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This paper has contributed to confirming the link between education and health in developed countries. The analysis is based on 11 European Union countries. We estimate country-specific health functions, where the dependent variable is self-reported health status and the education attainment is one of the main inputs. All eight waves (1994–2001) of the European Community Household Panel are deployed. A random effects ordered probit is estimated in order to control, to a given extent, for unobserved heterogeneity. Explanatory variables are both time invariant (education attainment and gender) and time varying (gross wages, hours of work, age and living alone). Results confirm the positive impact of secondary education on health in most cases and tertiary education in all cases, even after controlling for other inputs in the health function and taking unobserved heterogeneity into account. Secondary education has an impact on health in all countries in the sample except for The Netherlands and UK. The effect does not differ between secondary and tertiary education in France, Ireland and Greece. The correlation between education and health is interpreted in different but complementary ways by diverse approaches and we may not disentangle the precise mechanism that connects health with education from our results. Anyway, it seems clear that better coordination is needed between education and health policies to effectively improve health literacy. Other relevant results from our study are that women register poorer health than men, age contributes to worsening health status and wages contribute positively to health. [ABSTRACT FROM AUTHOR]

The ability to access and understand the meaning of multi-morphemic words is essential for age-appropriate literacy growth as well as for achievement in other participants, such as science and social studies, which are so print-dependent. This paper provides a theoretical basis for focusing on the morphology of English when teaching students who are deaf or hard of hearing to read through a review of the literature on the role of morphology in reading for both hearing students and those with a hearing loss. In addition, the authors review the empirical literature on Signing Exact English (SEE), a system of signing English constructed in which the morphology of words is made visible to children who might not be able to hear them. The authors propose that students’ use of SEE can provide a bridge to developing the morphemic awareness so necessary for age-appropriate reading development and achievement. [ABSTRACT FROM PUBLISHER]

Evaluating the effectiveness of social work education has become a topic of major interest in the UK in the wake of a succession of child-care tragedies that have undermined confidence in the profession. However, many key aspects of social work education remain under-researched and/or contested and our knowledge of how students acquire and develop professional expertise remains limited. This paper reports on the first part of a longitudinal study aimed at developing evidence-based knowledge in this area by considering student perceptions at different stages of their social work education at Queen's University Belfast. Focusing on the strengths and limitations of preparatory teaching, and their first experience of practice learning, this article considers the impact of demographic factors, including age, gender and experience, on how students experience the learning process. The findings indicate a significant level of disjunction between academic and practice learning and suggest that better integration between these two domains of learning is needed if social work students are to be more effectively prepared for the challenges they are likely to encounter in practice. [ABSTRACT FROM PUBLISHER]

Schnute, J. T. and Haigh, R. 2007. Compositional analysis of catch curve data, with an application to Sebastes maliger. – ICES Journal of Marine Science, 64: 218–233. This paper applies modern compositional analysis to catch curve data from a quillback rockfish (Sebastes maliger) population in British Columbia, Canada. Bubble plots and ternary diagrams portray variable age distributions and highlight distinctions between commercial and survey sample data. The models formalize important historical issues in catch curve analysis related to selectivity and recruitment variability, where a particular model corresponds to a prescribed vector of design parameters. The roles that compositional distributions (multinomial, Dirichlet, logistic-normal) can play in fishery data analysis are described, and Bayesian methods are used to examine how the distribution of a key mortality parameter depends on model choice. The framework provides a direct link between model designs and policy outcomes that depend on estimated mortalities or mortality ratios. [ABSTRACT FROM PUBLISHER]

Background and Objectives Older adults (≥65 years) are living longer with complex health needs and wish to remain at home as their care needs change. We aimed to determine which factors influence older persons' transitions from home living to facility-based care (FBC) settings such as long-term care facilities or assisted living. Research Design and Methods Through a scoping review of 7 databases, we considered all academic literature examining factors influencing transitions from home living to FBC. Only English articles were reviewed. Based on the Meleis' Health Transition (MHT) model, we categorized findings into: (a) transition conditions ; (b) patterns of response ; and (c) health services and interventions. Results We included 204 unique studies. Age, cognitive/functional impairments, and caregiver burden were the most consistent risk factors for older persons' transitions to FBC. Caregiver burden was the only consistent risk factor in both quantitative and qualitative literature. Other factors around health service use or nonmedical factors were examined in a small number of studies, or demonstrated mixed or nonsignificant results. Key research gaps relate to transitions to intermediate levels of FBC, research in public health systems, and research employing qualitative and interventional methods. Discussion and Implications We expanded the MHT model to capture informal caregivers and their critical role in transitions from home to FBC settings. More research is needed to address practical needs of clients and caregivers while at home, and self-directed care funding models could be expanded. Theory-driven interventional research focusing on caregivers and successful hospital discharge is critically needed. [ABSTRACT FROM AUTHOR]

