Personal Health Research Articles

Network analysis of meaning in life, perceived social support, and depressive symptoms among vocational undergraduate students

BackgroundDepression poses a considerable personal and public health problem, particularly in the post-epidemic era. The present study aimed to investigate the association between meaning in life (MIL) and perceived social support (PSS) with depressive symptoms among vocational undergraduate students, employing a network analysis approach to gain a deeper understanding of the underlying pathways and to prevent the progression of depressive symptoms into disorders.MethodsA total of 1367 Chinese vocational undergraduates (Mage = 20.1, SD = 1.6; 44.7% female) were recruited and were asked to complete a series of questionnaires, including the meaning in life questionnaire, perceived social support scale, and patient health questionnaire. The regularized partial correlation network was estimated. The partial correlations between nodes were calculated as edges. Moreover, network comparison tests were conducted to compare three subnetworks based on different levels of depression (minimal, subthreshold, and moderate/severe).ResultsThe top strength nodes within each network were identified as sleep and motor in minimal group, anhedonia and concentration in subthreshold group, and anhedonia and sleep in moderate/severe group. Additionally, the bridge strength nodes were determined as MIL-3, MIL-4, sleep, guilt, and school in minimal group; MIL-4, anhedonia, suicide, and friend in subthreshold group; MIL-9, MIL-7, anhedonia, sleep, and family in moderate/severe group. Furthermore, network comparison tests showed significant differences in centrality (all p < 0.05), while network invariance remained constant across groups. Notably, the accuracy and stability coefficients for all network structures were greater than 0.5, indicating stable and reliable results.ConclusionThese findings elucidate specific pathways and potential central nodes for interactions of MIL or PSS with depressive symptoms at different levels of depression, providing valuable insights for targeted prevention and intervention strategies.

Key Determinants of Tuberculosis Prevention Behaviors Among Families in Indonesia: A Cross-Sectional Study Analysis

Introduction: Tuberculosis (TB) is one of the infectious diseases that is still a global health problem, including in Indonesia. TB prevention requires the active role of the family as the smallest unit of society to create a supportive environment. Studies of TB prevention behaviors in families are important to understand the factors influencing prevention success. Objective: This study analyzes factors related to TB prevention behavior in families. Methods: This study used a cross-sectional study design involving 129 families with family members with a history of TB in the Batunadua Health Center working area in Padangsidimpuan City, selected by purposive sampling. Data was collected through a structured questionnaire. Data analysis was conducted using the chi-square and logistic regression tests to see the relationship between the variables and the most meaningful variables. Results: This study found that knowledge about TB (p=0.001), access to health services (p=0.001), social and cultural environment (p=0.001), and personal health experiences (p=0.001) were related to TB prevention behavior in families. Meanwhile, the variable most related to TB prevention behavior is knowledge about TB Exp (B) = 46.888. Conclusion: This study concludes that TB prevention behavior in families is influenced by factors such as knowledge about TB, access to health services, social and cultural environment, and personal health experience, which have a significant relationship. Of the four variables, knowledge about TB is the most dominant factor influencing TB prevention behavior. Therefore, health education campaigns must be a priority, focusing on increasing family knowledge about TB through easily accessible media, such as counseling, social media, and pamphlets.

Using dataflow diagrams to support research informed consent data management communications: participant perspectives.

Digital health research involves collecting vast amounts of personal health data, making data management practices complex and challenging to convey during informed consent. We conducted eight semi-structured focus groups to explore whether dataflow diagrams (DFD) can complement informed consent and improve participants' understanding of data management and associated risks (N = 34 participants). Our analysis found that DFDs could supplement text-based information about data management and sharing practices, such as by helping raise new questions that prompt conversation between prospective participants and members of a research team. Participants in the study emphasized the need for clear, simple, and accessible diagrams that are participant centered. Third-party access to data and sharing of sensitive health data were identified as high-risk areas requiring thorough explanation. Participants generally agreed that the design process should be led by the research team, but it should incorporate many diverse perspectives to ensure the diagram was meaningful to potential participants who are likely unfamiliar with data management. Nearly all participants rejected the idea that artificial intelligence could identify risks during the design process, but most were comfortable with it being used as a tool to format and simplify the diagram. In short, DFDs may complement standard text-based informed consent documents, but they are not a replacement. Prospective research participants value diverse ways of learning about study risks and benefits. Our study highlights the value of incorporating information visualizations, such as DFDs, into the informed consent procedures to participate in research. Future research should explore other ways of visualizing consent information in ways that help people to overcome digital and data literacy barriers to participating in research. However, creating a DFD requires significant time and effort from research teams. To alleviate these costs, research sponsors can support the creation of shared infrastructure, communities of practice, and incentivize researchers to develop better consent procedures.

