Health Problems In Adults Research Articles

Perceptions of mental health and psychosocial problems among conflict-affected adults in North Bougainville: Results of a rapid qualitative assessment

The Bougainville Crisis (1988–1997) was characterized by widespread human rights violations, civilian deaths, and displacement. In March 2017, a rapid qualitative assessment was conducted to better understand the major mental health and psychosocial (MHPS) problems of conflict-affected adults living in North Bougainville in order to contribute to the design of feasible interventions to address these problems and inform the development of culturally appropriate assessment instruments. We conducted 54 free-list interviews to gather information on the problems of people in local communities, and further explored five priority MHPS problems through 38 key-informant interviews. The major MHPS problems that emerged and were subsequently explored included alcohol use, drug use, arguments and fights, physical violence against women, and rape. Frequently reported indicators of these problems included anger, aggression, sadness, shame, worry, trauma, neglect, and fear. Findings highlight the highly interconnected relationship between substance use and violence in North Bougainville, as well as the set of emotional and behavioral problems that both contribute to and result from this relationship. The primacy of both drug and alcohol use in this setting is particularly notable, as is the role of these substances as individual coping mechanisms and instigators of violence. Overall, findings suggest the need for integrated strategies toward addressing MHPS issues in North Bougainville, with violence and substance use incorporated as both causes and consequences of psychological distress.

Semantic Similarity of Common Verbal Expressions in Older Adults through a Pre-Trained Model

Health problems in older adults lead to situations where communication with peers, family and caregivers becomes challenging for seniors; therefore, it is necessary to use alternative methods to facilitate communication. In this context, Augmentative and Alternative Communication (AAC) methods are widely used to support this population segment. Moreover, with Artificial Intelligence (AI), and specifically, machine learning algorithms, AAC can be improved. Although there have been several studies in this field, it is interesting to analyze common phrases used by seniors, depending on their context (i.e., slang and everyday expressions typical of their age). This paper proposes a semantic analysis of the common phrases of older adults and their corresponding meanings through Natural Language Processing (NLP) techniques and a pre-trained language model using semantic textual similarity to represent the older adults’ phrases with their corresponding graphic images (pictograms). The results show good scores achieved in the semantic similarity between the phrases of the older adults and the definitions, so the relationship between the phrase and the pictogram has a high degree of probability.

EFFECTIVENESS OF TELEDELIVERED BEHAVIORAL ACTIVATION AND MINDFULNESS INTERVENTIONS IN REDUCING LONELINESS

Abstract Loneliness is one of the most prevalent mental health problems in older adults, especially among those who live alone and are digitally excluded. The phenomenon has become more conspicuous during the COVID-19 pandemic because of the constraints on physical contact and travel. In this three-armed randomized controlled trial, we examined the effectiveness of two telephone-delivered loneliness interventions (i.e., behavioral activation [Tele-BA], mindfulness [Tele-MF]) against a telephone-delivered active control group (i.e., befriending [Tele-BF]) in reducing loneliness, based on the behavioral theory of depression and monitor acceptance theory. We trained retirees as lay counselors to deliver the interventions to enhance the scalability and sustainability of the interventions. Older adults who lived alone and under the poverty line in Hong Kong, did not have Internet at home, and felt lonely were randomly assigned to one of the three groups (N = 1045, Mage = 76.59, SDage = 7.83, 78% female). Participants in each group received two 30-minute weekly intervention sessions for four weeks. They completed assessments at the baseline (T1), four weeks (T2) and six months (T3) following the intervention, respectively. Compared with their counterparts in the Tele-BF group, participants in the Tele-BA and Tele-MF groups reported lower levels of loneliness and perceived stress and higher levels of psychological well-being and perceived social support at T2 and T3. These findings provide scientific understandings on the effectiveness of Tele-BA and Tele-MF interventions for reducing loneliness among older adults in Hong Kong, and demonstrate the feasibility of conducting lay counselor-delivered telephone-based interventions for older adults.