Objectives Contemporary immigration scholarship has typically treated immigrants with diverse racial backgrounds as a monolithic population. Knowledge gaps remain in understanding how racial and nativity inequities in mental health care intersect and unfold in midlife and old age. This study aims to examine the joint impact of race, migration, and old age in shaping mental health treatment. Methods Pooled data were obtained from the Canadian Community Health Survey (2015–2018) and restricted to respondents (aged ≥45 years) with mood or anxiety disorders (n = 9,099). Multivariable logistic regression was performed to estimate associations between race–migration nexus and past-year mental health consultations (MHC). Classification and regression tree (CART) analysis was applied to identify intersecting determinants of MHC. Results Compared to Canadian-born Whites, racialized immigrants had greater mental health needs: poor/fair self-rated mental health (odds ratio [OR] = 2.23, 99% confidence interval [CI]: 1.67–2.99), perceived life stressful (OR = 1.49, 99% CI: 1.14–1.95), psychiatric comorbidity (OR = 1.42, 99% CI: 1.06–1.89), and unmet needs for care (OR = 2.02, 99% CI: 1.36–3.02); in sharp contrast, they were less likely to access mental health services across most indicators: overall past-year MHC (OR = 0.54, 99% CI: 0.41–0.71) and consultations with family doctors (OR = 0.67, 99% CI: 0.50–0.89), psychologists (OR = 0.54, 99% CI: 0.33–0.87), and social workers (OR = 0.37, 99% CI: 0.21–0.65), with the exception of psychiatrist visits (p =.324). The CART algorithm identifies three groups at risk of MHC service underuse: racialized immigrants aged ≥55 years, immigrants without high school diplomas, and linguistic minorities who were home renters. Discussion To safeguard health care equity for medically underserved communities in Canada, multisectoral efforts need to guarantee culturally responsive mental health care, multilingual services, and affordable housing for racialized immigrant older adults with mental disorders. [ABSTRACT FROM AUTHOR]

Objectives According to a widely cited assertion, older adults are less likely than younger individuals to express pain complaints. Age-related differences in pain responses have been discussed in the literature despite a paucity of research involving direct comparisons of younger and older adults' pain reactions (i.e. verbal, nonverbal) in the context of a single experimental investigation. Our goal was to test the hypothesis that older adults are more stoic than younger adults in their expression of pain. Methods We measured trait stoicism as well as multiple responses to thermal pain. Results In contrast to suggestions in the literature, equivalence testing indicated that older and younger adults displayed similar verbal and nonverbal pain responses. Our results suggest that older adults are no more stoic about their pain than are younger persons. Discussion This is the first attempt to explore a wide array of age differences in pain expression within the context of a single experimental study. [ABSTRACT FROM AUTHOR]

Objectives This study examined short- and long-term psychological adjustment to parental bereavement in later life for mothers and fathers. Methods Using 9 waves of data from the United States (1998–2014 Health and Retirement Study), I estimated trajectories of mothers' and fathers' depressive symptoms surrounding child death in later life, highlighting gender differences in adjustment. Moderation analyses were performed to uncover heterogeneous trajectories across parental characteristics. Results Mothers were more likely to experience child death and reported higher depressive symptoms prior to parental bereavement than fathers. Mothers and fathers who lost a child reported an increase in depressive symptoms that diminished over time. The short-term elevation in depressive symptoms was marginally greater for mothers than fathers, but depressive symptoms declined at a faster rate for mothers than fathers in the years following the death. These counterbalancing changes resulted in mothers and fathers returning to their respective prebereavement levels of depressive symptoms between 2 and 4 years postbereavement. Parental age moderated trajectories distinctly by gender, and the presence of surviving children buffered the impact of child death on depressive symptoms for mothers but not fathers. Discussion Mothers more often experience child death in later life and their adjustment process differs from that of fathers, underscoring the salience of gender in shaping how older parents respond to the death of a child. Older parents and mothers without surviving children are vulnerable to prolonged elevations in depressive symptoms following the death of a child in later life. [ABSTRACT FROM AUTHOR]

This study aimed to examine characteristics associated with discharge against medical advice from the hospital in alcohol withdrawal patients, supporting the work of hospital staff and Alcohol Care Teams and identifying characteristics that may help target patients most likely to discharge against medical advice. We used Hospital Episode Statistics Data to identify demographic and clinical variables and compare these in alcohol withdrawal patients who discharged against medical advice from hospital, compared with those who were discharged by the clinical team. Factors significantly associated with alcohol withdrawal patients discharging against medical advice from hospital were: being admitted as an emergency; discharged on a weekend; living with no fixed abode; being male; being younger and having a shorter length of stay. This study identifies characteristics that can be used to support acute hospitals and Alcohol Care Teams, particularly in the allocation of resources to reduce discharges against medical advice and subsequent readmissions to the hospital. Particular consideration should be given to clinical provision in hospitals in emergency departments and on weekends, and also those patients who are admitted and are of no fixed abode. [ABSTRACT FROM AUTHOR]

Objectives We test whether higher awareness of age-related gains (AARC-gains), lower awareness of age-related losses (AARC-losses), and more positive attitudes toward own aging (ATOA) are cross-sectionally related to more frequent social media use. We also investigate the strength and direction of the associations of AARC-gains, AARC-losses, and ATOA with social media use over 1 year, from before to after the onset of the coronavirus 2019 pandemic. Methods We used cross-sectional data from 8,320 individuals (mean age = 65.95 years; standard deviation = 7.01) and longitudinal data from a subsample of 4,454 individuals participating in the UK PROTECT study in 2019 and 2020. We used ordered regression models, linear regression models, and tests of interaction. Models were adjusted for age, sex, education, and employment. Results Higher AARC-gains and more positive ATOA, but not AARC-losses, were cross-sectionally associated with more frequent social media use. Social media use became more frequent at follow-up. In the longitudinal models controlling for baseline levels of the outcome variable, more frequent baseline social media use predicted increases in AARC-gains, whereas baseline AARC-gains did not significantly predict the frequency of social media use at follow-up. Baseline frequency of social media use did not significantly predict AARC-losses, nor ATOA at follow-up, whereas lower levels of AARC-losses and more positive ATOA predicted more frequent social media use at follow-up. Discussion Although effect sizes were small, decreasing negative views on aging may help increase the engagement of middle-aged and older people with social media. At the same time, fostering social media use could promote positive self-perceptions of aging. [ABSTRACT FROM AUTHOR]

