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Objective: Microaggressions are brief verbal, behavioral, or environmental indignities toward people of color. Methods: Cross-sectional study examining the association between demographics, alcohol culture, and witnessing or experiencing microaggressions among undergraduate students. Analysis based on the "Color of drinking" study data collected at University of Wisconsin-Madison, WI between November 2017 and January 2018. Results: African-American/Black students significantly witnessed and experienced more microaggressions than other students, with a Relative Risk Ratio (RRR) of 9.5 (CI 95%: 4.7–19.1) and a RRR of 7 (CI 95%: 3.4–14.3). For students of color, experiencing microaggressions was associated with considering leaving (RRR = 3.5, CI 95%: 2–6.2). Additionally, the witnessing and experiencing of microaggressions appears to be associated with the alcohol culture on campus. Conclusions: African-American/Black was the racial group that witnessed and suffered more microaggressions. The percentage of students witnessing microaggressions increased with the year in school. Alcohol use in the last 30 days, feeling impacted by other's use of alcohol, and avoiding certain areas due to alcohol consumption were associated with experiencing microaggressions among students of color. [ABSTRACT FROM AUTHOR]

There are numerous sociological and psychosocial studies, both classic and current, that have analysed the images and representations of older people and aging. If gender, intersectional and land perspectives are added, the literature consulted is only a few years old, particularly in Spanish. In addition, research based on fieldwork from virtual image banks is still scarce and recent. The objective of this paper is to evaluate the images from some free access image banks (like Freepik, Canva, Pixabay, or Storyblocks) of older people from a gender, intersectional and socio-spatial and land perspective. Methods: 150 images have been analysed following different selected criteria: 22 variables related to gender, activity, socio-spatial environment, natural space and land, among others, briefly describe the main methods or treatments applied. The key results show a stereotyped and barely diverse image of old age and aging around positive representations, with a notable absence of images related to loneliness as opposed to the presence of social relationships. A feminization has also been observed in the representations, with an imbalance in the activities that are carried out (care in the case of women and leisure in the case of men) and in the visible space (indoor among women and outdoor among men). Older people are still identified with a rural, traditional, and more defined territory and not with more diverse and ecological spaces, which are more frequently attributed to younger profiles. This evaluation contributes to linking this necessary connection of current issues and challenges to ageism, sexism and other exclusions derived from territory and socio-spatial aspects. However, more research is still needed, and, in fact, a second phase of the fieldwork is underway to broaden the sample and to expand further evaluations of images. [ABSTRACT FROM AUTHOR]

Objectives. To analyze factors associated with COVID-19 vaccine acceptance in Spain, over time. Methods. We used data from a national study that included 5 online surveys carried out every 2 months from September 2020 to May 2021. Each round recruited a sample of 1000 participants aged 18 years or older. We performed a multivariable logistic regression with vaccination acceptance as the dependent variable. We evaluated time trends through the interaction terms of each of the explanatory variables and the time. Results. Vaccination acceptance increased from 43.1% in September 2020 to 84.5% in May 2021. Sex, age, concerns about disease severity, health services overload, and people not wearing a face mask, together with adherence to preventive behavior, health literacy, and confidence in scientists, health care professionals' information, and adequacy of governmental decisions, were variables associated with vaccination acceptance. Conclusions. In a changing situation, vaccine acceptance factors and time trends could help in the design of contextualized public health messages. It is important to strengthen the population's trust in institutions, health care professionals, and scientists to increase vaccination rates, as well as to ensure easy access to accurate information for those who are more reluctant. (Am J Public Health. 2022;112(11):1611–1619. https://doi.org/10.2105/AJPH.2022.307039) [ABSTRACT FROM AUTHOR]

