Low Social Isolation Research Articles

HEARING LOSS AND SOCIAL ISOLATION: THE ROLE OF NEIGHBORHOOD SOCIAL COHESION AND DISORDER

Social isolation is a critical public health issue that socially isolated individuals are at increased risk for mortality and deteriorated health. Those who acquire hearing loss in later life experience difficulties with communication, potentially leading to social isolation. However, less is known about the social consequences of age-related hearing loss, and few studies have assessed the influence of environmental factors on hearing loss and social isolation. The aims of this study are to examine: (1) the association between hearing loss and social isolation of older adults over time, and (2) the moderating effects of perceived neighborhood social cohesion and disorder on this relationship. We analyzed 2,080 community-dwelling Medicare beneficiaries aged 65 or above from Round 1 to 3 of National Health and Aging Trends Study. We conducted random coefficient models, entering hearing loss as a random coefficient. Older adults with hearing loss were less socially isolated than those without hearing loss. However, the effect of hearing loss on social isolation varied depending on perceived neighborhood social cohesion. Older adults with hearing loss who reported high neighborhood cohesion had significantly lower social isolation compared to those without hearing loss, while those with hearing loss who perceived low social cohesion had significantly higher social isolation. Our findings suggest neighborhood social cohesion can serve as a potential protective factor for older adults with hearing loss. This poster will propose neighborhood-level interventions that could supplement other services for those with hearing loss, such as assistive devices that are rarely covered by health insurance.

Subjective social status and inflammatory gene expression.

There exists a well-established link between low perceived social status and poorer health outcomes. However, the molecular mechanisms associated with this link remain unclear. This study begins to fill this gap by investigating the effects of low perceived subjective social status on health-related gene expression. Participants were 47 healthy heterosexual women (mean age 20.5 years) from a large American university. Participants gave 10 mL of peripheral blood and completed questionnaires assessing subjective social status (SSS), perceived childhood socioeconomic status (SES), health, and relevant demographics. Putatively associated genes were subject to TELiS promoter-based bioinformatic analysis to assess activity of proinflammatory, anti-inflammatory, and antiviral transcription factors. In analyses controlling for perceived childhood socioeconomic status (SES) and other covariates, 84 transcripts showed >1.5-fold difference in average expression across the range of SSS. TELiS bioinformatics analyses implicated the proinflammatory transcription factors, NF-κB and AP-1, in driving expression of genes that were up-regulated in low-SSS individuals. Results also indicated increased activity of CREB family transcription factors but no differential activity of the anti-inflammatory glucocorticoid receptor of interferon response factors. Transcript origin analysis implicated monocytes and dendritic cells as cellular mediators. In this first study examining the molecular correlates of SSS, experiences of low social status are associated with transcriptional effects similar to those previously observed for objective adversity conditions such as low SES, social isolation, and chronic stress. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Positive and Negative Experiences on Social Media and Perceived Social Isolation.

To examine the association between positive and negative experiences on social media (SM) and perceived social isolation (PSI). Cross-sectional survey. One large mid-Atlantic University. A total of 1178 students aged 18 to 30 were recruited in August 2016. Participants completed an online survey assessing SM use and PSI. We assessed positive and negative experiences on SM by directly asking participants to estimate what percentage of their SM experiences involved positive and negative experiences, respectively. Social isolation was measured using the established Patient-Reported Outcomes Measures Information System scale. We used multivariable logistic regression to assess associations between both positive and negative experiences on SM and PSI. Primary models controlled for sex, age, race/ethnicity, educational status, relationship status, and living situation. Participants had an average age of 20.9 (standard deviation = 2.9) and were 62% female. Just over one-quarter (28%) were nonwhite. After controlling for all sociodemographic covariates, each 10% increase in positive experiences was not significantly associated with social isolation (adjusted odds ratio [AOR] = 0.97; 95% confidence interval [CI]: 0.93-1.005). However, each 10% increase in negative experiences was associated with a 13% increase in odds of PSI (AOR = 1.13; 95% CI: 1.05-1.21). Having positive experiences on SM is not associated with lower social isolation, whereas having negative experiences on SM is associated with higher social isolation. These findings are consistent with the concept of negativity bias, which suggests that humans tend to give greater weight to negative entities compared with positive ones.

