Self-rated Health Research Articles

The patient and the family: investigating parental mental health problems, family functioning, and parent involvement in child and adolescent mental health services (CAMHS)

AbstractParental mental health problems can impact child mental health, as well as treatment of child mental health problems. The aim of this study was to investigate self-reported mental health problems in parents of children referred to outpatient child and adolescent mental health services (CAMHS) and to compare child mental health problems, family variables, treatment received and parent participation in treatment planning between parents above and below the cut-off for elevated mental health problems. The sample included N = 111 parents of N = 98 children. Parental reports covering their own and their children’s mental health problems, family functioning, adult relationship satisfaction, and previous treatment for mental health problems were collected at the time of the child’s intake appointment. Questions concerning contact with CAMHS were completed one year later. At the time of the intake appointment, 44% of the children had a parent who reported elevated mental health problems. In these families, children reportedly had significantly more mental health problems and problematic family functioning was more common than in families where parent mental health problems were not elevated. Parents with elevated mental health problems received group-based parent support/education to a greater extent during the first year of contact with CAHMS and reported less participation in treatment planning compared to parents without elevated mental health problems. To conclude, findings indicate that co-occurring mental health problems are common in parents when their child is referred to CAMHS, and in these families, it is reported that children have more symptoms, and more families experience problematic functioning. These factors merit consideration in assessment and treatment planning, indicating increased treatment needs in this group of families.

Access to Network Social Capital and Health Outcomes in Later Life: Understanding the Role of Tie Strength

Our study contributes to the scholarship by examining the concrete ways in which two distinct types of interpersonal connection—strong/close versus weak/distant—are independently related to self-rated health and life satisfaction cross-nationally. In addition, we explore whether and how the two types of interpersonal connection modify the magnitude of the associations between subjective social status (SSS) and health and well-being of older populations cross-nationally. According to results from our multilevel analysis, social capital available through strong ties (family and friends) is positively associated with both outcomes. On the other hand, social capital via weak ties (acquaintances) is positively related to health but negatively related to well-being. We also find that social capital mediated by strong ties significantly buffers the harmful implications of status disadvantage or low SSS on health and well-being of older adults. In comparison, weak tie-mediated social capital provides buffering against status disadvantage only for well-being.

Identifying predictors of stroke in young adults: a machine learning analysis of sex-specific risk factors

IntroductionStroke among Americans under age 49 is increasing. While the risk factors for stroke among older adults are well-established, evidence on stroke causes in young adults remains limited. This study used machine learning techniques to explore the predictors of stroke in young men and women.MethodsThe least absolute shrinkage and selection operator algorithm (LASSO) was applied to data from Wave V of the National Longitudinal Survey of Adolescent to Adult Health (N = 12,300)—nationally representative, longitudinal panel containing demographic, lifestyle, and clinical information for individuals aged 33–43—to identify the key factors associated with stroke in men and women. The resulting LASSO model was tested and validated on an independent sample and model performance was assessed using the area under the receiver operating characteristic curve (AUC) and calibration. For robustness, synthetic minority over sampling technique (SMOTE) was applied to address data imbalance and analyses were repeated on the balanced sample.ResultsApproximately 1.1% (N = 59) and 1.3% (N = 90) of the 5,318 and 6,970 men and women in the sample reported having a stroke. LASSO was used to predict stroke using demographic, lifestyle, and clinical predictors on both balanced and imbalanced data sets. LASSO performed slightly better on the balanced data set for women compared to the unbalanced set (Female AUC: 0.835 vs. 0.842), but performance for men was nearly identical (Male AUC: 0.820 vs. 0.822). Predictor identification was similar across both sets. For females, marijuana use, receipt of health services, education, self-rated health status, kidney disease, migraines, diabetes, depression, and PTSD were predictors. Among males, income, kidney disease, heart disease, diabetes, PTSD, and anxiety were risk factors.ConclusionsThis study showed similar clinical risk factors among men and women. However, variations in the behavioral and lifestyle determinants between sexes highlight the need for tailored interventions and public health strategies to address sex-specific stroke risk factors among young adults.