Objectives Individuals with more education are at lower risk of developing multiple, different age-related diseases than their less-educated peers. A reason for this might be that individuals with more education age slower. There are 2 complications in testing this hypothesis. First, there exists no definitive measure of biological aging. Second, shared genetic factors contribute toward both lower educational attainment and the development of age-related diseases. Here, we tested whether the protective effect of educational attainment was associated with the pace of aging after accounting for genetic factors. Methods We examined data from 5 studies together totaling almost 17,000 individuals with European ancestry born in different countries during different historical periods, ranging in age from 16 to 98 years old. To assess the pace of aging, we used DunedinPACE, a DNA methylation algorithm that reflects an individual's rate of aging and predicts age-related decline and Alzheimer's disease and related disorders. To assess genetic factors related to education, we created a polygenic score based on the results of a genome-wide association study of educational attainment. Results Across the 5 studies, and across the life span, higher educational attainment was associated with a slower pace of aging even after accounting for genetic factors (meta-analysis effect size = −0.20; 95% confidence interval [CI]: −0.30 to −0.10; p =.006). Further, this effect persisted after taking into account tobacco smoking (meta-analysis effect size = −0.13; 95% CI: −0.21 to −0.05; p =.01). Discussion These results indicate that higher levels of education have positive effects on the pace of aging, and that the benefits can be realized irrespective of individuals' genetics. [ABSTRACT FROM AUTHOR]

Objectives Age-related cognitive changes can be influenced by both brain maintenance (BM), which refers to the relative absence over time of changes in neural resources or neuropathologic changes, and cognitive reserve (CR), which encompasses brain processes that allow for better-than-expected behavioral performance given the degree of life-course-related brain changes. This study evaluated the effects of age, BM, and CR on longitudinal changes over 2 visits, 5 years apart, in 3 cognitive abilities that capture most of age-related variability. Methods Participants included 254 healthy adults aged 20–80 years at recruitment. Potential BM was estimated using whole-brain cortical thickness and white matter mean diffusivity at both visits. Education and intelligence quotient (IQ; estimated with American National Adult Reading Test) were tested as moderating factors for cognitive changes in the 3 cognitive abilities. Results Consistent with BM—after accounting for age, sex, and baseline performance—individual differences in the preservation of mean diffusivity and cortical thickness were independently associated with relative preservation in the 3 abilities. Consistent with CR—after accounting for age, sex, baseline performance, and structural brain changes—higher IQ, but not education, was associated with reduced 5-year decline in reasoning (β = 0.387, p =.002), and education was associated with reduced decline in speed (β = 0.237, p =.039). Discussion These results demonstrate that both CR and BM can moderate cognitive changes in healthy aging and that the 2 mechanisms can make differential contributions to preserved cognition. [ABSTRACT FROM AUTHOR]

Objectives We present a dynamic view of gender patterns in informal caregiving across Europe in a context of sociodemographic transformations. We aim to answer the following research questions: (a) has the gender gap in informal caregiving changed; (b) if so, is this due to changes among women and/or men; and (c) has the gender care gap changed differently across care regimes? Methods Multilevel growth curve models are applied to gendered trajectories of informal caregiving of a panel sample of 50+ Europeans, grouped into 5-year cohorts and followed across 5 waves of the Survey of Health, Ageing and Retirement in Europe survey, stratified by sex and adjusted for several covariates. Results For men in cohorts born more recently, there is a decrease in the prevalence of informal care outside the household, whereas cohort trajectories for women are mostly stable. Prevalence of care inside the household has increased for later-born cohorts for all without discernible changes to the gender care gap. Gender care gaps overall widened among later-born cohorts in the Continental cluster, whereas they remained constant in Southern Europe, and narrowed in the Nordic cluster. Discussion We discuss the cohort effects found in the context of gender differences in employment and care around retirement age, as well as possible demographic explanations for these. The shift from care outside to inside the household, where it mostly consists of spousal care, may require different policies to support carers, whose age profile and possible care burden seem to be increasing. [ABSTRACT FROM AUTHOR]

Objective To develop a prognostic model of 1-year mortality for individuals aged 65+ presenting at the emergency department (ED) with a fall based on health care spending patterns to guide clinical decision-making. Design Population-based cohort study (n  = 35,997) included with a fall in 2013 and followed 1 year. Methods Health care spending indicators (dynamical indicators of resilience, DIORs) 2 years before admission were evaluated as potential predictors, along with age, sex and other clinical and sociodemographic covariates. Multivariable logistic regression models were developed and internally validated (10-fold cross-validation). Performance was assessed via discrimination (area under the receiver operating characteristic curve, AUC), Brier scores, calibration and decision curve analysis. Results The AUC of age and sex for mortality was 72.5% [95% confidence interval 71.8 to 73.2]. The best model included age, sex, number of medications and health care spending DIORs. It exhibited high discrimination (AUC: 81.1 [80.5 to 81.6]), good calibration and potential clinical benefit for various threshold probabilities. Overall, health care spending patterns improved predictive accuracy the most while also exhibiting superior performance and clinical benefit. Conclusions Patterns of health care spending have the potential to significantly improve assessments on who is at high risk of dying following admission to the ED with a fall. The proposed methodology can assist in predicting the prognosis of fallers, emphasising the added predictive value of longitudinal health-related information next to clinical and sociodemographic predictors. [ABSTRACT FROM AUTHOR]

