Individual Health Research Articles

The effect of nurse health literacy interventions on patient health literacy scores in specialty consultations: a quasi-experimental study

BackgroundPatient health literacy (HL) affects health and wellbeing on both individual and population levels. The ability to receive, understand, manage and act upon health information can be positively influenced by nurses’ use of HL strategies. This study examined the relationship between nurses’ use of a HL checklist (intervention) and before and after patient HL scores, and the effects of frequency and types of strategies used in specialty consultations in Spain.MethodsThis quasi-experimental, non-randomized study used the HLS19-Q12 to calculate HL scores for 149 patients. Calculations were performed both before and after a nursing intervention that consisted of using a HL checklist. Paired samples t-test assessed the difference between patient HL scores pre- and post-nurse intervention. Frequency analysis and Pearson correlation where used to examine frequencies of nursing HL strategies used and associations with HL scores.ResultsThe mean difference between the HLS19-Q12 scores before and after intervention was − 9.94, with a standard deviation of 11.50. There was a statistically significant effect of the intervention on HL score (t = -10.00, p < 0.001). No participant had HL classified as ‘inadequate’ after the nursing intervention. Verbal teach back method was the most frequent strategy used by nurses, and the use of a computer image was the most frequent visual aid.ConclusionsThe use of a standardized HL intervention by nurses was shown to have a positive effect on patient general HL scores in specialty consultations in Spain. These results not only suggest that the use of a HL checklist can be an effective HL tool, but also reinforce the potential of nurses to make a positive impact on both individual and population health. Overall, these findings provide data that can be used by health systems, hospitals management, and nurse education programs to adopt strategies to improve patient HL and health outcomes, while potentially lowering costs and ineffective resource utilization related to inadequate HL.

Prevalence of Edentulousness among Patient visiting a Tertiary Care Centre

Introduction: Absence of teeth i.e., edentulism is a common oral health issue worldwide and is an under evaluated disability. It is a preventable oral disability which brings major impact on overall health of individuals affecting the function, aesthetics, comfort and psychology. So, it should be identified and awareness for its management should be done so as to improve the quality of life of an individual. Objective: The purpose of this study was to collect baseline data on edentulism in the Nepalese population so that community-level awareness and educational programs could explain the importance of replacement lost teeth with prosthesis. Methods: The study was conducted in the College of Medical Sciences in the department of Oral medicine and Radiology and in the department of Prosthodontics from the patient visiting in these OPD for five months duration. Data were recorded in proforma and classified as complete / partial edentulous and further classified into Kennedy’s classification. The data were recorded and analyzed in SPSS 20. Result: Out of 301 patients, 24 (8%) had total edentulism, while 277 (92% had partial edentulism). Of the partially edentulous individuals, 90 showed just maxillary edentulism, 148 showed only mandibular edentulism, and 39 showed both maxillary and mandibular edentulism. Conclusion: Females were more likely than males to exhibit partial edentulism. Females showed more Kennedy's Class III classification than males. Both had equal complete edentulism. The mandibular arch showed more partial edentulism than the maxillary arch.

Individuals' top values and health behavior engagement: results of a National US Survey.

Although linked with subjective wellbeing, little research has examined relations of values with health behaviors and health. Because values are principles that guide behavior across situations, this exploratory retrospective study examined how individuals' highest value relates to their health behaviors and health. Participants were 3865 (aged 18-89 years) adults who completed the Health Information National Trends Survey (HINTS), a nationally-representative survey administered by the US National Cancer Institute. HINTS 5 Cycle 4 data were collected early in 2020. Participants selected the value most important to them in their day-to-day life from a set of seven values. Five categories of health-related measures were assessed in relation to values: substance use, physical activity, cancer screening, general health, and coping. Top values were safety of family (29.9%), happiness (20.9%), and autonomy (14.1%). Findings indicated that some top values, such as health and religion, were associated favorably with some health behaviors, while other top values, such as happiness or autonomy, were in some instances associated with poorer health behaviors. These results, while exploratory, suggest that individuals' highest value may be meaningfully related to their health behaviors and self-reported health status. Future research into values and health appears warranted.

