Multinominal Logistic Regression Research Articles

Healthcare workers’ attitudes toward children getting Covid-19 vaccinations in Gaza Strip

Healthcare workers’ attitudes toward children getting Covid-19 vaccinations in Gaza Strip

A global typology of school principals’ time use: Exploring the effects of contextual and individual factors

This study aims to provide quantitative evidence regarding school principals’ time use by employing Latent Class Analysis (LCA) and multinominal logistic regression to the 2018 Teaching and Learning International Survey (TALIS) data from 47 societies. We examined (1) how principals spend their time across different societies by developing a global typology and (2) what macro (national) and micro (organizational) level contextual factors, as well as principals’ demographic characteristics, predict principals’ association with the identified typology. The results suggest four distinguishable categories of principal leadership in terms of their time use: Balanced Leadership, Administrative Leadership, Instructional Leadership, and Student-Centered Leadership. Several contextual (national and organizational) and individual variables influencing principals’ prioritization of their leadership responsibilities were also identified.

Use of insect repellent as personal protection among women of childbearing age in an arbovirus endemic area in Northeastern Brazil.

To analyze the factors associated with the individual use of insect repellent by women of childbearing age living in area endemic for arboviruses in Fortaleza, Brazil. This is a cohort study carried out between 2018 and 2019 with women aged between 15 and 39 years in Fortaleza, state of Ceará, Brazil. A total of 1,173 women users of one of the four selected primary health care units participated in the study. The outcome was divided into: continued use, discontinued use, and nonuse of insect repellent. Crude and adjusted multinominal logistic regression analysis was carried out guided by a hierarchical model, with presentation of the respective odds ratio (OR) and 95% confidence intervals (95%CI). The independent variables include: socioeconomic and demographic data, environmental and sanitary characteristics, knowledge of the insect repellent, and behavioral and pregnancy-related aspects. Only 28% of the participants reported using insect repellent during the two waves of the cohort. Women with higher education (OR=2.55; 95%CI 1.44-4.51); who are employed (OR=1.51; 95%CI 1.12-2.03); who received guidance from healthcare professionals (OR=1.74; 95%CI 1.28-2.36) and the media (OR=1.43; 95%CI 1.01-2.02); who intensified precautions against mosquitoes during the epidemic (OR=3.64; 95%CI 2.29-5.78); and who were pregnant between 2016 and 2019 (OR=2.80; 95%CI 1.83-4.30) had increased odds for continued use of insect repellent. The use of insect repellent among women of childbearing age was associated with a higher level of education, employment, guidance on insect repellent provided by healthcare professionals and the media, behavioral changes to protect against mosquitoes during the Zika virus epidemic, and pregnancy when occurring as of the beginning of the epidemic period.

잠재프로파일을 적용한 직업계고 학생들의 진로개발역량과 자기주도학습역량에 대한 잠재집단분류 및 영향요인 검증

The purpose of the study is to estimate the latent classes of vocational high school career development competencies and self-directed learning also, individual and school factors determining these latent profiles. To this end, we used data from the "2022 Career Education Status Survey" of 1,363 students, including (804 male and 559 female students). Based on the latent profile modeling analysis, we identified three distinct latent classes of students' career development competencies and self-directed learning. These classes were named ‘low-level group,’ ‘intermediate-level group,’ and ‘high-level group.’ Second, multinominal logistic regression analysis revealed that gender, career activity participation satisfaction, need for career information, conversation with parents, career information awareness, desired career preparation and learning motivation were significant predictors of the latent profiles at the individual-level. Also, perception of the principal's perception of career education support, career teacher's job performance, and the number of career experience operations were derived as predictive factors that distinguish the potential class was significant predictors of the latent profiles at the school-level. Implications of this study and suggestions for follow-up research were discussed.

