Self-rated Health Research Articles

Social inequalities in youth mental health in Canada, 2007-2022: a population-based repeated cross-sectional study.

Rising concern surrounds youth mental health in Canada, with growing disparities between females and males. However, less is known about recent trends by other sociodemographic factors, including sexual orientation, ethnocultural background, and socioeconomic status. This study analyzed data from 96 683 youths aged 15-24 who participated in the nationally representative Canadian Community Health Survey (CCHS) between 2007 and 2022. Trends in absolute and relative inequalities in poor/fair self-rated mental health (SRMH) by sex, sexual orientation, racialized and Indigenous identity, and socioeconomic conditions were assessed. The percent of youths reporting poor/fair SRMH quadrupled from 4.3% in 2007-08 to 20.1% in 2021-22. During the same period, absolute inequalities in SRMH increased by 9.9% points (95% CI: 6.6, 12.9) for females compared to males, 11.4% points (95% CI: 4.6, 18.2) for Indigenous versus non-racialized youth, and 15.4% points (95% CI: 5.7, 25.1) for youth (aged 18-24) identifying as lesbian, gay, or bisexual (LGB) compared to heterosexual. The sustained deterioration in youth SRMH over the past decade and a half has been accompanied by widening inequalities across several dimensions important for health equity in Canada. Action is needed to identify and implement effective programs and policies to support youth mental health and address disparities.

Compounding strain: The impact of caregiver strain on health outcomes in older adults with new cancer diagnoses.

We sought to examine the association between pre-existing caregiving strain levels and care recipient health outcomes following a new cancer diagnosis. We used the National Health and Aging Trends Study (NHATS) linked with the National Study of Caregiving (NSOC) and Medicare claims to identify older adults receiving family caregiving within one year before an index cancer diagnosis. Caregiving strain was determined using NSOC items of self-reported emotional, physical, and financial difficulties measured before the cancer diagnosis. We used care recipient NHATS responses to determine outcomes with the Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale (GAD-2), and self-reported general health pre and post-cancer diagnoses. Multivariable logistic regression models were used to examine care recipient's health outcomes following cancer diagnosis by previously existing caregiver strain levels. We identified 584 caregivers who had completed the NSOC items related to caregiving strain and were linked to 404 care recipients whose index cancer diagnoses occurred in the year following the NSOC interview. Care recipients with highly strained caregivers were more likely to report anxiety than recipients with less strained caregivers (33.5% vs. 22.9%, p<0.05). In adjusted models, high strain was associated with increased odds of recipient anxiety (aOR: 2.08, 95% CI 1.14-3.79). Depressive symptoms and general health outcomes did not differ by caregiver strain in adjusted models. The presence of caregiver strain may contribute to worsening care recipient anxiety following a new cancer diagnosis. Strategically placed caregiver screenings early in the cancer care planning could identify strained caregivers who may benefit from targeted support and training. and support.

Geriatrics-Focused vs Traditional Primary Care in the Veterans Affairs Health Care System