Health Coaching Impacts Stage-Specific Transitions in Multiple Health Behaviors for Patients at High Risk for Coronary Heart Disease and Type 2 Diabetes: A Multigroup Latent Transition Analysis.

Multiple behavior change interventions have gained traction in the behavioral health space. Yet, previous studies on health coaching (HC) focused on testing its effect on stages of change for individual health behaviors. The purpose of this study was to examine the effects of HC on stages of change across multiple health behavior domains among patients at high risk of coronary heart disease and type 2 diabetes. This secondary analysis of a randomized clinical trial included 200 primary care patients (mean age of 47.7 years, 49.0% women, 60.5% Whites) who completed transtheoretical model-based questionnaires related to weight reduction, exercise, healthier eating, and stress management. Multigroup latent transition analysis was used to compare the stage of change distributions and transitions over time between HC and controls at baseline, midpoint of the intervention (3 months), and postintervention (6 months). Three distinct categories of behavior change were identified ("Contemplation," "Preparation to Action," and "Action"), and membership in these categories changed over time as a function of intervention exposure. Both groups exhibited positive transitions through stages of change from baseline to 3 months. Pronounced intervention effects emerged from 3 to 6 months, revealing larger differences in transition probabilities between the groups. In particular, HC increased patients' likelihood of transitioning from "Contemplation" to both "Preparation for Action" and "Action," as well as from "Preparation for Action" to "Action." The control group remained stagnant during the same period. Although HC produces changes across multiple behavioral domains, it was most effective for patients who were reluctant or ambivalent about changing their behaviors.

Uptake of Digital Health Interventions for Cardiometabolic Disease in British South Asian Individuals: Think Aloud Study.

Digital health interventions (DHIs) could support prevention and management of cardiometabolic disease. However, those who may benefit most often experience barriers to awareness and adoption of these interventions. Among South Asian individuals, we evaluated user experience of DHIs for prevention and management of cardiometabolic disease, aiming to understand barriers and facilitators to initial and ongoing use. Among South Asian individuals recruited via primary care, community organizations, and snowball methods (n=18), we conducted "think-aloud" interviews using a reflective and reactive approach. Participants included nonusers, as well as those that used a range of DHIs as part of monitoring and improving their health. Participants were asked to think aloud while completing a task they routinely do in a familiar DHI, as well as while setting up and completing a search task in a novel DHI; they were encouraged to behave as if unobserved. Lack of cultural specificity was highlighted as reducing relevance and usability, particularly relating to dietary change. Preferred features reflected individual health beliefs and behaviors, digital skills, and trust in DHIs. For example, tracking blood glucose was considered by some to be positive, while for others it caused distress and anxiety. Similarly, some users found the novel DHI to be extremely simple to set up and use, and others grew frustrated navigating through initial interfaces. Many participants raised concerns about data privacy and needing to agree to terms and conditions that they did not understand. Participants expressed that with information and support from trusted sources, they would be interested in using DHIs as part of self-management. DHIs may support South Asians to prevent and manage cardiometabolic disease, but it is important to consider the needs of specific user groups in DHI development, design, and implementation. Despite motivation to make health changes, digital barriers are common. Cultural appropriateness and trusted sources (such as health care providers and community organizations) have roles in increasing awareness and enabling individuals to access and use DHIs.

Risk of physical health comorbidities in autistic adults: clinical nested cross-sectional study.

Physical health conditions are more common in individuals with autism. Some, like epilepsy, have considerable evidence supporting their increased prevalence, but many diseases lack literature to make strong conclusions. To investigate the prevalence of physical health comorbidities in autism. We undertook a nested cross-sectional study, using a sample from the National Centre for Mental Health database. It included participants from England and Wales who reported a clinician-made diagnosis of autism (n = 813), and a control sample without autism or mental illness (n = 2781). Participants had provided a medical history at enrolment. Analysis was carried out by binomial logistic regressions controlling for age, gender, smoking status, and antipsychotic and mood stabiliser use. A subanalysis of individuals with concurrent intellectual disability (n = 86) used binomial logistic regression with the same control variables. Many physical health conditions were significantly more common in autism. Sixteen out of 28 conditions showed increased odds, with the highest odds ratios observed for liver disease, chronic obstructive pulmonary disease, kidney disease, osteoporosis and rheumatoid arthritis. A subanalysis demonstrated a similar pattern of physical health in individuals with autism with and without concurrent intellectual disability. Some conditions, including osteoporosis, hyperthyroidism, head injury and liver disease, had larger odds ratios in individuals with concurrent intellectual disability. Physical health conditions occur more commonly in individuals with autism, and certain conditions are further increased in those with concurrent intellectual disability. Our findings contribute to prior evidence, including novel associations, and suggest that people with autism are at greater risk of physical health problems throughout adulthood.