HEAVY DRINKING, MENTAL HEALTH PROBLEMS AND RECOVERY IN OLDER ADULTS: EXPLORING SUPPORT NEEDS

Abstract Many older adults who consume alcohol at harmful levels experience mental health problems. Common life events such as retirement, bereavement, and declining health, can contribute to anxiety and depression, with alcohol consumption being used as a coping mechanism. Tailored support is crucial to address the unique needs of older adults facing both alcohol misuse and mental health problems. These patients often fall into gaps between services (family practice/alcohol/mental health), which are unable to meet their complex support needs. This qualitative study aimed to understand the lived experiences of older adults with co-occurring heavy drinking and mental health problems, support received and unmet needs. We conducted semi-structured interviews with 14 older adults living in the North of England (completed Summer 2023). Thematic analysis and constant comparison were employed in data analysis. Findings highlighted the importance of age-tailored initiatives such as access to mental health support while actively drinking, supervised detoxification, increased peer support and services that are age inclusive and friendly. Risk factors such as grief, loneliness, financial problems and undiagnosed trauma in older adults contributed to development of these conditions. Older adults need services to work together, integrated around patient needs and addressing heavy drinking and mental health concerns at the same time. Future research should focus on improving mental health literacy and, developing holistic and preventive interventions to address risk factors for co-occurring alcohol and mental health problems in older adults.

Edentulism and Individual Factors of Active Aging Framework in Colombia.

While edentulism remains a serious public health problem for older adults in Colombia, few analyses have been conducted from the framework of active aging as a part of the positive discourse of aging. This study analyzed complete edentulism and its relationship with determinants including personal, behavioral, and health systems and social services. This study included a total of 19,004 older adults. We used univariate, bivariate, and multivariate logistic regression type scores to investigate the relationships between the variables. The personal determinants included basic (Barthel scale) and instrumental activities of daily living (Lawton scale), public transportation, functional limitations, self-perceived health, and health problems. The behavioral factors included alcohol and tobacco use, mini nutritional tests, and physical activity. The last determinant was the healthcare system, while social services access included dental services. The analysis also included sociodemographic variables. The results revealed significant associations for the variables of the three determinants, including the risk of malnutrition (odds ratio [OR]=1.15), functional limitation (OR=1.15), moderate physical activity (OR=1.08), and access to dental services (OR=2.31). Sex, years of education, and race were also risk factors, among other variables. Personal determinants, behavior, and use and access to health services were related to edentulism in older adults. These findings support the need to include different analyses of edentulism from multicausality and to understand the oral cavity and the living conditions of aging adults.

Feasibility and potential effectiveness of the IdentifEYE training programmes to address mental health problems in adults with vision impairment.

Two training programmes about depression and anxiety in adults with vision impairment were developed to support eye care practitioners (ECPs) and low vision service (LVS) workers in identifying and discussing mental health problems. The purpose of this study was to evaluate the training programmes' potential effectiveness and feasibility. The training programmes were offered to ECPs (n = 9) and LVS workers (n = 17). All participants completed surveys pre-, mid- and post-training, and at a 4 week follow-up about the training programmes' content, effectiveness, feasibility and implementation. The Kirkpatrick model was used as a theoretical framework; linear mixed models were used to determine the potential effectiveness, and outcomes were explored during three focus group meetings. Expectations were met in the majority of the participants (84.6%). Post-training, both ECPs and LVS workers reported increased confidence (β = 3.67, confidence interval (CI): 0.53-6.80; β = 4.35, CI: 1.57 to 7.14, respectively) and less barriers (β = -3.67, CI: -6.45 to -0.89; β = -1.82, CI: -4.56 to 0.91). Mental health problems were more likely addressed in both the groups (ECP β = 2.22, CI: -0.17 to 4.62; LVS β = 4.18, CI: 2.67 to 5.68), but these effects did not last in ECPs (β = -3.22, CI: -7.37 to 0.92). Variations of these learning effects between individual participants were found within both the groups, and LVS workers indicated a need to focus on their own profession. Participants provided information on how to improve the training programmes' feasibility, effectiveness and implementation. The training programmes seemed feasible and potentially effective. Transfer of the lessons learned into daily practice could be enhanced by, for example, specifying the training programmes for healthcare providers with the same profession, introducing microlearning and incorporating mental health management into organisation policies.

