Health Status Of Adults Research Articles

Improving oral hygiene for better cognitive health: Interrelationships of oral hygiene habits, oral health status, and cognitive function in older adults.

To explore the interrelationships between oral hygiene habits, oral health status and cognitive function in older adults. A cross-sectional study. A total of 371 participants (age 76.79 [7.99] years) were enrolled from June 2020 to November 2021 in an aged care facility. Cognitive function was screened using the mini-mental state examination (MMSE) with adjusted cut-off points for age and education. Periodontal status (Biofilm-Gingival Interface index based on periodontal probing depth and bleeding on probing), dental status (plaque, calculus, and caries), and tooth loss were assessed through full-mouth examination. Oral hygiene habits were based on self- or informant-reporting. Poor periodontal status was an associated factor for MCI (OR = 2.89, 95% CI = 1.20-6.95), while multiple tooth loss (OR = 4.90, 95% CI = 1.06 ~ 22.59), brushing teeth less than once a day (OR = 2.88, 95% CI = 1.12 ~ 7.45) and delayed dental visits (OR = 2.45, 95% CI = 1.05 ~ 5.68) were associated factors for cognitive impairment. An indirect effect of brushing teeth ≥2 daily on MMSE score through periodontal status was observed only in older adults without cognitive impairment (Bootstrap-corrected B = 0.17, 95%CI = 0.03 ~ 0.36, SE = 0.08, β = 0.08). Adequate toothbrushing might prevent cognitive decline indirectly by improving periodontal health only in older adults without cognitive impairment. Multiple tooth loss, infrequent toothbrushing, and delayed dental visits were associated factors for cognitive impairment. Nursing professionals and health care policymakers should advocate for the improvement of basic oral hygiene in older adults, and provide regular professional oral hygiene care for older adults with cognitive impairment. The information on oral health habits of this study was based on an interview with the participants or their caregivers during the study period.

Physical function and activity, pain, and health status in adults with myelomeningocele after orthotic management from childhood: a descriptive study

BackgroundIndividuals with myelomeningocele (MMC) exhibit neurological deficits below the lesion level involving both motor and sensory functions. Ambulation and functional outcomes in patients offered orthotic management since childhood were investigated.MethodsPhysical function, physical activity, pain, and health status were assessed in a descriptive study.ResultsOf 59 adults with MMC, aged 18–33 years, 12 were in the community ambulation (Ca), 19 in the household ambulation (Ha), six in the non-functional (N-f), and 22 in the non-ambulation (N-a) groups. Orthoses were used by 78% (n = 46), i.e., by 10/12 in the Ca, 17/19 in the Ha, 6/6 in the N-f, and 13/22 in the N-a groups. In the ten-metre walking test, the non-orthosis group (NO) walked faster than those wearing ankle-foot orthoses (AFOs) or free-articulated knee-ankle-foot orthoses (KAFO-Fs), the Ca group faster than the Ha and N-f groups, and the Ha group faster than the N-f group. In the six-minute walking test, the Ca group walked farther than the Ha group. In the five times sit-to-stand test, the AFO and KAFO-F groups required longer than the NO group, and the KAFO-F group longer than the foot orthosis (FO) group. Lower extremity function with orthoses was higher in the FO than the AFO and KAFO-F groups, higher in the KAFO-F than the AFO group, and higher in the AFO group than in those using trunk-hip-knee-ankle-foot orthoses. Functional independence increased with ambulatory function. Time spent in physical recreation was higher in the Ha than the Ca and N-a groups. There were no differences between the ambulation groups in rated pain or reported health status.ConclusionThe physical function results in persons with MMC improve our understanding of this population’s heterogeneity and shed light on the importance of individualized orthotic management. The similarities between the various ambulatory levels in physical activity, pain, and health status may mirror opportunities to achieve equal results regardless of disability level. A clinical implication of the study is that orthotic management is likely to be beneficial for the patient with MMC of which the majority used their orthoses for most time of the day.

Risk of periodontitis & dental caries among 35 to 44 year old diabetic individuals: A case control study.

