing two personalized preventive interventions. If proven effective, the personalized interventions may serve as practical solutions that can have a meaningful impact on the sustainable health and employability of night shift workers. This study will thereby contribute to the current need for high–quality data on preventative strategies for night shift work in a real-life context. Trial registration This trial has been registered under ClinicalTrials.gov Identifier NCT06147089. Registered 27 November 2023.

Grief on pain and quality of life in combat veterans with PTSD

ABSTRACT Background: Persistent Complex Bereavement Disorder (PCBD) comprises a set of grief symptoms that are often linked to other psychological conditions such as PTSD and depression, may be prevalent in Veterans with combat experience, and may also impact general health. Objective: This study investigated the association between grief and sleep, pain, PTSD, and depression, among Veterans participating in a clinical trial for PCBD treatment. Method: Data from 155 Veterans receiving treatments for PCBD were analysed to explore the association between PCBD and symptoms of sleep pain, PTSD, and depression. Veterans experiencing grief reported symptoms related to physical health, emotional problems, energy, and fatigue, emotional well-being, social functioning, presence of pain, and general health. PCBD appeared to have a specific association with pain and physical functioning, independent of other variables. Conclusions: This study examined the potential independent association of PCBD on physical and mental health in Veterans with PTSD. PCBD appeared to have a very specific and significant association with pain and physical functioning. In other words, the pain of grief was related to ratings of physical pain. Future research on PCBD should address the potentially bidirectional association with bodily pain, particularly chronic pain, in relation to loss, with specific attention to potential mechanisms underlying this relationship.

Cannabis Uses in Dentistry: A Bibliometric Analysis.

Background: This bibliometric review seeks to understand metrics of papers, authors, journals, and universities, about the benefits of the therapeutic application of Cannabis sativa (CS), as well as the most harmful effects associated to its use. Methods: The main search strategy applied to the topic was conducted in Web Of Science Core Collection on February 2024. A crossmatch of the number of citations was performed in Scopus and Google Scholar. The analyses were carried out in VOSviewer and Altmetric for PubMed and Google Scholar. Results: Of a total of 196 records, 53 articles were included for analysis. There were 25 publications on either therapeutic or harmful effects. In the ranking of subjects, those of greatest interest were general oral health and periodontics, with 53% of the total. The most cited paper was authored by Thomson et al. (2008) with 85 citations, allowing the University of Otago to be the most cited. Although JAMA was the most cited journal, in the dental field this corresponded to the Journal of Clinical Periodontology. In relation to the distribution by country, the United States received the largest number of citations and New Zealand second. Related to dentistry, in the cluster analysis, keywords more occurrent were "periodontal disease" and "periodontitis". Conclusions: In the past 4 years, there has been a superlative growth in CS papers related to oral health effects. This growth follows the social and political events related to CS legalization in some countries and reveals that the use of CS in dentistry is an emerging research field.

Probiotics as a potential tool for gynecological cancers prevention and therapy suport

The human body is host to a variety of microbial species that are essential for maintaining general health. About nine percent of these microbial species inhabit the urogenital tract. It is therefore important to establish a symbiotic relationship between the host’s immune system and the microbiota in this region. Disruptions of this symbiosis can contribute to the development of pelvic inflammatory disease (PID), bacterial vaginosis (BV), vaginal candidiasis and/or even gynaecological cancers by promoting the proliferation of infectious agents. The chemotherapeutic agents currently used in cancer treatment are associated with undesirable side effects. Therefore, there is an urgent need for antitumor agents that have minimal toxicity compared to conventional treatments. Furthermore, the use of drugs to prevent or alleviate the side effects of cervical cancer treatment could significantly improve the quality of life of patients undergoing such therapy. In this review, we focus our attention on the potential efficacy of probiotics in both the prevention and therapeutic intervention of neoplasms affecting the genital tract.

Mobile Patient-Provider Communication and Lifestyle Improvement: Examining the Role of Mobile Technology Identity and Health Empowerment

ABSTRACT In the span of a decade, smartphones have gained popularity and acceptance among both patients and physicians thanks to their advantages in health care delivery. However, research investigating mobile patient-provider communication (MPPC) and its impact on patients’ lifestyles is only just beginning. Drawing on the pathway model of health communication and mobile technology (MTI) theory, we developed a research model to explore the effect of MPPC on lifestyle improvement, using health empowerment as a mediator and MTI as a moderator. The findings from 432 participants (Mage = 32.5 years old, female = 212) suggested that after controlling for respondents’ age, gender, education, income, and general health status, having greater communication with healthcare providers through mobile devices was positively related to lifestyle improvement and that health empowerment mediated this relationship. Moreover, MTI-emotional energy (MTIE) moderated the direct relationship between MPPC and lifestyle improvement, while MTI-dependency (MTID) moderated the indirect impact of MPPC. Individuals who hold a greater MTIE/MTID were more likely to benefit from MPPC such that they are more likely to be empowered for self-care and maintain healthy lifestyles. This study not only contributes to the growing literature on mobile health communication but also plays a reference role for interventions in patient empowerment and health promotion. Theoretical and practical implications were discussed.