Older adults often require specialized health care expertise, but the effects of geriatrics-focused models of primary care have not been fully evaluated. To compare the effects of geriatrics-focused primary care vs traditional primary care for older patients in the Veterans Affairs (VA) health care system. In this cohort study, geriatrics-focused primary care and traditional primary care patient dyads matched on variables associated with geriatrics-focused primary care entry and outcomes were enrolled from VA medical centers with operational geriatrics-focused primary care clinics serving 500 or more patients annually in fiscal year 2016. Across 57 eligible sites, patients 65 years or older who transferred their care to geriatrics-focused primary care within the previous 12 months (exposure period) (n = 291) and their matched traditional primary care controls (n = 277) were enrolled. Study recruitment occurred from March 22, 2018, through December 11, 2019, with patient outcomes data collection completed June 24, 2021. Data were analyzed from June 2023 to January 2024. At least 2 geriatrics-focused primary care visits during the exposure period. Geriatrics-focused primary care involves interprofessional teams of clinicians with geriatrics expertise to provide comprehensive primary care for older veterans with complex needs. The primary outcome was home time (days not in a hospital unit, short-term nursing facility, inpatient rehabilitation, or an emergency visit) within 18 months of the exposure period. Secondary outcomes were completion of advance directives, assessments (falls, incontinence, and function), and medication quality (potentially inappropriate medications, Anticholinergic Drug Scale score). Patients were surveyed over 18 months about care experiences using Patient Perceptions of Integrated Care subscales, and Patient-Reported Outcomes Measurement System self-reported health and well-being measures. A total of 568 patients were enrolled (mean [SD] age, 80.5 [7.0] years; 558 [98.2%] male), including 291 in the geriatrics-focused primary care and 277 matched in the traditional primary care groups; most baseline variables were comparable between the 2 groups. Geriatrics-focused primary care was not associated with more home time (rate ratio, 0.97; 95% CI, 0.62-1.51) over 18 months. Geriatrics-focused primary care was associated with higher odds of assessment for falls (odds ratio [OR], 2.86; 95% CI, 1.62-5.04), incontinence (OR, 2.73; 95% CI, 1.69-4.42), and function (OR, 4.05; 95% CI, 2.39-6.85) at 18 months. Geriatrics-focused primary care was not associated with advance directive completion, medication quality, or self-reported health and well-being. In this cohort study, geriatrics-focused primary care did not increase time at home or other measures of self-reported health and well-being or integration of care within the first 18 months after care transition. However, increases in some process measures important for quality of care were observed, suggesting that further studies are needed to evaluate outcomes over a longer time frame.

Universal health coverage for women of reproductive ages: a survey-based comprehensive assessment of service utilisation and health expenditure in Tanzania

IntroductionUniversal health coverage (UHC) for women of reproductive ages is a critical component of country and global health strategies but most evidence in high-fertility settings is limited to maternity care....

Adolescent Sports Participation and Health in Early Adulthood: An Observational Study

We study the impact of teenage sports participation on early-adulthood health using data from the National Study of Youth and Religion. We focus on two primary outcomes measured at ages 23 to 28 (self-rated health and PHQ9 Patient Depression Questionnaire score) and control for several demographic and socioeconomic confounders. To probe the possibility that certain types of sports participation may have larger effects on health than others, we conduct matched observational studies at each level within a hierarchy of exposures. Our hierarchy ranges from broadly defined exposures (e.g., participation in any organized after-school activity) to narrow (e.g., participation in collision sports). We maintained a fixed family-wise error rate using an ordered testing approach that exploits the hierarchical relationships between our exposure definitions. Compared to teenagers who did not participate in any after-school activities, those who participated in sports had statistically significantly better self-rated and mental health outcomes in early adulthood.

The Association Between the Digital Divide and Health Inequalities Among Older Adults in China: Nationally Representative Cross-Sectional Survey.