Assessing distributional justice around Cultural Ecosystem Services (CES) provided by urban green areas: The case of Bologna

Cultural Ecosystem Services (CES) and related flows of benefits – heavily influencing societal and individual health and wellbeing - are usually ascribed non-consumptive values. However, despite the increasing recognition of their contribution to citizens’ quality of life, the intangible nature of CES makes it difficult to quantify them and hard to be integrated in decision making and planning processes. Nevertheless, the assessment of the societal relevance of CES would largely help to improve people wellbeing and quality of life. CES depend not only on the characteristics and features of urban green areas, but also on preferences and needs of the users that interact with them and that contribute to co-produce ES related benefits and values. These diverse needs, coupled with the uneven distribution of urban green area and diverse ways of managing them in the city, could affect the way ES are produced and further exacerbate existing inequalities and disparities. This contribution investigates the case study of the city of Bologna, introducing a spatial approach based on a new and pluralistic notion of urban green area that consider sport facilities and Green Stewards activities, to assess the related CES co-production paths and distributional dimension of justice in the city. Results show a good accessibility to urban green area throughout the city of Bologna (around .70 %). Nevertheless, CES co-production paths are limited in those areas of the city with higher population vulnerability index, due to lower urban green area facilities and green stewards activities, thus highlighting areas with higher distributional and procedural injustice path.

Discrimination and health outcomes in England's black communities amid the cost-of-living crisis: evaluating the role of inflation and Bank Rates

ABSTRACT This study utilised longitudinal data from Black History Month events in London from 2021 to 2023. Novel findings revealed that increased inflation and Bank Rates, related to the cost-of-living crisis, were associated with greater discrimination and deteriorations in both general and mental health for Black individuals. Moreover, it was found that during the cost-of-living crisis period, i.e. 2022–2023, discrimination was more adversely related to general and mental health deterioration compared to the period before the cost-of-living crisis, i.e. 2021. In addition, women, non-native individuals, non-heterosexual individuals, the unemployed, economically inactive individuals, those with lower educational attainment, and older individuals experienced higher levels of discrimination and reduced general and mental health compared to reference groups. The findings of the study contribute to the literature by demonstrating the intertwined associations of macroeconomic deteriorations and discrimination with the health of the Black community, and its subgroup differences, providing a basis for targeted policies.

The Association Between Obesity, Chronic Inflammation, Metabolic Disorders and Mood Disorders Among Patients up to 12 Months After Hospitalization for SARS-CoV-2

Background/Objectives: The relationship between BMI, inflammation, and mental health is complex. A high BMI, especially obesity, is associated with chronic inflammation, which can lead to mental disorders such as depression. Inflammatory cytokines affect neurotransmitters and the stress axis, worsening mental health. Obesity and mental disorders can mutually reinforce each other. New findings show that inflammation can lead to neurobiological changes, and the gut microbiota may play a key role. Obesity has been implicated as a factor in the high mortality and duration of influenza-like illnesses, even in people who do not have other chronic diseases that may increase the risk of complications. The aim of this study was to determine the associations between BMI and chronic inflammation, metabolic disorders, depression, and anxiety in patients hospitalized with COVID-19 up to 12 months after hospitalization. Methods: The study included 248 participants previously hospitalized for SARS-CoV-2 infection up to 12 months after hospitalization. The study was conducted in a multistage design using a diagnostic survey, anthropometric measurements, and laboratory methods. Results: A statistically significantly higher BDI-II score was observed among women. Statistical analysis showed a statistically significant higher GAD-7 score among women and those over 75 years of age. Conclusions: Higher BMI among subjects is often associated with elevated values of inflammatory markers and immune cells, such as WBC, neutrophils, monocytes, and CRP, as well as higher blood glucose levels. These associations may be related to the chronic inflammation and metabolic disorders that often accompany obesity. Lymphocytes and eosinophils may show more varied relationships depending on individual factors and specific health conditions. It is therefore important to continue research in this area.