Rehumanizing Pedagogy: Is Slowing Down the Answer?

ABSTRACTMany universities began prioritizing efficiency over efficacy in the 1990s, contributing to educator and student exhaustion. Meanwhile, vocational awe paradigms have led faculty to sacrifice personal time and health to satisfy students. The Slow Academia movement offers a different approach. Bypassing quantifiable outcomes and metrics, it advocates slowing down teaching and learning activities to sustainable paces. Contemplative practices, self‐care, and trauma‐informed pedagogies are crucial components. This chapter imagines opportunities for a slowed‐down, rehumanized version of learning, teaching and sharing and provides recommendations for experimenting with format and content.

Flexible Optical Fiber Sensor for Non-Invasive Continuous Monitoring of Human Physiological Signals.

With increasing health awareness, monitoring human physiological signals for health status and disease prevention has become crucial. Non-invasive flexible wearable devices address issues like invasiveness, inconvenience, size, and continuous monitoring challenges in traditional devices. Among flexible sensors, optical fiber sensors (OFSs) stand out due to their excellent biocompatibility, anti-electromagnetic interference capabilities, and ability to monitor multiple signals simultaneously. This paper reviews the application of flexible optical fiber sensing technology (OFST) in monitoring human lung function, cardiovascular function, body parameters, motor function, and various physiological signals. It emphasizes the importance of continuous monitoring in personal health management, clinical settings, sports training, and emergency response. The review discusses challenges in OFST for continuous health signal monitoring and envisions its significant potential for future development. This technology underscores the importance of constant health signal monitoring and highlights the advantages and prospects of optical fiber sensing. Innovations in OFS for non-invasive continuous monitoring of physiological signals hold profound implications for materials science, sensing technology, andbiomedicine.

Abstract TP124: Perception of health status in stroke patients through Patient-Reported Outcome Measures depending on who collects them

Value-based medicine places the patient and their health status at the center of the intervention through the use of Patient-Reported Outcome Measures (PROMs). The ideal would be that these outcome measurements were answered directly by the patient but in many cases it is a caregiver or a healthcare professional who collects the person's health status perception. This reason could lead to a bias in the results. Our aim was to compare whether there were differences in the perception of health status depending on who answered these questionnaires. Stroke patients discharged from six European hospitals were included in a 1-year follow-up program based on a holistic communication tool (web platform for professionals and app for patients/caregivers) called NORA. PROMs at 7-90 days were collected through NORA-app. In case that the patient or caregiver didn't have access to a smartphone, the data collection was carried out by a professional healthcare who contacted them to manage PROMs by a phone call. Main outcome measures include: HAD-depression and HAD-anxiety (defined as pathological by a score ≥10 points in each of the subscales) and PROMIS-10 (cut-offs raws values of normality were defined as: Physical-PROMIS>13 and Mental-PROMIS>11). Median scores per collector were compared. In addition, a social questionnaire was collected from app-users'. Over two years, 5116 stroke patients were included in Harmonics project, 60% were men with a mean age of 70.2 years and median mRS of 2(1- 3) at hospital discharge. From them, 2432 were actively monitored and 1498 reported PROMs (428 patients (28.6%), 376 (25.1%) caregivers and 694 (46.3%) professionals). P-value < 0.05 was considered significant for all tests at 90 days. Median PROMs results are shown in Table-1. The social questionnaire (Figure-1) showed significant differences between male and female patients. From the total, 26.6% women and 11.7% men leave alone (p-value = 0.005). At the patients group 77.9% women considered they can take care of their basic needs’ vs 85.9% men (p-value= 0.036). Significant differences were found between the three groups of collectors, with professionals being the ones who perceive a better state of patient health through the collected PROMs collected. Among patients and caregivers groups, worse outcomes were reported by the last one. When using PROMs the collector should avoid bias in reporting the results and direct patient response should be encouraged.