The World Health Organization (WHO) has recommended the age group of 35-44 years for surveillance of oral health conditions in adults. There is a growing incidence of early onset of Type 2 diabetes mellitus (T2DM) worldwide. This study was conducted to find the strength of association between dental caries and periodontitis in patients with T2DM. This was a case-control study conducted among 35-44-year-old patients with T2DM (n = 185) reporting to various hospitals of Belagavi city and controls (n = 185), who met the inclusion criteria. Group matching was done for age and gender. The study participants were interviewed for their sociodemographic details, relevant medical history, oral health behaviors, and dietary behaviors using a self-designed questionnaire. Dental caries and periodontal status were recorded using the WHO criteria, 2013. The mean decayed missing filled teeth was significantly higher among controls than cases (P = 0.006). A significantly higher number of cases had periodontal pockets (crude odds ratio: 6.6) as compared to controls. Regression analysis showed that loss of attachment was significantly associated with T2DM (adjusted odds ratio: 5.9, 95% confidence interval: 2.81-6.89). Periodontitis was found to be associated with T2DM. However, no such association was found between dental caries and T2DM.

Oral health status and related behavior in adults from North-Eastern region of Romania

Oral health status and related behavior in adults from North-Eastern region of Romania

Adolescent health problems and strategies to improve them

Adolescent as any person between ages 10 and 19. It is a transitional stage of physical, physiological and psychological development from puberty to legal adulthood. The data about important adolescent’s health issues in different areas are limited. Hence detailed investigation and reports on adolescent’s health issues is the need of the hour. To achieve wholesome adolescent health, we need to have a multidimensional approach covering all the adolescent health problems with special emphasis on mental health, behavior change communication towards healthy lifestyle and positive social environment to acquire life skills. Availability of good quality care and healthcare workers trained to deal with adolescents is critical for delivering effective health interventions. Providing health care to adolescents presents a dual challenge: the treatment of immediate health problems, and the opportunity through health promotion and disease prevention, to influence health habits, lifestyle choices, and health status in adulthood because health behaviors originating in adolescence may well have long term health consequences.

Effectiveness of Digital Health Literacy Interventions in Older Adults: Single-Arm Meta-Analysis.

In a world of rapid digital technology development, the lack of digital health literacy (DHL) among older people cannot be ignored. DHL is becoming an essential competency that can facilitate the health status and health management of older adults. DHL interventions that are feasible and appropriate can be implemented on a large scale through the health care system for older people. The purpose of this meta-analysis was to assess the effectiveness of DHL interventions for older adults. English publications in PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to November 20, 2022. Two reviewers independently completed the data extraction and quality assessment. Review Manager (version 5.4; Cochrane Informatics & Technology Services) software was used for all meta-analyses. A total of 7 studies, including 2 randomized controlled trials and 5 quasi-experimental studies, involving 710 older adults were considered eligible. The main outcome was scores on the eHealth Literacy Scale, and secondary outcomes were knowledge, self-efficacy, and skills. Quasi-experimental studies compared baseline and postintervention outcomes, while randomized controlled trials compared pre- and postintervention outcomes in the intervention group. Of the 7 studies, 3 used face-to-face instruction, while 4 adopted web-based interventions. Among them, 4 of the interventions were conducted using theoretical guidance, while 3 were not. Intervention duration varied from 2 to 8 weeks. In addition, the studies included were all conducted in developed countries, mainly in the United States. Pooled analysis presented that DHL interventions had positive effects on eHealth literacy efficacy (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001). Subgroup analysis revealed that DHL interventions that chose face-to-face teaching (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), were guided by a conceptual framework (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), and were sustained over 4 weeks (standardized mean difference 1.1, 95% CI 0.46 to 1.84; P=.001) had a more significant effect. Moreover, the outcomes showed considerable gains in knowledge (standardized mean difference 0.93, 95% CI 0.54 to 1.31; P<.001) and self-efficacy (standardized mean difference 0.96, 95% CI 0.16 to 1.77; P=.02). No statistically significant effect was found for skills (standardized mean difference 0.77, 95% CI -0.30 to 1.85; P=.16). The small number of studies, variable study quality, and heterogeneity are some limitations of this review. DHL interventions have positive effects on the health status and health management of older adults. Practical and effective DHL interventions are crucial for the use of modern digital information technology in managing the health of older people. PROSPERO International Prospective Register of Systematic Reviews CRD42023410204; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=410204.

