Health-related Factors Research Articles

Association between childhood abuse and risk of post-COVID-19 conditions: Results from three large prospective cohort studies

BackgroundSignificant early life adversities, such as childhood sexual and physical/emotional abuse, are associated with risk of poor health outcomes but are understudied risk factors for post-COVID-19 conditions. In this prospective study, we examined the associations between combined exposure to sexual and physical/emotional abuse during childhood with risk of post-COVID-19 conditions in adulthood. Additionally, we explored the extent to which lifestyle, health-related and psychological factors explain this association. MethodsWe used data from three large, ongoing cohorts: Nurses’ Health Study (NHS)-II, NHS3, and the Growing Up Today Study. Between April 2020 and November 2021, participants responded to periodic COVID-19 surveys. Participants were included if they responded to a questionnaire about childhood abuse, subsequently tested positive for SARS-CoV-2 infection and responded to questions about post-COVID-19 conditions. Childhood sexual abuse was measured before the COVID-19 pandemic with the Sexual Maltreatment Scale of the Parent-Child Conflict Tactics Scale, and physical/emotional abuse was measured with the Physical and Emotional Abuse Subscale of the Childhood Trauma Questionnaire. Post-COVID-19 conditions, defined as COVID–19–related symptoms lasting 4 weeks or longer (e.g., fatigue, dyspnea), were self-reported in the final COVID-19 questionnaire in November 2021. Sexual abuse and physical/emotional abuse were examined separately and jointly in relation to post-COVID-19 conditions. Data on key lifestyle (e.g., cigarette smoking), health-related (e.g., asthma, diabetes), and psychological factors (e.g., depression and anxiety) were obtained. ResultsOf 2851 participants, the mean age (range) was 55.8 (22.0–75.0) years; 2789 (97.8 %) were females, and 2750 (96.5 %) were whites. We observed a dose-dependent relationship between severity of childhood abuse and post-COVID conditions (p-trend:<0.0001); participants with severe versus no childhood abuse had a 42 % higher subsequent risk of post-COVID conditions [relative risk (95 % confidence interval): 1.42 (1.25 to 1.61)]. Key lifestyle, health-related, and psychological factors mediated 25.5 % of this association. Both sexual and physical/emotional abuse, were independently associated with post-COVID conditions. ConclusionsIn this prospective study of 2851 participants, childhood abuse was significantly associated with increased risk of post-COVID conditions. Biological pathways connecting childhood abuse with subsequent risk of post-COVID conditions should be investigated.

Exploring the impact of subjective well-being on medication adherence: A cross-sectional study among individuals with multiple chronic diseases

BackgroundMedication non-adherence is a significant barrier to optimal treatment goals. The study explores the association between subjective well-being (SWB) and medication adherence among Lebanese individuals with multiple chronic diseases and identifies additional factors that may influence adherence in this population. MethodsAn exploratory, cross-sectional study was conducted for three months at six community pharmacies. Adherence was assessed using the Adherence to Refills and Medication Scale Arabic Lebanese Version (ARMS-A). The SWB was measured using the Arabic Scale of Happiness (ASH), Love of Life Scale (LLS), Arab Hope Scale (AHS), and Satisfaction with Life Scale (SWLS). Spearmen's Rho correlation analyzed the association between ARMS-A and SWB constructs. Binary logistic regression identified predictors of adherence among individuals with chronic diseases and on multiple chronic medications. ResultsOf 400 participants, 106 (26.5 %) with a 95 % CI, 0.22–0.31, were adherent. Lower medication adherence (reflected in higher ARMS-A scores) was associated with lower SWB (p = 0.01). Multivariate analysis showed that lower education (OR=2.21, 95 % CI, 1.01–4.81), lack of a specific diet (OR = 1.64, 95 % CI, 1.01–2.69), and frequent hospital and/or emergency visits (OR=3.29, 95 % CI, 1.75–6.17 for 2 visits; OR = 2.71, 95 % CI, 1.43–5.14 for ≥3 visits) significantly increased the odds of non-adherence to chronic treatment. However, higher income (OR = 0.06, 95 % CI, 0.01–0.38), healthcare provider occupation (OR = 0.42, 95 % CI, 0.21–0.48), and having diabetes mellitus (OR = 0.59, 95 % CI, 0.36–0.96) correlated with better adherence. ConclusionA significant portion of participants failed to adhere to their prescribed chronic medications, influenced by multicomplex socioeconomic, psychological, and health-related factors. These findings demonstrate the need for culturally-tailored, pharmacist-led interventions to improve medication adherence and overall health outcomes.