Co-occurrence of insufficient physical activity, smoking, inadequate diet, and alcohol consumption in university students from Minas Gerais, Brazil

The aim of this study was to estimate the prevalence and factors associated with the co-occurrence of insufficient physical activities, smoking, consumption of alcoholic beverages, and inappropriate eating habits in university. This is a cross-sectional study with a representative sample of students from the Federal University of Triângulo Mineiro, MG, Brazil. The information was obtained through a questionnaire and the risk criteria adopted were irregular consumption of fruits and vegetables, insufficient physical activity, smoking, and excessive consumption of alcoholic beverages. The independent variables were sex, age group, marital status, area of study and time of study. The outcomes were the co-occurrence of two and three/four risk factors. The association was measured using Odds Ratio (OR) and a multinominal logistic regression with a significance level of 5%. 1.110 university students participated. The prevalence of two and three/four risk factors was of 35.3% and 15.4%, respectively. College students with a partner were associated with lower chances for two risk factors (OR: 0.45; 95% CI: 0.21–0.98), and there was an association between three or four factors of behavioral risk with university students belonging to areas not related to health (OR: 1.90; 95% CI: 1.26–2.86). It was concluded that the prevalence of occurrence of two risk factors or more was high and that single students and those in fields unrelated to health were associated with the risk factors.

FACTORS ASSOCIATED WITH HELP-SEEKING AMONG US CHINESE OLDER ADULTS WHO REPORTED ELDER MISTREATMENT

Abstract Purpose Elder mistreatment (EM) is an important public health issue. Guided by the Andersen’s Behavioral Model of Health Services Use, this study aimed to examine factors that impede or facilitate help-seeking intentions and behaviors among U.S. Chinese older adults who reported EM. Methods Data were from the Population Study of Chinese Elderly in Chicago (PINE). Different types of mistreatments, informal and formal help-seeking intentions and behaviors were assessed. Descriptive statistics, linear regression, and multinominal logistic regression were used. Results Among 450 participants who reported EM, 46.55% experienced psychological mistreatment, 29.91% had financial exploitation, 14.92% had caregiver neglect, 4.68% had physical mistreatment, 1.11% had sexual mistreatment, and 17.78% had multiple victimizations. Intentions of informal help-seeking was higher among victims who were female and married, and those who experienced financial exploitation and caregiver neglect. Formal help-seeking intentions were lower among victims who had a larger social network size. EM victims who were female, married, perceived more social support, experienced financial exploitation, and experienced caregiver neglect were more likely to seek help from informal resources. EM victims who had higher income, perceived more social support, and had multiple victimizations were more likely to seek formal resources. Conclusion/implication: Our findings suggest that the predisposing factors, enabling resources, and need factors that impacted seeking help from informal and formal resources among older Chinese Americans who reported mistreatment. Findings provided important insights for developing early screening programs and interventions, such as increasing help-seeking channels and improving access to care services.

RELATIONSHIP BETWEEN INFORMAL AND FORMAL HELP-SEEKING BEHAVIORS FOR ELDER MISTREATMENT AMONG CHINESE IMMIGRANTS

Abstract Purpose Help-seeking minimizes the consequences from elder mistreatment (EM). However, formal help-seeking could be challenging for older immigrants due to cultural and linguistic barriers. Informal supporters have been shown to promote formal help-seeking among EM victims. This study aimed to examine whether informal help facilitates U.S. Chinese EM victims with seeking help from formal sources. Methods Data were derived from the Population Study of Chinese Elderly in Chicago. EM measurements included psychological, physical, sexual mistreatment, financial exploitation, and caregiver neglect. Seeking help from informal and formal sources were evaluated. Descriptive statistics and multinominal logistic regression were conducted. Results Among 450 EM victims, 53.48% of them sought informal help, 31.75% did not seek any help, 11.42% sought both informal and formal help, and 3.34% sought formal help. The most common informal sources were adult children, partners, and friends/neighbors. The most common formal sources were community social services organizations, followed by legal criminal justice systems. Compared to those who did not seek any help, victims who reported more emotional closeness within their social network and experienced financial exploitation were more likely to seek help from formal sources. However, informal help-seeking was not significantly associated with formal help-seeking. Conclusion/implication: The findings suggest that most U.S. Chinese older adults who experienced EM did not seek formal help. Higher levels of contact with social networks could increase seeking help from formal sources. However, future research is needed to explore why informal supporters did not facilitate seeking help from formal sources in Chinese EM victims.