Entangled Illnesses: Embodied Experiences of Managing Multimorbidity.

Multimorbidity, meaning multiple long-term conditions impacting a person's health, has become a rising societal and public health issue. The article contributes to the sociological study of chronic illness and multimorbidity by analysing how the blurriness of illnesses and entanglement of symptoms in multimorbidity is experienced and negotiated by people with coexisting chronic conditions. Drawing on qualitative interviews with people who live with endometriosis, fibromyalgia or hormonal migraine in Finland, we show how people with multiple chronic conditions distinguish between evolving symptoms based on past embodied experiences to make decisions about how to best manage their health. We argue that coexisting illnesses become entangled in ambiguous and open-ended ways, which, if left unaddressed, complicates treatment. Our analysis of illness experiences is aligned with the growing body of literature that argues that the single-disease model underlying healthcare systems fails to address the needs of patients living with multiple chronic conditions. Our emphasis on evolving entanglements between illnesses and the blurriness of conditions makes visible crucial discrepancies between lived illness and existing biomedical models and healthcare structures.

Additive Value of Polygenic Risk Score to Family History for Type 2 Diabetes Prediction: Results From the All of Us Research Database.

The goal of this study was to assess the additive value of considering type 2 diabetes (T2D) polygenic risk score (PRS) in addition to family history for T2D prediction. Data were obtained from the All of Us (AoU) research database. First-degree T2D family history was self-reported on the personal family history health questionnaire. A PRS was constructed from 1,289 variants identified from a large multiancestry genome-wide association study meta-analysis for T2D. Logistic regression models were run to generate odds ratios (ORs) and 95% CIs for T2D. All models were adjusted for age, sex, and BMI. A total of 109,958 AoU research participants were included in the analysis. The odds of T2D increased with 1 SD PRS (OR 1.75; 95% CI 1.71-1.79) and positive T2D family history (OR 2.32; 95% CI 2.20-2.43). In the joint model, both 1 SD PRS (OR 1.69; 95% CI 1.65-1.72) and family history (OR 2.06; 95% CI 1.98-2.15) were significantly associated with T2D, although the ORs were slightly attenuated. Predictive models that included both the PRS and family history (area under the curve [AUC] 0.794) performed better than models including only family history (AUC 0.763) or the PRS (AUC 0.785). In predicting T2D, inclusion of a T2D PRS in addition to family history of T2D (first-degree relatives) added statistical value. Further study is needed to determine whether consideration of both family history and a PRS would be useful for clinical T2D prediction.

Juggle Between Work, Home, and Stress; A Qualitative Analysis Using Nvivo-12 on Working Women During the COVID-19 Pandemic