Objectives We aimed at estimating the incidence and prevalence of SLE in northeastern Italy over the period 2012–20. Methods A retrospective population-based study was conducted in Veneto Region (4.9 million people) using the population registry, an administrative health database where all residents are recorded. Between 2012 and 2020, SLE prevalence was defined by a healthcare co-payment exemption for SLE (national registry code 028) or any hospital diagnosis of SLE (International Classification of Disease , Ninth Revision, Clinical Modification 710.0), whichever came first. Incident SLE was defined from 2013 to 2020 to exclude prevalent cases. Standardized incidence and prevalence rates were reported by age and sex. Results During the study period, we identified 4283 SLE patients (85% female), with 1092 incident cases. Across the study period, SLE standardized point prevalence increased from 63.5 (95% CI 61.2, 65.8) to 70.6 (95% CI 68.3, 73.0) per 100 000 residents, corresponding to an annual increment of 1.14% (P  < 0.0001). The highest prevalence was observed in females aged 60–69 years. SLE incidence corresponded to 2.8 per 100 000 person-years (95% CI 2.6, 2.9), with an annual decline of 7.3% (P  < 0.0001). Incidence was 5-fold higher in females (female-to-male incidence rate ratio: 5.00, 95% CI 4.25, 5.87; P  < 0.0001), with a peak among women aged 30–39 years. At diagnosis, women were significantly younger (45 years, IQR 33–58) than men (52 years, IQR 38–64). Conclusions Over the last decade, SLE prevalence has increased, while incidence has stably declined. In view of the introduction of new high-cost drugs, a clear definition of the epidemiology of SLE is crucial for all healthcare stakeholders. [ABSTRACT FROM AUTHOR]

High-quality interviews that follow best-practice guidelines are the best means available to frontline child protective service (CPS) workers and specially trained police officers to investigate and detect abuse and maltreatment. In Norway, the CPS and police are trained in the same interview method. In the current quantitative study, we investigate sixty-five interviews conducted by the CPS of children ages 4–8 years and seventy-two interviews conducted by the police of children ages 3–6 years. Our analysis shows that the CPS workers presented more open-ended invitations and fewer suggestive questions than the police officers. However, the CPS also asked more option-posing questions. Still, this finding may indicate that CPS workers come closer than police officers to follow best practice guidelines when they conduct child interviews. It should be noted that the police are also trained in an extended interview method, unlike the CPS workers. The number of open-ended invitations was sparse in both samples. Differences in the span of children's ages in the two samples and different legal frameworks may have affected the findings. Implications for interview training are discussed. [ABSTRACT FROM AUTHOR]

Objectives The goal of this preregistered study was to synthesize empirical findings on age differences in motivated cognition using a meta-analytic approach, with a focus on the domains of cognitive control and episodic memory. Methods A systematic search of articles published before July 2022 yielded 27 studies of cognitive control (N = 1,908) and 73 studies of memory (N = 5,837). Studies had to include healthy younger and older adults, a within-subjects or between-subjects comparison of motivation (high vs low), and a measure of cognitive control or memory. The Age × Motivation effect size was meta-analyzed using random-effects models, and moderators were examined using meta-regressions and subgroup analyses. Results Overall, the Age × Motivation interaction was not significant in either cognitive domain, but the effect sizes in both domains were significantly heterogeneous, indicating a possible role of moderating factors in accounting for effect size differences. Moderator analyses revealed significant moderation by incentive type for episodic memory, but not for cognitive control. Older adults' memory was more sensitive to socioemotional rewards, whereas younger adults' memory was more sensitive to financial gains. Discussion Findings are discussed with reference to the dopamine hypothesis of cognitive aging and to life-span theories of motivational orientation. None of these theories is fully supported by the meta-analysis findings, highlighting the need for an integration of neurobiological, cognitive process, and life-span-motivational perspectives. [ABSTRACT FROM AUTHOR]

Objectives Spousal caregivers of older adults, especially new spousal caregivers, face increased risks of negative health outcomes due to the demands of caregiving and their own health decline. Estimating the impacts of caregiving on health without controlling for caregivers' own aging-related health decline could exaggerate the negative health consequences of caregiving, while focusing solely on caregivers could result in selection bias where healthier individuals enter and/or remain in caregiving. This study aims to estimate the impacts of caregiving on health of new spousal caregivers while controlling for observable confounders. Methods We utilized coarsened exact matching analysis to compare health outcomes between new spousal caregivers and spousal noncaregivers using pooled panel data from 2006 to 2018 in the Health and Retirement Study. We analyzed 242,123 person-wave observations from 42,180 unique individuals, among whom 3,927 were new spousal caregivers. Variables used for matching were classified into 3 categories: care needs, willingness to provide care, and ability to provide care. Two-year outcomes assessed are spouse's self-rated health, depressive symptoms, and cognitive functioning. Results A total of 3,417 (87.01%) new spousal caregivers were matched with 129,798 observations of spousal noncaregivers. Regression analysis indicated being a new spousal caregiver was associated with a 0.18- (standard error = 0.05) unit increase in number of depressive symptoms. No statistically significant results were identified for self-rated health and cognitive functioning. Discussion Our results highlighted the needs to address mental health among new spousal caregivers and emphasized the importance of addressing mental health in long-term care programs and policies. [ABSTRACT FROM AUTHOR]

