Health Status Characteristics Research Articles

Understanding the Lifestyle Risk Profile of Men and Their Engagement With Preventive Care: A Cross-Sectional Survey.

To explore men's health status and lifestyle risk profile and understand how they engage with preventive health care. A cross-sectional survey within a sequential mixed-methods project. Four hundred thirty-one adult males, working or volunteering for the New South Wales Rural Fire Service (NSW RFS) completed the survey between September and November 2022. The survey captured demographic data, health status and lifestyle characteristics, as well as engagement with preventive health care. Nearly three-quarters of respondents (n = 314; 72.8%) described themselves as being in good or very good health. Just 18.6% of respondents recorded a 'healthy' body mass index (BMI), despite only 29.9% having been told by a doctor that they were overweight/obese. Most (n = 344; 79.8%) respondents identified having a regular general practitioner (GP)/general practice. Nearly all respondents described having had blood pressure measurements (n = 403; 93.5%) and lipid profile (n = 346, 80.3%) in the last 2 years. Having a regular GP/general practice was significantly associated with engaging in all preventive and screening activities, except having a dental check. Our findings demonstrate a significant opportunity to support men to reduce lifestyle risk, despite their current engagement with general practice. Strategies need to support men and health professionals to have conversations about risk and risk reduction to promote behaviour change. Nurses are well placed to provide preventive health care to men in general practice. The general practice nurse has a key role in communicating lifestyle risk, supporting patients in modifying their behaviours and reducing the impact of such factors on their health and well-being. Communicating the importance of lifestyle risk factors is imperative in supporting men to achieve behavioural change in the reduction in lifestyle risk. Nurses are well-placed to take a leading role in this area. The STROBE checklist guided reporting. Survey development was undertaken in collaboration with members of the NSW RFS. Key contacts within the organisation were involved in reviewing the analysis and interpretation of findings.

Promoting Mental Health Education Through Sunshine Sports Integration in the Context of New Curriculum Reform

This paper attempts to test and analyze students' mental health status through the reform of physical education curriculum setting mode, reveal the changes and characteristics of individual mental health status, and then promote reasonable and effective physical education reform and the integration of psychological education. Furthermore, this article investigates people's mental health using the Apriori algorithm and the BP algorithm, and accurately presents the current condition using data graphs and other approaches, and its accuracy has grown by 20.32%. It also concludes that we should pursue the aims of social adaption and mental health, as well as support improved implementation of the new physical education curriculum. Physical education instruction must be engaging, but it cannot be done in isolation from sports and practice. As part of the new curriculum reform, physical education should be linked with psychological education.

Understanding health literacy in men: a cross-sectional survey

BackgroundMales have a shorter life expectancy than females. Men are less likely to seek the advice of a health professional or utilise preventive health services and programs. This study seeks to explore health literacy and the characteristics affecting this among Australian men.MethodsFour hundred and thirty-one adult males engaged with the New South Wales Rural Fire Service, completed an online cross-sectional survey, undertaken from September – November 2022. The survey tool captured demographic data, health status and lifestyle risk characteristics. Health literacy was measured using the 44-item Health Literacy Questionnaire (HLQ). Descriptive statistics, frequencies, percentages, means and standard deviations, were used to describe the sample. Interferential statistics, including the Mann-Whitney U Test and the Kruskal-Wallis Test, were used to explore differences between demographics and HLQ scales.ResultsFor the first 5 scales (4-point Likert scale), the lowest score was seen for ‘Appraisal of health information’ (Mean 2.81; SD 0.52) and the highest score was seen for ‘Feeling understood and supported by healthcare providers ’ (Mean 3.08; SD 0.64). For the other 4 scales (5-point Likert scale), the lowest score was seen for ‘Navigating the healthcare system’ (Mean 3.74; SD 0.69). The highest score was seen for ‘Understand health information well enough to know what to do’ (Mean 4.10; SD 0.53). Age, income level and living in an urban/rural location were significantly related to health literacy scales.ConclusionsThis study provides new insight into men’s health literacy and the factors impacting it. This knowledge can inform future strategies to promote men’s engagement with health services and preventive care.