Complicated grief and its relationship with anxiety, depression, and suicidal ideation in older adults in the context of the COVID-19 pandemic in Peru: a cross-sectional analysis

BackgroundComplicated grief (CG) resulting from poor adaptation to the death of a close person may have been related with the presence of other mental health problems in older adults in Peru during the COVID-19 pandemic. Our study aimed to assess the association between CG and anxiety, depression, and suicidal ideation in older adults in Peru in the context of the COVID-19 pandemic.MethodsWe conducted a cross-sectional analysis using data from the “Socioemotional evaluation form” applied in 2020 to mental health problems in older adults attending the Peruvian Social Security (EsSalud). For our study, we included older adults who reported the death of a close person during the last six months when this assessment was performed. CG, depression, anxiety, and suicidal ideation were initially evaluated using validated questionnaires. The association between CG and the presence of mental health problems was calculated through multivariate analysis, where prevalence ratios (PR) were estimated with 95% confidence intervals (CI).ResultsOf the 249 older adults included, 175 (70.3%) were female with a median age of 71 years (interquartile range: 9), and 35 (14.1%) reported the presence of CG. It was found that CG in this population was associated with the presence of anxiety (PR: 1.35, 95% CI: 0.98 to 1.85), depression (PR: 1.44, 95% CI: 1.06 to 1.95), and suicidal ideation (PR: 2.84, 95% CI: 1.06 to 7.59).ConclusionsCG is related to the presence of mental health problems in older adults in Peru. It is essential to implement measures that facilitate the prevention and proper management of this condition in this population, especially in the context of high population mortality such as the COVID-19 pandemic.

FC47: To use or not to use? Multiple perspectives on residents’ alcohol and tobacco use in residential care facilities

Objectives:Residential care facilities (RCFs) provide 24/7 care to older adults with cognitive and/or physical disabilities. RCFs aim to provide person-centred care (PCC) to enhance the quality of life (QoL) of residents. Residents are dependent on their environment to fulfil their needs and wishes, such as drinking alcohol or smoking tobacco. Although alcohol and tobacco use can be experienced as a part of QoL in the final phase of life and the motivation to quit these substances is low, it can cause severe health problems in older adults. In RCFs this may cause a dilemma between the QoL of individual residents and the health and safety problems of all residents. This study aims to explore multiple perspectives on alcohol and tobacco use within the RCF.Methods:A qualitative research design was chosen, and semi-structured interviews were conducted. A various sample was purposively selected in two organizations on two types of units (psychogeriatric units and units providing care for residents with mainly physical disabilities): residents who use alcohol and/or tobacco and those who do not. Subsequently, four of these 16 residents were invited to participate in an in-depth case study. To explore the dynamics of the social environment, both formal and informal caregivers were invited to participate.Results:Residents are satisfied with their current use and value their autonomy regarding alcohol and tobacco use. Residents acknowledge that their use could cause a nuisance to others. Multiple caregivers are involved in their use and residents experience dependency on these caregivers to smoke tobacco or drink alcohol. There was limited interaction between the residents and their (in)formal caregivers and amongst the caregivers on this topic. Moreover, caregivers tended to act from their own perspectives, based on their professional expertise, knowledge, and attitudes towards residents’ alcohol and tobacco use.Conclusion:A dilemma arises between protecting residents from the adverse (health) outcomes of alcohol and tobacco use and sustaining their QoL by optimizing their autonomy. Future research could assess how to integrate providing PCC to residents by offering choices and autonomy, while considering the addictive component of these substances, health, and safety risks for all.

Digitally interconnected tertiary old age mental healthcare services and primary healthcare services for seniors in remote areas in Greece: An exportable model?

AbstractBackgroundEven though communities in remote areas across the globe age, old age mental healthcare services are mainly tertiary‐ or secondary hospital‐ based and subsequently not easily accessible by seniors with mental disorders living in such communities.MethodsThe INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) network embodies a model of digitally interconnected tertiary old age mental healthcare services and primary healthcare services for seniors in remote areas in Greece. It is coordinated by the Division of Old age mental health of the 1st Department of Psychiatry of the National and Kapodistrian University of Athens. INTRINSIC network is built around five pillars: The digital platform, bridging healthcare professionals, service users and communities; The old age mental health risk factor surveillance system, enabling the generation of a map of mental health problems of older adults living in each remote community and the initiation of the adequate treatment; the Modified Problem Adaptation Therapy (M‐PATH) intervention; Hearing and vision assessment and support of service users; and an advocacy body consisting of service users, their care partners and families and active members of the local communities. The initial, six‐month phase of INTRINSIC is funded by the Greek Ministry of Health.Results298 seniors living in remote areas of four different Nomenclature of Territorial Units for Statistics 2 (NUTS2) regions have been enrolled in INTRINSIC. They are on average 71.8 years old and 30.5% of them are males. Approximately 18% and 26% of INSTRINSIC service users suffer from depressive and anxiety symptoms, respectively; 62.3% complained about cognitive decline. Of note, only in 8% of service users the diagnosis of dementia had been established prior their enrolment, while 33.2% were treated with antidepressants.ConclusionBased on amplification of existing resources through the cooperation of tertiary‐ and primary healthcare professionals who share a vision of change, the INTRINSIC model offers a pragmatic opportunity to provide high quality old age healthcare services to seniors living in remote communities. The still ongoing collection and analyses of service users’ data may provide a solid foundation for INTRINSIC feasibility and sustainability

P157: Stigma of anxiety and depression: a comparison between older and younger adults.