Does arts and cultural group participation influence subsequent well-being? A longitudinal cross-country comparison of older adults in Japan and England

IntroductionArts engagement is a positive health behaviour that could support the mental and social well-being of ageing populations globally. However, research is predominantly from Western countries, leaving it unclear whether...

Exploring the Sociodemographic and Health-Related Determinants of Telehealth Use Among a Cohort of Older Australians During the COVID-19 Pandemic: Repeated Cross-Sectional Study.

During the COVID-19 pandemic, there was a rapid adoption of telehealth care services as a public health strategy to maintain access to essential health care. In Australia, there has been increasing optimism for the expansion of telehealth services. However, little is known about the patterns and determinants of telehealth adoption among older adults, with concerns that an expansion of telehealth services may only be of benefit to those who already have better access to health care. Leveraging data collected by The Sax Institute's 45 and Up COVID Insights study between November 2020 and April 2022, the objective of this study was to identify and describe the sociodemographic and health-related determinants of telehealth adoption and use among a cohort of older Australians. We hypothesized that health-related factors would be key determinants of telehealth adoption for Australians aged ≥65 years during the COVID-19 pandemic. A repeated cross-sectional design was used. The relationships between telehealth use (classified as low, moderate, or high) and selected sociodemographic and health-related characteristics were assessed using logistic regression techniques. Variable selection and findings were situated within the Technology Acceptance Model, the Unified Theory of Acceptance, and the Use of Technology theoretical frameworks. Of the 21,830 participants aged ≥65 years, the proportion who indicated adopting telehealth ranged from 50.77% (11,082/21,830) at survey 1 in 2020 to 39.4% (7401/18,782) at survey 5 in 2022. High levels of telehealth use were associated with being female, aged <85 years, living in a major city, cohabiting with others, and being from the most socioeconomically disadvantaged areas (deciles 1-3). Individuals with a disability, chronic disease, multimorbidity, and lower perceived quality of life and those experiencing missed or delayed care were significantly more likely to use telehealth across all levels (P<.001). A temporal association was observed, whereby participants who engaged with telehealth services before or early in the pandemic (as assessed in survey 1) were more likely to continue telehealth use when assessed in survey 5 in 2022 (P<.001). This research contributes to the broader understanding of telehealth adoption and use among older adults. As telehealth models of care expand, there is an opportunity to tailor these services to the needs of older adults, particularly those living with chronic diseases and multimorbidity, by using targeted strategies that overcome barriers to accessing specialized health care services.

Facilitators and barriers to employment for people with adult-onset physical disabilities: results from a U.S.A. survey.

Employment has long been an area of concern for people with disabilities. National samples in the United States are needed to understand the experiences of people with disabilities related to employment. (1) Describe and evaluate associations between personal and health-related factors with employment after disability, and (2) describe and evaluate associations between facilitators, barriers, and work-related external factors with maintaining a longest held job after disability. We recruited a national sample of people with physical disabilities from panels assembled by a United States market research organization; by selection, 1309 were working and 491 were not. We evaluated the likelihood of employment and maintaining employment after disability onset using Poisson regression. Model 1 evaluated factors associated with employment; Model 2 evaluated factors associated with maintained employment. Model 1: Older age, decreased ability to pay bills on time, and assistive device use were associated with decreased likelihood of employment after disability onset. Non-Black minority identification, fatigue, and higher physical function were associated with increased likelihood of employment. For Model 2, the likelihood of maintaining a longest held job was associated with acquiring a disability at work, receipt of job accommodations, valuing opportunities for advancement and health benefits, having a helpful living situation, and helpful human resource attitudes. Decreased likelihood of maintaining a longest held job after disability onset was associated with job dissatisfaction and supervisors' attitudes. This work highlights opportunities for employers to focus efforts on job accommodations and support in the maintenance of employment after disability.