Health Insurance Type and Outpatient Specialist Care Among Children With Asthma

Although children with asthma are often successfully treated by primary care clinicians, outpatient specialist care is recommended for those with poorly controlled disease. Little is known about differences in specialist use for asthma among children with Medicaid vs private insurance. To examine differences among children with asthma regarding receipt of asthma specialist care by insurance type. In this cross-sectional study using data from the Massachusetts All Payer Claims Database (APCD) between 2014 to 2020, children with asthma were identified and differences in receipt of outpatient specialist care by whether their insurance was public (Medicaid and the Children's Health Insurance Program) or private were examined. Eligible participants included children with asthma in 2015 to 2020 aged 2 to 17 years. Data analysis was conducted from January 2023 to April 2024. Medicaid vs private insurance. The primary outcome was receipt of specialist care (any outpatient visit with a pulmonology, allergy and immunology, or otolaryngology physician). Multivariable logistic regression models estimated differences in receipt of specialist care by insurance type accounting for child and area characteristics including demographics, health status, persistent asthma, calendar year, and zip code characteristics. Additional analyses examined if the associations of specialist care with insurance type varied by asthma persistence and severity, and whether associations varied over time. Among 198 101 unique children, there were 432 455 child-year observations (186 296 female [43.1%] and 246 159 male [56.9%]; 211 269 aged 5 to 11 years [48.9%]; 82 108 [19.0%] with persistent asthma) including 286 408 (66.2%) that were Medicaid insured and 146 047 (33.8%) that were privately insured. Although persistent asthma was more common among child-year observations with Medicaid vs private insurance (57 381 [20.0%] vs 24 727 [16.9%]), children with Medicaid were less likely to receive specialist care. Overall, 64 239 child-year observations (14.9%) received specialist care, with substantially lower rates for children with Medicaid vs private insurance (34 093 child-year observations [11.9%] vs 30 146 child-year observations [20.6%]). Regression-based estimates confirmed these disparities; children with Medicaid had 55% lower odds of receiving specialist care (adjusted odds ratio, 0.45; 95% CI, 0.43 to 0.47) and a regression-adjusted 9.7 percentage point (95% CI, -10.4 percentage points to -9.1 percentage points) lower rate of receipt of specialist care. Compared with children with private insurance, there was an additional 3.2 percentage point (95% CI, 2.0 percentage points to 4.4 percentage points) deficit for children with Medicaid with persistent asthma. In this cross-sectional study, children with Medicaid were less likely to receive specialist care, with the largest gaps among those with persistent asthma. These findings suggest that closing this care gap may be one approach to addressing ongoing disparities in asthma outcomes.

Pediatric Respiratory Syncytial Virus Hospitalizations, 2017-2023

Respiratory syncytial virus (RSV) transmission was disrupted worldwide following the COVID-19 pandemic, and further study is required to better understand these changes. To compare observed and expected RSV hospital and intensive care unit (ICU) admission rates and characteristics of admitted children during the 2021-2022 and 2022-2023 seasons. A population-based cohort study of all children aged younger than 5 years in Ontario, Canada, July 1, 2017, through March 31, 2023, was conducted. Individual and neighborhood-level sociodemographic and clinical characteristics were identified from administrative data, including age, palivizumab eligibility, complex medical conditions, rurality, and living in a marginalized neighborhood. The main outcome was RSV-associated hospitalization. Secondary outcomes included ICU admissions, mechanical ventilation, extracorporeal membrane oxygenation, and in-hospital death. Poisson generalized estimating equations were used to model weekly age- and sex-specific hospitalization rates and estimate expected rates in the postpandemic era; adjusted rate ratios (RRs) and 95% CIs are reported. This cohort study included approximately 700 000 children per study year. Compared with prepandemic years (2017-2018, 2018-2019, and 2019-2020), the 2021-2022 RSV season peaked slightly earlier, but overall admission rates were comparable (289.1 vs 281.4-334.6 per 100 000, or approximately 2000 admissions). The 2022-2023 season peaked a month earlier and resulted in more than twice as many hospitalizations (770.0 per 100 000; n = 4977 admissions). The proportion of children admitted to an ICU in 2022-2023 (13.9%) was slightly higher than prepandemic (9.6%-11.4%); however, the population-based rate was triple the prepandemic levels (106.9 vs 27.6-36.6 per 100 000 children in Ontario). With the exception of palivizumab-eligible children, all sociodemographic and health status characteristics were associated with lower-than-expected RSV hospitalization rates in 2021-2022. In contrast, older age of patients was associated with higher-than-expected rates in 2022-2023 (ie, 24-59 months: RR, 1.90; 95% CI, 1.35-2.66). There were notable differences in RSV epidemiologic characteristics in Ontario following the COVID-19 pandemic. It is not yet clear whether and how long atypical RSV epidemics may persist. Clinicians and program planners should consider the potential for ongoing impacts to health care capacity and RSV immunization programs.