Background: Following the active ageing model based on the Health, Lifelong Learning, Participation and Security pillars, this research has a twofold objective: i) to classify older adults according to active ageing profiles, taking into account the four pillars, and ii) to ascertain the relationship between the profiles and personal and contextual factors, as well as well-being and quality of life in old age. Methods: A study sample of 5,566 Spanish older adults who participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was included. Data were analysed in different steps applying several statistical analyses (Principal Component, Cluster, Discriminant, Multiple Correspondence and bivariate analysis with Pearson chi-square and ANOVA). Results: Five older adult profiles were obtained (I: with moderate activity; II: quasi-dependents; III: with active ageing-limiting conditions; IV: with diverse and balanced activity; V: with excellent active ageing conditions). The first three profiles were characterised by subjects with a high average age, low educational level, who were retired or housewives, and who perceived a moderate level of loneliness, satisfaction with the social network and quality of life, as well as having a larger family network, but living in small households or alone. In contrast, the latter two profiles showed better personal and contextual conditions, well-being and quality of life. Discussion and conclusions: The multidimensional approach to active ageing followed in this article has revealed the presence of several older adult profiles, which are confined to groups with better or worse active ageing conditions. In this context, if ageing is a process that reflects the previous way of life, intervention priorities will have to consider actions that promote better conditions during the life cycle. [ABSTRACT FROM AUTHOR]

This paper investigates positive perceptions of ageing in rural people aged 65 and over as a key predictor of the self-assessment of one's health. Method: The sample covers a total of 3389 people from the 'Survey of Health, Ageing and Retirement' (SHARE), wave 6 (W6, 2015). This research analyses men and women who live in a rural environment. A linear regression model is proposed to consider the dependent variable 'self-rated health' and independent variables based on measures of quality of life in older adults. This study confirms that rural women perceive their health on the basis of factors different to those of their male contemporaries. The variable 'How often do you feel/think that you can do the things that you want to do?' is associated with women's self-perceived health. In men, a high relationship (with p < 0.001) is obtained for the variables 'How often do you feel/think look back on your life with a sense of happiness?' and 'How often do you feel/think that family responsibilities prevent you from doing what you want to do?' Certain daily activities (e.g., leisure or care), along with a positive perception of life, influence one's perceptions of one's own health, especially in the case of women. In sum, rural older women make a positive evaluation of their own health and ageing, while rural older men relate self-rated health to passivity and reminiscing. There is a need for further research on psycho-social and socio-spatial issues from an intergenerational, technological and gender perspective for rural and territorial influences to attain better health and quality of life for rural older people in comparison to urban people. [ABSTRACT FROM AUTHOR]

Background: The Living with Chronic Illness (LW‐CI) Scale is a comprehensive patient‐reported outcome measure that evaluates the complex process of living with long‐term conditions. Objective: This study aimed to analyse the psychometric properties of the LW‐CI scale according to the classic test theory and the Rasch model among individuals living with different long‐term conditions. Design: This was an observational, international and cross‐sectional study. Methods: A total of 2753 people from six Spanish‐speaking countries living with type 2 diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure, Parkinson's disease, hypertension and osteoarthritis were included. The acceptability, internal consistency and validity of the LW‐CI scale were analysed using the classical test theory, and fit to the model, unidimensionality, person separation index, item local independency and differential item functioning were analysed using the Rasch model. Results: Cronbach's α for the LW‐CI scale was.91, and correlation values for all domains of the LW‐CI scale ranged from.62 to.68, except for Domain 1, which showed correlation coefficients less than.30. The LW‐CI domains showed a good fit to the Rasch model, with unidimensionality, item local independency and moderate reliability providing scores in a true interval scale. Except for two items, the LW‐CI scale was free from bias by long‐term condition type. Discussion: After some adjustments, the LW‐CI scale is a reliable and valid measure showing a good fit to the Rasch model and is ready for use in research and clinical practice. Future implementation studies are suggested. Patient and Public Contribution: Patient and public involvement was conducted before this validation study ‐ in the pilot study phase. [ABSTRACT FROM AUTHOR]