Exploring factors influencing the severity of pregnancy anemia in India: a study using proportional odds model

Pregnancy-associated anemia is a significant health issue that poses negative consequences for both the mother and the developing fetus. This study explores the triggering factors of anemia among pregnant females in India, utilizing data from the Demographic and Health Survey 2019–21. Chi-squared and gamma tests were conducted to find out the relationship between anemia and various socioeconomic and sociodemographic elements. Furthermore, ordinal logistic regression and multinomial logistic regression were used to gain deeper insight into the factors that affect anemia among pregnant women in India. According to these findings, anemia affects about 50% of pregnant women in India. Anemia is significantly associated with various factors such as geographical location, level of education, and wealth index. The results of our study indicate that enhancing education and socioeconomic status may serve as viable approaches for mitigating the prevalence of anemia disease developed in pregnant females in India. Employing both Ordinal and Multinominal logistic regression provides a more comprehensive understanding of the risk factors associated with anemia, enabling the development of targeted interventions to prevent and manage this health condition. This paper aims to enhance the efficacy of anemia prevention and management strategies for pregnant women in India by offering an in-depth understanding of the causative factors of anemia.

Sociodemographic Correlates of Low Health Literacy Skills Among Cancer Survivors: National Findings From BRFSS 2016

Purpose This study aimed to explore associations of sociodemographic factors with difficulties in three health literacy (HL) skills and the severity of low HL skills. Design Cross-sectional secondary data analysis. Subjects: Data came from 17,834 adults who responded to the HL module with a response rate of 47% in the 2016 Behavioral Risk Factor Surveillance System. Measures Independent variables included sex, age, race/ethnicity, education, employment and income. Dependent variables are three HL skills: obtaining, understanding oral, and understanding written health information. Analysis We conducted weighted Chi-square tests and multinominal logistic regressions. Results Cancer survivors younger than 65 (aged 18-39: AOR = 4.46, P < .001; aged 40-64: AOR = 2.29, P < .001), Hispanic (AOR = 2.17, CI = 1.61-2.50, P < .01) had higher odds of difficulty obtaining health information. Female cancer survivors had lower odds of difficulty comprehending oral (AOR = .69, CI = .55-.87, P < .01) and written (AOR = .58, CI = .46-.74, P < .001) information. The relative risk ratio of having difficulties in three HL tasks was higher for those who were younger than 65 (aged 18-39: RRR = 10.18, CI = 2.41-4.3, P < .01; aged 40-64: RRR = 4.01, CI = 2.09-7.69, P < .001), Hispanic (RRR = 3.24, CI = 1.66-11.34, P < .01), unemployed (RRR = 6.1, CI = 2.88-12.76, P < .001), education levels lower than some college (some high school: RRR = 4.34, P < .01; high school: RRR = 2.62, P < .05) and household income under $25,000 (RRR = 6.99, CI = 2.8-17.5, P < .001). Conclusion Intervention and communication materials need to be tailored for patients with different HL skills considering age, gender, socioeconomic status and cultural backgrounds.

The public's antibiotic use behavioural patterns and their determinants for upper respiratory tract infections: a latent class analysis based on consumer behaviour model in China.