Living in the vicinity of pesticide-treated crop fields: Exploring associated perceptions and psychological aspects in relation to self-reported and registry-based health symptoms.

Exposure to pesticides in the living environment can be associated with the prevalence of health symptoms. This study investigates associations between health symptoms among residents in areas with fruit crop fields where pesticides are applied, and psychological perceptions and attitudes about environmental aspects and exposures. A cross-sectional survey combined with routine primary care electronic health records (EHR) data was conducted in 2017 in rural areas of the Netherlands with high concentration of fruit crops (n = 3,321, aged ≥ 16 years). Individual exposure to pesticides was estimated using geocoded data on fruit crops around the home. Validated instruments were used to assess symptom report and psychological perceptions and attitudes. Annual prevalence of various health symptoms was derived from EHRs. Multilevel regression models were used to analyze associations between health symptoms (outcome), fruit crops, and multiple psychological perceptions and attitudes (confounders). Living in the vicinity of fruit crop fields was generally not associated with self-reported symptom duration and general practitioner (GP) registered symptoms. For self-reported symptoms, symptom prevalence decreased when crop density within 250m and 500m from the home increased. No associations were found at other distances. Furthermore, higher levels of environmental worries, perceived exposure, and perceived sensitivity to pesticides and attribution of symptoms to environmental exposures were generally associated with a higher number of self-reported symptoms, and longer symptom duration. Symptoms reported to GPs were not associated with psychological perceptions and attitudes, except for perceived sensitivity to pesticides. Psychological perceptions and attitudes appear to be related to self-reported symptoms, but not to GP-registered symptoms, independent of the actual levels of exposure as measured by the size of the area of crop fields. Perceptions about environmental factors should be taken into account in environmental health risk assessment research when studying health symptoms.

Comparing self-rated health among exclusive e-cigarette users and traditional cigarette smokers: an analysis of the Health Survey for England 2019.

The health implications of e-cigarette use compared to traditional cigarette smoking continue to attract significant public health interest. This study examines self-rated health (SRH) outcomes among exclusive e-cigarette users versus exclusive traditional cigarette smokers, using data from the Health Survey for England 2019. From an initial sample of 10,299 participants, the study focused on 8204 adults, excluding those aged 0-15. Further refinement to exclusive nicotine product users led to 274 e-cigarette users and 1017 cigarette smokers, after excluding dual users, never users, ex-users, non-responders, and users of other tobacco products such as pipes and cigars. SRH was derived from participants' responses to a question asking how they rated their general health, with five possible options: "very good", "good", "fair", "bad", and "very bad". For the purposes of this study, these responses were collapsed into two categories: "Good Health" (combining "very good" and "good") and "Poor Health" (combining "fair", "bad", and "very bad"). Consequently, 834 participants were classified as reporting good health, while 457 reported poor health. Binary logistic regression, adjusted for factors such as age, sex, ethnicity, residence, education, body mass index, alcohol use, age started smoking, physical or mental health conditions, and frequency of GP visits, revealed that exclusive e-cigarette users were significantly more likely to report good health compared to exclusive cigarette smokers, with an odds ratio(OR) of 1.59 (95% CI: 1.10 - 2.32, p = 0.014). As a sensitivity analysis, a generalized ordered logistic regression model was performed using the original five SRH categories. The adjusted model confirmed consistent results, with exclusive e-cigarette users showing higher odds of reporting better health across the full range of SRH outcomes (OR = 1.40, 95% CI: 1.08-1.82, p = 0.011). These findings suggest that exclusive e-cigarette users perceive their health more positively than traditional cigarette smokers, contributing useful insights to the discussions around harm reduction strategies.

Be kind, don't rewind: trait rumination may hinder the effects of self-compassion on health behavioral intentions after a body image threat.