Public Attitudes, Inequities, and Polarization in the Launch of the 988 Lifeline.

To address the considerable burden of mental health need in the United States, Congress passed the National Suicide Hotline Designation Act in 2020. The act rebranded the national suicide prevention lifeline as 988, a three-digit number akin to 911 for individuals to call in the case of a mental health emergency. Surprisingly little is known about American attitudes toward this new lifeline. The authors use a demographically representative survey of 5,482 US adults conducted June 24-28, 2022, to examine the influence of mental health status, partisan identification, and demographic characteristics on public awareness of the new 988 lifeline, public support for the lifeline, and intention to use it. The authors find that while only a quarter of Americans are aware of the lifeline, support for the 988 lifeline is widespread, with more than 75% of Americans indicating they would be likely to use the new number if needed. The authors identify key disparities in awareness, support, and intended use, with Republicans, individuals with low socioeconomic status, and Blacks less supportive of the 988 lifeline and in some cases less likely to use it. The results point to the need for additional interventions that increase public awareness of 988 and reduce disparities in program knowledge, support, and intention to use.

Baseline characteristics and recruitment for SWOG S1820: altering intake, managing bowel symptoms in survivors of rectal cancer (AIMS-RC)

PurposeMany survivors of rectal cancer experience persistent bowel dysfunction. There are few evidence-based symptom management interventions to improve bowel control. The purpose of this study is to describe recruitment and pre-randomization baseline sociodemographic, health status, and clinical characteristics for SWOG S1820, a trial of the Altering Intake, Managing Symptoms in Rectal Cancer (AIMS-RC) intervention.MethodsSWOG S1820 aimed to determine the preliminary efficacy, feasibility, and acceptability of AIMS-RC, a symptom management intervention for bowel health, comparing intervention to attention control. Survivors with a history of cancers of the rectosigmoid colon or rectum, within 6–24 months of primary treatment completion, with a post-surgical permanent ostomy or anastomosis, and over 18 years of age were enrolled. Outcomes included total bowel function, low anterior resection syndrome, quality of life, motivation for managing bowel health, self-efficacy for managing symptoms, positive and negative affect, and study feasibility and acceptability.ResultsThe trial completed accrual over a 29-month period and enrolled 117 participants from 34 institutions across 17 states and one US Pacific territory. At baseline, most enrolled participants reported self-imposed diet adjustments after surgery, persistent dietary intolerances, and bowel discomfort post-treatment, with high levels of constipation and diarrhea (grades 1–4).ConclusionsSWOG S1820 was able to recruit, in a timely manner, a study cohort that is demographically representative of US survivors of rectal cancer. Baseline characteristics illustrate the connection between diet/eating and bowel symptoms post-treatment, with many participants reporting diet adjustments and persistent inability to be comfortable with dietary intake.ClinicalTrials.gov registration date12/19/2019.ClinicalTrials.gov IdentifierNCT#04205955.

Intentions of healthcare seeking and self-isolation for MPOX among men who have sex with men in China: a national cross-sectional study