Background: India and other parts of the world have witnessed a health emergency due to COVID-19 that immensely affected the globe. These infectious diseases changed the lives of people, and the condition of working women worsened due to the responsibility of work, home, children, family, house, etc., altogether simultaneously. In a patriarchal society like India, where women are considered as ‘nurturing sex’ where domestic chores and care giving responsibilities are shouldered on women, the juggle between work and home elevated the work demand and heightened the level of stress. Based on the background discussed above, this research is an attempt to address the condition of working women the juggling between work and home elevated stress, work pressure amid COVID-19. Introduction: The world has been struggling with the greatest health crisis for the last two and a half years, affecting everyone’s life, especially working women. The condition of working women has worsened by bearing the heap of responsibilities of work, home, children, family, house, etc., which undoubtedly results in stress, frustration, and anger affecting women’s physical and mental health. This paper is to study the condition of working women who are juggling between work and home amid this COVID-19 pandemic. Methods: For conducting the comprehensive study, a questionnaire was designed, which consisted of 14 questions excluding the demographic information, namely Name, Age, Gender, Profession, Experience, etc. Questionnaires were floated to 60 working women under different job profiles. Convenience Sampling was used to collect the data. Out of a sample of 60, 50 women recorded their responses via Google Sheets, and 38 questionnaires were finally used for analysis. The authors have utilized qualitative data analysis techniques to address the issue with the help of computer-assisted qualitative data analysis software NVIVO. For analyzing the qualitative data, NVIVO 12 was used by applying three tools Word Cloud Analysis, thematic analysis, and sentiments analysis. Results: The findings of the study show that working women are facing continuous challenges and are under stress due to multiple roles, responsibilities, and work demands since the onset of COVID-19. It is supported by Word Cloud Analysis, thematic analysis, and sentiment analysis. Conclusion: The outbreak of this COVID-19 pandemic, and its exceptional impact on lives, has generated an array of challenges in everyone’s life, but it shattered the lives of working women. The objective of this research is to unearth the stress in working women’s life amid COVID-19 due to the juggling between personal and professional life simultaneously. Results show that amid COVID-19, working women are under stress due to familial responsibility, household chores, work demands, caregiving, etc., all simultaneously without any breather. This societal stereotype lays high pressure and exceptions on working women leading to stress affecting the personal well-being and health of the woman.

Motivators and Barriers to Seeking Metabolic and Bariatric Surgery Among Adolescents: A Qualitative Study.

The prevalence of severe obesity among adolescents has increased the use of metabolic and bariatric surgery (MBS) as a therapeutic option. Understanding factors influencing adolescent MBS choice and the support needed to undergo MBS is crucial for improving health outcomes. This study examines the motivations and support needs of a diverse sample of adolescents seeking MBS via the patient voice. Adolescents (n=14) at a weight loss surgery clinic in a large academic healthcare system participated in qualitative interviews. Of the participants, 10 were female, 6 were non-Hispanic Black, 3 were non-Hispanic White, and 5 were Hispanic. Interviews were recorded, transcribed, and thematically analyzed. Three themes emerged: Intrinsic motivators, extrinsic motivators, and barriers. Intrinsic motivators include personal physical and mental health goals. Extrinsic motivators involved family and medical team support, which provided encouragement, validation, and perceived confidence for lifestyle changes. Additionally, observing family members who previously completed MBS was a significant extrinsic motivator. Concerns included fear of dying/complications from MBS, and possible weight regain post-MBS. Adolescent MBS programs should enhance intrinsic motivation for behavior changes. Findings highlight opportunities for bolstering support pre- and post-MBS and addressing MBS-related anxieties related to long-term weight management.

Exploring the Use of Psychedelic Drugs for Personal Growth and Mental Health Improvement: Early Qualitative Lessons From Focus Groups

Exploring the Use of Psychedelic Drugs for Personal Growth and Mental Health Improvement: Early Qualitative Lessons From Focus Groups

High-efficiency respiratory protection and intelligent monitoring by nanopatterning of electroactive poly(lactic acid) nanofibers.