Perceptions of Relatives about Symptoms and Signs in Older Adults with Sepsis: A Cross-Sectional Study

Sepsis is a common health condition in older adults that may present with typical or atypical symptoms and signs. The perception of warning symptoms and signs by relatives is important in their decision to seek hospital medical treatment. This cross-sectional study was conducted to explore the symptoms and signs of sepsis in older adults as perceived by their relatives, the awareness of symptoms and signs of sepsis, and the duration from the symptom onset to hospital arrival at a tertiary care hospital in Bangkok, Thailand. Seventy-seven dyads of older adults with sepsis and their relatives were recruited. Data were collected using the Personal Information of Older Adults and Relatives Questionnaire and the Symptoms and Signs of Sepsis Questionnaire. Descriptive statistics and Fisher’s exact test were used to analyze the data. Results revealed that both typical and atypical symptoms and signs occurred in older adults with sepsis. The top five typical presentations were drowsiness/deep sleep, rapid breathing, fever, chilling, and difficulty breathing. The top five atypical presentations were malaise or fatigue, loss of appetite, signs of dehydration, comorbidity exacerbations, and decreased activities of daily living. Atypical presentations were the most common presentations that relatives were unsure of and did not recognize as sepsis. The majority of older adults with sepsis (72.7%) arrived at the emergency department within 24 hours of the onset of symptoms or signs. There was no significant difference between the number of participants arriving at the emergency department within ≥24 hours, classified by typical and atypical presentations. These findings point to the important role of relatives to be proactive in the management of sepsis in older adults, starting at home. Nurses should teach relatives about early detection and timely seeking of medical care in hospitals. A system of telehealth consultations through phone or video calls should be established to facilitate healthcare-seeking decisions prior to clinical deterioration.

Determinants of Self-Rated Health for Adults in Türkiye

Objective: Self-rated health as an important health outcome is affected by several factors. It is of great importance to investigate the determinants of self-rated health of individuals in order to obtain better results regarding public health. The purpose of this study was to determine the factors that affect the self-rated health of adults in Türkiye. &#x0D; Methods: Logistic regression analysis was performed to analyze data from the TurkStat’s 2014 Health Survey, with 19,129 people. The independent variables were related to socio-economic characteristics, health problems, lifestyle, and utilisation of healthcare services, while the dependent variable was self-rated health. &#x0D; Results: It was found that younger people, men, and people with higher educational and income levels rated their health status better. The health status of individuals with chronic diseases, mental disorders, sleeping problems and those who did not have a normal range body mass index also rated their health status as poor. However, the self-rated health of people who had no inpatient treatment in the last 12 months and those who took no prescription medicine in the last two weeks was good. &#x0D; Conclusion: This study provided the identification of the most advantaged and disadvantaged groups through determining the factors affecting the health status of adults in Türkiye. To improve the unfavourable condition of disadvantaged individuals, more specific interventions need to be designed and implemented.

Self-Rated Oral Health as a Valid Measure of Oral Health Status in Adults Living in Rural Australia.

It is unclear how well self-rated oral health (SROH) reflects actual oral health status in the rural Australian population. Therefore, this study aimed to compare the clinically assessed oral health status and SROH of adults living in rural Australia. The data were from 574 participants who took part in the Crossroads II cross-sectional study. Three trained and calibrated dentists evaluated the oral health status of participants based on WHO criteria. SROH was assessed with the question 'Overall, how would you rate the health of your teeth and gums?', with a score ranging from excellent = 5 to poor = 1. A logistic regression analysis (LRA) was performed, allowing us to assess factors associated with SROH. The mean age of participants was 59.2 years (SD 16.3), and 55.3% were female. The key results from the LRA show poorer SROH in those with more missing teeth (OR = 1.05; 95% CI; 1.01-1.08), more decayed teeth (OR = 1.28; 95% CI: 1.11-1.46), and more significant clinical attachment loss of periodontal tissue (6mm or more) (OR = 2.63; 95% CI: 1.29-5.38). This study found an association between negative SROH and clinical indicators used to measure poor oral health status, suggesting that self-rated oral health is an indicator of oral health status. When planning dental healthcare programs, self-reported oral health should be considered a proxy measure for oral health status.