ABSTRACT Linking identified MPOX cases to care is essential for MPOX control. This study aims to investigate the intentions of healthcare seeking and self-isolation for MPOX among men who have sex with men (MSM) in China. A cross-sectional online survey was conducted in early August 2023 in China. Respondents were recruited by community-based organizations (CBOs), collecting information on demographics, health status, behavioural and psychological characteristics. Univariate and multivariate logistic regression analyses were performed to examine the predictors of intentions to seek healthcare and self-isolate for MPOX within the MSM population. A total of 7725 participants were recruited, with a median age of 30 years. 92.21% of the participants would seek healthcare for MPOX-like symptoms, but only 52.50% intended to self-isolate if diagnosed. Intentions to seek healthcare were lower among those with MPOX-like symptoms in the past 3 months (standardized prevalence ratio (SPRs) = 0.82, 95% CI: 0.74–0.89) and the willingness to self-isolate was reduced among those diagnosed with MPOX in the past 3 months (SPRs = 0.65, 95% CI: 0.48–0.87). Participants free of sexually transmitted infections (STIs) and those aware of their HIV status were more likely to seek healthcare and self-isolate than those with STIs or unaware of their HIV status. Regular followers of MPOX information and those perceiving a low risk of infection were more inclined to take preventive measures. These findings highlight the need for targeted MPOX prevention strategies for high-risk groups and the importance of addressing barriers in infectious disease prevention response.

Quality of care transition, patient safety incidents, and patients’ health status: a structural equation model on the complexity of the discharge process

BackgroundThe transition of patients between care contexts poses patient safety risks. Discharges to home from inpatient care can be associated with adverse patient outcomes. Quality in discharge processes is essential in ensuring safe transitions for patients. Current evidence relies on bivariate analyses and neglects contextual factors such as treatment and patient characteristics and the interactions of potential outcomes. This study aimed to investigate the associations between the quality and safety of the discharge process, patient safety incidents, and health-related outcomes after discharge, considering the treatments’ and patients’ contextual factors in one comprehensive model.MethodsPatients at least 18 years old and discharged home after at least three days of inpatient treatment received a self-report questionnaire. A total of N = 825 patients participated. The assessment contained items to assess the quality and safety of the discharge process from the patient’s perspective with the care transitions measure (CTM), a self-report on the incidence of unplanned readmissions and medication complications, health status, and sociodemographic and treatment-related characteristics. Statistical analyses included structural equation modeling (SEM) and additional analyses using logistic regressions.ResultsHigher quality of care transition was related to a lower incidence of medication complications (B = -0.35, p < 0.01) and better health status (B = 0.74, p < 0.001), but not with lower incidence of readmissions (B = -0.01, p = 0.39). These effects were controlled for the influences of various sociodemographic and treatment-related characteristics in SEM. Additional analyses showed that these associations were only constant when all subscales of the CTM were included.ConclusionsQuality and safety in the discharge process are critical to safe patient transitions to home care. This study contributes to a better understanding of the complex discharge process by applying a model in which various contextual factors and interactions were considered. The findings revealed that high quality discharge processes are associated with a lower likelihood of patient safety incidents and better health status at home even, when sociodemographic and treatment-related characteristics are taken into account. This study supports the call for developing individualized, patient-centered discharge processes to strengthen patient safety in care transitions.

Abstract PO5-21-04: Leveraging Digital Twins for Patient Stratification and Treatment Optimization in geriatric oncology: A Breast Cancer Multivariate Clustering Analysis

Abstract Context: Geriatric oncology necessitates an accurate evaluation of a patient's health status and cancer characteristics. Digital twins, virtual replicas of a patient and their cancer, can aid in predicting real-world behaviors and support therapeutic decision-making. Objectives: This study aims to demonstrate how digital twins can optimize treatments by simulating various scenarios based on the individual characteristics of patients and their cancers. Methods: Creation of a digital twin relies on the use of advanced manifold learning technologies. A model is built to represent the variability present in the reference cohort, capturing complex relationships and inherent data structures. A reference digital twin is generated by drawing samples from this model, thus reflecting the characteristics distribution of the reference population. Stratification (MeanShift algorithm) enables cohort structure visualization and classical statistics estimation for each stratum. Multivariate analysis was performed on a French monocentric population of 1345 patients aged over 70 years who underwent surgery for HER2-negative early breast cancer. Results: 8 cluster, created by manifold learning based on biological, demographic, and tumoral variables, exhibits unique five-year survival rates and influential factors. The clusters represent specific patient subgroups, each with its distinct set of characteristics and prognostic indicators. Table 1 provides a summary of these variables' averages within each cluster. we can thus see that the variables of clusters 3 and 6 (including only HR+ cancers) do not show statistically significant differences, unlike their 5-year survival rates (cluster 3 : 80,9% (CI95 :70-88.5) and 63.9% (CI95 :47.6-77.5) for cluster 6, p= 0,04). Provided with model results, the relative importance of these variables varies from one cluster to another, underscoring the heterogeneity among patient subgroups. Interestingly, Hormonal receptor status, nodal involvement and tumoral grade were not the predominant variables in these clusters, which challenges traditional perspectives. Table 1 : Mean value of variables per cluster (SBR grade 0=grade 1 and 2 ; 1= grade 3) Discussion: The findings underscore the vast variability of individual variable importance across clusters. Digital twins enabled the modeling of these complex interactions, providing valuable insights for clinical decision-making. Conclusion: Digital twins offer a valuable tool for personalizing care in oncogeriatrics, facilitating the identification of patient subgroups, yielding more accurate treatment outcomes, and guiding future research directions. The results affirm that incorporating digital twins into oncogeriatric care could potentially lead to the enhanced personalization of therapeutic approaches, ultimately improving patient outcomes. Table. Citation Format: Pierre Heudel, Mashal Ahmed, Felix Renard. Leveraging Digital Twins for Patient Stratification and Treatment Optimization in geriatric oncology: A Breast Cancer Multivariate Clustering Analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-21-04.