Drone-based infrared thermography to measure the intranasal temperature of baleen whales

ABSTRACT Traditional methods for quantifying the internal temperature of marine mammals require handling live animals, which is not practical for free-swimming baleen whales. Developing a less invasive, more repeatable method would significantly improve our understanding of whale health and thermal physiology. Infrared thermography (IRT) devices compatible with remotely piloted aircraft systems (RPAS) have facilitated qualitative assessments of heat signatures from marine mammals at sea, but absolute temperatures derived using this approach are rare. The goal of this study was to develop a precise empirical method for estimating intranasal temperatures of baleen whales using RPAS-based IRT. We conducted controlled field experiments and flights over North Atlantic right whales (Eubalaena glacialis, NARWs) to develop and test the methodology. Two approaches were evaluated to estimate intranasal temperatures from IRT sensor intensities: a three-point empirical line regression calibrated per flight using known-temperature objects and a generalized linear model incorporating environmental variables. Controlled field experiments demonstrated that the former approach had a median bias of −0.6°C (interquartile range: 1.5ºC), while the latter approach had unexplained negative proportional bias with increasing true temperature of the target object. After accounting for bias, the former approach yielded an average intranasal temperature of 26.9 ± 1.7°C for 21 unique NARWs. The anatomy of the mysticete upper respiratory tract and physiological heat conservation strategies may explain why estimates were low compared to internal temperatures measured from baleen whales using other techniques (30–39ºC). Variability within whales was less than ± 2°C, supporting the use of these methods to monitor the health of individuals over time. However, variability among whales was greater (up to 7ºC). Improvements in our understanding of whale physiology and respiratory mechanics and advancements in RPAS-based IRT calibrations could make this technology more reliable for assessing individual body temperatures and monitoring populations in the future.

Medical and health benefits of noise reduction at Intensive Care Units

Introduction: The presence of excessive noise poses a significant risk to the overall well-being and health of individuals. The presence of elevated noise levels within Intensive Care Units (ICUs) has the potential to exert detrimental effects on both the well-being of patients and the healthcare personnel. The aim of this study: This study aims to gather knowledge about the effects of noise pollution on patient’s wellbeing within Intensive Care Units, analyze various investigations around the world and discuss the possible preventive methods of reducing noise and thus sleep disturbances. Materials and methods: This review was based on available data collected in the PubMed database and Google Scholar web search engine using the key words Intensive Care Unit, sleep deprivation, noise pollution Conclusions: Intensive Care Unit noise disrupts patient’s sleep, communication, and increases stress, potentially leading to medical errors and longer recovery times. Addressing this issue is vital, aligning with patient-centered care and holistic therapy trends. Solutions include architectural changes, quieter equipment, staff education, clinical guidelines, and providing earplugs and eye masks for patient comfort. Noise negatively impacts sleep, causing circadian disruptions, cognitive impairments, and health issues. Identifying and mitigating noise sources can significantly enhance patient well-being and treatment outcomes.

The Impact of Nusinersen Treatment on Respiratory Function in Patients with Spinal Muscular Atrophy: A Systematic Review