A Machine Learning Approach towards Detecting Dementia based on its Modifiable Risk Factors

Dementia is considered one of the greatest global health and social care challenges in the 21st century. Fortunately, dementia can be delayed or possibly prevented by changes in lifestyle as dictated through known modifiable risk factors. These risk factors include low education, hypertension, obesity, hearing loss, depression, diabetes, physical inactivity, smoking, and social isolation. Other risk factors are non- modifiable and include aging and genetics. The main goal of this study is to demonstrate how machine learning methods can help predict dementia based on an individual’s modifiable risk factors profile. We use publicly available datasets for training algorithms to predict participant’ s cognitive state diagnosis, as cognitive normal or mild cognitive impairment or dementia. Several approaches were implemented using data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) longitudinal study. The best classification results were obtained using both the Lancet and the Libra risk factor lists via longitudinal datasets, which outperformed cross-sectional baseline datasets. Moreover, using only data of the most recent visits provided even better results than using the complete longitudinal set. A binary classification (dementia vs non- dementia) yielded approximately 92% accuracy, while the full multi-class prediction performance yielded to a 77% accuracy using logistic regression, followed by random forest with 92% and 70% respectively. The results demonstrate the utility of machine learning in the prediction of cognitive impairment based on modifiable risk factors and may encourage interventions to reduce the prevalence or severity of the condition in large populations.

Perspectives of Portuguese People with Physical Disabilities Regarding Their Sexual Health: A Focus Group Study

The World Health Organization has considered sexual health as a major dimension of global health and a sexual right. However, the sexual health of people with physical disabilities is still poorly addressed by health and social care professionals, and it is very stigmatized by society. This study aimed to assess the perspectives of Portuguese people living with physical disabilities regarding issues affecting their sexual health. Nine women and 17 men with different physical disabilities participated in the study. Participants were recruited from a professional rehabilitation facility located in the North of Portugal and were assigned to four groups in one-hour sessions. Three main categories emerged from the content analysis: (1) meanings and beliefs regarding sexuality; (2) experiences of sexuality; (3) necessary changes. Despite the positive social changes towards sexuality, participants expressed that their sexual rights are still unfulfilled, as they live in a context that perpetuates their dependency. They pointed out low self-esteem, prejudice and social isolation, poor architectural accessibility and scarcity of financial support as some of the barriers to their lives and their sexual health. Finally, participants identified the main needs regarding their sexual health, such as: access to specialized information; training for health professionals. This study gives voice to people with physical disabilities and sheds light into both individual and contextual factors affecting their sexual health. Of utmost importance, this study draws attention to the need for reinforcing sexuality of people with disabilities in the social agenda and brings implications for future research and practice.

Anxiety and depression in women with breast cancer: Social and clinical determinants and influence of the social network and social support (DAMA cohort)

BackgroundAnxiety and depression are the most prevalent mental health pathologies among women with breast cancer. Social, clinical and contextual variables may influence emotional stress among women with breast cancer.The aim of this work is to study anxiety and depression in a cohort of women diagnosed with breast cancer between 2003 and 2013 in Barcelona. We evaluate social and clinical determinants. MethodsWe performed a mixed cohort study (prospective and retrospective) using a convenience sample of women diagnosed with breast cancer. The information sources were the Hospital Anxiety and Depression questionnaire and hospital medical records. Dependent variables were anxiety and depression; independent variables were social class, age, employment status, tumour stage at diagnosis, time since diagnosis, social network and social support. We performed a descriptive analysis, a bivariate analysis, and a multivariate logistic regression analysis. ResultsA total of 1086 (48.6%) women had some degree of anxiety-related problem. As for depression. In the case of depression, 225 (15%) women had some degree of depression-related problem. Low emotional support and social isolation were clear risk factors for having more anxiety and depression. Low social class was also a risk factor, and age also played a role. DiscussionOur results show that women long period of cancer survival have high prevalences of anxiety than depression, and this prevalence of anxiety is higher than the general population. In addition, we found inequalities between social classes and the isolation and social support are worse too in low social class.

Biopsychosocial Assessment of Pain with Thermal Imaging of Emotional Facial Expression in Breast Cancer Survivors.