Health inequalities among older adults become increasingly pronounced as aging progresses. In the digital era, some researchers argue that access to and use of digital technologies may contribute to or exacerbate these existing health inequalities. Conversely, other researchers believe that digital technologies can help mitigate these disparities. This study aimed to investigate the relationship between the digital divide and health inequality among older adults and to offer recommendations for promoting health equity. Data were obtained from the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) scale, the Instrumental Activities of Daily Living scale, the Mini-Mental State Examination scale, and a 5-point self-rated health scale, respectively. The chi-square and rank sum tests were used to explore whether internet use and access were associated with health inequality status. After controlling for confounders, multiple linear regression models were used to further determine this association. Sensitivity analysis was conducted using propensity score matching, and heterogeneity was analyzed for different influencing factors. The 2018 analysis highlighted widening health disparities among older adults due to internet access and use, with statistically significant increases in inequalities in self-rated health (3.9%), ADL score (5.8%), and cognition (7.5%). Similarly, internet use widened gaps in self-rated health (7.5%) and cognition (7.6%). Conversely, the 2020 analysis demonstrated that internet access improved health disparities among older adults, reducing gaps in self-rated health (3.8%), ADL score (2.1%), instrumental ADL score (3.5%), and cognition (7.5%), with significant results, except for ADL. Internet use also narrowed disparities, with significant effects on self-rated health (4.8%) and cognition (12.8%). The robustness of the results was confirmed through propensity score-matching paired tests. In addition, the study found heterogeneity in the effects of internet access and use on health inequalities among older adults, depending on sex, age, education, and region. The impact of internet access and use on health inequalities among older adults showed different trends in 2018 and 2020. These findings underscore the importance of addressing the challenges and barriers to internet use among older adults, particularly during the early stages of digital adoption. It is recommended to promote equitable access to the health benefits of the internet through policy interventions, social support, and technological advancements.

Sociodemographic Variables Associated with Self-reported Access to Mental Healthcare Among Brazilian Immigrant Women in the U.S.

Brazilians are a rapidly growing immigrant population in the United States (U.S.), yet little is known about their mental health and access to mental healthcare. Our goal was to access associations between the pursuit of- and access to-mental healthcare with mental health status and socio-demographic characteristics among Brazilian immigrant women. We conducted an online survey of Brazilian women aged 18 or older who reported being born in Brazil and currently residing in the U.S. We recruited respondents via Brazilian cultural media, community organizations serving Brazilian immigrants, and social media. We assessed respondents' perceived access to mental healthcare, self-reported mental health (CES-D-10), and socio-demographic characteristics and conducted multivariable logistic regression. Our analysis included 351 participants. Half (52%) had CES-D-10 scores indicating high levels of depressive symptomatology. A third (33%) reported seeking care for their mental health in the past 12 months, 87% of whom reported obtaining care. Results of multivariable logistic regression determined that respondents who sought mental healthcare were more likely to have higher CES-D-10 scores (OR = 1.09, 95% CI 1.03-1.15), very low incomes (<$10,000 per year; OR = 0.34, 95% CI 0.12-0.96), and were marginally more likely to have a primary care provider (OR = 2.11, 95% CI 1.00, 4.46). We found that despite a high level of depressive symptomology, only one-third reported accessing care. While difficulty accessing care for mental issues is a widespread issue, our findings suggest that efforts are needed to ameliorate mental health issues for Brazilian women to reduce systemic, interpersonal, and individual barriers to seeking care among the 13% who sought healthcare but were unable to receive it.

The Development and Initial Validation of the REST Questionnaire: A Multidimensional Tool for Assessing Fatigue in Individuals with and Without a History of Cancer.

Fatigue is a prevalent and complex condition with significant impacts on well-being. Existing fatigue assessments often lack comprehensiveness or practicality for general population studies. This study validated the REST Questionnaire, a novel fatigue assessment tool, in a sample of 268 adults. Psychometric properties, including internal consistency and construct validity, were evaluated. REST scores were correlated with WHO-5 well-being, BMI, self-rated health, and chronic conditions. Exploratory factor analysis identified underlying dimensions of fatigue. The REST Questionnaire demonstrated excellent internal consistency (Cronbach's alpha = 0.918) and construct validity. Higher fatigue scores were associated with lower well-being, female gender, and the presence of certain chronic conditions (cancer, kidney stones, gastric ulcers). Two distinct fatigue dimensions, "physical fatigue and functional impacts" and "emotional and social consequences", were identified. The REST Questionnaire is a reliable and valid tool for assessing fatigue in the general population. Its multidimensional framework and sensitivity to comorbidities offer valuable insights for research and public health applications, with the potential to inform targeted interventions aimed at improving well-being.

The effects of volunteering on loneliness among lonely older adults: the HEAL-HOA dual randomised controlled trial.