Investigating the Impact of Social Media Usage on the Mental Health of Young Adults in Buffalo City, South Africa

In South Africa, social media usage has consistently increased over time, with young individuals being the most active users. However, there are concerns about mental illness, such as depression, as a result of the surge in social comparison. This study explored the relationship between social media usage and mental health among young adults in the Buffalo City Metropolitan Municipality. This study used a quantitative research approach and was based on the positivism paradigm. Data was collected from 127 young individuals aged 14 to 35 who live in the Buffalo City Metropolitan Municipality through the use of structured questionnaires. The data collected was analysed using a descriptive statistical package for the social sciences. The findings of the study amongst others showed that the young adults spend an average of 6 hours per day on social media platforms. Also, the fear of missing out (FoMO) was identified as another major reason why young adults stay on social media platforms for long hours every day. Based on the results presented in this study, one can convincingly state that the excessive use of social media is negatively contributing to the mental health status of young adults. Some of these detrimental impacts include depression, anxiety, low self-esteem, suicide and other mental health issues. The study recommends amongst others that an urgent and continuous well-structured awareness campaign be made to help sensitise the young adults on the danger of excessive use of social media platforms, both on their mental health status and life in general.

Association between adverse childhood experiences and social integration among older people in Japan: Results from the JAGES study

Social integration, network, and support are beneficial to health. However, there is little evidence of the association between adverse childhood experiences (ACEs) and social integration in later life. This study investigates the association between ACE history and social integration in older people. We used data from the Japan Gerontological Evaluation Study (JAGES) 2013, which conducted a self-reported survey of functionally independent people aged ≥ 65 years from 30 municipalities across Japan and yielded information on ACE history. We conducted a Poisson regression analysis with robust error variances to assess the association between ACE history and social integration, adjusting for sex, age, childhood economic hardship, adult socioeconomic status, health status, living status, and trust in others. The number of respondents with at least one incident of ACE was approximately 36.8%. The prevalence ratios for those who reported a history of ACEs were as follows: housebound 1.495 (95% confidence interval [CI]: 1.19–1.88), small network size 1.146 (95% CI: 1.10–1.19), low network contact 1.059 (95% CI: 1.00–1.059), non-membership sports group 1.038 (95% CI: 1.00–1.07), and non-membership hobby group 1.06 (95% CI: 1.03–1.09). Among older people in Japan, a history of ACEs is inversely associated with social integration. These findings support the life course approach and suggest that adverse events in early life may have an impact on social life in old age. In order to promote healthy aging, it is important to recognize the significant impact of early-life adversities that can extend into later life.

Prevalence and Factors Related to Functional Status of Older Adult Patients in Primary Health Care

Functional status means the ability to perform self-care, self-maintenance, and daily activity. Older adults are at risk of experiencing a decline in functional status regarding their condition and other factors. The study literature found no clear evidence of the factors related functional status of older adults, especially those who have comorbid and regularly come to the geriatric clinic in the Primary Health Care Center. This study aimed to identify the prevalence and factors related to the functional status of older people who visit geriatric out-patient in the primary health care center. A cross-sectional design was utilized to assess 100 samples of older adult patients in one Primary Health Care Center, in Indonesia. The functional status of the respondent was good where the mean score was 7.45 (SD = 1.07) with a minimum score was 2, and a maximum score was 8. The mean age of the sample was 66 years old, the gender was primarily women (59%), the education level of the respondents was more likely only reach elementary school (45%), and primarily they consume drugs (71%) and also more than a half of respondent have multimorbidity (60%). The model fit of multivariate analysis resulted in 44% of all the variables giving effect to the functional status where the most influential factor was balance and health status of the older adults. Discussion: More than half of the older people who regularly visit the Primary Health Care Center have an excellent functional status. This condition is in accordance with the experience of older people itself who most of them could come to the clinic independently by public or private transportation. Older people who have good health or balance status and less morbidity also show a good performance in functional status, though, their age was older. All the variables give 44% effects of older people’s functional status where the most influential factor for functional status of the older adults was balance status. Therefore, the accessibility of health services for the older adult in the community can be improved by providing more elderly-friendly health facilities.