Background: Recent research has evaluated psychological and biological characteristics associated with pain in survivors of breast cancer (BC). Few studies consider their relationship with inflammatory activity. Voluntary facial expressions modify the autonomic activity and this may be useful in the hospital environment for clinical biopsychosocial assessment of pain. Methods: This research compared a BC survivors group under integral treatment (Oncology, Psychology, Nutrition) with a control group to assess the intensity of pain, behavioral interference, anxiety, depression, temperament-expression, anger control, social isolation, emotional regulation, and alexithymia and inflammatory activity, with salivary interleukin 6 (IL-6). Then, a psychophysiological evaluation through repeated measures of facial infrared thermal imaging (IRT) and hands in baseline—positive facial expression (joy)—negative facial expression (pain)—relaxation (diaphragmatic breathing). Results: The results showed changes in the IRT (p < 0.05) during the execution of facial expressions in the chin, perinasal, periorbital, frontal, nose, and fingers areas in both groups. No differences were found in the IL-6 level among the aforementioned groups, but an association with baseline nasal temperature (p < 0.001) was observable. The BC group had higher alexithymia score (p < 0.01) but lower social isolation (p < 0.05), in comparison to the control group. Conclusions: In the low- and medium-concentration groups of IL-6, the psychophysiological intervention proposed in this study has a greater effect than on the high concentration group of IL-6. This will be considered in the design of psychological and psychosocial interventions for the treatment of pain.

‘All suffering together’: student drinkers’ experiences of alcohol hangover

Background: There is a pervasive norm of drinking to intoxication among young people in many affluent countries, despite recent falls in overall alcohol consumption. Students’ accounts of their experiences of alcohol hangovers have not been explored in any depth, which is surprising given the high rates of heavy episodic drinking amongst this group. This study investigated student drinkers’ lay health beliefs about alcohol hangovers, considering the role of hangovers in student drinking culture and the implications for safer drinking initiatives.Method: The present study involved a Thematic analysis of semi-structured individual interviews with 23 students aged 18 to 29 (8 women and 15 men) at a university in South West England about their thoughts, feelings and experiences regarding hangovers and drinking.Results: Hangovers were relatively frequent events for most participants, associated with heavy drinking and producing unpleasant physical and psychological effects. Participants employed a range of strategies to minimise the effects of hangovers although very few considered reducing their alcohol consumption. A key negative aspect of hangovers involved low mood and social isolation, in contrast to the positive experience of shared collective suffering that strengthened social bonds in participants’ friendship groups.Conclusions: Collective periods of shared suffering formed a valued aspect of participants’ hangover experiences, strengthening group identity and linking to the culture of heavy drinking. It is important to acknowledge positive as well as negative aspects of students’ views on hangovers in public health guidance on young adults’ alcohol consumption.

Social isolation, health literacy, and mortality risk: Findings from the English Longitudinal Study of Ageing.

To investigate the relationships between social isolation, health literacy, and all-cause mortality, and the modifying effect of social isolation on the latter relationship. Data were from 7731 adults aged ≥50 years participating in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing. Social isolation was defined according to marital/cohabiting status and contact with children, relatives, and friends, and participation in social organizations. Scores were split at the median to indicate social isolation (yes vs. no). Health literacy was assessed as comprehension of a medicine label and classified as "high" (≥75% correct) or "low" (<75% correct). The outcome was all-cause mortality up to February 2013. Cox proportional hazards models were adjusted for sociodemographic factors, health status, health behaviors, and cognitive function. Mortality rates were 30.3% versus 14.3% in the low versus high health literacy groups, and 23.5% versus 13.7% in the socially isolated versus nonisolated groups. Low health literacy (adj. HR = 1.22, 95% CI 1.02-1.45 vs. high) and social isolation (adj. HR = 1.28, 95% CI 1.10-1.50) were independently associated with increased mortality risk. The multiplicative interaction term for health literacy and social isolation was not statistically significant (p = .81). Low health literacy and high social isolation are risk factors for mortality. Social isolation does not modify the relationship between health literacy and mortality. Clinicians should be aware of the health risks faced by socially isolated adults and those with low health literacy. (PsycINFO Database Record

The health benefits and constraints of exercise therapy for wheelchair users: A clinical commentary.