Previous randomised controlled trials have largely relied on self-reported volunteer work to assess the effects of volunteering and have rarely provided structured volunteering activities during the intervention period. The present study aimed to investigate the effects of social volunteering work over 12months on loneliness among older adults during the COVID-19 pandemic. A dual randomised controlled trial was done in Hong Kong to investigate the long-term effects of telephone-delivered psychosocial interventions by older Chinese volunteers who were screened as lonely, for older adult recipients who had low income, lived alone, felt lonely, and were digitally excluded. Participants were included if they were aged 50-70years; had provided consent to be trained and serve as a volunteer for at least 2h per week for 6months; had at least 3years of secondary school education; had no severe self-reported physical, mental, or cognitive health problems; were not working full or part-time; had engaged in formal volunteering fewer than four times within the past year; and were lonely (ie, had a score of at least 6on the three-item UCLA Loneliness Scale). Participants were allocated into either the volunteering or control group (psychoeducation programme) using a random number method. The details of group allocation were concealed as the research assistant responsible for randomisation was different to the research assistants responsible for recruitment and assessments (who were masked to the condition). Following a 6-week training, the volunteers delivered a psychosocial intervention to older intervention recipients for 6months. The primary outcome was loneliness measured with the 20-item UCLA Loneliness Scale and the De Jong Gierveld (DJG) Loneliness Scales at 6months and 12months. Assessments were performed before training (baseline; T1), at 6months (T2), and at 12months after training (T3). The intention-to-treat principle was used to compare the effects of volunteering between the two groups. The trial was registered in the Clinical Trials Registry of the University of Hong Kong Clinical Trials Centre (HKUCTR-2929). This trial has completed. Between May 3, 2021, and Oct 6, 2022, a total of 375individuals were recruited to the trial, including 84males (22%) and 291females (78%). 185were randomly assigned to the volunteering group (56 to deliver a mindfulness intervention, 65to deliver a behavioural activation intervention, and 64to deliver a befriending intervention) and 190were assigned to the control group. 311 (83%) of 375participants were 60years or older (median 64years [SD4·86]). Participants in the volunteering group reported a significantly lower level of loneliness at T2 (dppc2 ranged from -0·41to -0·70) compared with T1 than participants in the control condition. There was a significant decrease in loneliness measured using the UCLA Loneliness Scale at T2 in the volunteering group but such a decline was not shown in the control group (condition × time interaction, estimate 0·19 [95% CI 0·08to 0·29], p=0·00058, dppc2=-0·41). Similarly, when measured with the DJG Loneliness Scale, there was a significantly greater decrease in loneliness in the volunteering group compared with the control group at T2, including a medium to large effect size on total DJGscores (estimate 1·34 [95% CI 0·83to 1·84], p<0·0001, dppc2=-0·70) and a medium effect size on emotional (estimate 0·63 [0·35to 0·90], p<0·0001, dppc2=-0·59) and social subscales (estimate 0·71 [95% CI 0·37to 1·05], p<0·0001, dppc2=-0·58). Although most of the positive effects of volunteering were not sustained at T3, the volunteers who continued to volunteer for more than 2h per week at T3 reported lower levels of loneliness than those who did not maintain volunteering. This randomised controlled trial demonstrates the beneficial effect of volunteering on reducing lonelinessin older adults who feel lonely, and that this benefit can be maintained through continued participation in voluntary work. Future intervention programmes should strengthen older adults' commitment to volunteer. Research Grants Committee of the Hong Kong Special Administrative Region, China.

Psychometric assessment of the Beck anxiety inventory and key anxiety determinants among Ukrainian female refugees in the Czech Republic.