Dietary Habits, Physical Activity and Body Mass Index in Transgender and Gender Diverse Adults in Italy: A Voluntary Sampling Observational Study

Transgender and gender-diverse (TGD) individuals continue to experience harassment and discrimination across various aspects of life, significantly impacting their physical and mental health. The scarcity of data on their general health, particularly regarding dietary habits, remains a challenge in developing effective healthcare strategies for this population. To address this gap, we analyzed selected dietary habits, physical activity (PA), and body mass index (BMI) among Italian TGD adults compared to the Italian general population (IGP). An online anonymous survey was conducted via the Computer Assisted Web Interviewing technique from June 2020 to June 2021. Participants were enrolled through clinical centers and TGD organizations. Data from 959 TGD adults were analyzed using chi-squared tests and logistic regression models. Key findings indicated that approximately 70% of TGD individuals consumed fewer servings of fruit and vegetables (FV) than recommended (five or more servings per day). Although red meat consumption was lower overall, a greater percentage of TGD individuals reported consuming more than three servings per week. Additionally, 58% of TGD participants indicated that they did not engage in any PA, compared to 36% of the IGP. Notably, significant differences in BMI were identified, with higher rates of overweight and obesity among TGD individuals assigned female at birth. These results underscore the urgent need for tailored nutritional guidelines and inclusive public health strategies to meet the specific health needs of the Italian TGD population. Expanding access to targeted interventions could contribute to improving overall well-being in this marginalized group.

Self-Reported Health and Associated Factors among Nepalese Older Adults

Background: Self-reported health (SRH) is a subjective measurement tool for overall health status that integrates biological, social, mental, and functional aspects of individuals. Objectives: The purpose of this article is to assess the SRH and its correlates among community-living older adults. Methods: This study is a secondary analysis of structured interview data collected by the Central Department of Population Studies at Tribhuvan University (TU) via a cross-sectional survey of community-dwelling persons aged 60+ in the Pharping area of Kathmandu. For this study, there were 1320 valid responses. A simple and direct question was used “In general, how do you rate your general health?” Its answer was recorded on the 5-point Likert scale ranging from “Very Good to Very Bad”. Results: The mean age of the participants was 69.92 years. Of the participants, 19.2% reported poor SRH. Results show mental health problems, total number of children still alive, age of respondent, literacy status, physical health problem now, satisfaction with current living arrangements, walking efficiency, adequate income sources, marital status and currently working were correlated with SRH. However, linear regression shows that significant factors of SRH are walking efficiency (β= 0.324, 95% CI= 0.240 to 0.323), physical health problems (β = -0.258, 95% CI= -0.493 to -0.346), currently working (β: 0.197, 95% CI=0.223 to 0.373), having enough income to meet basic needs (β: 0.065, 95% CI= -0.136 to -0.021) and satisfied with living arrangements (β= 0.065, 95% CI= 0.018 to 0.116). Conclusion: Nepal is aging rapidly, and the proportion of older people will increase in the coming days. Walking efficiency, physical health, currently working and having sufficient income are important factors related to SRH. Identifying these determinants through self-rated status can support the planning of actions aimed at improving the health of the community living older adults.

Health risk assessment of heavy metals in Malay herbal medicine (MHM) consumed by pregnant and postpartum mothers

BackgroundMalay herbal medicine (MHM) is a popular medication and supplementation among Malaysian mothers during pregnancy and postpartum. It is expected to improve the baby’s health, increase breastmilk production, promote slimming and uterine involution, and improve the mother’s general health. Recent increases in reports of heavy metal contamination have raised safety concerns.ObjectiveThis pilot exploratory study employed a comparative cross-sectional design to investigate the types of MHM ingested during pregnancy and postpartum, their possible heavy metal contamination and associated health risks.MethodThis study involved 167 healthy postpartum Malay women.FindingsMHM consumption was significantly associated with the mother’s number of pregnancies and children (p < 0.05) as well as her pre-pregnancy weight (p < 0.05). Mothers who consume MHM were twice as likely (95% CI 1.077–3.963) to experience threatened abortion. Heavy metals were detected in the three most widely consumed MHM samples. The mean concentration of heavy metals in these samples were 47.44 ± 67.74 μg/kg for As, 25.34 ± 2.48 μg/kg for Cd, 3685.87 ± 5683.36 μg/kg for Cr and 194.33 ± 195.19 μg/kg for Pb. The calculated non-carcinogenic hazard health risks (HQ) and health index (HI) were less than one, suggesting no adverse health impacts under the exposure conditions studied.ConclusionWhile the HQ and HI values indicate no immediate health risks, the potential transfer from mother to foetus during pregnancy and from mother to infant during breastfeeding warrants further investigation. Additional studies are essential to confirm our findings and monitor the health of mothers and infants.