BackgroundThere are approximately 1 billion people living with chronic lower limb disability, many of whom are wheelchair users.ObjectivesReview cardiometabolic and neuromuscular risk profiles of wheelchair users, benefits of regular exercise and the causes of neuromuscular upper limb and hip injuries that hinder regular adherence.MethodLiterature published between 2013 and 2017 was adopted according to the standard practices for systematic reviews (PRISMA) through Crossref Metadata and Google Scholar searches. Individual paper quality was evaluated using a modified Downs and Black Appraisal Scale.ResultsThe literature search identified 16 600 papers which were excluded if they were non-English, non-peer-reviewed or published before 2013. Finally, 25 papers were accepted, indicating that sedentary wheelchair users have poor cardiometabolic risk profiles (PCMRP) because of a lack of physical activity, limiting their quality of life, characterised by low self-esteem, social isolation and depression. Their predominant mode of physical activity is through upper limb exercises, which not only improves their cardiometabolic risk profiles but also precipitates neuromuscular upper limb overuse injuries. The primary cause of upper limb injuries was attributed to poor wheelchair propulsion related to incorrect chair setup and poor cardiorespiratory fitness.ConclusionWheelchair users have a high body mass index, body fat percentage and serum lipid, cholesterol and blood glucose concentrations. Empirical investigations illustrate exercise improves their PCMRP and cardiorespiratory fitness levels. Although literature encourages regular exercise, none discusses the need to individualise chair setup in order to eliminate wheelchair pathomechanics and upper limb neuromuscular injuries. Wheelchair users must be encouraged to consult a biokineticist or physiotherapist to review their wheelchair setup so as to eliminate possible incorrect manual wheelchair propulsion biomechanics and consequent overuse injuries.

A revelation of employee feelings of alienation during post-mergers and acquisition

PurposeIn the literature of mergers and social justice, equality is regarded as a crucial phenomenon to achieve social integration. This paper is based on the philosophy that during mergers and acquisitions (M&As), the employees who experience the equal distribution of resources, equal respect to each other’s policies and procedures, and fair and respectful interactions, are more likely to have a sense of control and lower social isolation and hence tend to get influenced positively by the M&A process. Thus, the purpose of this paper is to study the relationship between perceived organizational justice and employee feelings of alienation during post-M&As.Design/methodology/approachA cross-sectional survey research design has been used. This study was undertaken on a sample of 315 employees from five organizations in India. The quantitative data were subjected to univariate and bivariate analysis, while qualitative data were subjected to relational content analysis. Different dimensions of justice were studied in relation to the feelings of alienation using multiple correlational analysis and hierarchical regression analysis.FindingsMultiple correlational analyses revealed significant negative correlation of perceived organizational justice and of all of its dimensions with all the dimensions of alienation. However, the results of the hierarchical regression analysis found interactional justice and distributive justice to be the major predictors of alienation during M&As. Apart from the quantitative analysis, qualitative analysis also revealed interesting insights, unique to the individual organization.Originality/valueThe study has significant value for both MNCs and researchers. This study has strong implications for the multinational corporations that are making inroads into M&As but consistently failing due to employee issues. This study also presents future directions to the researchers to explore more in the area of soft issues of M&As.

Abstract P092: Association of Social Isolation with Functional Status and Mental Health in Patients with Heart Failure

Background: Social isolation has been shown to have a negative impact on psychosocial and physical health, particularly among older adults. However, these relationships have not been fully examined among patients with heart failure (HF). Methods: Residents from 11 southeast MN counties with a first-ever ICD-9 code 428 for HF between 1/1/2013 and 3/31/2014 (N=1649) were mailed a survey to measure social isolation (PROMIS Social Isolation Short Form) and functional status and mental health (PROMIS 29 Health Profile). A total of 778 patients returned the survey (response rate 47%), and among these, 645 completed all questions and were retained for analysis. Patients who returned a completed survey were similar on age (p=0.15), sex (p=0.80), and Charlson comorbidity index (p=0.28) to those who did not return or returned an incomplete survey. The relationship between social isolation and functional status and mental health was analyzed using linear regression, adjusted for age, sex, and Charlson comorbidity index. Results: Among 645 patients with HF, 53% were men, the mean age was 73 years, and the mean Charlson index was 2.2. The mean scores for each functional and mental health subscale and the total score increased with increasing severity of social isolation (Table). For example, the mean physical function scores were 8.6, 11.3, and 12.8 and the mean depression scores were 5.0, 7.3, and 9.8 for those with low, moderate, and high social isolation, respectively. In addition, the total score increased from 51.1 among those with low social isolation to 80.2 for those with high social isolation. Observed differences persisted after adjustment for age, sex, and comorbidity. Conclusion: In patients with HF, greater social isolation is associated with worse functional and mental health, independent of comorbidity. As functional status and mental health impact disease management, addressing social isolation may help with managing HF.