The full-scale Russian war has caused Ukrainian female refugees to experience many stressful events which may have an adverse impact on their mental health. Understanding the prevalence and determinants associated with anxiety is essential for psychosocial support. The study aimed: to evaluate the psychometric validity of the Ukrainian version of the Beck Anxiety Inventory (BAI) among Ukrainian female refugees in the Czech Republic, to determine the prevalence of anxiety, and to identify key determinants for anxiety in this population. Anxiety was measured by BAI, which was validated by applying confirmatory factor analysis. Linear regressions were run to understand associations between social, physical and mental health determinants and anxiety, adjusted by socio-demographics. The BAI had a high level of internal consistency. External consistency was confirmed through: structural validity via CFA, indicating that a four-factor model, including cognitive, autonomic, neuromotor, and panic factors, were the most appropriate for the Ukrainian version of BAI; and convergent validity, shown by significant correlations between the total scores of the BAI and coping strategies, perceived stress, depression as well as self-reported physical and mental health. The study revealed that more than half of the participants had moderate to concerning symptoms of anxiety. The analysis indicated that poor perceived health, ineffective coping strategies, high perceived stress, and hampered daily activities due to health issues, are significant predictors of increased anxiety. Conversely, positive or stable social relations with relatives, neighbors, and locals, and the absence of discrimination, were shown to be crucial in reducing anxiety levels.

Health literacy levels and self-rated health in the state of Delaware: a cross-sectional study

BackgroundBetter health literacy has been found to be associated with better health outcomes across varied populations. This study aimed to (1) examine the health literacy levels of individuals with respect to the extent to which they acquire, understand, appraise, and apply health information, and (2) to assess the relationship between health literacy and self-reported health in the state of Delaware.MethodsThe sampling frame consisted of 60 purposively selected faith-based organizations across the state of Delaware who predominantly serve minorities. Accounting for clustering design, a sample size was determined based on a Mixed Methods test. In total, 1095 participants responded to a survey questionnaire which included a validated short version of the European Health Literacy Questionnaire (HLS-EU-Q16). The data was analyzed using descriptive statistics, reliability techniques, chi-square test of independence, and ordinal logistic regression.ResultsThe study found that about a quarter of the participants had inadequate level of health literacy and about another quarter had problematic level of health literacy. These results are reflected across the health domains—health care, disease prevention, and health promotion. Health literacy was predictor of self-rated health. The odds of better self-rated health are 0.360 times lower for people with inadequate health literacy levels compared to those with sufficient health literacy.ConclusionHealth literacy profoundly shapes health outcomes. The high proportion of people expressing difficulty concerning accessing, comprehending, appraising, and using health information in the health care, disease prevention, and health promotion domains in state of Delaware would require a concerted effort.

Adverse health outcomes and health-related quality of life (HRQoL) among long-term adolescent and young adult (AYA) brain tumour survivors: results from the population-based SURVAYA study

PurposeAdolescent and young adult (AYA) malignant brain tumour (BT) survivors are at risk of adverse health outcomes, which may impact their health-related quality of life (HRQoL). This study aimed to investigate the (1) prevalence of physical and psychological adverse health outcomes, (2) the HRQoL, and (3) the association of adverse health outcomes and HRQoL among long-term AYA-BT survivors. Adverse health outcomes and HRQoL were compared to other AYA cancer (AYAC) survivors.MethodsA cross-sectional secondary data analysis of the SURVAYA study among 133 AYA-BT and 3877 AYAC survivors was conducted. Participant self-reported adverse health outcomes and HRQoL scores were analysed and compared between the two populations. Associations with HRQoL were assessed using linear regression modelling with AIC-based backward elimination.ResultsAYA-BT survivors faced significant issues of fatigue (47.6%), future uncertainty (45.2%), and medical conditions like vision (34.4%), speech, taste, or smell (26.2%) impairments, cancer recurrence, and metastasis (25.4%). Neurocognitive symptoms were identified as BT-specific issues (13.6–33.6%). Compared to AYAC survivors, AYA-BT survivors reported significantly (p < 0.05) lower functioning scores on the role, cognitive, emotional, and social HRQoL, with cognitive (56.0%) and emotional (40.0%) domains being the most affected. Adverse health outcomes were negatively associated with HRQoL, ranging from small to large clinical relevance.ConclusionLong-term AYA-BT survivors were identified as a highly burdened population, affected by multifaceted issues and multidimensional detriments in HRQoL years beyond their cancer diagnosis. This study highlights the necessity of long-term follow-up and a holistic, multidisciplinary approach to survivorship care to ultimately improve the quality of AYA-BT survivorship.