The irrational use of antibiotics among the public is a major contributor to antimicrobial resistance (AMR), which is a serious global threat. Prior studies have demonstrated that there are different behavioural patterns regarding antibiotic use among the public, and targeted interventions for subgroups with different behavioural patterns may be more effective. Thus, this study aimed to identify the public's behavioural patterns of antibiotic use for upper respiratory tract infections (URTIs) and their influencing factors. A cross-sectional survey was conducted among the general population in Chongqing, China. Consumer decision-making (Consumer Behaviour Model, CBM) was used to assess the public's behaviours regarding antibiotic use, including need recognition, information searching, alternative evaluation, obtaining antibiotics, antibiotic consumption, and postuse evaluation. Furthermore, a latent class analysis was used to identify the underlying behavioural patterns among the public. The identified behavioural patterns of antibiotic use were further linked with individuals' capacity, opportunity, and motivation factors of antibiotic use based on a multinominal logistic regression to explore possible determinants. A total of 815 respondents were enrolled in the study. The public's irrational use of antibiotics was prevalent, including antibiotic self-medication (39.63%), nonprescription antibiotic purchasing (59.02%), and early stopping of antibiotic prescriptions (76.56%). Participants had inadequate knowledge of antibiotics (Mean = 2.33, SD = 1.71), reported high availability to antibiotics (Mean = 7.13, SD = 2.41), held strong belief in antibiotic effectiveness (Mean = 10.29, SD = 2.71), and demonstrated a high perceived threat of AMR (Mean = 12.30, SD = 3.20). Four behavioural patterns regarding antibiotic use for URTIs were identified, namely, "antibiotic self-medicators" (n = 165, 20.25%), "formal health care seekers" (n = 216, 26.50%), "various treatment users" (n = 198, 24.20%), and "self-medication without antibiotics" (n = 236, 28.96%). Individuals' self-efficacy of antibiotic use, belief in antibiotic effectiveness, awareness of antibiotic side effects, perceived antibiotic availability, social influence, and demographics (age, education, medical insurance, and having a medical background) were significantly associated with the public's different behavioural patterns of antibiotic use for URTIs. This study calls for collaborative efforts among the public, physicians, policy makers, and the implementation of precise and multifaceted interventions to effectively reduce irrational use of antibiotics in the public. Such interventions include identifying subgroups within the public to provide more targeted education about antibiotics and the management of URTIs, reinforcing the regulation of antibiotic dispensing, and improving physicians' rational antibiotic prescriptions.

What happens after forensic psychiatric care? A latent class analysis of dimensions of welfare for former forensic psychiatric patients

BackgroundMentally disordered offenders are a heterogenous group regarding psychopathology as well as background factors, which makes it likely that more than one stereotypical life situation will apply to all forensic psychiatric patients following discharge. Knowledge about typical life situations would be valuable for optimising support for improving the overall life situation of these individuals. This paper investigates life situations from the perspective of level of living research and resources in terms of different welfare dimensions.MethodsIncluded were all all individuals (n = 1146) who had been discharged from forensic psychiatric care in Sweden during 2009–2018 and were included in the Swedish National Forensic Psychiatric Register. Follow-up time varied from 4 to 3644 days, (m = 1697, Md = 1685). Register data from several different registers was combined. Data was analysed using latent class analysis, and multinominal logistic regression analysis investigated what background factors were associated with class membership.ResultsThe results show that there are four subgroups of post-discharge life situations: the high support group, the general psychiatric needs group, the working group, and the family group. The high support group was the largest, representing 54% of the entire sample. There are background factors associated with group membership, including both age at discharge, length of stay in forensic psychiatric care and pre-index crime historical factors.ConclusionsThis study contributes to the understanding of the post-discharge lives of former forensic psychiatric patients and shows that for several subgroups, negative outcomes are rare. Knowledge about these subgroups could be drawn upon to make informed decisions about in- and outpatient forensic psychiatric care, discharge from forensic psychiatric services, and what support is offered to former forensic psychiatric patients.

Relationship between dietary carotenoid intake and sleep duration in American adults: a population-based study