The contribution of socio-demographic, health-related and psychological factors to the perception of changes in life following a few waves of the COVID-19 pandemic

BackgroundAs a result of the long-lasting COVID-19 pandemic, we have experienced numerous losses in psychological and economic domains. Research covering two years (2020-2021) of the pandemic suggests that at present, the period is also perceived in terms of gains. The factors affecting opinions about the losses and gains include personality traits, intensity of COVID-19 PTSD, age, and others. The study aimed to determine which aspects changed in life after two years of the pandemic, which were assessed as negative or positive, and which factors contributed to these opinions.Participants and procedureAn online survey was carried out and responses were received from an international sample of 418 adults. The following tools were used: the Ten Item Personality Inventory, Impact of Event Scale-Revised, and COVID-19 Sense of Life Changes Questionnaire.ResultsConscientiousness and emotional stability were those personality traits which increased positive perceptions of the past years of the pandemic. The older age of respondents contributed to a more negative opinion about the changes in life caused by the pandemic.ConclusionsThe personality traits of conscientiousness and emotional stability and younger age may protect against negative percep-tions of the two-year period of the pandemic.

Intention to leave the current health facility among healthcare workers in Ethiopia: Systematic review and meta-analysis.

Strengthening workforce management to address retention challenges is worldwide concern. Ethiopia did different human resource reforms to improve retention and performance of available health workforce to step up towards universal health coverage. However, there is limited and fragmented research on intention to leave their current facility and related factors on health workers. This review was done to assess pooled national prevalence of intention to leave their current health facility and related factors among Ethiopian health workers. This systematic review and meta-analysis followed PRISMA guidelines. Authors prepared a review protocol per Joanna Briggs Institute (JBI) manual for evidence synthesis and got registered from PROSPERO for transparency. The authors conducted a comprehensive search of PubMed, Web of Science, Cochrane, Google Scholar and African Index Medicus databases and grey literature like WHO library from 8 June 2022 to 30 May 2023. Pooled prevalence of intention to leave current health facility and related factors was computed using MedCalk, Meta Essentials and R software. Publication bias was assessed using Egger's test and a funnel plot. Pooled prevalence of intention to leave among health workers in Ethiopian healthcare setting was found to be 63.52% (95% CI (58.606-67.904)) for random effects model at Q = 141.5689 (I2(inconsistency) = 90.82%, P < 0.0001). Only organizational justice OR = 0.29 (0.14-0.61) was found to be a significantly associated factor for health workers' intention to leave their current healthcare setting in Ethiopia. More than 6 in 10 of the health workers in Ethiopia were ready to leave their current healthcare facility. This result was higher than studies done in other parts of the world, even in African countries. The associated factor for health workers' intention to leave their current health facility was only organizational justice. So, health authorities should improve their organizational justice to retain their employees.

Alcohol Consumption Patterns and Mortality Among Older Adults With Health-Related or Socioeconomic Risk Factors