The Mediating Role of Social Support on COVID-19 Concern and Self-Rated Physical Health of Older Adults in the United States.

The COVID-19 significantly impacted older adults, worsening their physical health and social connectedness. This study examined whether social support mediates the correlation between COVID-19 concerns and self-rated physical health (SRPH) using data from 2672 participants (aged 50-99) in the NSHAP COVID-19 sub-study (2019-20). Mediation analysis revealed that COVID-19 concerns significantly predicted lower perceived social support (b = -0.0397, p < .001) and worse SRPH (b = -0.0536, p < .001). The indirect effect through perceived social support was significant and negative (b = -0.0045, p = .006).

State-level LGBTQ+ policies and health: the role of political determinants in shaping health equity.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals in the United States experience higher rates of discrimination and stressors that negatively impact health compared with their straight, cisgender counterparts. Using 2022 Behavioral Risk Factor Surveillance Survey (BRFSS) data, estimating multilevel mixed-effects logistic regressions, we examined the relationship between state LGBTQ+ policies and health among LGBT people. Findings reveal a statistically significant inverse link between protective (high) state policy scores and poor self-rated health, poor mental health days, and poor physical health days. Specifically, with each 1-point increase in policy score, the odds of poor self-rated health are reduced by 0.03%, high mental health burden by 0.02%, and high physical health burden by 0.02%. Inequalities in self-rated health, high mental health burden, and high physical health burden are greater in policy environments with fewer state-level protections, with LGBT individuals reporting better health where there are more protections. These results indicate that discriminatory state policies are linked to poorer health for LGBT individuals and suggest that protective policies could improve health. Further research with comprehensive data is needed to deepen understanding.

Associations Between Daily-Use Products and Urinary Biomarkers of Endocrine-Disrupting Chemicals in Adults of Reproductive Age.

Daily-use products, including personal care products, household products, and dietary supplements, often contain ingredients that raise concerns regarding harmful chemical exposure. Endocrine-disrupting chemicals (EDCs) found in daily-use products are associated with numerous adverse health effects. This pilot study explores the relationship between concentrations of EDCs in urine samples and products used 24 h prior to sample collection, and ingredients of concern in those products, in 140 adults of reproductive age in Northern Nevada. Having higher numbers of products and ingredients of concern, especially in the personal care category, was associated with higher levels of mono-(-ethyl-5-carboxypentyl) phthalate (MECPP). Similarly, taking more supplements was associated with higher levels of methylparaben (MePB). In contrast, using household products with more ingredients of concern was associated with lower levels of monobutyl phthalate (MBP). Generally, women used more products, were exposed to more ingredients of concern and had higher urinary metabolites than men. Participants who rated themselves as being in poor/fair health were exposed to more personal care and supplement ingredients of concern than those in better health. Interestingly, those in excellent health also took supplements with more ingredients of concern. Greater product use and more ingredients of concern are associated with urinary metabolites of known EDCs and self-ratings of poor health. Women and people who take supplements are at greater risk, and even people who consider themselves to be healthy can be highly exposed. More education among the general public is needed to make people aware of the presence of these chemicals in their everyday products so they can make efforts to avoid them.

Association of Pre- and Postinjury Mental Health With Long-term Clinical and Financial Outcomes.