Background/Objectives: This systematic review evaluated the impact of nusinersen therapy on respiratory health and function in individuals with spinal muscular atrophy (SMA) and determined whether nusinersen improves pulmonary function, focusing on differences based on patient age and the timing of treatment initiation. Methods: A systematic search of PubMed, Ovid Medline, ScienceDirect, and Web of Science databases was conducted up to January 2024 in accordance with the PRISMA guidelines. Thirteen studies were included, comprising clinical trials, observational studies, and case series that focused on respiratory outcomes in SMA patients treated with nusinersen. The data on study design, participant characteristics, nusinersen intervention, respiratory outcomes, and adverse events were extracted. The Joanna Briggs Institute Critical Appraisal Tool was used to assess study quality. A narrative synthesis was conducted to address the heterogeneity of the studies. Results: This review found a general trend of improvement in pulmonary function, specifically in forced vital capacity (FVC), although the extent and duration of improvement varied across the studies. Peak cough flow (PCF) and peak expiratory flow (PEF) showed positive trends in some studies, although the results were not consistently significant. Respiratory function improvements were frequently observed, particularly in younger patients and those treated earlier. Conclusions: Nusinersen appears to enhance respiratory function and improve motor outcomes in SMA patients, especially with early treatment. However, further research is needed to fully understand its mechanisms and long-term effects on respiratory health in SMA.

Challenging public stigma: the impact of a statewide social media campaign to reduce opioid use disorder stigma

Background Opioid-related stigma can affect the health and recovery of individuals with opioid use disorder (OUD). As such, campaigns to reduce stigma are needed. We evaluated Life Unites Us (LUU), a comprehensive social media campaign to reduce public stigma of opioids and those who use them, 12 months after campaign launch. Methods A cross-sectional web survey of 1,045 people was used to assess differences in public stigma by exposure to LUU. Survey items focused on public OUD stigma and were divided into three subscales: desire for social distance, treatment availability and effectiveness, and general attitudes. Results Controlling for relevant covariates (i.e. gender, political ideology, education level, race), individuals exposed to LUU endorsed less stigma in the desire for social distance and treatment subscales. There were no significant differences in stigma for the general attitudes subscale. Those who identified as more politically conservative held more stigma across all subscales than those who identified as less politically conservative. Females reported less treatment and general OUD stigma than males. Conclusions Findings suggest that comprehensive social media campaigns that foster connections, educate the public, and advocate for community-level change may positively influence public attitudes toward individuals with OUD and create a more supportive environment for recovery.

Chemical composition, physical properties, and sensory evaluation of wheat-based cookies enriched with different proportions of corn silk

Incorporating dried corn silk powder (CSP) into food products is considered beneficial for health and suitable for individuals of all ages. Thus, our study is designed to evaluate the effects of adding CSP to prepared cookies as a nontraditional source of dietary fiber and natural antioxidants, focusing on the chemical composition, physical properties, color attributes, antioxidant activity, and sensory properties of fortified cookies. Different CSP proportions (5%, 10%, 15%, and 20%) replaced wheat flour (WF) with a 72% extraction rate. The results revealed that CSP had significant levels of total phenolic content (TPC) and flavonoid content (TFC), measuring 86.42 mg GAE/g and 112.68 mg QE/g, respectively. CSP contained higher quantities of protein and fiber than WF, with values of 14.81 g and 15.21 g per 100 g of flour weight basis, respectively. The amounts of phenolic compounds in cookie samples increased proportionally with the increasing substitution of CSP, while total carbohydrates decreased. Adding CSP at concentrations of 5%, 10%, 15%, and 20% resulted in corresponding increases in crude fiber of 0.52, 1.2, 2.04, and 2.7 times compared to the control cookie samples. As the amount of CSP supplementation increased (0–20%), TPC and TFC in the cookies increased to 3.06 and 4.08 mg GAE/g and 0.02 to 1.28 mg QE/g, respectively. Increasing CSP proportions led to a significant decrease in diameter, thickness, spread factor, volume, and density of fortified cookies. Furthermore, the L* value exhibited a substantial decline from 65.48 to 51.12 as the amount of CSP substitution increased from 5% to 20%. The sensory evaluation characteristics of the cookie samples indicated that the sample with 15% CSP had the highest overall acceptability score. Therefore, this study demonstrates that adding 15% CSP can effectively yield functional cookies without compromising their sensory acceptability.

The relationship between BMI and depression: a cross-sectional study.