Many individuals encounter situations that may elicit body-related concerns and impact how they think and feel about their weight, daily habits, and physical attractiveness. Research shows body image threats can predict poor health behaviors, but approaching those difficult moments with self-compassion-being kind, forgiving, and nonjudgmental-may reduce the impact of that threat and promote engagement in positive health behaviors. However, trait rumination, or tending to perseverate on negative events, may both dampen the benefits of a self-compassionate state and predict poor health behaviors. The present study examined whether a brief self-compassion writing exercise, after recalling a negative body-related event, predicted intent to perform health-promoting behaviors, and whether trait rumination attenuated this relationship. Participants (N = 217) completed a measure of trait rumination, underwent a body image threat, and were randomly assigned to cope with self-compassion or a distraction. Subsequently, participants completed a measure of health behavioral intentions. Analyses revealed participants in the self-compassion condition reported greater health-promoting behavioral intentions compared to control, with no significant main effect of trait rumination. However, a condition-by-rumination interaction emerged, suggesting the self-compassion condition was associated with higher health behavioral intentions, but only for participants with low trait rumination levels. These effects washed out when controlling for participants' self-rated health. The findings suggest that a self-compassion practice can help mitigate the adverse effects of a body image threat and facilitate health-promoting behavioral intentions, although its efficacy may depend on individual levels of trait rumination and perceived health.

Mental health, risk behaviors, and social life factors in relation to adolescents' suicide ideation, plans and attempt.

This study investigated differences in mental health and well-being, risk behaviors, and social life factors among adolescents who experienced different forms of suicidality. We examined 18-years-olds in the Danish National Birth Cohort (N = 47,852). Suicidality was defined with mutually exclusive categories ranging from no suicidality, self-reported suicide ideation, plans, and attempt as well as hospital-recorded suicide attempt. The proportion of adolescents with self-reported poor mental health and well-being, risk behaviors, and social life factors were compared across forms of suicidality. Sample weights were applied. Depressive symptoms were reported by 14% (95% CI 13%;14%) of girls with no suicidality, 44% (95% CI 43%;45%) of girls with suicide ideation, and 68% (95% CI 65%;72%) 66% (95% CI 60%;72%) of girls with self-reported suicide attempt or hospital-recorded suicide attempt respectively. Among boys, depressive symptoms were reported by 5% (95% CI 4%;5%) of those with no suicidality, 27% (95% CI 26%;28%) of those with suicide ideation, and 51% (95% CI 45%;57%) and 40% (95% CI 22%;58%) of those with self-reported suicide attempt or hospital-recorded suicide attempt respectively. Likewise, other aspects of poor mental health and well-being gradually increased relative with more severe forms of suicidality, while no notable differences were identified between adolescents with self-reported and hospital-recorded suicide attempt. Similar tendencies were observed for risk behaviors and social life factors. These findings suggest that adolescents with suicidality, including the large proportion with suicide ideation only, faces challenges across several parameters of mental health and well-being, risk behavior, and social life factors. This emphasizes the need for community-based interventions to identify and support the large group of adolescents experiencing both more and less severe forms of suicidality. Clinicians should prioritize comprehensive psychiatric intervention to address the complex needs of suicidal adolescents effectively.

Irregular meal pattern and later sleep midpoint are associated with increased BMI z-score and waist–height ratio during early adolescence

BackgroundRapid gains in adiposity may have more adverse health implications in later life compared with having stable adiposity throughout childhood and adolescence. A knowledge gap concerns concomitant health behaviors contributing to adiposity gain among adolescents.ObjectivesWe investigated the associations of health behaviors relating to dietary habits, sleep, physical activity (PA), and screen time with an increase in body mass index z-score (BMIz) and waist–height ratio (WHtR) during adolescence.MethodsWe included 4,785 adolescents (53% of girls) aged 11.1 (SD 0.8) years at baseline and followed them for 3 years. We clustered them into decreased, stable, and increased BMIz and WHtR categories using the K-means clustering method. Using Cox regression, we computed hazard ratios (HR) with 95% CI for the associations of self-reported health behaviors (dietary habits, physical activity, sleep midpoint, and sedentary digital media use) with belonging to an increased BMIz or WHtR group. In a subsample (n = 3,840), we ran a sensitivity analysis considering puberty status as an additional covariate.ResultsLater sleep midpoint (having later midpoint of sleep between bedtime and waking time) and irregular meal pattern (not eating lunch and dinner every school day) predicted increased BMIz (HR 1.26 [95% CI 1.13–1.41] and 1.23 [1.08–1.39], respectively) and WHtR (1.23 [1.09–1.39] and 1.18 [1.02–1.36], respectively) over the follow-up period, after adjusting for other health behaviors. Associations remained after considering puberty status as a covariate.ConclusionsEarly bedtime with adequate sleep duration and regular meal pattern should be encouraged to prevent adiposity gain during early adolescence.