ObjectiveTo investigate the relationship between dietary carotenoid intake and sleep duration.MethodsAdults enrolled in the National Health and Nutrition Examination Survey (NHANES) 2007–2018 without missing information on dietary carotenoid intake (α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein + zeaxanthin), sleep duration, and covariates were included. Participants’ carotenoid consumption was divided into three groups by quartiles and sleep duration was grouped as short (< 7 h/night), optimal (7–8 h/night), and long (> 8 h/night). Multinominal logistic regression was constructed to examine the association between dietary carotenoid intake and sleep duration. Restricted cubic spline (RCS) regression was further utilized to explore their dose-response relationship. The weighted quantile sum (WQS) model was adopted to calculate the mixed and individual effect of 5 carotenoid sub-types on sleep duration.ResultsMultinominal logistic regression presented that people with higher intakes of α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein + zeaxanthin were less likely to sleep too short or too long. Consistent with the findings from multinominal logistic regression, the RCS models suggested a reverse U-shaped relationship between sleep duration and carotenoid intakes. The mixed effects were also significant, where β-cryptoxanthin and lutein + zeaxanthin were the top 2 contributors associated with the decreased risks of short sleep duration, while β-carotene, α-carotene, and β-cryptoxanthin were the main factors related to the lower risk of long sleep duration.ConclusionOur study revealed that the American adults with optimal sleep duration were associated with more dietary carotenoid intake, in comparison to short or long sleepers.

Mental health profiles and the related socio-demographic predictors in Hong Kong university students under the COVID-19 pandemic: A latent class analysis

While the COVID-19 pandemic has brought about significant challenges to mental health of university students, there is limited research in this area. Particularly, few studies examined the person-centered mental health symptom profiles such as depression and anxiety and the related socio-demographic predictors. Using Latent Class Analysis (LCA), this study investigated the symptom profiles of depression and anxiety in university students in Hong Kong under the COVID-19 pandemic and the socio-demographic predictors. A total of 978 undergraduate students completed an online questionnaire including socio-demographic factors and measures of depression and anxiety during the summer of 2022. The LCA identified three latent classes: “normal” group, “moderate comorbid depression and anxiety” group and “severe comorbid depression and anxiety” group. Multinominal logistic regression showed that comparing with the “normal” group and the “moderate symptom” group, the “severe symptom” group had higher personal financial difficulties and individual/family member unemployment during the pandemic. In contrast, other socio-demographic factors (age, gender, year of study, living status, and COVID-19 infection status) had no significant association with group status. The study contributes to understanding of person-centered depression and anxiety symptom profiles and the risk role of personal financial difficulty in mental health of university students under the pandemic.

Effect of baseline oestradiol serum concentration on the efficacy of anastrozole for preventing breast cancer in postmenopausal women at high risk: a case-control study of the IBIS-II prevention trial