Alcohol consumption is a leading cause of morbidity and mortality that may be more important in older adults with socioeconomic or health-related risk factors. To examine the association of alcohol consumption patterns with 12-year mortality and its modification by health-related or socioeconomic risk factors. This prospective cohort study used data from the UK Biobank, a population-based cohort. Participants were current drinkers aged 60 years or older. Data were analyzed from September 2023 to May 2024. According to their mean alcohol intake in grams per day, participants' drinking patterns were classified as occasional: ≤2.86 g/d), low risk (men: >2.86-20.00 g/d; women: >2.86-10.00 g/d), moderate risk (men: >20.00-40.00 g/d; women: >10.00-20.00 g/d) and high risk (men: >40.00 g/d; women: >20.00 g/d). Health-related risk factors were assessed with the frailty index, and socioeconomic risk factors were assessed with the Townsend deprivation index. All-cause and cause-specific mortality were obtained from death certificates held by the national registries. Analyses excluded deaths in the first 2 years of follow-up and adjusted for potential confounders, including drinking patterns and preferences. A total of 135 103 participants (median [IQR] age, 64.0 [62.0-67.0] years; 67 693 [50.1%] women) were included. In the total analytical sample, compared with occasional drinking, high-risk drinking was associated with higher all-cause (hazard ratio [HR], 1.33; 95% CI, 1.24-1.42), cancer (HR, 1.39; 95% CI, 1.26-1.53), and cardiovascular (HR, 1.21; 95% CI, 1.04-1.41) mortality; moderate-risk drinking was associated with higher all-cause (HR, 1.10; 95% CI, 1.03-1.18) and cancer (HR, 1.15; 95% CI, 1.05-1.27) mortality, and low-risk drinking was associated with higher cancer mortality (HR, 1.11; 95% CI, 1.01-1.22). While no associations were found for low- or moderate-risk drinking patterns vs occasional drinking among individuals without socioeconomic or health-related risk factors, low-risk drinking was associated with higher cancer mortality (HR, 1.15; 95% CI, 1.01-1.30) and moderate-risk drinking with higher all-cause (HR, 1.10; 95% CI, 1.01-1.19) and cancer (HR, 1.19; 95% CI, 1.05-1.35) mortality among those with health-related risk factors; low-risk and moderate-risk drinking patterns were associated with higher mortality from all causes (low risk: HR, 1.14; 95% CI, 1.01-1.28; moderate risk: HR, 1.17; 95% CI, 1.03-1.32) and cancer (low risk: HR, 1.25; 95% CI, 1.04-1.50; moderate risk: HR, 1.36; 95% CI, 1.13-1.63) among those with socioeconomic risk factors. Wine preference (>80% of alcohol from wine) and drinking with meals showed small protective associations with mortality, especially from cancer, but only in drinkers with socioeconomic or health-related risk factors and was associated with attenuating the excess mortality associated with high-, moderate- and even low-risk drinking. In this cohort study of older drinkers from the UK, even low-risk drinking was associated with higher mortality among older adults with health-related or socioeconomic risk factors. The attenuation of mortality observed for wine preference and drinking only during meals requires further investigation, as it may mostly reflect the effect of healthier lifestyles, slower alcohol absorption, or nonalcoholic components of beverages.

Charting Health Challenges for Digital Preventive Interventions Among Adult Survivors of Childhood Acute Lymphoblastic Leukemia: National Long-Term Follow-Up Survey of Self-Rated Health Outcomes.

Acute lymphoblastic leukemia (ALL) is the most common malignancy in childhood, but the prognosis has remarkably improved over the last 50 years in high-income countries, and thus, there is a focus on long-term health outcomes following survival and how to best provide health care support to adult long-term survivors of childhood ALL to prevent and handle potential health problems. Digital health interventions are promising to deliver feasible health promotion and prevention programs. This is particularly relevant for ensuring long-term follow-up in cases where continuous contact with oncology care may be disrupted. Moreover, these interventions are beneficial in reaching geographically dispersed target groups and overcoming the time constraints of everyday life that often hinder participation in such programs. This study aimed to fill the gaps in existing research on adult long-term survivors of childhood ALL and provide formative data that can inform the development of formalized follow-up services designed to meet the needs of these survivors in ways that align with their preferences for digital health interventions. In this cross-sectional national study, adult survivors (aged ≥18 years) of childhood ALL for over 10 years after diagnosis were compared to their siblings in terms of mental and physical health-related factors, including sleep, stress, anxiety, and depression (Depression Anxiety and Stress Scale 21 [DASS-21]); several dimensions of fatigue (Multidimensional Fatigue Inventory 20 [MFI-20]); work ability (Work Ability Index); chronic pain; and prevalences of diabetes, cardiovascular disease, headache or migraine, and rheumatic disease. Overall, 426 of 855 eligible ALL survivors responded (mean age 30.9, SD 7.7 years), and they participated at an average of 24 (SD 6.9) years after ALL diagnosis. Siblings (n=135; mean age 31.5, SD 7.7 years) acted as controls. Sleep quality, sleep quantity, and mean work ability scores were significantly lower, and physical fatigue, reduced motivation, and reduced activity scores were higher in ALL survivors than in siblings. There were no significant differences between the groups in terms of BMI and prevalence of chronic pain, depression, anxiety, or stress. Physical and psychological complications were more frequent among adult ALL survivors who had received hematopoietic stem cell transplantation (HSCT) than among those who had not received HSCT. Our nationwide cross-sectional study addressed the scarcity of knowledge regarding the self-reported health outcomes of adult long-term survivors of childhood ALL. We highlighted significant disparities within this population and emphasized the potential of comprehensive digital interventions that target vitality, sleep quality, fatigue, and psychosocial well-being to enhance well-being and bolster the capacity for managing chronic health conditions in this target group. Such an intervention would align with the needs of this target group, which is a prerequisite for successfully incorporating technology into the daily lives of survivors of childhood ALL.