Physical and mental well-being of older adults: examining the impact of financial support from male migrant children on Indian left-behind parents.

Amid high youth out-migration, India's older parents face severe social, economic, psychological, and health crises due to their children's separation. However, remittances from their migrant children alleviate economic hardships, improve healthcare access, and partially compensate for their absence. So, this study examines how adult-child migration affects older parents' physical and mental health and how remittance support helps mitigate these challenges. This study used the 2011 Building a Knowledge Base on Population Ageing in India (BKPAI) dataset, the current study (n = 5122) employs bivariate statistics, logistic regression, and mediation analysis to address the objectives. Logistic regression determines the factors of self-rated health and depression, while mediation analysis is implied to understand the intermediate effect of financial support i.e. remittance on left-behind older adult health. The findings indicate that approximately 43% of the study populations were left behind, meaning they have at least one migrant child. Notably, 20% of these left-behind older adults report poor health conditions, and 17% exhibit depressive symptoms, while the poor health and having depressive symptoms were lower among the non-left-behind older adults i.e., 13% and 12% respectively. The mediation analysis indicates that the likelihood of good self-rated health increased 1.35 times through the effect of remittance, which compensates for around 55% of the total adverse effect of migration. The consistent inflow of remittances serves to alleviate the impact on household finances, ensure food security, and address medical expenses. However, it is crucial to recognize that while remittances contribute significantly to economic stability, they cannot fully replace the physical presence of adult children, especially in terms of caregiving.

Loneliness, socio-demographics, and self-rated health outcomes among the high-risk 50+ population in the Czech Republic: COVID-19 early outbreak responses

ABSTRACT Loneliness in late life can act as a trigger of negative feelings, reduce well-being, and cause significant health problems. Yet, we have a limited understanding of older adults’ lived experiences of loneliness, especially during pandemics. Based on the Survey of Health, Ageing, and Retirement in Europe (SHARE) conducted in the Czech Republic (n = 2,631), we found that depression, nervousness, gender, trouble with sleep, and physical health condition before COVID-19 were significantly associated with loneliness. These determinants should be taken into account when planning further supportive fieldwork to optimize the functioning of the aging population during the pandemic and beyond.

A Systematic Review and Meta-Analysis of Interventions Targeted to Parents for Improving the Oral Health of Children from Culturally and Linguistically Diverse (CALD) Backgrounds.

A high prevalence of dental caries is a significant health problem, especially in the pediatric population. Low-income minority groups, including the refugee and immigrant populations, are at higher risk of compromised oral health. It has been suggested that migrant parents do not have enough understanding of oral health, risk factors associated with dental caries, or the progress of dental decay. This systematic review aims to study quantitative literature on oral health interventions, health promotion programs, or behaviour change interventions targeting the parents/ caregivers of culturally and linguistically diverse (CALD) children. A systematic search of electronic databases, including MEDLINE, EMBASE, PUBMED, CINAHL, SCOPUS, WEB OF SCIENCE, COCHRANE, and PROQUEST, was conducted until August 2023. Randomised (RCT) or non-randomised controlled trials (NRCTs) were included. Two reviewers independently assessed the quality of the included studies using the Cochrane Risk of Bias (RoB) 2.0 and ROBINS-I tools. Meta-analysis was performed as appropriate. The initial search from the databases retrieved 2073 articles. After the removal of duplicates, 1683 articles remained. Finally, 69 articles were reviewed in full text, and 15 articles were considered eligible in this review. The RoB assessment for RCTs rated three as low-risk and three as high-risk. The serious RoB in these NRCTs mostly pertained to measurement bias based on self-reporting oral health behaviours. The meta-analysis pooling of results (for RCTs and NRCTs) favoured interventions for CALD parents' oral health knowledge [0.73 (95% CI, 0.08 to 1.38) for RCTs, 1.73 (95% CI; 1.45 to 2.02) for NRCTs] and attitudes [0.86 (95% CI, 0.31 to 1.42)]. Relatively high heterogeneity was observed. Oral health educational interventions can be effective in improving the oral health literacy of CALD parents' oral health knowledge and attitudes, especially when facilitated by lay health advisors. However, the low quality of evidence due to high heterogeneity and high RoB further highlighted the need for well-designed RCTs targeting CALD parents.