Objective:Anxiety and depressive disorders are among the most frequently diagnosed mental health problems in older adults. Despite the availability of effective treatments, underutilization of mental health care services is problematic and more pronounced in the older population compared to young adults. Stigma of mental illness may be one explanation for this underutilization as it may impede help-seeking and participation in treatment. The objective of this study was to compare older and young adults on different types of stigma related to depression and anxiety while adjusting for potentially confounding variables.Methods:Young adults aged 18 to 36 years (n = 96) and older adults aged 60 years and over (n = 103) completed questionnaires measuring self-stigma, personal stigma, and perceived stigma related to anxiety and depression.Results:We found that older adults have higher levels of personal stigma but lower levels of perceived stigma and self-stigma than young adults.Conclusion:The results provide some support for the idea that older adults have greater stigma for mental illness and suggest the importance of age-differentiated interventions for reducing the stigma of mental illness.

Associations between healthy lifestyle behavioral patterns and mental health problems: A latent class analysis of 161,744 Chinese young adults

BackgroundYouth mental health problems are a public health priority. Multiple healthy lifestyle behaviors may cluster into healthy lifestyle behavioral patterns (HLBPs) that increase mental health risks in adolescents and older adults, but little is known regarding young adults. This study aimed to explore the associations between cluster HLBPs and mental health problems in young adults. MethodsWe selected 161,744 young adults aged 20–39 as participants from the database of a Chinese general hospital health management center for the years 2015–2020. The latent class analysis was used to identify HLBPs. ResultsA total of 15.0 % of young adults have at least one mental health problem. Five clusters of HLBPs were identified, characterized as low-risk class (1.6 %), moderate-risk class 1 (12.0 %), moderate-risk class 2 (2.1 %), moderate-risk class 3 (56.8 %), and high-risk class (27.4 %). The odds ratios (ORs) for young adults with two mental health problems increased with the risk grade of HLBPs, while the ORs for young adults with one or three mental health problems ranged from high to low according to the risk grade of HLBPs: high-risk class, moderate-risk class 2, moderate-risk class 3, moderate-risk class 1. LimitationsCross-sectional design and no causal conclusions could be drawn. ConclusionYoung adults demonstrated a cluster phenomenon of healthy lifestyle behaviors and significant associations between HLBPs and mental health problems. Young adults with a higher risk grade for HLBPs were more likely to have mental health problems. Different HLBPs should be taken into account when implementing mental health interventions.

Meta-analysis and moderator analysis of the prevalence of malnutrition and malnutrition risk among older adults with dementia

BackgroundAging and dementia are common and closely related health problems in older adults, affecting their ability to maintain a healthy diet and ultimately resulting in malnutrition. ObjectiveIn this study, we estimated the global prevalence of malnutrition and malnutrition risk in older adults with dementia. DesignMeta-analysis. Data sourcesEmbase, Ovid MEDLINE, PubMed, CINAHL, Scopus, and Web of Science were comprehensively searched for articles published from database inception to October 2022. MethodsPooled prevalence analysis was conducted using a generalized linear mixed model and a random-effects model. I2 and Cochran's Q statistics were used for identifying heterogeneity. Publication bias was evaluated using Peters' regression test and a funnel plot. Moderator analyses were conducted to investigate variations in the prevalence estimates of the included studies. All statistical analyses were conducted using R software. ResultsA total of 16 studies involving a total of 6513 older adults with dementia were included in the analysis. The results indicated that 32.52 % (95 % confidence interval: 19.55–45.49) of all included older adults with dementia had malnutrition, whereas 46.80 % (95 % confidence interval: 38.90–54.70) had a risk of malnutrition. The prevalence of malnutrition was found to be high among older patients living in institutionalized settings (46.59 %) and those with Alzheimer's disease (12.26 %). The factors moderating the prevalence of malnutrition included adequate vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. The prevalence of malnutrition risk was high among women (29.84 %) and patients with Alzheimer's disease (26.29 %). The factors moderating the prevalence of malnutrition risk included total cholesterol level, vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. ConclusionsApproximately one-third of older adults with dementia are malnourished and nearly half of older adults are at a risk of malnutrition. Encouraging collaboration among health-care professionals and ensuring early assessment and effective management of malnutrition are crucial for maintaining a favorable nutritional status in older adults with dementia. RegistrationThis study was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022369329). Tweetable abstractGlobally, approximately 32.52 % of older adults with dementia are malnourished and approximately 46.80 % are at a risk of malnutrition.