Mental health problems, especially depressive symptoms, are becoming increasingly prominent, posing a significant risk to public health. Changes in the body mass index (BMI) may impact an individual's mental health, however, the relationship between BMI and depressive symptoms is unclear. The purpose of this study was to investigate the association between BMI and depressive symptoms. Using a multi-stage sampling method, 10,686 adults in Longgang District, Shenzhen City, Guangdong Province, China, were selected for participation in this study. Surveys were distributed in 2020 and 2021 to measure participant demographic data and health. Binary logistic regression, restricted cubic spline regression, and subgroup analyses were performed to explore the relationship between BMI and depressive symptoms. The results showed a U-shaped relationship between BMI and depression. Both obesity and underweight increased the risk of depression among the participants, especially in subgroups of participants who were young, highly educated, single and employed. These findings suggest that adults should try to maintain a normal body weight as a way to prevent depression and maintain their physical and mental health.

Feasibility of Emergency Department-Initiated HIV Pre-Exposure Prophylaxis

Introduction: Pre-exposure prophylaxis (PrEP) for HIV—using antiretroviral medication in non-infected individuals to prevent HIV—has immense potential to slow the spread of the virus. However, uptake has been insufficient, and stark racial disparities exist in both HIV acquisition and PrEP usage, making PrEP access a health equity issue. A promising venue to engage high-risk populations in PrEP care is the emergency department (ED); however, existing ED PrEP initiatives have been costly or have had limited success. We hypothesize that two strategies could overcome these barriers: prescribing PrEP during an ED visit and providing patients with an initial supply of PrEP medication in the ED. Here, we describe the results of a qualitative study exploring multidisciplinary emergency clinicians and HIV clinicians’ needs and views about the feasibility of such an initiative. Methods: We conducted 22 semi-structured interviews with multidisciplinary clinicians from an urban, safety-net medical center in the ED and the on-site HIV clinic that provides PrEP services.We performed thematic analysis to summarize challenges and potential solutions described by participants. Results: Participants’ responses fell into three thematic categories: operational challenges; patient-level considerations; and potential impacts. Operational challenges highlighted the difficulty of PrEP initiation in a busy ED and clinician support needs. Patient-level considerations included the complex psychosocial needs of ED patients who could benefit from PrEP. Finally, participants anticipated that an ED-based PrEP initiation program could positively impact both individual patients and public health. Conclusion: Interviews with emergency department and HIV clinic staff revealed important considerations and potential solutions for ED-initiated PrEP workflows. Clinicians in both specialties were enthusiastic about such an initiative, which could facilitate its success. This study lays the groundwork for the future design of an efficient and innovative workflow to leverage the ED as an essential entry point into HIV prevention services.

A control theoretic approach to evaluate and inform ecological momentary interventions.

Ecological momentary interventions (EMI) are digital mobile health interventions administered in an individual's daily life to improve mental health by tailoring intervention components to person and context. Experience sampling via ecological momentary assessments (EMA) furthermore provides dynamic contextual information on an individual's mental health state. We propose a personalized data-driven generic framework to select and evaluate EMI based on EMA. We analyze EMA/EMI time-series from 10 individuals, published in a previous study. The EMA consist of multivariate psychological Likert scales. The EMI are mental health trainings presented on a smartphone. We model EMA as linear dynamical systems (DS) and EMI as perturbations. Using concepts from network control theory, we propose and evaluate three personalized data-driven intervention delivery strategies. Moreover, we study putative change mechanisms in response to interventions. We identify promising intervention delivery strategies that outperform empirical strategies in simulation. We pinpoint interventions with a high positive impact on the network, at low energetic costs. Although mechanisms differ between individuals - demanding personalized solutions - the proposed strategies are generic and applicable to various real-world settings. Combined with knowledge from mental health experts, DS and control algorithms may provide powerful data-driven and personalized intervention delivery and evaluation strategies.