Association of oral health with nutritional status of the older adults: a cross-sectional study.

The potential association between oral health and nutritional status of the very old, has been poorly investigated. Thus, we carried out the cross-sectional study to evaluate the association of oral health with the nutritional status of the older adults. 210 participants aged over 75 years were included in the study. Nutritional status was assessed by the Short-form Mini-Nutritional Assessment (MNA-SF) and body composition measurement. Data were available for self-reported oral health (10-item Eating Assessment Tool (EAT-10) and Chewing Function Questionnaire (CFQ)) and specific experimental tests including salivary flow, tongue and lip pressure, occlusal force, water swallow test and taste test for the detection of oral functions. Spearman rank correlation was used to analyze the correlation between body composition and oral health. Logistic regression and restricted cubic spline models were applied to examine the association of oral health with malnutrition. The study reveals that poor oral health is related to the malnutrition. The tongue pressure and molar occlusal force were significantly associated with malnutrition in an L-shaped dose-response relationship after adjustment for potential confounding factors. The higher the tongue pressure and molar occlusal force, the lower the risk of malnutrition. Besides, the CFQ score, salty, sour, and bitter taste, are risk factors for malnutrition. The presence of malnutrition is significantly associated with poor oral health in older adults. Our study supposes that the design of food suitable for oral conditions of the older adults may be another feasible solution to the nutritional problems among them.

Fast-Food Consumption and Asthma-Related Emergency Room Visits in California

Introduction Asthma is common, affecting up to 8% of adults in the United States. Several studies have shown an association between poorer diet and asthma. Despite the prevalence of fast-food consumption in the Western diet, research examining fast food consumption and asthma is limited. Objective This study aimed to examine the association between fast food consumption and asthma-related emergency room visits among adults with asthma in California from 2011-2016. Methods This cross-sectional study focused on 11,561 adults with asthma in California. Publicly available data from the California Health Interview Survey was used. The independent variable included fast food consumption, and the dependent variable was emergency room visits due to asthma. This study used logistic regression models and controlled for sex, race, self-reported overall health, BMI, and current smoking status. Survey weights were applied to ensure the analysis represented the general population. Results Consumption of fast food ≥3 times per week was associated with increased odds of emergency room visits for asthma among adults with asthma in California (unadjusted model: OR = 1.64 CI: 1.13-2.40, p = 0.01; adjusted model: ORadj =1.53, CI: 1.03-2.26, p = 0.03). Conclusion Our findings suggest that high consumption of fast food among adults with asthma may result in higher odds of asthma-related emergency room visits. Thus, decreasing fast food consumption may benefit adults with asthma by reducing emergency room visits.