Prevalence and Predictors of Soft Drink Consumption among Adolescents in the Gulf Countries: Findings from National Surveys.

This study aimed to investigate the prevalence and predictors of soft drink consumption among adolescents in the Gulf Cooperation Council (GCC) countries using nationally representative data from the Global School-based Student Health Survey (GSHS). Cross-sectional data were collected using a self-administered questionnaire in a school survey and included 22,116 adolescents aged 12-18 years from Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates. Data were collected and analyzed using complex survey methods. The GSHS was not available for Saudi Arabia. Soft drink consumption was the main outcome variable. Multivariable logistic regression was used to examine its associations with sociodemographic characteristics, dietary behaviors, parental factors, and health-related behaviors. The prevalence of soft drink consumption three or more times per day ranged from 10.6% to 26.8% across the countries, with the highest being in Qatar. Adjusted analyses showed that girls had lower odds of SD consumption compared to boys (OR = 0.66; 95% CI: 0.57-0.77). Food insecurity, a proxy for low socioeconomic status, was associated with twice the odds of frequent consumption (OR = 2.06; 95% CI: 1.75-2.43). Parental smoking and low physical activity levels were also associated with higher soft drink intake (OR = 1.46, 95% CI: 1.13-1.88 and OR = 1.18, 95% CI: 1.08-1.28, respectively), while obesity showed a weak positive association. Daily soft drink consumption was highly prevalent among adolescents in the GCC countries. Sociodemographic, behavioral, and health-related factors were significantly associated with frequent intake. These findings highlight the need for comprehensive, multi-sectoral interventions to reduce soft drink consumption in the region.

Associations of frailty, self-reported balance problems, hearing abilities, and posturography in a sample of older adults

Objective The aim of this study was to identify risk factors for self-reported balance problems, and to analyse associations between hearing and balance. Design A battery of tests was administered to assess hearing and balance performance, as well as additional health-related factors indicative of frailty and fall risk. In a retrospective analysis, logistic regression was used to identify risk factors for self-reported balance problems and linear regression was used to identify associations between hearing ability and functional balance. Study sample For the risk factor analysis, 199 volunteers aged 55–81 years (mean:67) were divided into two groups according to their self-reported balance problems. Only participants lacking self-reported balance problems (n = 157) were included in the second analysis. Results Female gender, frailty, and fine-motor skills were statistically significant predictors of self-reported balance problems. Functional balance performance was related to hearing impairment for dynamic, but not for static, balance tasks. Conclusion For a holistic approach to healthcare and regardless of age, individuals with multiple comorbidities and/or phenotypic signs of frailty should be considered at risk for falls. For further research, it was shown that dynamic, rather than static, balance tasks may be needed to gain deeper insights into the relationship between hearing and balance.

Satisfaction of chronic patients with community-based health insurance schemes and related factors: Explanatory sequential mixed methods study.

Chronic disease poses a serious threat to accessible, high-quality healthcare. Community-based health insurance (CBHI) schemes provide the poor with financial security. However, there is no evidence in Ethiopia on how satisfied chronic patients are with the schemes. The objective of the current study was to evaluate the satisfaction of chronic patients with the schemes and identify contributing factors. A hospital-based explanatory sequential mixed methods study on 632 chronic patients and 12 key informants was carried out between February 28 and May 31, 2022, in the hospitals of East Gojjam, Northwest Ethiopia. Hospitals and study participants were selected using multistage sampling methods. Quantitative data was entered using Epi Data 3.1 and exported to SPSS version 25 for analysis. P value <0.05 was used to consider significant association in multivariable binary logistic regression. Thematic analysis was a method to manually review qualitative data. A narrative approach was used for integrating the two data. The mean age of study participants was 46.1 (46.1± 5.2, range: 25-82). Patients aged 45 to 64 made up the majority of the population (60.6%). Rheumatoid arthritis affected the preponderance of individuals (36.4%). The overall level of satisfaction of chronic patients with the CBHI scheme was 31% (95% CI; 27-35%). Respect and friendliness (AOR = 7.05; CI: 3.71-13.36), knowledge of benefits packages (AOR = 2.02; CI: 1.24-3.27), partial or non-availability of drugs (AOR = 0.24, AOR = 0.21, respectively), waiting times (AOR = 1.84; CI: 1.12-3.0), and availability of laboratory tests (AOR = 1.59; CI: 1.01-2.48) were significantly associated with participants' satisfaction with the schemes. Our study revealed that the overall satisfaction of chronic patients was quite low and affected by the availability of drugs and laboratory tests, caregivers' respect and friendliness, waiting times, and participant knowledge. Therefore, stakeholders must concentrate on reducing waiting times, improving the availability of drugs and laboratory tests at each hospital, opening back up community pharmacies, and promoting awareness about benefits packages primarily through health education. The main focus of researchers needs to be on nationally representative studies that include more important factors.