Perspectives of adults with neurofibromatosis regarding the design of psychosocial trials: Results from an anonymous online survey.

Individuals with neurofibromatosis, including neurofibromatosis 1 (NF1), neurofibromatosis 2 (NF2)-related schwannomatosis (SWN), and other forms of SWN, often experience disease manifestations and mental health difficulties for which psychosocial interventions may help. An anonymous online survey of adults with neurofibromatosis assessed their physical, social, and emotional well-being and preferences about psychosocial interventions to inform clinical trial design. Neurofibromatosis clinical researchers and patient representatives from the Response Evaluation in Neurofibromatosis and Schwannomatosis International Collaboration developed the survey. Eligibility criteria included age ≥ 18 years, self-reported diagnosis of NF1, NF2, or SWN, and ability to read and understand English. The online survey was distributed internationally by the Neurofibromatosis Registry and other neurofibromatosis foundations from June to August 2020. Surveys were completed by 630 adults (18-81 years of age; M = 45.5) with NF1 (78%), NF2 (14%), and SWN (8%) who were mostly White, not Hispanic/Latino, female, and from the United States. The majority (91%) reported that their neurofibromatosis symptoms had at least some impact on daily life. In the total sample, 51% endorsed a mental health diagnosis, and 27% without a diagnosis believed they had an undiagnosed mental health condition. Participants indicated that neurofibromatosis affected their emotional (44%), physical (38%), and social (35%) functioning to a high degree. Few reported ever having participated in a drug (6%) or psychosocial (7%) clinical trial, yet 68% reported they "probably" or "definitely" would want to participate in a psychosocial trial if it targeted a relevant concern. Top treatment targets were anxiety, healthier lifestyle, and daily stress. Top barriers to participating in psychosocial trials were distance to clinic, costs, and time commitment. Respondents preferred interventions delivered by clinicians via individual sessions or a combination of group and individual sessions, with limited in-person and mostly remote participation. There were no significant group differences by neurofibromatosis type in willingness to participate in psychosocial trials (p = 0.27). Regarding interest in intervention targets, adults with SWN were more likely to prefer psychosocial trials for pain support compared to those with NF1 (p < 0.001) and NF2 (p < 0.001). This study conducted the largest survey assessing physical symptoms, mental health needs, and preferences for psychosocial trials in adults with neurofibromatosis. Results indicate a high prevalence of disease manifestations, psychosocial difficulties, and untreated mental health problems in adults with neurofibromatosis and a high degree of willingness to participate in psychosocial clinical trials. Patient preferences should be considered when designing and implementing psychosocial interventions to develop the most feasible and meaningful studies.

Voluntary wheel running from early adolescence reduces disease progression, and anxiety- and depression-related symptoms in an adult male mouse model of rheumatoid arthritis

Rheumatoid arthritis (RA) is a multifactorial autoimmune disease that progressively destroys synovial joints and leads to chronic systemic inflammation. This autoimmune disorder is associated with increased anxiety- and depression-related symptoms, which reduces quality of life. Clinical and experimental evidence suggests that higher physical activity from early adolescence may prevent chronic diseases and reduce the risk of mental health problems in adulthood. This study aimed to assess whether voluntary wheel running from early adolescence can decrease clinical symptoms, anxiety- and depression-related behaviors in adult mice with rheumatoid arthritis. Adolescent male mice were exposed to voluntary wheel running until adulthood and got collagen-induced arthritis. We measured body weight, the thickness of the hind paw and knee joint (clinical signs), anxiety- and depression-related behaviors, serum testosterone, and cytokines (IFN-γ IL-1β, IL-6, TNF-α, IL-10). The findings showed that collagen-induced arthritis resulted in anxious-like behavior, increased anhedonia, elevated IL-6, IL-1β, TNF-α, and IFN-γ, and decreased testosterone levels in the serum of mice. However, no change was observed in behavioral despair. We found that higher physical activity from early adolescence significantly reduced the severity of clinical signs, anxiety- and anhedonia-like behaviors, and decreased behavioral despair in RA-induced mice. In addition, the running wheel exposure normalized RA-induced abnormalities in testosterone and inflammatory cytokines in mice. Altogether, this study suggests that higher physical activity from early adolescence may make mice less vulnerable or resistant to RA-induced clinical symptoms and anxiety- and depression-related behaviors by changing testosterone and inflammatory cytokines productions in adulthood.