Abstract 4128962: Medicaid Work Requirements and Changes in Insurance Coverage, Employment, Access to Care, and Health Status Overall and Among People with Cardiovascular Disease

Introduction: Medicaid work requirements have been at the forefront of health policy debate. Proponents argue that these policies increase employment, reduce poverty, and improve health. Critics have raised concerns that work requirements lead to loss of coverage and impede access to care. Hypothesis: We hypothesized that Medicaid work requirement implementation would be associated with decreased insurance coverage and healthcare access without impacting employment. Methods: We used the Behavioral Risk Factor Surveillance System (a nationally representative survey administered by the CDC) to estimate the impact of Medicaid work requirements on insurance coverage, employment, access to care, and self-reported health. We used a difference-in-differences (DID) approach to compare changes in outcomes in Arkansas (where work requirements were implemented) versus control states. Outcomes were self-reported and included: 1) insurance coverage, 2) employment, 3) presence of a personal healthcare provider, 4) inability to see a doctor due to cost, and 5) self-reported health. The analysis was conducted among all respondents and among respondents with cardiovascular disease, who were hypothesized to be particularly vulnerable to negative sequelae of insurance loss. Results: The implementation of Medicaid work requirements in Arkansas was associated with decreased insurance coverage compared with control states (adjusted DID estimate -4.3%, CI -8.4%, -0.1%), but no increase in employment rates (-2.2% CI -7.0%, 2.6%). There was a trend toward decreased likelihood of having a personal healthcare provider (-4.7% CI -9.9%, 0.5%). There was no change in inability to see a doctor due to cost or self-reported good health. When this analysis was repeated among participants with cardiovascular disease, work requirement implementation was not associated with changes in any of the outcome variables. Conclusions: The implementation of Medicaid work requirements in Arkansas was associated with decreased insurance coverage and no change in employment. Our findings are particularly relevant given national policy debate about work requirement expansion and the recent implementation of Medicaid work requirements in Georgia. Despite the null findings among respondents with cardiovascular disease (likely the result of a small sample size), this study has important implications for cardiovascular health given the close association between insurance coverage and cardiovascular outcomes.

The associations between well-being and Cloninger’s personality dimensions in a Korean community sample

Background Well-being is a multidimensional construct comprising affective and non-affective components. Previous research has consistently linked personality traits to well-being, yet cultural variations in this association remain underexplored, particularly in collectivistic cultures such as Korea. Therefore, this study aims to identify universal and culture-specific characteristics of personality in relation to well-being. Methods A sample of 527 Korean university students participated, providing data through the Korean version of the Temperament and Character Inventory-RS (TCI-RS), self-rated health (SRH), social support (SS), Satisfaction With Life Scale (SWLS), and positive and negative affect schedule (PANAS). Pearson correlation analysis and ANCOVA, with sex and age as covariates, were employed to examine linear associations. Multidimensional personality profiles were utilized to investigate non-linear associations among character dimensions on different aspects of well-being. All analysis was performed using jamovi 2.3.12. Results Self-directedness and cooperativeness exhibited positive linear associations with both affective (positive and negative affect) and non-affective (SRH, SS, SWLS) components of well-being. Self-directedness emerged as a key predictor across various well-being aspects. Cooperativeness was strongly associated with perception of social support. Self-transcendence showed positive associations with both positive and negative affect, considering interactions with other character dimensions. Discussion While self-directedness played a pivotal role universally, the impact of cooperativeness and self-transcendence appeared to be influenced by cultural factors, enhancing perception of social support and affecting both positive and negative affect in a collectivistic culture. This study illustrates the importance of considering cultural nuances in the relationship between personality and well-being. Future research should delve deeper into cultural differences, emphasizing the need for subtle interpretations of specific personality traits within diverse cultural contexts.

Abstract 4139194: Predicting Cholesterol Screening Behavior After Age 50 Using Machine Learning: Insights from the Health and Retirement Study