Despite the efforts of recent decades to reduce gender inequality, sexism is still prevalent among adolescents. The objective of this study was to identify the main socioeconomic characteristics, personal experiences, resources, and competencies associated with sexism in a sample of adolescents from different European countries. Baseline data from the Lights4Violence project included 1555 students ages 12–17 from secondary schools in six European countries (Spain, Italy, Romania, United Kingdom, Portugal, and Poland). Linear regression models were carried out, stratified by sex for benevolent (BS) and hostile (HS) dimensions of the Ambivalent Sexism Inventory. The average age of the sample was 14.3 years (SD = 1.5), 59.3% were girls. Boys scored higher on the measure of sexism (mean BS = 29.7; HS = 29.1) than girls (BS = 27.5, HS = 23.0; p <.001). Girls whose mothers had a university degree reported lower BS (β = −0.113; p =.023) (reference: lower education). Girls who had experienced dating violence reported higher HS (β =.080; p =.010) than those who had never been in an intimate relationship. For both sexes, high aggressiveness was associated with high levels of HS, and high aggressiveness was related to high levels of BS in boys. High assertiveness was associated with high levels of BS in both sexes and with high levels of HS in boys. A high level of problem‐solving ability was associated with lower HS in both sexes. The study reinforces the need to invest in school programs aimed at preventing dating violence and promoting positive youth development. [ABSTRACT FROM AUTHOR]

Background: Several scales are available for rating the severity of tremor at present. However, the sensitivity to change of these instruments has remained to be clarified. Objective: To compare the sensitivity of the Fahn-Tolosa-Marin Tremor Rating Scale, the Part III of the Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the MDS-UPDRS Tremor Scale to the effects of various antitremor treatments. Methods: Enrolling subjects with parkinsonism associated with tremor, we analyzed two scenarios: (1) tremor changes associated with acute levodopa challenge (n = 287) and (2) a 12-month outcome of different treatment options (n = 512) including deep brain stimulation (n = 146), levodopa/carbidopa intestinal gel infusion (n = 30), and initiating (n = 63) or adjusting oral antiparkinsonian medication (n = 273). Changes in tremor scales were assessed by effect size values (Cohen's d and eta-square). Results: Part B of the Fahn-Tolosa-Marin Tremor Rating Scale was the most sensitive to acute levodopa challenge (Cohen's d = –1.04, η2 = 0.12). However, Part A of the Fahn-Tolosa-Marin Tremor Rating Scale showed the highest effect size, which was a small one (Cohen's d = –0.33, η2 = 0.03), for detecting a treatment-related change in the severity of tremor during long-term follow-up. Conclusions: The Fahn-Tolosa-Marin Tremor Rating Scale has a better ability to capture changes due to levodopa challenge or antiparkinsonian treatment than MDS-UPDRS Part III or MDS-UPDRS Tremor Scale. [ABSTRACT FROM AUTHOR]