The advent of multifunctional nanofibrous membranes (NFMs) has led to the development of next-generation air filters that are ready to intercept fine particulate matters (PMs) and monitor the respiratory diseases. However, it is still challenging to fabricate biodegradable NFMs featuring the desirable combination of high filtration efficiencies, low air resistance, and intelligent real-time monitoring. Herein, a hierarchical nanopatterning approach was proposed to functionalize the stereocomplexed poly(lactic acid) (PLA) (SC-PLA) nanofibers via the combined electrospinning of SC-PLA and electrospray of CNT@ZIF-8 nanohybrids. The nanopatterned SC-PLA (NSC-PLA) NFMs were characterized by largely increased surface activity and electroactivity, as evidenced by the nearly two-fold increase in surface potential (up to 7.3kV) and substantial improvements in the dielectric properties. Furthermore, the NSC-PLA NFMs exhibited excellent tribo-output performance, yielding a voltage of as high as 13.5V for NSC-PLA NFMs loaded 10% nanohybrids (NSC-PLA10). In particular, the exceptionally high electroactivity and unique protrusion structure together contributed to promote the filtration efficiencies, while providing a low pressure drop (e.g., 96.1% for PM2.5 and 88.3% for PM0.3, only 67.6Pa of NSC-PLA10, at 32L/min). More importantly, NSC-PLA NFMs enabled real-time monitoring of physiological signals during different respiratory states, as evidenced by the output voltages of 17.2, 32.9 and 37.5mV for normal breath, fast breath and cough recorded by NSC-PLA10. The proposed NSC-PLA NFMs show enormous potential in the fields of air filtration and real-time respiratory monitoring, thus providing ecofriendly solutions to personal health management.

A systematic review of the effect of personal health records on patient activation.

Personal health records (PHRs) or patient portals have been on the healthcare policy agenda for many countries as a promising mechanism to support patient-centred healthcare by making medical records accessible to patients and those assisting patients in health self-management. Studies on clinical outcome have been inconsistent. To help us to understand why, we propose to look at measures that precede clinical outcome, specifically patient engagement and activation. Patient activation describes the knowledge, skills and confidence a person has in managing their own health and healthcare. To systematically review the current evidence on the impact of PHRs on patient activation. A literature search was conducted for randomised controlled trials and quasi-experimental studies published up to January 2024 across EMBASE, PsycINFO, CINAHL and PubMed. Publications were included in the study if they examined any association between PHR use and activation. The search initially produced 3062 papers for review, of which 88 full-text articles were screened for eligibility. Two reviewers assessed 22 of these articles, and 8 papers were identified as meeting the selection criteria. Among these, seven studies found no statistically significant differences in activation. However, one study reported a significantly greater effect than the others. Data from seven randomised controlled trials and quasi-experimental studies examining the effects of PHRs on patient activation and similar measures were extracted for meta-analysis. Overall, the use of PHRs was associated with a 0.41 standardised mean difference increase in activation (95% confidence interval 0.31-0.51). There was a high degree of heterogeneity (I² = 98%), with one study showing a much larger effect size compared to the rest. Most studies showed little impact on activation, but one study found a large effect. This study notably offered PHRs combined with health coaching and training in the use of the system to their intervention group, which may indicate an important requirement for how to get the best out of a PHR system.

Randomized controlled trials of digital health interventions for rheumatic disease management: a systematic review.

To evaluate the adoption, effectiveness and cost-effectiveness of digital health interventions for rheumatic disease management. Between 25 May 2024 and 2 June 2024, we systematically searched PubMed®, Scopus, ClinicalTrials.gov, the Global Observatory for eHealth and the World Bank Open Knowledge Repository for randomized controlled trials (RCTs) evaluating digital health interventions for rheumatic disease management. We included studies published between 2000 and 2024 that reported on adoption rates and efficacy. Two reviewers independently screened the studies, extracted data and categorized the digital interventions according to the World Health Organization's classification of digital health interventions. Of the 455 unique records identified, 21 RCTs met the inclusion criteria. Most digital health interventions (15 studies) focused on individual-centric interventions, such as targeted communication, personal health tracking, educational tools and wearable devices. Studies in high-income countries implemented advanced, integrated digital interventions combining individual-focused approaches with health worker interventions and data services using telemedicine platforms and decision support systems. In contrast, studies in low- and middle-income countries adapted accessible technologies such as mobile messaging and telephone-based education. Many telehealth, wearable technologies and educational interventions significantly improved disease control, patient adherence, knowledge and self-efficacy. Of the five studies assessing cost-effectiveness, all found digital interventions to be cost-effective. Digital health interventions show promise for managing rheumatic diseases. Tailoring these interventions to local infrastructure and emphasizing patient engagement are crucial for successful adoption. Future research should focus on standardizing evaluation methods, addressing digital divides and enhancing provider support and data services.