Background: In the U.S., about 8% of adults never received cholesterol screening. Although machine learning (ML) has been used to develop decision tools for Atherosclerotic Cardiovascular Disease (ASCVD) risk prediction, its application in behavioral forecasting has not yet been explored in the context of cholesterol screening behaviors. This study aimed to examine the performance and accuracy of ML algorithms in forecasting cholesterol screening behaviors in adults after age 50. Methods: This analysis used deidentified data from the Health and Retirement Study (HRS) 2004-2018. HRS is a longitudinal survey among 23,000 households in the U.S. Participants were excluded from the current analysis if they passed away by 2019, ever had ASCVD or stroke, were under age 50 at baseline, or had missing data in self-reported cholesterol screening. In total, 7176 participants (mean age [SD]=62 [8]) met the inclusion criteria; participants were randomly split into a training set (80%) and a testing set (20%). The synthetic minority oversampling technique was used to solve the imbalance distribution of the rare event. Five ML algorithms were used: random forest, gradient boosting machine (GBM), XGBoost, Support Vector Machine (SVM), and logistic regression. Accuracy, AUROC, and positive predictive value (PPV) were used to compare model performance. The average gain was evaluated for feature importance in the demographic and health domains. Results: In total, 232 (3.2%) respondents did not receive any cholesterol screening from 2008 to 2018. Experiments with five ML algorithms suggested that XGBoost with deeper trees and learning rate performed better in classifying those who did not screen for cholesterol levels over 10 years. Adding prior cholesterol screening history (2004-2006) into the model significantly improved model performance. Hypertension, self-rated health, and smoking were the major health features, while insurance, poverty, and work status were the major demographic features in the predictive model (accuracy=0.97; AUROC=0.88; PPV=0.42). Conclusion: Findings underscore the potential utility of ML models in predicting cholesterol screening behaviors after age 50. This could be the basis for developing decision tools for clinicians to identify those with a lower chance of cholesterol screening or make reminders accordingly. The low-cost predictive model might improve the uptake of preventive screening behaviors in middle-aged and older adults.

Mental and physical health characteristics of older and younger adults receiving medication for opioid use disorder

BackgroundMethadone is an effective and widely used medication for opioid use disorder (MOUD). Within in the United States (US), older adults represent an increasing proportion of those receiving MOUD, yet little is known about characteristics of older individuals in these programs.ObjectivesTo evaluate mental and physical health characteristics of younger and older adults receiving MOUD and test whether age moderates the relation between physical and mental health variables.MethodsData for this secondary analysis are drawn from a cross-sectional survey of a convenience sample of individuals seeking methadone dosing as part of MOUD at four opioid treatment programs in two regions of the US. Descriptive statistics and correlational and moderation analyses examined outcomes of pain severity, pain interference, self-rated health, physical activity, depression, and anxiety across younger (18-49) and older (50+ years) participants.ResultsAnalyses included 469 participants (mean [range] age, 41.01 [20–70] years). Older participants reported higher pain severity and interference, less physical activity, and worse self-rated health than those in the younger age group (ps < 0.05). Associations between mental and physical health variables were generally weak-to-moderate in the older age group (r = 0.26 to r = 0.44, p < 0.01), and weak in the younger age group, although age did not moderate associations.ConclusionClinically significant mental and physical health variables are associated among individuals receiving methadone for MOUD, with older adults facing unique challenges.Clinical implicationsOpioid use treatment should include not only pain management but also assessment and treatment of depression and anxiety and optimization of other health behaviors (e.g., physical activity) across age groups. Pain management and health promotion are particularly relevant targets for aging individuals receiving MOUD.

The effects of remdesivir on long-term symptoms in patients hospitalised for COVID-19: a pre-specified exploratory analysis.

There is an unmet need for treatment of long-term symptoms following COVID-19. Remdesivir is currently the only antiviral approved by the European Medicines Agency for hospitalised patients. Here, we report on the effect of remdesivir in addition to standard of care on long-term symptoms and quality of life in hospitalised patients with COVID-19 as part of the open-label randomised NOR-Solidarity trial (NCT04321616). A total of 185 patients were included in the main trial, of which 118 (60%) were randomised to either remdesivir (n = 42; 36%) or a post-hoc defined control group composed of patients who received standard of care alone or standard of care with hydroxychloroquine (n = 76; 64%). Participants were given quality of life surveys to fill out to gauge their self-reported health over time (the COPD assessment test, the EQ-5D-5L and the RAND SF-36). Here we show that after three months, patients treated with remdesivir do not show significant improvements in stated health compared to those who were not. There are self-reported symptoms of fatigue [mean remdesivir group 2.6 (standard deviation 1.5) v control 2.1 (1.6), 95% confidence interval(CI) -1.17 to 0.15, p = 0.129], shortness of breath [3.0 (1.7) v 2.1 (1.8), 95% CI -1.53 to 0.16, p = 0.110] and coughing [1.8 (1.6) v 1.2 (1.5), 95% CI -1.3 to 0.33, p = 0.237] 3 months after randomisation assessed via the COPD Assessment Test. Our findings indicate that treatment with remdesivir during hospitalisation does not provide any clinically relevant long-term benefit.