The Socio-Emotional Adjustment of Learning-Disabled Students Undergoing School Transitions

This study examined learning-disabled (LD) students’ subjective interpretation of their socio-cultural reality during the transition periods into junior high school. LD students are liable to have emotional, psychological and social problems: they are prone to anxiety, depression, and behavioral disorders, as well as feelings of low self-esteem and social isolation. These may lead to genuine crisis during the already difficult transition from elementary school to junior high. Research in the form of in-depth interviews was conducted on a sample of 12 LD adolescent, junior-high students. The findings point to three main concerns of LD adolescents regarding their transition to junior-high: A sense of isolation, a lack of social and adaptation skills, and a poor relationship with teachers. The findings of this study may be useful for planning intervention and prevention programs that provide support and assistance for LD students’ adaptation. It is crucial to assist LD students to develop and cultivate social and educational skills during the transition period, thus allowing them to learn how to cope, not only during this crisis period, but with other life situations.

Psychosocial Aspects in Cardiac Rehabilitation: From Theory to Practice. A Position Paper From the Cardiac Rehabilitation Section of The European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with establishedCHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

Heridas neoplásicas: Aspectos básicos del cuidado de enfermería

Neoplastic wounds are related to the tumor and require a special and more careful approach for the different factors associated with cancer. Problems of difficult handling can be found such as bad odor, exudate, bleeding, pain, infection, visual appearance that causes low self-esteem and social isolation that leads to a marked deterioration in the quality of life of patients and their families. Objective: to determine what are the basic aspects of nursing care in neoplastic wounds. Materials and methods: this documentary review analyzes the epidemiology, classification, assessment instruments and current care interventions that the nursing professional should have when providing care to these patients. Conclusion: a multidisciplinary team is required for the management of neoplastic wounds. The problems or needs must be identified, according to this a personalized management plan will be designed and the interventions will be evaluated, generating a positive impact on the current and future lifestyle of the patient.

Human social genomics.

A growing literature in human social genomics has begun to analyze how everyday life circumstances influence human gene expression. Social-environmental conditions such as urbanity, low socioeconomic status, social isolation, social threat, and low or unstable social status have been found to associate with differential expression of hundreds of gene transcripts in leukocytes and diseased tissues such as metastatic cancers. In leukocytes, diverse types of social adversity evoke a common conserved transcriptional response to adversity (CTRA) characterized by increased expression of proinflammatory genes and decreased expression of genes involved in innate antiviral responses and antibody synthesis. Mechanistic analyses have mapped the neural “social signal transduction” pathways that stimulate CTRA gene expression in response to social threat and may contribute to social gradients in health. Research has also begun to analyze the functional genomics of optimal health and thriving. Two emerging opportunities now stand to revolutionize our understanding of the everyday life of the human genome: network genomics analyses examining how systems-level capabilities emerge from groups of individual socially sensitive genomes and near-real-time transcriptional biofeedback to empirically optimize individual well-being in the context of the unique genetic, geographic, historical, developmental, and social contexts that jointly shape the transcriptional realization of our innate human genomic potential for thriving.

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology.

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

A Missing Piece of the Departure Puzzle: Student–Institution Fit and Intent to Persist

According to prevailing theory and anecdotal evidence, the congruence between institutional attributes and students’ needs, interests, and preferences plays a key role in promoting college satisfaction and retention. However, this assertion has received little direct empirical attention, and the few available studies appear to have some key limitations. This study examined the factor structure and predictive validity of a newly developed student–institution fit instrument, which was designed to avoid the problems in previous research. Confirmatory factor analyses identified several interrelated dimensions of fit, and these dimensions can be combined into a single overall fit index. Moreover, a six-factor structure of student–institution fit is similar at two institutions that differ in terms of size, control, type, region, and religious affiliation. Structural equation modeling analyses show that student–institution fit is associated with greater college satisfaction and lower social isolation; fit also has a positive, indirect effect on intent to persist. Implications for practice and future research are discussed.

P3.438 Challenges in Managing Transgender Individuals - Observations in a UK Sexual Health Clinic

BackgroundTransgender individuals may have complex medical and psychosocial needs. Prior studies have reported an increased incidence of STIs including HIV. Low self esteem, social isolation, self-harm and suicide have been...

English

It is well established that children and adolescents with learning disabilities are more likely to experience depressed mood than are their peers. Many scholars explain this relationship as resulting from low selfesteem, stress, or social isolation. However, little work has explored whether this relationship continues to exist into young adulthood. Using longitudinal data from national data, this study finds that young adults with physical and learning disabilities have higher levels of depression than do young adults who are not disabled. In almost every case, this relationship persists no matter the levels of self-esteem, self-perception and stress experienced by young adults with disabilities.