We estimate how much caregiving men and women respectively do, and how much of the caregiving is done by older (65+) and younger persons, inside their household and for other households, in Spain and in Sweden. To assess this, we use self-reported hours of caregiving from two national surveys about caregiving, performed in 2014 (Spain, N = 2003; Sweden, N = 1193). Spain and Sweden have dissimilar household structures, and different social services for older (65+) persons. Caregivers, on average, provide many more hours of care in Spain than in Sweden. Women provide about 58% of all hours of caregiving, in Spain in all age groups, in Sweden only among younger caregivers. The reason is the dominance of partner caregivers among older Swedes, with older men and women providing equal hours of care. Family caregiving inside the household is more extensive in the more complex Spanish households than in Swedish households. Family care between households prevails in Sweden, where the large majority of older persons live with a partner only, or alone. This is increasingly common in Spain, although it remains at a lower level. We estimate that older persons provide between 22% and 33% of all hours of caregiving in Spain, and between 41% and 49% in Sweden. Patterns of caregiving appear to be determined mainly by demography and household structure. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to present a predictive model of Parkinson's disease (PD) global severity, measured with the Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD). Methods: This is an observational, longitudinal study with annual follow-up assessments over 3 years (four time points). A multilevel analysis and multiple imputation techniques were performed to generate a predictive model that estimates changes in the CISI-PD at 1, 2, and 3 years. Results: The clinical state of patients (CISI-PD) significantly worsened in the 3-year follow-up. However, this change was of small magnitude (effect size: 0.44). The following baseline variables were significant predictors of the global severity change: baseline global severity of disease, levodopa equivalent dose, depression and anxiety symptoms, autonomic dysfunction, and cognitive state. The goodness-of-fit of the model was adequate, and the sensitive analysis showed that the data imputation method applied was suitable. Conclusion: Disease progression depends more on the individual's baseline characteristics than on the 3-year time period. Results may contribute to a better understanding of the evolution of PD including the non-motor manifestations of the disease. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) is a health determinant among middle-aged and older adults. In contrast, poor health is expected to have a negative impact on PA. This study sought to assess to what extent specific International Classification of Functioning, Disability and Health (ICF) health components were associated with PA among older adults.Methods: We used a sample of 864 persons aged ≥50 years, positively screened for disability or cognition in a cross-sectional community survey in Spain. Weekly energy expenditure during PA was measured with the Yale Physical Activity Survey (YPAS) scale. The associations between body function impairment, health conditions or World Health Organization Disability Assessment Schedule (WHODAS 2.0) disability scores and energy expenditure were quantified using negative-binomial regression, and expressed in terms of adjusted mean ratios (aMRs).Results: Mean energy expenditure was 4542 Kcal/week. A lower weekly energy expenditure was associated with: severe/extreme impairment of mental functions, aMR 0.38, 95% confidence interval, CI (0.21-0.68), and neuromusculoskeletal and movement functions, aMR 0.50 (0.35-0.72); WHODAS 2.0 disability, aMR 0.55 (0.34-0.91); dementia, aMR 0.45 (0.31-0.66); and heart failure, aMR 0.54 (0.34-0.87). In contrast, people with arthritis/osteoarthritis had a higher energy expenditure, aMR 1.27 (1.07-1.51).Conclusion: Our results suggest that there is a strong relationship between selected body function impairments, mainly mental, and PA. Although more research is needed to fully understand causal relationships, strategies to improve PA among the elderly may require targeting mental, neuromusculoskeletal and movement functions, disability determinants (including barriers), and specific approaches for persons with dementia or heart failure. [ABSTRACT FROM AUTHOR]

Aim: To carry out an analysis of the psychometric properties of the Disease Burden Morbidity Assessment (DBMA) according to the assumptions of the Classical Test Theory. Methods: A sample of 707 community-dwelling adults aged 65 years and older, living in Spain, completed the DBMA. Psychometric properties of the scale (feasibility, acceptability, scaling assumptions, reliability and construct validity) were analyzed. Results: The mean DBMA score was 6.8. Feasibility and acceptability were satisfactory, except for large floor effects (>50%), as well as a skewed distribution (1.8). Item-total corrected correlation ranged 0.10–0.49, item homogeneity index was 0.09 and Cronbach's alpha was 0.72. Disease burden correlated strongly with physical functioning (r = –0.56) and perceived health (r = –0.56), and moderately with depression (r = 0.41) and the Personal Wellbeing Index (r = –0.41). Exploratory factor analysis extracted five factors, explaining 44% of the variance. Conclusions: The DBMA is an acceptable and valid instrument for measuring disease burden in older adults. Future studies should include Rasch analysis to further assess dimensionality and explore other measurement properties. [ABSTRACT FROM AUTHOR]