As increased attention is placed on optimizing long-term outcomes of trauma patients by addressing mental health, little is known regarding the interplay of pre- and postinjury mental health on long-term financial and functional outcomes. Patients from 19 Level 1 and 2 trauma centers took part in serial surveys 1 to 24 months postdischarge. Preinjury mental health diagnoses were identified using trauma registry data and postinjury mental health symptoms from survey data. Outcomes included (1) health-related quality of life from the EuroQol-5D-5L and (2) elements of financial toxicity (e.g. medical debt, job/income loss, nonmedical bills, unaffordable care). Multivariable models were created, adjusting for patient, injury, and treatment factors, to evaluate the association of preinjury mental health diagnoses and postinjury mental health symptoms on health-related quality of life and financial toxicity. A total of 1,017 patients completed 1,297 surveys from July 2021 to December 2023, at a median of 6 months postinjury. Forty-six percent were female, the median age was 67.5 years, and 89% had blunt injuries. Thirty-two percent of patients had a preinjury mental health diagnosis, and 49% had self-reported mental health symptoms postdischarge. Patients with preinjury mental health diagnoses had higher odds of postinjury mental health symptoms (adjusted odds ratio, 3.6 [2.6-4.9]; p < 0.001); however, 55% of those with postinjury symptoms had no preinjury diagnosis. Postinjury symptoms alone were associated with worse health-related quality of life or financial toxicity. Notably, patients with new postinjury mental health symptoms (no preinjury mental health diagnosis) had the highest rate of foregone postinjury care because of costs (26% vs. 14%, p < 0.01). More than one-in-two patients had peri-injury mental health conditions, and patients with postinjury mental health symptoms experienced worse financial and functional outcomes. Addressing postinjury mental health may potentially improve long-term health-related quality of life of trauma survivors; however, efforts are needed to ensure that patients can afford the care needed for optimal health. Prognostic and Epidemiological; Level IV.

Evaluation of an AI-Based Voice Biomarker Tool to Detect Signals Consistent With Moderate to Severe Depression.

Mental health screening is recommended by the US Preventive Services Task Force for all patients in areas where treatment options are available. Still, it is estimated that only 4% of primary care patients are screened for depression. The goal of this study was to evaluate the efficacy of machine learning technology (Kintsugi Voice, v1, Kintsugi Mindful Wellness, Inc) to detect and analyze voice biomarkers consistent with moderate to severe depression, potentially allowing for greater compliance with this critical primary care public health need. We performed a cross-sectional study from February 1, 2021 to July 31, 2022 to examine ≥25 seconds of free-form speech content from English-speaking samples captured from 14,898 unique adults in the United States and Canada. Participants were recruited via social media, provided informed consent, and their voice biomarker results were compared with a self-reported Patient Health Questionnaire-9 (PHQ-9) at a cut-off score of 10 (moderate to severe depression). From as few as 25 seconds of free-form speech, machine learning technology was able to detect vocal characteristics consistent with an increased PHQ-9 ≥10, with a sensitivity of 71.3 (95% CI, 69.0-73.5) and a specificity of 73.5 (95% CI, 71.5-75.5). Machine learning has potential utility in helping clinicians screen patients for moderate to severe depression. Further research is needed to measure the effectiveness of machine learning vocal detection and analysis technology in clinical deployment.

Understanding residents’ experiences of home, health, and wellbeing in new and novel low carbon homes

As significant contributors to CO2, UK homes must be decarbonized. Active Homes represent a possible route to addressing both societal concerns and policy ambitions, while providing comfortable high quality living environments. However, changes to the material structure of homes have potential implications for people’s ability to live well within them. Our qualitative longitudinal (QL) research as part of the living well in low carbon homes project unpacks how changes brought about by living within an Active Home are experienced by residents, including to self-reported health and wellbeing. We explore how living in an Active Home may challenge expectations of home, including embodied experiences of comfort and intrinsic values of privacy and control. We suggest that it is important to recognize that these different but interwoven elements impact upon residents’ sense of home, and health and wellbeing, which has implications for future innovative low carbon homes.