Food insecurity and dietary diversity among food aid recipients in urban and rural areas at the covid‐19 outbreak: An exploratory study

AbstractThe covid‐19 pandemic has affected food aid. This paper reports an exploratory study to estimate the prevalence and degree of food insecurity, household dietary diversity score (HDDS), and the association with demographic, social, and economic characteristics of health status in a sample of food aid recipients in urban and rural areas of Catalonia, Spain. Cross‐sectional data on food insecurity, dietary diversity, household income, health, and sociodemographic characteristics were obtained from the survey taken at seven different food aid distribution points from urban and rural locations. Sixty‐six percent of the participants identified as new users since the covid‐19 crisis. Only 12.5% of the sample lived in households where all adults were unemployed, and 44.8% were employed. Almost a third of the sample (32.3%) reported having someone in their household who suffered from a diet‐related illness or disease. The prevalence of severe food insecurity was 52.1%, followed by 28.1% suffering moderate food insecurity. New food aid users due to covid‐19 pandemic showed a significantly higher prevalence of food insecurity. No significant differences were found in terms of HDDS. This paper provides evidence that much of the gap in food insecurity is related to dietary diversity and children in households considering different urban or rural areas.

Oral pathology following treatment of brain tumors in childhood

Relevance. The limited selectivity of antitumor therapy for central nervous system neoplasms entails the risk of dental morbidity in patients.The aim of the study is to assess the severity of damage to the dental hard tissues in patients with tumors of the posterior cranial fossa (medulloblastoma, astrocytoma) and other tumors of the central nervous system.Materials and methods. Three comparison groups were established based on the toxicity profiles of antitumor therapy among 251 patients at the "Russian Field" treatment and rehabilitation scientific center, to assess the characteristics of oral health status. The assessment of oral health status included diagnosing the carious process and calculating the DMFT index. The degree of damage to the dental hard tissues was evaluated on a four-point scale. The clinical manifestations of oral cavity pathology were compared using the Z-criterion for multiple pairwise comparisons of data, with adjustments for multiple testing (Multiple pairwise comparison Z-test for proportions with multiple testing correction) using the free R software version 3.5.2. The null hypothesis of equal indicators in the compared groups was rejected with a 95% confidence probability when comparing groups of patients.Results. Dental hard tissue pathology was significantly more prevalent in patients with medulloblastoma compared to those diagnosed with astrocytomas and other central nervous system tumors. Additionally, the prevalence of dental hard tissue pathology progressively decreased as the observation period following the completion of antitumor remission was extended.Conclusion. The most severe damage to dental hard tissues is observed in patients with medulloblastoma, who undergo more intensive antitumor therapy compared to those with CNS tumors of other histological types.