Quantifying consumers’ cost-value trade-offs on on-demand food delivery services: Value-of-time framework and partitioned pricing

PurposeThis study aims to quantitatively characterize consumers' value-cost trade-offs in on-demand food delivery (ODFD) services. On the value side, the study endeavors to monetize the convenience value of ODFD with a Value-of-Time (VOT) framework, while on the cost side, this study investigates the implication of ODFD's partitioned pricing structure with the theoretical tenet of Attribution Theory. Design/methodology/approachA stated choice experiment is developed and distributed to an online panel in Singapore with 580 valid responses collected. The data is then analyzed with a mixed logit model. FindingsThe results show that cost, time, and health-related factors significantly influence consumers' dining channel choices. In terms of time, consumers' differentiated time sensitivities are revealed. Specifically, consumers are most sensitive to walking time, followed by waiting time at food establishments and at their own places. Also, the food type and dining locations affect consumers’ time perceptions. Regarding cost, consumers exhibit an inflated price sensitivity toward food premiums compared to delivery fees. Originality/valueThis study addresses the lack of quantitative investigations into the value-cost tradeoffs in ODFD services. ODFD's convenience values are quantified and monetized with a novel VOT-based framework. Besides, the study sheds light on the underexplored partitioner pricing scheme with the theoretical tenet of the Attribution Theory. Overall, the research provides behavioral insights to support practitioners' operational decision-making.

Loneliness and social isolation are associated with an increased risk of glaucoma: a UK Biobank cohort study

BackgroundLoneliness and social isolation have been found to be associated with various health-related outcomes. Our study aimed to evaluate the association of loneliness and social isolation with the risk of glaucoma.MethodsA total of 373,330 participants from the UK Biobank without glaucoma at recruitment were included in this study. Self-reported questionnaires were used to define loneliness and social isolation. Incident glaucoma events were identified by hospital inpatient admissions and self-reported data. COX proportional hazards models adjusted for sociodemographic, lifestyle, and health-related factors were used to estimate hazard ratios (HRs) and 95% CIs.ResultsDuring a median follow-up of 13.1 (interquartile range: 12.3–13.9) years, 6,489 participants developed glaucoma. After adjusting for confounding factors, loneliness (yes vs. no: adjusted HR: 1.16; 95% CI: 1.04–1.30; P = 0.009) and social isolation (yes vs. no: adjusted HR: 1.08; 95% CI: 1.01–1.16; P = 0.033) were associated with an increased risk of glaucoma.ConclusionsIn this population-based prospective cohort study, loneliness and social isolation were associated with a higher risk of glaucoma.

Frailty after Liver Transplantation: A Complex Unexplored Issue.

Frailty is a multidimensional syndrome predominantly studied in the elderly, characterized by reduced resistance to stressors due to diminished physiological reserve and resilience. Advances in surgical techniques and immunosuppressive drugs have improved long-term survival rates in solid organ transplant recipients, yet the 10-year survival is satisfying. However, liver transplant recipients have a noteworthy risk of developing frailty status. After liver transplant, frailty can be favored by socioeconomic, cultural, and health-related factors, leading to increased risks of hospitalization, morbidity, and mortality. Various tools for frailty assessment exist, but none are universally validated for post-transplant patients. The integration of socioeconomic and psychological factors into frailty evaluation could improve quality of life and long-term outcomes for transplant recipients. Multidisciplinary approaches, including psychosocial support, are essential for managing frailty and enhancing the overall care of transplanted patients. This narrative review aims to comprehensively address the principal frailty risk factors associated with liver transplantation.