Objectives Several theories predict changes in individuals' economic preferences across the life span. To test these theories and provide a historical overview of this literature, we conducted meta-analyses on age differences in risk, time, social, and effort preferences as assessed by behavioral measures. Methods We conducted separate meta-analyses and cumulative meta-analyses on the association between age and risk, time, social, and effort preferences. We also conducted analyses of historical trends in sample sizes and citation patterns for each economic preference. Results The meta-analyses identified overall no significant effects of age for risk (r  = −0.02, 95% CI [−0.06, 0.02], n  = 39,832) and effort preferences (r  = 0.24, 95% CI [−0.05, 0.52], n  = 571), but significant effects of age for time (r  = −0.04, 95% CI [−0.07, −0.01], n  = 115,496) and social preferences (r  = 0.11, 95% CI [0.01, 0.21], n  = 2,997), suggesting increased patience and altruism with age, respectively. Equivalence tests, which compare these effects to practically important ones (i.e. r  = |0.1|), however, suggest that all effects are of trivial significance. The analyses of temporal trends suggest that the magnitude of effects and sample sizes have not changed significantly over time, nor do they dramatically affect the extent that articles are cited. Discussion Overall, our results contrast with theories of aging that propose general age effects for risk and effort preferences, yet provide some but tenuous support for those suggesting age-related changes in time and social preferences. We discuss implications for theory development as well as future empirical work on economic preferences. [ABSTRACT FROM AUTHOR]

Aims Germany is experiencing a decline in alcohol consumption but not for every alcoholic beverage type. Given the differential health impacts of alcoholic beverage type, it is important to understand the drivers of these trends. We investigated: (a) temporal trends in beverage preference and (b) the effects of age, period and cohort on these trends. Methods Data came from nine waves (1995–2018; n total = 75,550) of the German Epidemiological Survey of Substance Abuse, a nationally representative household survey of individuals aged 18–59 years. The quantity of beer, wine, spirits and mixed drinks drank in the last 30 days was transformed into grammes of ethanol, and the beverage type preference was estimated as the proportion of total ethanol consumption. Fractional multinomial logit regression was applied to analyse the age, period and cohort effects on temporal trends of beverage preference by sex. Results The preference for spirits and mixed drinks decreased with increasing age, while the preference for wine increased with no age effect on beer. There was a general decrease in the preference for beer and an increase in the preference for wine among both sexes, with an additional increase in the preference for spirits in males. Conclusion Trends in beverage preference were more related to individual ageing and changes in the whole population than to cohorts. With the continued reduction in alcohol consumption, the decreasing preference for beer and the growing preference for wine suggest a positive development. Trends of an increasing preference for spirits in males are of concern. [ABSTRACT FROM AUTHOR]

Aim To examine trends in public awareness and knowledge of drinking guidelines in the UK since their revision in 2016, which had moved from a daily to a weekly guideline, made the guideline the same for men and women, and reduced the guideline for men by around one-third. Method Data were from a representative, repeat cross-sectional survey. We analysed changes in awareness and knowledge of drinking guidelines among 8168 adult drinkers between 2016 and 2022 and associations with sociodemographic characteristics, smoking status and level of alcohol consumption. Results The proportion of drinkers aware of guidelines declined from 86.0% (95%CI 84.0–88.0%) in 2016 to 81.7% (79.5–84.0%) in 2019, then increased during the COVID-19 pandemic, peaking at 91.6% (90.1–93.1%) in 2020. The proportion who correctly identified the guideline as a maximum of exactly 14 units/week remained at around a quarter from 2016 (25.0%, 22.4–27.5%) to 2018 (25.8%, 23.2–28.3%), whereas the proportion who gave a figure of 14 units or fewer rose from 52.1 (49.2–55.0%) to 57.4% (54.6–60.3%). However, by 2022, guideline knowledge had worsened significantly, with these figures falling to 19.7 (17.4–21.9%) and 46.5% (43.6–49.4%), respectively. Changes over time were similar across subgroups. Odds of guideline awareness and knowledge were higher among drinkers who were aged ≥35, female, more educated and from more advantaged social grades. Conclusions The majority of adult drinkers in the UK are aware of low-risk drinking guidelines. However, 6 years since their announcement, knowledge of the revised drinking guidelines remains poor. Less than a quarter know the recommended weekly limit and only around half think it is 14 units or less. Inequalities have persisted over time, such that disadvantaged groups remain less likely to know the guidelines. [ABSTRACT FROM AUTHOR]

Objectives RA is a chronic inflammatory disease in which possible interstitial lung disease (ILD) is an extra-articular manifestation that carries significant morbidity and mortality. RF and ACPA are included in the RA classification criteria but prognostic and diagnostic biomarkers for disease endotyping and RA-ILD are lacking. Anti-protein arginine deiminase antibodies (anti-PAD) are a novel class of autoantibodies identified in RA. This study aimed to assess clinical features, ACPA and anti-PAD antibodies in RA patients with articular involvement and ILD. Methods We retrospectively collected joint erosions, space narrowing, clinical features and lung involvement of a cohort of 71 patients fulfilling the 2010 ACR/EULAR RA classification criteria. Serum samples from these patients were tested for ACPA IgG (QUANTA Flash CCP3), and anti-PAD3 and anti-PAD4 IgG, measured with novel assays based on a particle-based multi-analyte technology (PMAT). Results Anti-PAD4 antibodies were significantly associated with radiographic injury (P  = 0.027) and erosions (P  = 0.02). Similarly, ACPA levels were associated with erosive disease (P  = 0.014). Anti-PAD3/4 double-positive patients displayed more joint erosions than patients with anti-PAD4 antibodies only or negative for both (P  = 0.014 and P  = 0.037, respectively). RA-ILD (15.5%, 11/71 patients) was associated with older age (P  < 0.001), shorter disease duration (P  = 0.045) and less erosive disease (P  = 0.0063). ACPA were elevated in RA-ILD, while anti-PAD4 were negatively associated (P  = 0.043). Conclusion Anti-PAD4 and anti-PAD3 antibodies identify RA patients with higher radiographic injury and bone erosions. In our cohort, ILD is associated with lower radiographic and erosive damage, as well as low levels of anti-PAD4 antibodies. [ABSTRACT FROM AUTHOR]