Racial and Ethnic Disparities in Attendance to Well-Child Visit Recommendations during COVID-19

ObjectiveTo measure the impact of the COVID-19 pandemic on racial and ethnic disparities in attendance to well-child visit recommendations. MethodsWe used the nationally representative Medical Expenditure Panel Survey (MEPS) to compare pre-pandemic (2018–2019) and pandemic (2020 and 2021) ratios of well-child visits to age-based recommendations, presenting both unadjusted and adjusted attendance disparities over time. We also used the 1996–2021 MEPS to place the pandemic changes in an historical context. ResultsAverage attendance decreased from 66.6% in 2018–2019 (95% confidence interval [CI]: 64.1, 69.1) to 58.6% in 2020 (95% CI: 55.5, 61.6), rebounding to 65.1% in 2021 (95% CI: 61.5, 68.7). The unadjusted disparity in attendance between White non-Hispanic and Black non-Hispanic children widened from 9.6 percentage points in 2018–2019 (95% CI: 2.8, 16.4) to 24.8 percentage points in 2020 (95% CI: 17.5, 32.2) and 21.4 percentage points in 2021 (95% CI: 11.2, 31.5). The unadjusted disparity in attendance between White non-Hispanic and Hispanic children widened from 14.8 percentage points in 2018–2019 (95% CI: 9.7, 19.8) to 26.3 percentage points in 2020 (95% CI: 19.9, 32.7) and 24.9 percentage points in 2021 (95% CI: 17.5, 32.3). Changes in disparities were large even when we controlled for health status, demographic and socioeconomic characteristics, health insurance, and state of residence. Magnitudes of the racial and ethnic attendance disparities during the pandemic’s first two years were unprecedented since 1996. ConclusionsWidening attendance disparities during the pandemic highlight the need to build a more equitable health care system for all children.

Profiles of well-being in French older adults and associations with successful aging and personality: findings from the SHARE project

Maintaining the well-being of the older adults is a primary concern in gerontology. This study determined different profiles of well-being (WB) and compared the profiles in terms of successful aging (SA), personality, and sociodemographic variables. The study sample consisted of 856 adults aged 65–98 years. WB was taken into account in an eudemonic and hedonic approach. SA was measured by assessing the three distinct components of Rowe and Kahn's model (Successful aging. Gerontol 37(4):433–440. 10.1093/geront/37.4.433, 1997), personality by the Big Five Inventory, and sociodemographic variables. Latent class analyses (LCA) determined the number of WB profiles, and ANOVAs and Chi2 tests to compare them. The LCA revealed three WB profiles: Profile 1 (9.35%, n = 80), Profile 2 (37.38%, n = 320), and Profile 3 (53.27%, n = 456) in which participants reported lower, intermediate, and higher WB scores. Our results confirm that a high level of WB (Profile 3) can be linked to the components of SA and socio-demographic characteristics (age, marital status, level of education, income). This raises questions about the injunctions concerning healthy aging that older people integrate. It's also interesting to note that the intermediate profile (profile 2) can be either close to the "lower WB" profile (Profile 1) in terms of openness, conscientiousness, and agreeableness or to the "higher WB" profile (Profile 3) in terms of extraversion. However the three profiles do not have the same level of neuroticism. These results also showed the importance of adapting the support offered to older people according to their health status and/or individual characteristics.

The association of adverse childhood experiences with household income, educational attainment and partnered status among adults aged 30-39

BackgroundThe association of adverse childhood experiences (ACEs) with young adult social outcomes is poorly understood. ObjectiveTo examine the relationship between ACEs and young adult household income, education, and partnered status. Participants13,767 respondents (population-weighted estimate N = 13,191,291) aged 30–39 completed the optional ACES module in the 2019 Behavioral Risk Factor Surveillance System (BRFSS) from 17 states. MethodsThe 2019 BRFSS was used to analyze the significance of ACE scores for the likelihood of reporting household income greater than $75,000, a college or postgraduate degree, and living with a partner among respondents aged 30–39. Poisson regression analyses controlled for sociodemographic, health status, and behavioral risk characteristics. ResultsAs compared to those with zero ACEs, respondents reporting four or more ACE exposures (20.2% of respondents) were marginally less likely to report high income (IRR: 0.87, 95% CI: 0.79–0.97) and one-third less likely to report a college degree (IRR: 0.68, 95% CI: 0.61–0.76), with no significant difference in partnered status. ConclusionsYoung adult social status may be shaped by social-emotional effects of ACEs that go beyond demographic and health status differences. Enhancing resilience to childhood adversity can benefit from a trauma-informed approach in health care, education, and employment.