Physical Activity Engagement among Black Immigrants and African American Adults in the 2010 to 2018 NHIS Study.

High rates of physical inactivity persist in the United States, with higher rates among non-Hispanic Black adults than among their White peers. However, a comparison of physical activity engagement across nativity among Black adults in the United States has yet to be fully documented. The purpose of this cross-sectional study was to examine physical activity engagement rates among African immigrant and Afro-Caribbean immigrant adults compared with native-born African American adults using data from the 2010 to 2018 National Health Interview Survey. Using data from the 2010 to 2018 National Health Interview Survey, we used generalized linear models to compare levels of physical activity (meeting the moderate-to-vigorous physical activity [MVPA] recommendations) by ethnic subgroups of Black adults, sequentially adjusting for sociodemographic and health-related risk factors. Data from 38,037 adults (58.8% female, 21% college/graduate degree, and 41.4% with obesity) were included. Only 41.9% of all participants met the MVPA recommendations. In the fully adjusted models across the 9 years, higher levels of MVPA were seen among African Americans (42%) than among African immigrants (38%) and Afro-Caribbean immigrants (41%). Compared with African Americans, African immigrants were less likely to engage in physical activity that met the MVPA guidelines (prevalence ratio: 0.90; 95% confidence interval: 0.85, 0.96), whereas there were no differences in meeting the guidelines between Afro-Caribbean immigrants (prevalence ratio: 0.96; 95% confidence interval:0.90, 1.02) and African Americans. Culturally tailored interventions addressing socioenvironmental barriers and facilitators of physical activity may have important impacts on physical activity promotion and long-term disease burden among Black adults across nativity.

Erectile dysfunction among male patients receiving methadone maintenance treatment: focusing on anxiety-related symptoms.

Erectile dysfunction (ED) in patients receiving methadone maintenance treatment (MMT) is a relatively neglected issue. In this study we sought to determine the actual prevalence of ED and risky sexual behaviors in patients receiving MMT and identify clinically relevant risk factors for ED, particularly mental health conditions, that may contribute to achieving holistic healthcare and improving treatment adherence in this patient population. A cross-sectional study of male Chinese MMT patients was conducted. Comprehensive demographic and clinical data regarding age, obesity, history of major mental and physical illness, HIV infection, other substance use, methadone dose/duration, and associated risky sexual behaviors were all collected. Assessment tools, including the 5-item International Index of Erectile Function, the Chinese Health Questionnaire, and the Taiwanese Depression Questionnaire were administered. The relationship between mental health-related factors and ED was fully analyzed and elaborated. The prevalence of ED among male patients in a methadone maintenance therapy outpatient clinic was 55.7%. The prevalence rate of ED among the individuals treated for longer than 6months was 56.8%, whereas that for untreated individuals was 52.0%. Additionally, methadone-treated individuals were older and had a higher proportion of condom use and drug-assisted sexual activity than untreated individuals. Pearson correlation revealed that higher Chinese Health Questionnaire and Taiwanese Depression Questionnaire scores were negatively correlated with lower scores on the 5-item International Index of Erectile Function. In the multivariate regression model, anxiety and other psychosomatic symptoms were associated with more severe ED, whereas individuals who consumed alcohol within the past month had less severe ED after adjustment for other demographic and clinical variables. The findings of the present study revealed no association between ED and methadone treatment duration or dosage. Healthcare professionals should discuss mental health issues in patients on MMT with ED, especially anxiety symptoms and recent alcohol use. This study is one of the few reports within the limited body of research highlighting a significant association of ED with anxiety-related symptoms in patients undergoing MMT. Our study had some limitations. First, the sample size of HIV-infected individuals was insufficient. Second, the cross-sectional study design could not definitively demonstrate a causal mechanism. In patients undergoing MMT, individuals who reported less severe anxiety symptoms and alcohol consumption in the past month tended to have less severe ED, regardless of the MMT duration or dosage.

Association of back pain with all-cause and cause-specific mortality among older men: a cohort study.