On the basis of MEDLINE and manual searches, we examined the main papers in the English literature regarding risk factors for spontaneous (i.e. not related to fertility drug use) multiple births. The constant frequency of monozygotic (MZ) pregnancies over time and in different geographical areas suggests that the determination of MZ twins is largely unchanged over time, and that a genetic mechanism may have a role. In contrast, temporal and geographical trends observed in dizygotic (DZ) pregnancies suggest that environmental factors play a role in determining this condition. At present, maternal age and hereditary components are the best-defined determinants for spontaneous multiple births. [ABSTRACT FROM AUTHOR]

A 'poor response' in the context of in-vitro fertilization (IVF) can be defined as failure to produce an adequate number of mature follicles, and/or a peak oestradiol concentration less than a defined minimum. The cut-off points implied in this definition vary between different centres. Many opt to cancel the IVF cycle when their defined minimum concentrations are not reached despite the lack of evidence of improved outcome in subsequent cycles. Patients attending the Oxford Fertility Unit who are 'poor responders' have always been given the option of continuing with treatment. The first cycles of IVF in 124 patients, with normal day 3 follicle stimulating hormone (FSH), who produced less than five follicles within a 2 year period were studied. The patients were divided into three groups according to the number of follicles produced: A (one or two follicles; n = 33), B (three follicles; n = 33) and C (four follicles; n = 58). The three groups were similar in age, day 3 FSH, total gonadotrophin dose, duration of stimulation, peak oestradiol concentration, oocyte yield, fertilization rate and the clinical pregnancy rate. However, group A had a significantly higher oestradiol concentration per follicle (P < 0.001). The clinical pregnancy rate/cycle in the three groups was comparable to our overall rate in the study period (25.5%). This paper suggests that poor responders with a normal day 3 FSH may still achieve a pregnancy rate similar to that of normal responders. [ABSTRACT FROM AUTHOR]

Recent questions about the role of cholesterol (particularly blood cholesterol) in human cancer have assumed considerable scientific and public health importance. This paper has reviewed the evidence relating human cancer to cholesterol, in diet, blood, and feces. With respect to dietary cholesterol, there is moderately consistent evidence, both descriptive and analytic, of a small-to-medium increase in risk of cancers of the colon and female breast in association with increased dietary cholesterol. However, the close correlation of cholesterol with other foods and nutrients precludes causal inference. The association of fecal cholesterol with large bowel cancer, in both descriptive and analytic studies, is inconsistent. However, there is some evidence that individuals with reduced degradation of fecal cholesterol are at increased risk of colon cancer. Other bile-derived fecal components, particularly the acid sterols, show a somewhat more consistent relationship with large bowel cancer. It may be of relevance to the findings on blood cholesterol that bile is produced from hepatic cholesterol which derives, in part, from blood cholesterol. Studies of blood cholesterol and cancer have been either experimental (intervention) or observational (primarily follow-up). Deliberate lowering of blood cholesterol, by either drugs or diet, does not appear to alter the risk of cancer, either overall or of specific types. The findings from 20 published follow-up studies, each initiated as a cardiovascular disease study, have been more varied. In 12 studies, an inverse association was observed between blood cholesterol level and overall cancer risk. Eight of those 12 were mortality studies, and in six, the inverse association was confined to deaths that occurred early in follow-up; this observation is consistent with lowered blood cholesterol having occurred as a metabolic response to a preclinical cancer. However, the results of the other two mortality studies do not exclusively support this interpretation. Furthermore, in three of the four incidence studies that reported an inverse association, the inverse association persisted for 10 or more years. This relationship was most marked for colon cancer in men and showed some evidence of being maximal in the proximal colon. The biologic plausibility of these particular observations on colon cancer risk in relationship to an antecedent naturally occurring low blood cholesterol gains some support from a body of epidemiologic, clinical, and experimental evidence.(ABSTRACT TRUNCATED AT 400 WORDS) [ABSTRACT FROM AUTHOR]

The article presents the authors' reply to a letter from D. Meyre regarding their systematic review and meta-analysis on the associations of variants of proprotein convertase subtilisine/kexin type I gene (PCSKI) with obesity. The reply addresses Meyre's criticisms of what he perceives as errors in the paper including an assertion that meta-analysis included 2 overlapping cohorts and suggestion that the analysis was underpowered to find significant association of rs632 with body mass index.