Loneliness, social isolation, and cardiovascular disease among nonveteran and veteran women

We examined the prospective associations of social isolation and loneliness with incident cardiovascular disease (CVD) among aging nonveteran and veteran women, and effect modification by veteran status. Participants with no history of myocardial infarction (MI), stroke, coronary heart disease (CHD), or coronary heart failure from the Women’s Health Initiative Extension Study II self-reported social isolation, loneliness, health behaviors, health status, and veteran status. CVD and CVD subevents were physician adjudicated. Hazard ratios (HR) and 95% confidence intervals (CI) for the Interquartile Range (IQR) in social isolation (IQR = 1) and loneliness (IQR=.33) were calculated using Cox proportional hazard models adjusting for sociodemographic, health behavior, and health status characteristics. Veteran status was tested as an effect modifier. Among 52,442 women (Mean age = 79 ± 6.1; veterans n = 1023; 89.2% non-Hispanic White), 3579 major CVD events occurred over an average 5.8 follow-up years. Compared to nonveterans, veteran women reported higher levels of social isolation (p < .01) and loneliness (p < .01). The CVD HR was 1.07 (95% CI, 1.04–1.10) for the IQR in social isolation and 1.03 (95% CI, 1.10–1.06) for the IQR in loneliness. The HR for the IQR in both social isolation and loneliness was 1.10 (95% CI, 1.05–1.15). Social isolation was associated with CHD (HR = 1.12; 95% CI, 1.03–1.21). The CHD HR for the IQR in social isolation was 1.12 (95% CI, 1.03–1.21). Associations did not differ by veteran status (all p-interactions > 0.08). Findings suggest that the adverse associations of social isolation and loneliness with CVD are similar among veteran and nonveteran women.

A cross‐sectional study on predictors of patients' tinnitus severity

AbstractObjectiveTo identify factors that influence the severity of tinnitus via a hierarchical multiple linear regression model.MethodsThe study was a retrospective cross‐sectional analysis. The study included 331 patients experiencing tinnitus as their primary concern, who visited Shanghai Changzheng Hospital of the Navy Medical University between 2019 and 2021. Data on general health status and disease characteristics were collected from all patients. With their consent, participants underwent audiological evaluatons and completed questionnaires to analyze the characteristics of their tinnitus and the factors influencing its severity.ResultsThe correlation analysis showed a positive relationship between tinnitus frequency, tinnitus loudness, SAS scores, and PSQI scores with THI scores (P &lt; 0.05) among nine examined variables (gender, handedness, employment status, age, BMI, tinnitus frequency, tinnitus loudness, SAS scores, and PSQI scores). The variables that were extracted from the multiple regression were; for the constant; β = −51.797, t = −4.484, P &lt; 0.001, variable is significant; for the tinnitus loudness; β = 0.161, t = 2.604, P &lt; 0.05, variable is significant; for the tinnitus frequency; β = 0.000, t = 1.269, P = 0.206, variable is not significant; for the SAS scores; β = 1.310, t = 7.685, P &lt; 0.001, variable is significant; for the PSQI scores; β = 1.680, t = 5.433, P &lt; 0.001, variable is significant. Therefore, the most accurate model for predicting severity in tinnitus patients is a linear combination of the constant, tinnitus loudness, SAS scores, and PSQI scores, Y(Tinnitus severity) = β0 + β1(Tinnitus loudness) + β2(SAS scores) + β3(PSQI scores). β0, β1, β2, and β3 are −51.797, 0.161, 1.310 and 1.680, respectively.ConclusionTinnitus severity is positively associated with loudness, anxiety levels, and sleep quality. To effectively manage tinnitus in patients, it is essential to promptly identify and address these accompanying factors and related symptoms.

Understanding the impact of chronic diseases on COVID-19 vaccine hesitancy using propensity score matching: Internet-based cross-sectional study.