An increased risk of breast cancer is associated with high serum concentrations of oestradiol and testosterone in postmenopausal women, but little is known about how these hormones affect response to endocrine therapy for breast cancer prevention or treatment. We aimed to assess the effects of serum oestradiol and testosterone concentrations on the efficacy of the aromatase inhibitor anastrozole for the prevention of breast cancer in postmenopausal women at high risk. In this case-control study we used data from the IBIS-II prevention trial, a randomised, controlled, double-blind trial in postmenopausal women aged 40-70 years at high risk of breast cancer, conducted in 153 breast cancer treatment centres across 18 countries. In the trial, women were randomly assigned (1:1) to receive anastrozole (1 mg/day, orally) or placebo daily for 5 years. In this pre-planned case-control study, the primary analysis was the effect of the baseline oestradiol to sex hormone binding globulin (SHBG) ratio (oestradiol-SHBG ratio) on the development of all breast cancers, including ductal carcinoma in situ (the primary endpoint in the trial). Cases were participants in whom breast cancer was reported after trial entry and until the cutoff on Oct 22, 2019, and who had valid blood samples and no use of hormone replacement therapy within 3 months of trial entry or during the trial. For each case, two controls without breast cancer were selected at random, matched on treatment group, age (within 2 years), and follow-up time (at least that of the matching case). For each treatment group, we applied a multinominal logistic regression likelihood-ratio trend test to assess what change in the proportion of cases was associated with a one-quartile change in hormone ratio. Controls were used only to determine quartile cutoffs. Profile likelihood 95% CIs were used to indicate the precision of estimates. A secondary analysis also investigated the effect of the baseline testosterone-SHBG ratio on breast cancer development. We also assessed relative benefit of anastrozole versus placebo (calculated as 1 - the ratio of breast cancer cases in the anastrozole group to cases in the placebo group). The trial was registered with ISRCTN (number ISRCTN31488319) and completed recruitment on Jan 31, 2012, but long-term follow-up is ongoing. 3864 women were recruited into the trial between Feb 2, 2003, and Jan 31, 2012, and randomly assigned to receive anastrozole (n=1920) or placebo (n=1944). Median follow-up time was 131 months (IQR 106-156), during which 85 (4·4%) cases of breast cancer in the anastrozole group and 165 (8·5%) in the placebo group were identified. No data on gender, race, or ethnicity were collected. After exclusions, the case-control study included 212 participants from the anastrozole group (72 cases, 140 controls) and 416 from the placebo group (142 cases, 274 controls). A trend of increasing breast cancer risk with increasing oestradiol-SHBG ratio was found in the placebo group (trend per quartile 1·25 [95% CI 1·08 to 1·45], p=0·0033), but not in the anastrozole group (1·06 [0·86 to 1·30], p=0·60). A weaker effect was seen for the testosterone-SHBG ratio in the placebo group (trend 1·21 [1·05 to 1·41], p=0·011), but again not in the anastrozole group (trend 1·18 [0·96 to 1·46], p=0·11). A relative benefit of anastrozole was seen in quartile 2 (0·55 [95% CI 0·13 to 0·78]), quartile 3 (0·54 [0·22 to 0·74], and quartile 4 (0·56 [0·23 to 0·76]) of oestradiol-SHBG ratio, but not in quartile 1 (0·18 [-0·60 to 0·59]). These results suggest that serum hormones should be measured more routinely and integrated into risk management decisions. Measuring serum hormone concentrations is inexpensive and might help clinicians differentiate which women will benefit most from an aromatase inhibitor. Cancer Research UK, National Health and Medical Research Council (Australia), Breast Cancer Research Foundation, and DaCosta Fund.

Comorbid trajectories of posttraumatic stress disorder symptoms and depressive symptoms in a 10-year cohort of Chinese Wenchuan earthquake survivors: Course, predictors, and consequences.

Survivors may suffer mental health problems following disasters, particularly posttraumatic stress disorder (PTSD) and depressive symptoms. However, few studies have explored longitudinal processes of co-occurring PTSD and depressive symptoms among adolescent survivors and their associated predictors and consequences. The present study examines the codevelopment of both symptoms postearthquake using a 10-year cohort. A total of 1,357 senior high school students reported PTSD and depressive symptoms at 6, 12, 18, and 24 months after the 2008 Wenchuan earthquake. Self-report measures were also used to evaluate earthquake exposure, negative life events, social support, and trait resilience. At the 10-year follow-up (T10y), 799 participants reported their quality of life (QoL) online and 744 of them provided available data. A parallel-process latent class growth analysis was used to identify trajectories. Multinominal logistic and linear regressions were used, respectively, to analyze the predictors and consequences of these trajectories. Three comorbid trajectories were found: a resilient group (56.7%), a vulnerable group (33.3%), and a chronic high-risk group (9.9%). Gender, injury/missing/killed of family members, witnessing of traumatic sciences, negative life events, social support, and trait resilience were significant predictors of vulnerable and chronic high-risk groups. Finally, adolescents in these two groups were more likely to experience poorer QoL in adulthood. The results highlight the heterogeneity of depression-PTSD comorbidities among adolescent survivors. They also emphasize PTSD-depression symptoms predictors and their adverse impacts on life outcomes in adulthood. Individualized interventions should be provided for adolescents affected by natural disasters, especially those in the vulnerable and higher risk groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patterns of sleep quality and its influence factors: A latent class model among students of medical university in Hubei Province, China