Background Screening options for pancreatic ductal adenocarcinoma (PDAC) are limited. New-onset type 2 diabetes (NoD) is associated with subsequent diagnosis of PDAC in observational studies and may afford an opportunity for PDAC screening. We evaluated this association using a large administrative database. Methods Patients were identified using claims data from the OptumLabs® Data Warehouse. Adult patients with NoD diagnosis were matched 1:3 with patients without NoD using age, sex and chronic obstructive pulmonary disease (COPD) status. The event of PDAC diagnosis was compared between cohorts using the Kaplan–Meier method. Factors associated with PDAC diagnosis were evaluated with Cox's proportional hazards modeling. Results We identified 640 421 patients with NoD and included 1 921 263 controls. At 3 years, significantly more PDAC events were identified in the NoD group vs control group (579 vs 505; P  < 0.001). When controlling for patient factors, NoD was significantly associated with elevated risk of PDAC (HR 3.474, 95% CI 3.082–3.920, P  < 0.001). Other factors significantly associated with PDAC diagnosis were increasing age, increasing age among Black patients, and COPD diagnosis (P  ≤ 0.05). Conclusions NoD was independently associated with subsequent diagnosis of PDAC within 3 years. Future studies should evaluate the feasibility and benefit of PDAC screening in patients with NoD. [ABSTRACT FROM AUTHOR]

Background Outdoor air pollution is the largest environmental risk to health. Air pollution, deprivation and poor health status are inextricably linked; highlighting issues of environmental injustice, social and health inequalities. Methods Air pollution (nitrogen dioxide, NO2 and fine particulate matter, PM2.5), population and deprivation data were identified at Lower Super Output Area level in Wales, UK, for 2012–18. Air pollution data were categorized according to different air pollution concentrations. Population and deprivation data were considered simultaneously to describe population vulnerabilities, susceptibilities and inequalities. Simple statistical analyses were performed using a difference in proportions method with 95% confidence intervals. Results Over time, the majority of Welsh people transitioned to living in areas of lower NO2 and PM2.5 pollution. Areas of worse air pollution comprised more young people than people aged 65+; both populations are known to be susceptible to air pollution exposure. By 2018, significant socioeconomic inequality gaps were found where 'most deprived' population groups for both pollutants experienced greater disadvantage. Conclusion Air quality in Wales is improving. However, local-level variations in exposure risk still exist. System-wide action must ensure that air quality improvement-related benefits are equitable and acknowledge current evidence about the harms that even low levels of air pollution can have on health. [ABSTRACT FROM AUTHOR]

Objectives This study examines how age and cognitive ability predict use of different emotion regulation strategies in a laboratory task eliciting emotions varying in valence and arousal. Methods Participants (N = 287) aged 25–85 completed the NIH Toolbox Cognitive Battery and an emotion regulation task in a laboratory setting. They watched a series of emotional clips (disgust, sadness, amusement, and contentment) under instructions to increase positive emotions or decrease negative emotions. After each clip, they rated the extent to which they used emotion regulation strategies that involve different types of engagement with emotional stimuli and disengagement from emotional stimuli. Results Older age was predictive of greater use of immersive-engagement strategies (e.g. perspective taking) and less use of disengagement strategies (e.g. distraction). Fluid cognitive ability was positively associated with immersive-engagement strategy use, particularly for high-arousal clips. For older adults, fluid cognitive ability was also associated with using positive-engagement strategies (e.g. positive reappraisal) to a greater extent to regulate negative emotions. Discussion Patterns of emotion regulation strategy use varied by age, even when accounting for differences in reactivity. Findings suggest that older adults may not necessarily prefer strategies that are lower in cognitive demands or that focus on enhancing positivity. Results support the idea that strategy preferences are driven by a combination of characteristics of the regulator and the regulation context. The relevance of cognitive resources likely varies across situations, perhaps being most consequential for deeper processing of high-arousal stimuli and for older adults' engagement with positive aspects of an otherwise negative situation. [ABSTRACT FROM AUTHOR]

Objectives This study aims to examine age differences in the intensity of chronic pain among middle-aged and older adults, where intensity is measured on a scale differentiating between chronic pain that is often troubling and likely requires intervention versus more endurable sensations. We aim to explore whether individual health and national gross domestic product (GDP) explain these differences as well. Methods Cross-nationally harmonized data from 20 countries on self-reported intensity of chronic pain (0 = no, 1 = mild, 2 = moderate, 3 = severe) in 104,826 individuals aged 50+ observed in 2012–2013. Two-level hierarchical ordinal linear models with individuals nested within countries were used to isolate estimations from heterogeneity explained by methodological differences across single-country studies. Results Overall, mean participant age was 66.9 (SD = 9.9), 56.1% were women, and 41.9% of respondents reported any chronic pain. Chronic pain intensity rose sharply with age in some countries (e.g. Korea and Slovenia), but this association waned or reversed in other countries (e.g. the United States and Denmark). Cross-country variation and age differences in chronic pain were partly explained (85.5% and 35.8%, respectively) by individual-level health (especially arthritis), country-level wealth (as indicated by GDP per capita), and demographics. Discussion Chronic pain intensity is not an inevitable consequence of chronological age, but the consequence of potential selection effects and lower activity levels combined with individual-level health and country-level wealth. Our findings suggest further investigation of health conditions and country affluence settings as potential targets of medical and policy interventions aiming to prevent, reduce, or manage chronic pain among older patients and aging populations. [ABSTRACT FROM AUTHOR]

Background The income gradient in mortality is generated through an interplay between socio-economic processes and health over the life course. International migration entails the displacement of an individual from one context to another and may disrupt these processes. Furthermore, migrants are a selected group that may adopt distinct strategies and face discrimination in the labour market. These factors may have implications for the income gradient in mortality. We investigate whether the income gradient in mortality differs by migrant status and by individual-level factors surrounding the migration event. Methods We use administrative register data comprising the total resident population in Sweden aged between 30 and 79 in 2015 (n  = 5.7 million) and follow them for mortality during 2015–17. We estimate the income gradient in mortality by migrant status, region of origin, age at migration and country of education using locally estimated scatterplot smoothing and Poisson regression. Results The income gradient in mortality is less steep among migrants compared with natives. This pattern is driven by lower mortality among migrants at lower levels of income. The gradient is less steep among distant migrants than among close migrants, migrants that arrived as adults compared with children and migrants that received their education in Sweden as opposed to abroad. Conclusions Our results are consistent with the notion that income inequalities in mortality are generated through life-course processes that may be disrupted by migration. Data restrictions prevent us from disentangling life-course disruption from selection into migration, discrimination and labour market strategies. [ABSTRACT FROM AUTHOR]