To investigate whether chronic diseases are associated with higher COVID-19 vaccine hesitancy and explore factors that influence COVID-19 vaccine hesitancy in patients with chronic diseases. Vaccine hesitancy has been acknowledged as one of the greatest hazards to public health. However, little information is available about COVID-19 vaccine hesitancy among patients with chronic diseases who may be more susceptible to COVID-19 infection, severe disease or death. From 6 to 9 August 2021, we performed an internet-based cross-sectional survey with 22,954 participants (14.78% participants with chronic diseases). Propensity score matching with 1:1 nearest neighbourhood was used to reduce confounding factors between patients with chronic diseases and the general population. Using a multivariable logistic regression model, the factors impacting COVID-19 vaccine hesitancy were identified among patients with chronic diseases. Both before and after propensity score matching, patients with chronic diseases had higher COVID-19 vaccine hesitancy than the general population. In addition, self-reported poor health, multiple chronic diseases, lower sociodemographic backgrounds and lower trust in nurses and doctors were associated with COVID-19 vaccine hesitancy among patients with chronic diseases. Patients with chronic diseases were more hesitant about the COVID-19 vaccine. Nurses should focus on patients with chronic diseases with poor health conditions, low socioeconomic backgrounds and low trust in the healthcare system. Clinical nurses are recommended to not only pay more attention to the health status and sociodemographic characteristics of patients with chronic diseases but also build trust between nurses and patients by improving service levels and professional capabilities in clinical practice. Patients or the public were not involved in setting the research question, the outcome measures, or the design or implementation of the study. However, all participants were invited to complete the digital informed consent and questionnaires.

The Effect of the Covid-19 Pandemic on Mental Health: Quasi-Experimental Evidence from Indonesia

Introduction/Main Objectives: This research aims to explore and analyze the effect of the COVID-19 pandemic on mental health status as measured by DASS-21. Background Problems: The prolonged impact of the COVID-19 pandemic on the global economy may have adversely affected mental health. A decrease in income and consumption and the uncertainties surrounding job security and business performance have been some of the main factors contributing to mental health issues. Novelty: This paper aims to evaluate the effect of the COVID-19 pandemic—as a natural experiment—on mental health measured by DASS-21 and how the effect of the pandemic varied across different socioeconomic subgroups. Research Methods: We conducted an online survey across Indonesia to collect self-reported mental health status and socioeconomic characteristics before and during the COVID-19 pandemic to measure its impacts on mental health. Finding/Results: Our results suggest that the COVID-19 pandemic has had an adverse impact on mental health, particularly in terms of anxiety and stress. The effect has been higher among individuals with lower self-efficacy, lower expenditure, and lower education levels. Conclusion: The health and economic crisis driven by the COVID-19 pandemic affected individuals' mental health, suggesting the need for appropriate policy responses.

COVID-19 vaccination willingness among people living with HIV in Shijiazhuang, China: a cross-sectional survey.

The COVID-19 pandemic imposed an enormous disease and economic burden worldwide. SARS-CoV-2 vaccination is essential to containing the pandemic. People living with HIV (PLWH) may be more vulnerable to severe COVID-19 outcomes; thus, understanding their vaccination willingness and influencing factors is helpful in developing targeted vaccination strategies. A cross-sectional study was conducted between 15 June and 30 August 2022 in Shijiazhuang, China. Variables included socio-demographic characteristics, health status characteristics, HIV-related characteristics, knowledge, and attitudes toward COVID-19 vaccination and COVID-19 vaccination status. Multivariable logistic regression was used to confirm factors associated with COVID-19 vaccination willingness among PLWH. A total of 1,428 PLWH were included, with a 90.48% willingness to receive the COVID-19 vaccination. PLWH were more unwilling to receive COVID-19 vaccination for those who were female or had a fair/poor health status, had an allergic history and comorbidities, were unconvinced and unsure about the effectiveness of vaccines, were unconvinced and unsure about the safety of vaccines, were convinced and unsure about whether COVID-19 vaccination would affect ART efficacy, or did not know at least a type of domestic COVID-19 vaccine. Approximately 93.00% of PLWH have received at least one dose of the COVID-19 vaccine among PLWH, and 213 PLWH (14.92%) reported at least one adverse reaction within 7 days. In conclusion, our study reported a relatively high willingness to receive the COVID-19 vaccination among PLWH in Shijiazhuang. However, a small number of PLWH still held hesitancy; thus, more tailored policies or guidelines from the government should be performed to enhance the COVID-19 vaccination rate among PLWH.