Wisdom and socio-cognitive mindfulness as predictors of loneliness in late adulthood: the mediating role of meaning in life

Objectives This research aimed to examine whether (1) socio-cognitive mindfulness, defined as actively noticing novel distinctions in events and situations, negatively predicted loneliness in older adults and whether (2) meaning in life mediated the relationships between wisdom and loneliness and between socio-cognitive mindfulness and loneliness. Method Two cross-sectional studies were conducted. In Study 1 (N = 76), participants aged 60 to 85 years completed questionnaires measuring wisdom, loneliness, meaning in life, and self-rated health. In Study 2 (N = 117), care home residents aged 60 to 87 years completed measures of socio-cognitive mindfulness, loneliness, meaning in life, and self-rated health. Results Study 1 found a negative relationship between wisdom and loneliness, even after accounting for socio-demographic factors and meaning in life. Study 2 revealed a negative relationship between socio-cognitive mindfulness and loneliness. The relationships of both wisdom and socio-cognitive mindfulness to loneliness were mediated by meaning in life. Conclusion The two studies indicate that attributes associated with wisdom and socio-cognitive mindfulness, such as perceiving events from multiple perspectives and maintaining a compassionate attitude, contribute to an increase in meaning in life, which in turn reduces loneliness in late adulthood.

Prevalence and associated factors of self-reported oral health problems among adults in the Fanteakwa districts in Ghana

BackgroundThere is a paucity of data on oral health problems among the residents of Fanteakwa districts (South and North) in the Eastern region of Ghana. Therefore, this study assessed the prevalence and factors associated with self-reported oral health problems in the Fanteakwa districts of Ghana.MethodsThis community-based cross-sectional study targeted residents of the towns of the Fanteakwa districts, who have not had any dental care visit in the past six months preceding the study. The participants were enrolled from July – October, 2023. Socio-demographic study variables collected were sex, age, educational level, income level, ethnicity, area of residence, household size and frequency of brushing teeth in a day. Whereas the self-reported oral health problems were tooth ache, swollen gum, bleeding gum, sensitive tooth/teeth, hole in tooth/teeth, discoloured tooth/teeth and mouth odour. The chi-square statistical test was used to test the association between the presence of oral health problem(s) and other independent variables. Whereas, Modified Poisson regression was used to test the relationships among the variables.ResultsIn total, 400 community members were interviewed. The mean age of respondents was 31 years (SD ± 12.4, Min = 19, Max = 81). The majority were females (55.2%) and more than 96% had some form of formal education. The Akan ethnic group accounted for as much as 47% of the respondents. The overall prevalence of self-reported oral health problems was 58.5% (95% CI 53.5% – 63.4%). The commonly reported oral health problems were toothache (51.7%), swollen gum (38.5%), difficulty in chewing (33.3%), bleeding gum (32.1%), and mobile teeth (17.1%). About 98% (229/234) of the study participants who self-reported oral health problems, reported up to four different problems. Self-reported oral health problems associated with participants’ age (χ2 = 7.2, p = 0.027), income level (χ2 = 19.3, p < 0.001), ethnicity (χ2 = 21.2, p < 0.001), area of residence (χ2 = 26.9, p < 0.001), religious affiliation (χ2 = 15.7, p < 0.001) and frequency of brushing teeth in a day (χ2 = 6.85, p < 0.032). Despite the observed relationships, Modified Poisson regression identified that compared to the rural dwellers, the urban dwellers had lower odds of self-reporting oral health problems (aOR = 0.718, p = 0.032, CI: 0.531–0.971), after controlling for age and frequency of teeth brushing in a day.ConclusionHigh rate of self-reported oral health problems was observed in the study site. Participants from rural residence were disproportionately affected. Therefore, local health authorities are encouraged to leverage on the identified risk groups for enhanced oral health education towards reduction in the reported oral health problems.