Trends in the health status of Ukrainian refugees in Norway according to month of arrival during 2022.

More than 35 000 refugees from Ukraine applied for temporary collective protection in Norway during 2022. Previous studies have shown that the refugees have poor health in several domains, and crude reports have suggested that those fleeing Ukraine at later stages have even poorer health. However, more systematic knowledge is lacking. This study aimed to analyse trends in self-reported health in a sample of adult refugees from Ukraine, by month of arrival to Norway during 2022. Data were collected via an online, digital questionnaire, in a cross-sectional study design between 28.10.22-31.01.23. Recruitment was via multiple physical and social media contact points, including asylum reception centres, municipalities, non-profit organisations, and Facebook groups for refugees in Norway. The survey included the following self-reported health outcomes: overall health, oral health, presence of long-term illnesses or disabilities, and a short version of the Hopkins Symptom Checklist (HSCL-5). Among the 727 respondents, 82% were female, 65% were aged 30-49 years, 69% had higher education and 53% were responsible for children in Norway. There were 383 respondents who arrived between February-April (T1), 200 between May-August (T2) and 144 between September-December (T3). Compared to T1, respondents who arrived in the two later time periods were more often male, had younger age distributions, and were less likely to have completed higher education. The proportions of respondents reporting poor/very poor overall health, presence of long-term illnesses and long-term disabilities were highest in T3. Oral health and HSCL-5 showed the opposite trend, with lower proportions reporting poorer health among respondents in both later periods. Respondents in T3 were still more likely to report poor/very poor health and long-term illnesses after adjusting for sex, age group and education (adjusted odds ratio, aOR: 2.71 [95%CI 1.51-4.89]) and 1.74 [1.14-2.65], respectively). Respondents who arrived later in 2022 generally reported poorer long-term health, but less psychological distress than those who arrived earlier in the year. These findings may help inform the planning of health services for refugees from Ukraine, especially in areas receiving large numbers of refugees.

Socioeconomic Inequality in Perceived Need for Mental Healthcare in Patients with Type 2 Diabetes Mellitus in Hamadan, Western Iran

Background and aims: The use of mental healthcare services in type 2 diabetes mellitus (T2DM) patients can depend on socioeconomic status (SES). The current study aimed to evaluate socioeconomic inequality in the perceived need for mental healthcare in patients with T2DM in Hamadan, Western Iran. Methods: This cross-sectional study was conducted between March and July 2023 in Hamadan, Western Iran. The study included T2DM patients who were referred to the Diabetes Center of Hamadan. The variables included in the study were demographics, SES, health insurance status, social support, and self-rated mental health. The outcome of interest was the perceived need for mental healthcare. The socioeconomic inequality was evaluated using concentration index and decomposition analysis. Results: A total of 393 patients (mean age: 56.48±10.65, 62% female and 88% urban inhabitants) were enrolled. The prevalence of perceived need for mental healthcare was 43%, and 50.30% of the patients (85) had delay/avoidance of mental healthcare services. The concentration index (95% confidence interval) of perceived mental healthcare needs was -0.24 (-0.18, -0.30), indicating that perceived needs are more concentrated in the socio-economically disadvantaged patients. Decomposition analysis revealed that low economic status and illiteracy were the main contributors to the inequality (approximately 50%). Cost, minimization, and stigma were the most frequently reported reasons for avoidance/delay of mental healthcare services, respectively. Conclusion: There was a pro-poor socioeconomic inequality in perceived need for mental healthcare among T2DM patients. Healthcare policies and facilities to reduce socioeconomic inequality should mainly focus on disadvantaged T2DM patients.