We evaluated whether more severe back pain phenotypes-persistent, frequent, or disabling back pain-are associated with higher mortality rate among older men. In this secondary analysis of a prospective cohort, the Osteoporotic Fractures in Men (MrOS) study, we evaluated mortality rates by back pain phenotype among 5215 older community-dwelling men (mean age, 73 years, SD = 5.6) from 6 sites in the United States. The primary back pain measure used baseline and Year 5 back pain questionnaire data to characterize participants as having no back pain, nonpersistent back pain, infrequent persistent back pain, or frequent persistent back pain. Secondary measures of back pain from the Year 5 questionnaire included disabling back pain phenotypes. The main outcomes measured were all-cause and cause-specific death. After the Year 5 exam, during up to 18 years of follow-up (mean follow-up = 10.3 years), there were 3513 deaths (1218 cardiovascular, 764 cancer, 1531 other). A higher proportion of men with frequent persistent back pain versus no back pain died (78% versus 69%; sociodemographic-adjusted HR = 1.27, 95%CI = 1.11-1.45). No association was evident after further adjustment for health-related factors, such as self-reported general health and comorbid chronic health conditions (fully adjusted HR = 1.00; 95%CI = 0.86-1.15). Results were similar for cardiovascular deaths and other deaths, but we observed no association of back pain with cancer deaths. Secondary back pain measures, including back-related disability, were associated with increased mortality risk that remained statistically significant in fully adjusted models. Although frequent persistent back pain was not independently associated with risk of death in older men, additional secondary disabling back pain phenotypes were independently associated with increased mortality rate. Future investigations should evaluate whether improvements in disabling back pain affect general health and well-being or risk of death.

Impact of Alcohol-Induced Facial Flushing Phenotype on Alcohol Consumption Among Korean Adults: 2-Year Cross-Sectional Study.

The alcohol-induced facial flushing phenotype (flushing) is common among East Asians. Despite a small intake of alcohol, they experience heightened levels of acetaldehyde, a group-1 carcinogen, which, in turn, causes unpleasant symptoms such as redness, acting as a robust protective mechanism against consuming alcohol. However, some individuals with this genetic trait exhibit weakened alcohol restraint, which increases the risk of developing alcohol-related cancers, such as esophageal and head or neck cancer, by several times. Although this flushing phenomenon is crucial for public health, there is a paucity of studies that have comprehensively investigated the effect of flushing or its genotype on alcohol consumption in a large group of East Asians while controlling for various sociodemographic and health-related variables at a country level. This 2-year cross-sectional study aims to explore the effect of flushing on drinking behavior in Koreans and to examine whether the effect varies across sociodemographic and health-related factors. We used data from the Korea National Health and Nutrition Examination Survey (KNHANES) for 2019 and 2020 conducted by the Korea Disease Control and Prevention Agency. Our sample comprised 10,660 Korean adults. The study investigated the association of 26 variables, including flushing, with drinking frequency and amount. The effect of flushing was examined with and without adjusting for the other 25 variables using multinomial logistic regression analysis. In addition, we tested the interaction effect with flushing and conducted a simple effect analysis. We used complex sample design elements, including strata, clusters, and weights, to obtain unbiased results for the Rao-Scott χ2 test, 2-tailed t test, and multinomial logistic regression analysis. The suppressive effect of flushing was significant (P<.001) across all pronounced categories of alcohol consumption in 2019. The ranges of standardized regression slopes and odds ratios (ORs) were -6.70≥β≥-11.25 and 0.78≥OR≥0.50 for frequency and -5.37≥β≥-17.64 and 0.73≥OR≥0.36 for amount, respectively. The effect became somewhat stronger when adjusted for confounders. The effect also exhibited an overall stronger trend as the severity of alcohol consumption increased. The β values and ORs were consistently smaller in 2020 compared to the previous year. A simple effect analysis revealed a diminished alcohol-suppressive effect of flushing on alcohol consumption for specific groups (eg, those with low levels of education, limited family support, physical labor, or health-related issues). Our findings suggest that flushing suppresses drinking in Koreans overall but has little or no effect in certain susceptible populations. Therefore, health authorities should conduct targeted epidemiological studies to assess drinking patterns and disease profiles, particularly regarding alcohol-related cancers, and establish effective preventive measures tailored to this population.

Effects of Stress on Health-Related Factors of Infants

Effects of Stress on Health-Related Factors of Infants