RELATIONS BETWEEN ERUPTION OF PERMANENT TEETH AND BODY MASS INDEX IN BULGARIAN CHILDREN

Introduction: Obesity and dental caries are diseases that have a strong social impact. Being overweight and obesity during childhood are a risk factor for cardiovascular, respiratory, skeletal diseases and other health problems in both children and adults. Aim: The aim of the study is to estimate the relationship between tooth eruption, tooth pathology and BMI in 7-8 year old Bulgarian children. Methods and Material: The present study observed 187 individuals. Oral and dental status were examined. The height was measured in a standing position with an anthropometer, weight was measured with an electric scale to the nearest 0.1 kg, and Body Mass Index (BMI) was calculated. The data was analyzed with the Statistical Package for Social Sciences (SPSS) version 16. The differences were considered statistically significant at p&lt;0.05. Results: A positive relation is found between the eruption of teeth and BMI. A statistically significant association is found between BMI and dental caries on the upper left first molar (26). Conclusion: A high percentage of the examined children were overweight and obese. A positive but low correlation between BMI, tooth eruption and dental caries is established. With the increase of the BMI, the number of erupted teeth also increases. Girls had more erupted teeth compared with boys. The caries of the first molar (26) correlate positively with the nutritional status of the 7-8 year old children studied.

Oral health care intervention protocol for older adults at home in dental hygienists: a narrative literature review

Objectives: This study aims to propose a standard protocol for oral health care intervention activities by dental hygienists. Methods: A narrative literature review of home visit oral health care intervention activities reported in Cheonan, South Korea was conducted to enable the proposal of a standard home visit protocol for dental hygienists in the context of community care. Results: Oral health management intervention activities contributed to improving the quality of life, as well as the oral health, of older adults living at home. This was a result of applying a protocol consisting of oral observation, oral massage, expert oral hygiene management, oral muscle function training, and final stages. Conclusions: The visiting oral health intervention protocol was effective in resolving oral health problems of older adults. In the future, customized programs and reimbursement systems should be developed to promote oral health care for older adults that can be provided at home.

Decreased lipid levels in adult with congenital heart disease: a systematic review and Meta-analysis

BackgroundMetabolic disorders were a health problem for many adults with congenital heart disease, however, the differences in metabolic syndrome-related metabolite levels in adults with congenital heart disease compared to the healthy population were unknown.MethodsWe collected 18 studies reporting metabolic syndrome-associated metabolite levels in patients with congenital heart disease. Data from different studies were combined under a random-effects model using Cohen’s d values.ResultsThe results found that the levels of total cholesterol (Cohen’s d -0.68, 95% CI: -0.91 to -0.45), high-density lipoprotein cholesterol (Cohen’s d -0.63, 95% CI: -0.89 to -0.37), and low-density lipoprotein cholesterol (Cohen’s d -0.32, 95% CI: -0.54 to -0.10) were significantly lower in congenital heart disease patients compared with controls. Congenital heart disease patients also had a lower body mass index (Cohen’s d -0.27, 95% CI: -0.42 to -0.12) compared with controls. On the contrary, congenital heart disease patients had higher levels of hemoglobin A1c (Cohen’s d 0.93, 95% CI: 0.17 to 1.70) than controls. Meanwhile, there were no significant differences in triglyceride (Cohen’s d 0.07, 95% CI: -0.09 to 0.23), blood glucose (Cohen’s d -0.12, 95% CI: -0.94 to 0.70) levels, systolic (Cohen’s d 0.07, 95% CI: -0.30 to 0.45) and diastolic blood pressure (Cohen’s d -0.10, 95% CI: -0.39 to 0.19) between congenital heart disease patients and controls.ConclusionsThe lipid levels in patients with congenital heart disease were significantly lower than those in the control group. These data will help in the health management of patients with congenital heart disease and guide clinicians.PROSPERO registration numberCRD42022228156.