Fabrication of microplastic-free biomass-based Masks: Enhanced Multi-functionality with All-natural fibers

With the coronavirus-2019 epidemic, disposable surgical masks have become a common personal protective necessity. However, off-the-shelf masks have low filtration efficiency and short service life and can only physically isolate pathogens, easily leading to secondary infection and cross-infection between users. Additionally, they produce debris and microplastics, which can be inhaled by the human body and cause serious diseases. To address this, this study introduced a brand-new, microplastic-free, long-life, biodegradable, self-disinfecting, and gas-sensitive mask made of basal dialdehyde-chitosan crosslinked animal-collagen/plant composite fibers (CP-Mask) with an asymmetric bilayer structure using scalable paper-processing technology. The CP-Mask demonstrated outstanding filtration performance (95.9%) for particulate matter with various sizes and constantly maintained filtration efficiency even after 20 friction cycles. The CP-Mask also exhibited stable and lasting antibacterial properties, with significant inhibition rates of 99.21% for Staphylococcus aureus and 98.86% for Escherichia coli and could effectively filter bacterial aerosols. In addition, CP-Mask realized the real-time detection of respiratory ammonia concentration and timely identified the ammonia level. The average response value was 68.26%, and the average response time was 159.3 s, presenting good circulatory stability and is suitable for early diagnosis of ammonia-related diseases. Breakthrough, the origin of natural ingredients, fundamentally makes CP-Mask less likely to emit microplastics than commercially available masks and endows it with complete biodegradability in soil within three months, eliminating the risk of microplastic inhalation from the source. The proposed CP-Mask provides a new idea to facilitate personal health monitoring and portability of medical protection equipment regarding biocompatibility, biodegradability, self-disinfection, and ammonia sensing ability.

The moderating effect of recent positive and negative life events on the impact of early life stress on mental wellbeing and distress.

Early life stress (ELS) significantly influences mental health in later stages of life. Yet it is unclear whether recent life events lessen or intensify the effects of ELS on present wellbeing and distress. We addressed this question in 1064 healthy community adults with a normative range of wellbeing and distress. We tested whether recent daily life events (DLE), occurring in the 12 months prior to assessment, moderated the association between effects of past ELS on present wellbeing and distress. Principal components analysis was first used on both ELS and DLE to determine the event types loading together on components. For wellbeing, we observed associations with the ELS component 'family conflict', and DLE components 'positive work changes', 'positive lifestyle changes', 'vacation', and 'negative work changes'. There was no evidence of these DLEs moderating the relationship between ELS and wellbeing. For distress, we found associations with three ELS components, 'interpersonal violence', 'personal health trauma', and 'peer conflict', of which 'interpersonal violence' showed an interaction with two negative DLE components - 'relationship problems' and 'sexual/pregnancy difficulties'. These findings suggest that the pervasive impact of interpersonal violence (childhood physical, sexual, and emotional abuse) on psychological distress is further compounded by maladaptive relationships in adulthood, which lead to higher distress; however, for wellbeing, the effects of ELS and DLE are independent. Our findings indicate a complex pattern of associations between life events and mental health, and highlight the importance of examining both wellbeing and distress outcomes, which may vary depending on the associations between early and recent life events.

A wearable platform for biochemical sweat analysis using photonic crystal hydrogel.

Wearable systems for health monitoring are highly desired in personal diagnostics and precision medicine while challenges remain in constructing such wearable systems with reliability and high performance. Herein, we report a wearable platform for non-invasive monitoring biomarkers in sweat. The device is composed of a butterfly-shaped like microfluidic platform in which responsive photonic crystal hydrogels are embedded in each butterfly wing as sensors. Sweat lactate concentration and pH can be obtained via the color variation of the sensor with naked eyes. Accurate quantitative analysis of the two target analytes can be obtained via the image analysis on a mobile phone by integrating the linear range response to analytes within the physiological range. Moreover, the sensor exhibits good reproducibility, excellent selectivity and long-term stability. On-body trials have been conducted by attaching the device on volunteers' body, and the obtained results are consistent with those analyzed through standardized methods, demonstrating its potentiality in real-time and continuous monitoring sweat biomarkers. This non-invasive wearable sensor provides a new strategy for personal health monitoring and sports performance assessment.