BackgroundSleep problem among undergraduate students has become one of the most pressing public health problems. This study aimed to explore the latent class of sleep patterns and the factors affecting sleep in Chinese students of medical university. Methods3423 students participated in the cross-sectional study. The survey consisted of the reduced Morningness-Evening Questionnaire, the Pittsburgh Sleep Quality Index, and Health-Promoting Lifestyle Profile-II. Latent profile analysis and multinominal logistic regression analysis were performed. ResultsThree potential sleep categories were identified: “sleep disorder group” (1.87 %), “daytime dysfunction group” (24.42 %), and “good sleep group” (73.71 %). Compared with the “good sleep group,” the “sleep disorder group” showed monthly living expenses (RMB) ≥ 3000 yuan (OR) = 13.04), interpersonal relationships as poor (OR = 3.71), health status as poor (OR = 45.09), circadian rhythm as eveningness (OR = 6.17), and poor health-promoting lifestyles (OR = 2.090) as its risk factors (all p < 0.05). Meanwhile, sophomore (OR = 1.75), junior (OR = 1.52), interpersonal relationships as poor (OR = 1.88), health status as poor (OR = 4.62), intermediate-chronotype (OR = 2.19), eveningness chronotype (OR = 5.66), and health-promoting lifestyles as poor (OR = 1.55) were identified as risk factors for the “daytime dysfunction group” (all p < 0.05). LimitationsCausal conclusions can not be drawn and recall bias in data collection. ConclusionsSignificant population heterogeneity was found in the sleep quality. Implementing targeted interventions focusing on circadian rhythm and lifestyle is crucial to improve the sleep quality of students with different conditions.

Helping behaviours of community members towards older adults and the related factors: a cross-sectional study.

Community members can play important roles in helping older adults in their community. This study aimed to clarify the actual situation of community members' helping behaviours towards older adults and examine the related factors. This cross-sectional study was conducted using an online survey system with a sample of 1000 community members in the Tokyo metropolitan area selected using quota sampling. Participants were asked about their experiences with helping an older adult, involvement with older adults with dementia, knowledge of dementia and care resources in the community, and perceptions regarding the community. Content analysis was used to classify participants' freely answered responses about helping behaviours, with logistic regression analysis subsequently used to examine the related factors. Community members provided older adults with various types of spontaneous help, including help with walking (20.0%), accident care (16.8%), giving directions to a destination (11.6%), accompanying them to a destination (12.9%), and support in daily life (10.4%). In the multinominal logistic regression analysis, advanced helping behaviours were associated with having a family member with dementia, experiences involving people living with dementia, knowledge of dementia and community support centres, and a stronger sense of community integration (P < 0.05). The reasons for not being able to help included being physically unable to (42.5%), not feeling responsible (19.3%), not knowing how to help (17.4%), and hesitating to help (14.4%). The results suggest that providing learning opportunities for community members could further promote their helping behaviours for older adults. These could include interacting with older adults, especially those living with dementia; promoting a sense of community integration; or receiving training in helping actions. Such efforts could support the development of an effective community-based care system for older adults.

Blood pressure in the longevous population with different status of hypertension and frailty.

Blood pressure(BP) of the longevous population with hypertension and/or frailty was under-investigated. To investigate the association between age, BP, variation of BP, and survival among the old adults with different status of hypertension and frailty, the present study included adults ≥65 years in the Chinese Longitudinal Healthy Longevity Survey(2008-2018), defined frailty using the Fried criteria, and identified hypertension by self-report or SBP/DBP ≥ 140/90 mm Hg. The association between age and BP were investigated using linear regression models. Variation of BP was defined if annual change of BP lower than quartile1(sharp decrease) or higher than quartile3(sharp increase). The association between age and BP variation were investigated using multinominal logistic regression models. The association between BP and survival was analyzed using Cox regression models. Among 13,447 adults(centenarian: 1965[14.6%]), age was positively associated with SBP in robust hypertensive elderly but negatively associated with it in frail hypertensive elderly. Annual change of BP was more likely to be increment among the normotensive elderly, but be decrement among the hypertensive elderly, especially among those with frailty. SBP < 120 mmHg was the risk factor of mortality among the frail oldest-old(≥85 years) while SBP ≥ 150 mmHg was that among the robust young-old(65-84 years). DBP ≥ 90 mmHg was the risk factor of mortality both in the robust young-old and the frail oldest old. In conclusion, age and frailty might be the criteria to predict the change of BP to guide the BP management of the longevous population.