Age-related physical health of older autistic adults in Sweden: a longitudinal, retrospective, population-based cohort study

Research of health outcomes in older autistic adults (≥45 years) is concerningly scarce, and little is known about whether intellectual disability and sex affect the health outcomes of this population. The aim of this study was to investigate the association between autism and physical health conditions in older adults and to examine these associations by intellectual disability and sex. We conducted a longitudinal, retrospective, population-based cohort study of the Swedish population born between Jan 1, 1932, and Dec 31, 1967, using linked data from the nationwide Total Population Register and the National Patient Register. We excluded individuals who died or emigrated before the age of 45 years, or with any chromosomal abnormalities. Follow-up started at age 45 years for all individuals, and ended at emigration, death, or Dec 31, 2013 (the latest date of available follow-up), whichever was soonest. Diagnoses of autism, intellectual disability, 39 age-related physical conditions, and five types of injury (outcomes) were obtained from the National Patient Register. For each outcome, we calculated 25-year cumulative incidence and used Cox models to estimate hazard ratios (HRs). All analyses were repeated separately by intellectual disability and sex. Of 4 200 887 older adults (2 063 718 women [49·1%] and 2 137 169 men [50·9%]) in the study cohort, 5291 (0·1%) had a diagnosis of autism recorded in the National Patient Register. Older autistic adults (median follow-up 8·4 years [IQR 4·2-14·6]) had higher cumulative incidence and HRs of various physical conditions and injuries than their non-autistic counterparts (median follow-up 16·4 years [8·2-24·4]). In autistic individuals, the highest cumulative incidence was observed for bodily injuries (50·0% [95% CI 47·6-52·4]). Conditions that autistic adults were at higher risk of than were non-autistic adults included heart failure (HR 1·89 [95% CI 1·61-2·22]), cystitis (2·03 [1·66-2·49]), glucose dysregulation (2·96 [2·04-4·29]), iron deficiency anaemia (3·12 [2·65-3·68]), poisoning (4·63 [4·13-5·18]), and self-harm (7·08 [6·24-8·03]). These increased risks mainly persisted regardless of intellectual disability or sex. Our data indicate that older autistic adults are at substantially increased risk of age-related physical conditions and injuries compared with non-autistic adults. These findings highlight the need for collaborative efforts from researchers, health services, and policy makers to provide older autistic individuals with the necessary support to attain healthy longevity and a high quality of life. Swedish Research Council, Servier Affaires Medicales. For the Swedish translation of the abstract see Supplementary Materials section.

Perceived barriers to maintain physical activity and its association to mental health status of Bangladeshi adults: a quantile regression approach

Insufficient physical activity and unhealthy lifestyle preferences have been significant concerns for decades. This study aimed to determine the perceived barriers to maintaining physical activity among adults in three major cities of Bangladesh and their association with mental health status. This is a cross-sectional study where 400 participants were selected using a multistage sampling technique. Twenty municipal wards were randomly selected from three cities, followed by a convenient selection of the study participants from each ward. Questionnaires about perceived physical activity barriers were developed based on previously published literature. The DASS-21 scale assessed the mental health status of the study participants. Descriptive statistics were applied to narrate the baseline characteristics of the respondents. The Shapiro–Wilk test was used to check the normality of the perceived physical activity scores. Quantile regression analysis was applied to model the physical activity barrier scores depending on several covariates. Five quantiles were used: the 10th, 25th, 50th, 75th, and 90th. A p-value less than 0.05 was considered significant for hypothesis testing. Among the respondents, 68.50% were male, half of them were married, 68.0% belonged to nuclear families, 48.0% completed graduate level education, 34.25% were service holders, one-third of the respondent's working hours were 6–8 h, and 19.50% belongs to the overweight and obese groups. Poor traffic and construction work near the road (60.30%) was seen as the most significant barrier to physical activity. Over half of the respondents stated that lack of time, facilities, and expenses hinder physical activity. Mental health status reported mild to extremely severe levels of depression (32%), anxiety (47%), and stress (42.50%), respectively. Significant associations between the perceived physical activity scores and gender, family type, occupation, income, BMI, anxiety, and depression were obtained. Ensuring a safe environment, facilitating accessibility and availability of low-cost exercise facilities, improving road and traffic conditions, and providing appropriate mental health counseling may help to mitigate physical activity barriers.

P337 Bone health status and audit of DEXA scan frequency of adults with cystic fibrosis at a UK centre

Adults with CF are at increased risk of low bone mineral density (BMD), with single-centre studies reporting up to 70% may have lower than expected BMD due to factors such as lung disease, cortico-steroid treatment, low body mass index (BMI), nutrient malabsorption, and insufficient weight bearing exercise. CF guidelines recommend screening patients using dual energy x-ray absorptiometry (DEXA) at specific intervals to enable identification and timely management of low BMD. This audit was conducted to assess bone health status of adults with CF at a UK centre.