Quality of life of women with a screen-detected versus clinically detected breast cancer in the Netherlands: a prospective cohort study.

Breast cancer (BC) screening enables early detection of BC, which may lead to improved quality of life (QoL). We aim to compare QoL between women with a screen-detected and clinically detected BC in the Netherlands. We used data from the 'Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaluation' (UMBRELLA) between October 2013 and March 2022. Patients were categorized as screen-detected or clinically detected. We analysed three questionnaires, namely EORTC QLQ C-30, BR23, and HADS (Hospital Anxiety and Depression Scale) completed by BC patients shortly after diagnosis (T1) and one-year after treatment (T2). Independent t-tests were performed to compare QoL average differences between the two groups. Bonferroni-corrected p-value significance threshold of 0.00057 was used. The magnitude of differences was calculated using Cohen's d. The clinical relevance of QLQ-C30 differences was assessed based on interpretation guideline of EORTC-QLQ-C30 results. After applying inclusion and exclusion criteria, there were 691 women with screen-detected BC and 480 with clinically detected BC. Generally, screen-detected BC patients reported a better QoL. At T1, their average QLQ-C30 summary score was higher (86.1) than clinically detected BC patients (83.0) (p < 0.0001). Cohen's d for all items ranged between 0.00 and 0.39. A few QLQ-C30 score differences were clinically relevant, indicating better outcomes in emotional functioning, general health, constipation, and fatigue for women with screen-detected BC. In the Netherlands, women with screen-detected BC reported statistically significant and better QoL than women with clinically detected BC. However, clinical relevance of the differences is limited.

Technology for advancing behavioral health integration: implications for behavioral health practice and policy.

Behavioral health integration (BHI) encompasses the integration of general health, mental health, and substance use care. BHI has promise for healthcare improvement, yet several challenges limit its uptake and successful implementation. Translational Behavioral Medicine published the Continuum-Based Framework by Goldman et al., 2020 to create comprehensive guidance for BHI within primary care settings. Technology can help advance BHI and provide evidence to support it. This commentary describes challenges and illustrative use cases in which technology solutions help organizations achieve BHI through the Continuum-Based Framework domains. Two rounds of semi-structured interviews with field leaders, practice sites, and technology stakeholders identified key barriers in BHI amenable to technology solutions, applications of technologies, and how they facilitate BHI. Findings showed that technology can facilitate the implementation and scaling of BHI by reducing care fragmentation and improving patient engagement, accountability and financial sustainability, provider experience and support, and equitable access to culturally competent care. Continued efforts by stakeholders to address legacy policy and implementation issues (e.g. incentives, investment, privacy, and workforce) are needed to optimize the impact of technology on BHI.

Spectrophotometric Determination of Biopolymers in Alabama Benchmark Soils

Biopolymers are organic polymers synthesized by biological organisms. Cellulose, lignin, and proteins are important soil biopolymers known to bind soil particles to improve or strengthen soil structures and support agricultural productivity. In this study, we spectrophotometrically determined the amount of soil cellulose, acetyl bromide lignin, and autoclaved citrate extractable protein in soils in relation to other soil properties. Results showed acetyl bromide lignin &gt; cellulose &gt; autoclaved citrate extractable protein. High clay soils have relatively higher amounts of cellulose and lignin but have lower protein content. The coefficient of variation (CV) of the three biopolymers in the soils studied was autoclaved citrate extractable protein (56.8%), &gt;cellulose (55.2%), &gt;acetyl bromide lignin (44.7%). Pearson correlation analysis showed that soil cellulose was significantly related to cation exchange capacity (CEC), total nitrogen, soil organic matter, and available phosphorus. An increase in soil acetyl bromide lignin suggested an increase in soil organic matter and lower soil available phosphorus. Soil autoclaved citrate extractable protein was significantly correlated with extractable acidity. However, cellulose, acetyl bromide lignin, and autoclaved citrate extractable protein were not significantly correlated with permanganate oxidizable carbon (POxC), electrical conductivity (EC), and C:N ratio. We assume that the concentrations of biopolymers in soils are an intrinsic soil characteristic and contribute to general soil health and productivity.