Resumo Justificativa e objetivo As lesões dentárias que ocorrem durante a intubação traqueal são mais frequentes em pacientes com patologia oral prévia. O objetivo do estudo foi desenvolver um questionário de saúde bucal para avaliação no período pré‐anestesia, de fácil aplicação por pessoal sem formação odontológica, e estabelecer um valor de corte para detectar pessoas com má saúde bucal. Métodos Estudo de validação de um questionário autoadministrado, projetado de acordo com uma revisão da literatura e recomendações de um grupo de especialistas. O questionário foi aplicado a uma amostra de pacientes avaliados em uma consulta pré‐anestesia. A análise Rasch das propriedades psicométricas do questionário incluiu viabilidade, aceitabilidade, validade de conteúdo e confiabilidade da escala. Resultados A amostra incluiu 115 indivíduos, 50,4% de homens, com mediana de 58 anos (variação: 38‐71). A análise final dos 11 itens apresentou um índice de separação dos indivíduos de 0,861 e um bom ajuste dos dados ao modelo de Rasch. A escala foi unidimensional e seus itens não foram influenciados por sexo, idade ou nacionalidade. A medida linear da saúde bucal apresentou boa validade de constructo. O valor de corte foi fixado em 52 pontos. Conclusões O questionário mostrou propriedades psicométricas suficientes para ser considerado uma ferramenta confiável, válida para medir o estado de saúde bucal nas avaliações pré‐anestesia antes da operação. Background and objectives Dental injuries incurred during endotracheal intubation are more frequent in patients with previous oral pathology. The study objectives were to develop an oral health questionnaire for preanaesthesia evaluation, easy to apply for personnel without special dental training; and establish a cut‐off value for detecting persons with poor oral health. Methods Validation study of a self‐administered questionnaire, designed according to a literature review and an expert group's recommendations. The questionnaire was applied to a sample of patients evaluated in a preanaesthesia consultation. Rasch analysis of the questionnaire psychometric properties included viability, acceptability, content validity and reliability of the scale. Results The sample included 115 individuals, 50.4% of men, with a median age of 58 years (range: 38‐71). The final analysis of 11 items presented a Person Separation Index of 0.861 and good adjustment of data to the Rasch model. The scale was unidimensional and its items were not biased by sex, age or nationality. The oral health linear measure presented good construct validity. The cut‐off value was set at 52 points. Conclusions The questionnaire showed sufficient psychometric properties to be considered a reliable tool, valid for measuring the state of oral health in preoperative anaesthetic evaluations. [ABSTRACT FROM AUTHOR]

This study analyzes the relationship between gender and self-perceived health status in Spanish retirees and housewives from a sample of 1,106 community-dwelling older adults. A multivariate linear regression model was used in which self-perceived health status was measured by the EQ-5D visual analogue scale and gender according to work status (retired men and women and housewives). Retired males reported a significantly better health status than housewives. Self-perceived health status was closely associated with physical, mental, and functional health and leisure activities. Finally, being a woman with complete dedication to domestic work is associated with a worse state of self-perceived health. [ABSTRACT FROM AUTHOR]

Background: The goal of the study was to analyze the factors associated with quality of life (QoL) in institutionalized older adults with dementia, based on self and proxy ratings, and if these characteristics differ by dementia severity.Methods: Cross-sectional study of 525 people with dementia (PwD) and their caregivers (professional or family caregivers). Two different QoL questionnaires, leading to three measures, were used: QoL in Alzheimer's disease scale (QOL-AD), self and proxy-rated, and QoL in late-stage dementia scale (QUALID), proxy-rated. Multivariate linear regression models were tested for each QoL measure and for mild/moderate and severe stages of dementia.Results: Multiple regression analyses showed a significant association between the three QoL measures and depression. Functional ability was significantly associated with QoL when assessed by proxy. Other factors such as education level, leisure activities and frequency of visits were significantly related with QOL-AD by proxy. The associated factors that differed by dementia severity were education level for moderate dementia, and frequency of visits and who answered the questionnaire (professional vs. family member) for severe dementia.Conclusions: QoL was consistently associated with depressive symptoms independently of the measures as well as functional ability and social leisure activities when the QoL questionnaire was rated by proxy. Treating depressive symptoms, increasing social activities and maintaining the functional ability may decrease the deterioration of QoL in institutionalized older adults with dementia. [ABSTRACT FROM AUTHOR]