Predicting adult-age mental health with childhood reading and math disability: do resilience and coping styles matter?

We studied the associations between childhood-identified learning disabilities and adult-age mental health and whether adult-age reading and math skills, coping styles, or resilience influenced the associations. The participants were 159 Finnish adults (60.4% males). Of them, 48 (30%) had a reading disability (RD), 22 (14%) had a math disability (MD), 21 (13%) had RD + MD identified in childhood, and 68 (43%) were population-based controls, matched based on gender, age, and place of residence. At ages 20–40 (Mage = 29), they reported their mental health, coping styles, and resilience, and their reading and math skills were assessed. The hierarchical regression analyses, predicting mental health with RD, MD, and their interaction while controlling for gender and age, indicated that childhood MD predicted the occurrence of more mental health problems in adulthood, but this was not observed in the case of RD. The RDxMD positive interaction effect reflected better mental health in both the RD and the RD + MD groups than in the MD group. Controlling for adult-age reading and math skills had no effect on the association between MD and mental health outcomes while controlling for resilience and coping styles diminished the impact of MD. Strong resilience without the use of an emotion-oriented coping may thus alleviate the association between MD and mental health. As childhood MD can have long-term associations with mental health problems, these issues need to be addressed in school, at work, and in healthcare. Based on our findings, strengthening effective coping and resilience may be one avenue of support.

Educational attainment and symptoms of anxiety and depression in young adulthood

Abstract Background Young adulthood is a life phase when mental health problems are common. Although education is known to exert an influence on health, increased knowledge about the links between educational attainment and mental health problems in young adults is needed. The aim of this study was to analyse if educational attainment at the end of upper secondary (U.S.) school (i.e. age 19) predicted self-reported anxiety and depression symptoms two years later. Methods Data was derived from the Swedish population-based cohort study Futura01 (n = 3247; 56% women). Anxiety and depression were measured by self-reports in 2022 (age 21) through the Patient Health Questionnaire (PHQ-4). Educational attainment was measured through linked registry information from 2020 (age 19). Linear regression analysis was used. Covariates included parental country of birth, parental education and family type. Results Co-occurring symptoms of anxiety and depression were more common among young adults with a compulsory than a U.S. academic degree (women: b = 0.79, 95% CI 0.49, 1.09; men: b = 0.77, 95% CI 0.37, 1.17). Symptoms of depression only were more common among women with a compulsory degree (b = 0.60, 95% CI 0.20, 1.00), and among participants with a U.S. vocational degree (women: b = 0.51, 95% CI 0.09, 0.94; men: b = 0.50, 95% CI 0.08, 0.91), compared to those with a U.S. academic degree. Symptoms of anxiety only were, in contrast, less common among men and women with a compulsory degree compared to those with a U.S. academic degree, although statistically significant only among women (b=-0.50, 95% CI -0.88, -0.12). Conclusions Educational level in young adulthood was clearly associated with subsequent symptoms of anxiety and depression but the social patterning varied between symptoms. Lower educational level was linked to a higher reporting of co-occurring anxiety and depression and of depression only, while a higher educational level was linked to a higher reporting of anxiety only. Key messages • Young adult educational attainment was negatively associated with symptoms of co-occurring anxiety and depression and of depression only, but positively associated with symptoms of anxiety only. • In young adulthood educational level is associated with anxiety and depression in complex ways. Efforts to improve educational attainment and/or mental health need to consider this complexity.

New Approaches to Food Allergy Immunotherapy

Food allergy is an increasing public health problem in children and adults. In addition to the risk of potentially severe reactions, food allergy can have a significant burden on quality of life, nutrition, cost of living, and social activities. Traditionally, treatment has primarily included strict food allergen avoidance and use of emergency medications to treat an allergic reaction. However, in recent years, there have been significant strides in the advancement of food allergy treatment, including the approval of the first and only approved therapy (peanut oral immunotherapy) for food allergy in 2020. Clinical trials have primarily focused on food allergen immunotherapy (oral, epicutaneous, sublingual). Building off of a foundation of promising data supporting the efficacy of food oral immunotherapy and our greater understanding of the underlying mechanism of immunotherapy, newer approaches, including alternative routes of delivery, adjuncts to therapy, modified allergens, and utilization in younger patients, aim to provide safer and more effective treatment approaches to the millions of patients burdened by food allergy.