The effect of informal social support on the health of Chinese older adults: a cross-sectional study

BackgroundThis study aimed to assess the effect of informal social support (ISS) on the health of Chinese older adults, identify channels of the association between the two, and assess the magnitude of this effect in different groups of older adults.MethodsBased on the data from the 2018 China Longitudinal Aging Social Survey (CLASS), we first used both the Quality of Well-Being (QWB) scale and the analytic hierarchy process (AHP) method to construct the QWB score that can objectively measure the health status of Chinese older adults. Next, we conducted an econometric equation controlling for various high-dimensional fixed effects, estimated the effects using the Tobit model, and used various robustness check strategies and the propensity score matching (PSM) method to ensure reliability and deal with the potential endogeneity, respectively. Finally, we performed staging and grouping regression for mechanism and heterogeneity analysis.ResultsThe mean QWB score of Chinese older adults was 0.778. ISS has a significant positive effect on the health of older adults (P < 0.001), and there were similar patterns of findings for the effects of SE (P < 0.001), PSS (P < 0.001), and ES (P < 0.001). Additionally, the health promotion effect is higher in older adults who are male (P < 0.001), under the age of 80 (P < 0.001), with agricultural household registration (P < 0.001), or with high income (P < 0.001) than in the control group.ConclusionISS, including SE, PSS, and ES, had significant promotion effects on the health of older adults, especially on those who are male, under the age of 80, with agricultural household registration, or with high income. Meanwhile, these effects could be reflected through two channels: alleviating loneliness and improving the positive emotional status of older adults.

Information needs and health status in adolescents and young adults with differences of sex development or sex chromosome aneuploidies

When and how to provide condition-related information to adolescents and young adults (AYAs) with differences of sex development or sex chromosome aneuploidies (DSDs or SCAs) is largely based on anecdotal experience and lacks informed guidance. For AYAs with a DSD or SCA, having accurate information is critical for attaining optimal adjustment and well-being, participating in decision making related to treatment options, and transitioning successfully to adult health care, yet prior studies have focused exclusively on parental perspectives and not on the views of adolescents themselves. The objective of this study was to describe unmet information needs in AYAs with a DSD or SCA and examine associations with perceived global health. Participants were recruited from specialty clinics at Children's Hospital of Philadelphia (n=20) and Children's Hospital Colorado (n=60). AYAs ages 12-21 years with a DSD or SCA and a parent completed a survey assessing perceived information needs across 20 topics, importance of those topics, and global health using the PROMIS Pediatric Global Health questionnaire (PGH-7). AYAs had diagnoses of Klinefelter syndrome (41%), Turner syndrome (25%), and DSD (26%) and were 16.7 years (SD=2.56) and 44% female. Parent participants were primarily mothers (81%). AYAs perceived that 48.09% of their information needs were unmet (SD=25.18, range: 0-100). Parents perceived that 55.31% of AYAs' information needs were unmet (SD=27.46 range: 5-100). AYAs and parents across conditions reported unmet needs related to information about transition to adult health care, financial support for medical care, and how the condition might affect the AYA's health in the future. While AYA-reported PGH-7 scores were not associated with percentage of AYA unmet information needs, parent-reported PGH-7 scores were (r=-.46, p<.001), such that lower parent-reported global health was associated with higher percentage of AYA unmet information needs. On average, parents and AYAs perceived that half of AYAs' information needs were unmet, and a higher percentage of AYA unmet information needs was associated with lower perceived global health. The frequency of unmet needs in this sample of AYAs reflects an opportunity for improvement in clinical care. Future research is needed to understand how education to children and AYAs unfolds as they mature and to develop strategies to address the information needs of AYAs with a DSD or SCA, promote well-being, and facilitate AYA engagement in their own health care.

The co-occurrence and cumulative prevalence of hypertension, rheumatoid arthritis, and hypothyroidism in preterm-born women in the Women's Health Initiative.