Did the COVID-19 pandemic change the importance of health for life satisfaction? Evidence from France.

COVID-19 has brought health protection to the top of the political agenda in many countries, at the cost of reduced freedoms, social relationships, and economic opportunities. This context may have led individuals to pay more attention to their health and to attach greater importance to it in life satisfaction. This paper examines the possibility of an increase in the correlation between life and health satisfaction after the onset of the pandemic using repeated cross-sectional data in France between 2016 and 2021 and an original jittering strategy to smooth the ordinal variables of life and health satisfaction in regression models of subjective well-being. The estimates show an increased correlation between health and life satisfaction for women aged 50 and over, but no change for men. However, the increase in correlation observed for older women disappears by the second half of 2021. These results are robust to several sensitivity analyses and lead to the conclusion that the COVID-19 pandemic did not significantly and permanently change the importance of personal health for life satisfaction.

Trajectory changes and temporal priorities between depressive symptoms and social participation: A longitudinal study.

Depressive symptoms and social participation are important factors influencing the health of older persons. Further research is needed to understand the interaction between these two variables. The Center for Epidemiological Studies Depression Scale (CES-D) and the Social Participation Questionnaire were employed to assess depressive symptoms and social participation. A latent growth model (LGM) was used to investigate changes in the trajectories of variables. The parallel process latent growth model (PP-LGM) and autoregressive cross-lagged model (ARCL) determined whether correlations existed. Older persons' depressive symptoms worsened while their level of social participation decreased. The intercept of depressive symptoms was negatively correlated with the slope of social participation(r=-0.133, p = 0.011). The slope of depressive symptoms and social participation were positively correlated(r = 0.444, p < 0.001). Depressive symptoms at earlier time points predicted later social participation(β1=-0.025, p1=0.032, β2=-0.040, p2=0.001). There are dynamic changes and correlations between depressive symptoms and social participation in older persons.

The Effect of European Health Literacy-Based e-Pulse Education and e-Pulse Instructional Materials on Health Literacy Levels in Adults Aged 45-64: A Randomized Controlled Trial.

e-Pulse is an electronic personal health record system known as e-Nabız in Turkey. This study compares the effect of European Health Literacy-based e-Pulse education and e-Pulse instructional materials on the health literacy levels of adults aged 45-64 with inadequate and problematic-limited health literacy levels. This single-blind, randomized controlled trial was conducted from June 2023 to September 2023. It included 140 participants, assigned to either the intervention group (n = 70) or the active control group (n = 70). The intervention group received HLS-EU-based e-Pulse education, which consisted of two 45-min sessions over 6 weeks, along with the e-Pulse user guide and introduction video. The active control group only received the e-Pulse user guide and introduction video, and each participant was individually briefed on the e-Pulse system content for 5-10 min. Results were measured using the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and the eHealth Literacy Scale (eHEALS) at baseline and the sixth week. Both the intervention and active control groups showed an increase in health literacy and eHealth literacy scores, but the mean change was greater in the intervention group. A statistically significant difference was found in the effects of HLS-EU-based e-Pulse education and e-Pulse instructional materials on both health literacy (F (1, 137) = 25.215; p < 0.001) and eHealth literacy (F (1, 137) = 36.134; p < 0.001). HLS-EU-based e-Pulse education significantly improved health literacy (d = 0.8492; p < 0.001) and eHealth literacy (d = 1.0175; p < 0.001) compared to e-Pulse instructional materials. The intervention group demonstrated significantly higher rates of sufficient (32.9%) and excellent (12.9%) health literacy. Notably, a medium correlation (r = 0.602; p < 0.001) was observed between health literacy and eHealth literacy. Trial Registration: ClinicalTrials.gov (ID: NCT05831254) https://clinicaltrials.gov/study/NCT05831254.