Psychological morbidity among coal miners compared to other occupations in Appalachia

ObjectivesDepressive symptoms, anxiety, and post-traumatic stress disorder (PTSD) are common morbidities among coal miners, but the risk of these morbidities has not been analyzed relative to other occupations taking into account relevant covariates.MethodsUsing random digit dialing, we surveyed men aged 50 or over with a history of employment who resided in counties in Appalachia with high coal workers’ pneumoconiosis (CWP) mortality rates. We used the Primary Care Post-Traumatic Stress (PTSD) Screen and the Brief Trauma Questionnaire to query specific traumatic experiences. We used the Patient Health Questionnaire scale to assess depression symptoms and the Generalized Anxiety Disorder questionnaire to measure anxiety. Multivariable logistic regression analyzed associations between coal mining and depression, anxiety, and PTSD, adjusting for trauma, smoking and demographics.ResultsOf 1,428 participants, 233 (16.3%) reported coal mining employment. Coal mining was associated with increased odds of depression (OR 1.6; 95% CI 1.1 to 2.4) and anxiety (OR 1.7; 95% CI 1.1 to 2.7). Among those with any trauma (n = 711), coal mining was not associated with increased risk of PTSD (OR 0.80; 95% CI 0.5 to 1.3]. Non-coal trauma was associated with three-fold increased odds of anxiety (OR 3.2; 95% CI 2.0 to 5.1); for coal trauma, anxiety was associated with six-fold increased odds (OR 6.0; 95% CI 2.9 to 12.4).ConclusionsAppalachian region coal miners carry an increased burden of depression and anxiety. This should be recognized by clinicians and at a population level, as worthy of individual and public health intervention.

Association between Mediterranean diet adherence and dyslipidemia among type-2 diabetes mellitus patients in Dhaka, Bangladesh: a hospital-based study

BackgroundMediterranean diet (MD) adherence is critical for an individual's physical and mental health. Cardiovascular diseases (CVDs) are the leading cause of death in Bangladesh and are closely associated with diabetes mellitus (DM) and dyslipidemia. This study aims to determine the level of adherence to the MD among patients with type 2 diabetes mellitus (T2DM) and identify any association between poor adherence to the MD and dyslipidemia.MethodsThis facility-based cross-sectional study was conducted in the outpatient department of a tertiary care hospital from March to May 2021. A total of 251 T2DM patients were interviewed. Bivariate and multivariate analyses were carried out using a logistic regression model with SPSS 23 statistical package software.ResultsThe prevalence of dyslipidaemia was 83% among T2DM patients. There was a high prevalence of hypertension (61%), overweight or obesity (57%), cardiovascular problems (30%), kidney disease (19%), and sleep problems (28%). Low adherence to MD was highly prevalent (49%) among participants, and another 28% had medium adherence. Patients with poor MD adherence had higher odds of developing dyslipidaemia (AOR: 2.8, 95% CI 1.18–6.63). Normal-weighted patients had lower odds of developing dyslipidaemia (AOR: 0.40, 95% CI 0.18–0.89) compared to overweight or obese individuals.ConclusionsThere was a relatively low adherence to MD among T2DM patients, which is a significant predictor of dyslipidemia. Therefore, T2DM patients should be more conscious of their dietary habits to control dyslipidemia and cardiovascular diseases effectively.

Relationship between big five personality and health literacy in elderly patients with chronic diseases: the mediating roles of family communication and self-efficacy

The significance of health literacy for elderly individuals with chronic illnesses lies in managing and delaying disease development, which is affected by personal and environmental factors. Family communication can provide an emotional support environment; self-efficacy is an important factor of subjective initiative and personality. A relatively persistent thinking and behavior pattern can affect the environment, subjective initiative, and individual health outcomes. This study aims to explore the effects of the Big Five personality traits on the health literacy of elderly individuals with chronic illnesses and to hypothesize that family communication and self-efficacy mediate the Big Five personalities and health literacy. A cross-sectional study of 2251 elderly individuals with chronic diseases was conducted through nationwide random quota sampling. The structural equation model was used to explore the mediating role of family communication and self-efficacy between the Big Five personality and health literacy. Family communication played a simple mediating role in the influence of extraversion, agreeableness, conscientiousness, and neuroticism on health literacy. Self-efficacy played a simple mediating role in the influence of the Big Five personalities on health literacy. Self-efficacy and family communication played a chain mediating role between extraversion, agreeableness, conscientiousness, neuroticism, and health literacy. Nurses can enhance the health literacy of elderly individuals with chronic illnesses with extraversion, agreeableness, conscientiousness, and neuroticism through family communication and self-efficacy while promoting the health literacy of those with openness through self-efficacy.