LOADING OF PHYSICAL ACTIVITY REDUCES RISK OF SARCOPENIA IN MIDDLE-AGED ADULTS

AbstractObjectivesThe aim of this study was to investigate whether mechanical loading induced by physical activity can reduce risk of sarcopenia in middle-aged adults.MethodsThis was a longitudinal study based on a subset of UK Biobank data consisting of 1,918 participants (902 men and 1,016 women, mean age 56 years) who had no sarcopenia at baseline (assessed between 2006 and 2010). The participants were assessed again after 6 years at follow-up, and were categorized into no sarcopenia, probable sarcopenia, or sarcopenia according to the definition and algorithm developed in 2018 by European Working Group on Sarcopenia in Older People (EWGSOP). Physical activity was assessed at a time between baseline and follow-up using 7-day acceleration data obtained from wrist worn accelerometers. Raw acceleration data were then analysed to study the mechanical loading of physical activity at different intensities (i.e. very light, light, moderate-to-vigorous). Multinominal logistic regression was employed to examine the association between the incidence of sarcopenia and physical activity loading, between baseline and follow up, controlled for other factors at baseline including age, gender, BMI, smoking status, intake of alcohol, vitamin D and calcium, history of rheumatoid arthritis, osteoarthritis, secondary osteoporosis, and type 2 diabetes.ResultsAmong the 1918 participants with no sarcopenia at baseline, 230 (69 men and 161 women) developed probable sarcopenia and 37 (14 men and 23 women) developed sarcopenia at follow-up. Physical activity loading at moderate-to-vigorous intensity was higher in men (p&lt;0.05), while women had higher physical activity loading at very light intensity (p&lt;0.05). No significant difference was found in physical activity loading at light intensity between men and women (p&gt;0.05). Logistic regression models showed that increase in physical activity loading at moderate-to-vigorous intensity significantly reduced the risk of sarcopenia (odds ratio = 0.368, p&lt;0.05), but not probable sarcopenia (odds ratio = 0.974, p&gt;0.05), while loading at light or very light activity intensity were not associated with the risk of sarcopenia or probable sarcopenia (p&gt;0.05).ConclusionLoading of physical activity at moderate-to-vigorous intensity could reduce risk of sarcopenia in middle-aged adults.Declaration of Interest(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Internalization of negative societal views on old age into self-perceptions of aging: exploring factors associated with self-directed ageism.

A growing number of research has provided evidence for the negative impact of ageism on older people's health and well-being. Among the three different manifestations of ageism, namely institutional, interpersonal and self-directed ageism, significant ageism-health associations have been proved to be strongest for self-directed ageism. This supports stereotype embodiment theory, which maintains that lifetime exposure to negative age stereotypes leads to the internalization of ageism as a form of negative attitudes towards own aging and it adversely affects health and well-being in old age. However, little is known about how people internalize negative age stereotypes held in the society into self-perceptions of aging. This study aimed to explore how socially shared beliefs about old age are internalized into self-perceptions of aging focusing on uncovering factors related to self-directed ageism. Data were derived from the survey that had examined citizen's attitudes towards old age and aging in Finland. Multinominal logistic regression models were performed to examine the association of sociodemographic and contextual factors with different combinations of societal age stereotypes and two indicators of self-perceptions of aging: subjective views on old age and personal feelings of own old age. The analyses showed that being female, attaining tertiary education, evaluating poor quality of life and awareness of institutional old age discrimination were related to holding negative views on aging towards both society and oneself. The findings from univariate and multivariate models suggest that it is not age per se, but structural and cultural circumstances shaped with growing older that turns socially shared negative age stereotypes into negative self-perceptions of aging. Even though the study addressed situations in one country, the findings have an important implication for other rapidly aging societies regarding how social and cultural contexts are closely linked to the formation of self-directed ageism.