Diarrheagenic Escherichia coli (DEC) cause acute and persistent diarrhoea worldwide, but little is known about their epidemiology in Mexico. We determined the prevalence of bacterial enteropathogens in 831 children with acute diarrhoea over a four-year period in Yucatan, Mexico. Six DEC supplementary virulence genes (SVG), mainly associated with enteroaggregative E. coli (EAEC), were sought in 3100 E. coli isolates. DEC was the most common bacterial enteropathogen (28%), surpassing Salmonella (12%) and Shigella (9%). Predominant DEC groups were diffusely adherent E. coli (DAEC) (35%), EAEC (24%), and enteropathogenic E. coli (EPEC) (19%). Among children with DEC infections, 14% had severe illness mainly caused by EPEC (26%) and DAEC (18%); 30% had moderate diarrhoea mainly caused by DAEC (36%), mixed DEC infections (33%) and EAEC (32%). DAEC was most prevalent during spring, while ETEC, EAEC and EPEC predominated in summer. EAEC was more frequent in children 6–24 months old than in those younger than 6 months of age (P = 0.008, OR = 4.2, 95% CI, 1.3–13.9). The presence of SVG dispersin, (aatA), dispersin-translocator (aatA), enteroaggregative heat-stable toxin 1 (astA), plasmid encoded toxin (pet), cytolethal distending toxin (cdt) was higher in DEC than non-DEC strains, (36% vs 26%, P <0.0001, OR = 1.5, 95% CI, 1.3–1.8). 98% of EAEC-infected children harboured strains with SVG; 85% carried the aap-aatA gene combination, and 33% of these also carried astA. 28% of both EPEC and ETEC, and 6% of DAEC patients had strains with SVG. 54% of EPEC patients carried pet-positive strains alone or in combination with astA; only this DEC group harboured cdt-positive isolates. All ETEC patients carried astA- or astA-aap-positive strains. astA and aap were the most common SVG in DAEC (3% and 2%) and non-DEC strains (21% and 13%). DEC carrying SVG are an important cause of moderate to severe bacterial diarrhoea in Mexican children. Author Summary: Diarrhoea is an important cause of illness and death among young children in low- and middle-income countries. Nonetheless, very few epidemiological studies of diarrhoea have been conducted in Mexico during the last two decades. In recent years, a group of bacteria known as diarrheagenic Escherichia coli (DEC) have been recognized as a major cause of diarrheal illness worldwide. This group cannot be identified by the conventional biochemical methods used for other diarrhoeal pathogens such as Salmonella or Shigella, which limits its identification. We conducted a study in Yucatan, Mexico, to identify the bacterial causes of acute diarrhoea in children less than five years of age who required hospitalization. All DEC strains were further characterized for the presence of six E. coli supplementary virulence genes (SVG). Of the 831 children with acute diarrhoea, a bacterial pathogen was found in 56%. DEC was the most prevalent (28%) pathogen, surpassing Salmonella and Shigella. Among children with DEC diarrhoea, 44% were moderately or severely ill. Thirty-six percent of the DEC strains had one or more SVG, which were more common in older children. Our results strongly suggest that DEC carrying SVG are an important cause of moderate to severe bacterial diarrhoeal disease in Mexico. [ABSTRACT FROM AUTHOR]

Background Multimorbidity is common in older people and may contribute to many adverse health events, such as disability. The aim of the study was to investigate how chronic health conditions (single, paired, and grouped) affect functional independence. Method We used two samples (a one-time, convenience sample and a nationally representative cross-sectional survey) of community-dwelling people of 65years old or over, with a total of 2818 subjects in Spain. To assess functional independence, we used the Barthel index, administered as an interview. Information about the presence of 11 chronic health problems was collected by interview or review of their medical chart. Explanatory factor analysis was performed to assess associations between chronic health conditions. Results Diabetes mellitus and hypertension emerged as the pair of chronic health conditions that most affected functional status [OR 1.98; 95% CI (1.51-2.60)], followed by visual and hearing impairment. A synergistic effect was found (p<0.05) for the cardiovascular disease and hypertension pair. Four multimorbidity groups emerged from the factor analysis: sensory and bone; cancer, lung and gastrointestinal; cardiovascular and metabolic; neuropsychiatric disorders. The neuropsychiatric disorders group was the most strongly associated with physical impairment [OR 4.94; 95% CI (2.71-8.99)], followed by the sensory and bones group [OR 1.90; 95% CI (1.56-2.31)]. Conclusion Despite its low prevalence, the neuropsychiatric disorders group was most strongly associated with lower functional status. Analysis of the relationship between chronic medical conditions and functional status could be useful to develop primary health care strategies to improve functional independence in older people with comorbidities. [ABSTRACT FROM AUTHOR]