Emerging evidence suggests that preterm-born individuals (<37 weeks gestation) are at increased risk of developing chronic health conditions in adulthood. This study compared the prevalence, co-occurrence, and cumulative prevalence of three female predominant chronic health conditions - hypertension, rheumatoid arthritis [RA], and hypothyroidism - alone and concurrently. Of 82,514 U.S. women aged 50-79 years enrolled in the Women's Health Initiative, 2,303 self-reported being born preterm. Logistic regression was used to analyze the prevalence of each condition at enrollment with birth status (preterm, full term). Multinomial logistic regression models analyzed the association between birth status and each condition alone and concurrently. Outcome variables using the 3 conditions were created to give 8 categories ranging from no disease, each condition alone, two-way combinations, to having all three conditions. The models adjusted for age, race/ethnicity, and sociodemographic, lifestyle, and other health-related risk factors. Women born preterm were significantly more likely to have any one or a combination of the selected conditions. In fully adjusted models for individual conditions, the adjusted odds ratios (aORs) were 1.14 (95% CI, 1.04, 1.26) for hypertension, 1.28 (1.12, 1.47) for RA, and 1.12 (1.01, 1.24) for hypothyroidism. Hypothyroidism and RA were the strongest coexisting conditions [aOR 1.69, 95% CI (1.14, 2.51)], followed by hypertension and RA [aOR 1.48, 95% CI (1.20, 1.82)]. The aOR for all three conditions was 1.69 (1.22, 2.35). Perinatal history is pertinent across the life course. Preventive measures and early identification of risk factors and disease in preterm-born individuals are essential to mitigating adverse health outcomes in adulthood.

Double Stigma in Portuguese Lesbian, Gay, and Bisexual Older Adults: A Study of Health Status

The double stigma—sexual stigma and ageism—can affect the health status of lesbian, gay, and bisexual (LGB) older adults, but little is known about this topic in Portugal and internationally. The aim of this study was to assess the health status and the prevalence of chronic diseases of Portuguese LGB older adults, as well as to assess the relationship between double stigma and health status. A sample of 280 Portuguese LGB older adults completed a chronic disease questionnaire, the Homosexuality-Related Stigma Scale, the Ambivalent Ageism Scale, and the SF-12 Short Form Health Survey. A structural equation model was performed using the double stigma variables as independent variables and health status as outcome. The mental health status of Portuguese LGB older adults was lower when compared to people from studies from more than 10 countries. Higher sexual self-stigma, sexual enacted stigma related to health care, and benevolent ageism significantly explained the worse general health status. The double stigma significantly affects the health status of these older adults in a profile of internalization of sexual stigma and benevolent age discrimination, and not necessarily by a hostile/aggressive profile. More research is needed on the double stigma.

The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis

BackgroundThe majority of people with a chronic disease (e.g., diabetes, hypertension, COPD) have more than one concurrent condition and are also at higher risk for developing comorbidities in mental health, including anxiety and depression. There is an urgent need for more relevant and accurate data on digital interventions in this area to prepare for an increase demand for mental health services. The aim of this study was to conduct a meta-analysis of the digital mental health interventions for people with comorbid physical and mental chronic diseases to compare the effect of technology systems and level of support.MethodsThis secondary meta-analysis follows a rapid review of systematic reviews, a virtual workshop with knowledge users to identify research questions and a modified Delphi study to guide research methods: What types of digital health interventions (according to a recognized categorization) are the most effective for the management of concomitant mental health and chronic disease conditions in adults? We conducted a secondary analysis of the primary studies identified in the rapid review. Two reviewers independently screened the titles and abstracts and applied inclusion criteria: RCT design using a digital mental health intervention in a population of adults with another chronic condition, published after 2010 in French or English, and including an outcome measurement of anxiety or depression.ResultsSeven hundred eight primary studies were extracted from the systematic reviews and 84 primary studies met the inclusion criteria Digital mental health interventions were significantly more effective than in-person care for both anxiety and depression outcomes. Online messaging was the most effective technology to improve anxiety and depression scores; however, all technology types were effective. Interventions partially supported by healthcare professionals were more effective than self-administered.ConclusionsWhile our meta-analysis identifies digital intervention’s characteristics are associated with better effectiveness, all technologies and levels of support could be used considering implementation context and population.Trial registrationThe protocol for this review is registered in the National Collaborating Centre for Methods and Tools (NCCMT) COVID-19 Rapid Evidence Service (ID 75).