Context There is still controversy over the effect of vitamin D3 supplementation on bone health. Objective The effects of vitamin D3 supplementation on bone mineral density (BMD) and markers of bone turnover, as well as the dose-response relationship between vitamin D3 and bone health in adults, were evaluated. Data Sources The PubMed, Scopus, Cochrane, Web of Science, and AGRIS databases were searched for articles published through April 30, 2022. Thirty-nine of the 6409 records identified met the inclusion criteria Data Extraction Data were extracted from articles by 2 authors, and data extraction was cross-checked independently. A random-effects model was used to estimate the pooled effect size and the associated 95%CI for the effect of vitamin D3 for each outcome. A one-stage random-effects dose-response model was used to estimate the dose-response relationship between vitamin D3 supplementation and BMD. Data Analysis Results of meta-analysis showed a beneficial effect of vitamin D3 at the lumbar spine (standardized mean difference [SMD] = 0.06; 95%CI, 0.01–0.12) and femoral neck (SMD = 0.25; 95%CI, 0.09–0.41). Dose-response analysis revealed a linear relationship between vitamin D3 supplementation doses and BMD at the femoral neck, lumbar spine, and total hip sites. No significant effect of vitamin D3 supplementation on whole-body or total hip BMD was observed (P  >   0.05). Vitamin D3 supplementation significantly decreased BMD at both proximal and distal forearm (SMD = −0.16; 95%CI, −0.26 to −0.06). The variables of ethnicity, age, baseline 25-hydroxyvitamin D (25[OH]D), menopause status, vitamin D3 dosing frequency, and bone health status (P interaction = 0.02) altered the effect of vitamin D3 supplementation on BMD. Additionally, a nonlinear relationship between vitamin D3 supplement doses and markers of bone turnover was found. Conclusion A protective effect of vitamin D3 supplementation on BMD of the lumbar spine, femoral neck, and total hip is implicated. Systematic Review Registration PROSPERO registration number CRD42017054132. [ABSTRACT FROM AUTHOR]

Aims Frailty is closely related to the prognosis and quality of life of patients with heart failure (HF). However, the predictors of it are still unclear. Our study aimed to describe the frailty status of Chinese hospitalized patients with HF and explore predictive factors guided by Theory of Unpleasant Symptoms. Methods and results In this cross-sectional descriptive study, questionnaire-based survey was conducted among 323 patients hospitalized with HF in three tertiary hospitals in Wuhan, China. Frailty was measured by the Tilburg Frailty Indicator (TFI) in this study. The model based on Theory of Unpleasant Symptoms fits the sample well (root mean square error of approximation = 0.063, goodness of fit index = 0.977, normed fit index = 0.901, and comparative fit index = 0.940). Frailty among Chinese patients hospitalized with HF was at high level (TFI = 6.57 ± 3.05). General demographic characteristics (older age, female gender, lower education level, and medical payment method), physical factors (higher New York Heart Association cardiac function class), psychological factors (more severe depression), and social factors (poorer social support) were significant predictors of more severe frailty (P < 0.05). Depression played an important mediating role in this study. Conclusion Theory of Unpleasant Symptoms can be used to guide the research on the frailty of HF patients. It is suggested to strengthen emotional support and health education for HF patients in China. In addition, more attention should be paid to the less educated population by providing more personalized health guidance. [ABSTRACT FROM AUTHOR]

Age-related loss of muscle mass, strength, and performance, commonly referred to as sarcopenia, has wide-ranging detrimental effects on human health, the ramifications of which can have serious implications for both morbidity and mortality. Various interventional strategies have been proposed to counteract sarcopenia, with a particular emphasis on those employing a combination of exercise and nutrition. However, the efficacy of these interventions can be confounded by an age-related blunting of the muscle protein synthesis response to a given dose of protein/amino acids, which has been termed "anabolic resistance." While the pathophysiology of sarcopenia is undoubtedly complex, anabolic resistance is implicated in the progression of age-related muscle loss and its underlying complications. Several mechanisms have been proposed as underlying age-related impairments in the anabolic response to protein consumption. These include decreased anabolic molecular signaling activity, reduced insulin-mediated capillary recruitment (thus, reduced amino acid delivery), and increased splanchnic retention of amino acids (thus, reduced availability for muscular uptake). Obesity and sedentarism can exacerbate, or at least facilitate, anabolic resistance, mediated in part by insulin resistance and systemic inflammation. This narrative review addresses the key factors and contextual elements involved in reduction of the acute muscle protein synthesis response associated with aging and its varied consequences. Practical interventions focused on dietary protein manipulation are proposed to prevent the onset of anabolic resistance and mitigate its progression. [ABSTRACT FROM AUTHOR]

Despite the importance of health literacy for health promotion, Nepalese undergraduate students are largely unaware of its importance. The present study assessed the health literacy levels of undergraduate health sciences students and explored various sociodemographic, clinical and health information-related factors associated with health literacy at Pokhara University in the Kaski district of western Nepal. A cross-sectional web-based observational study was conducted among 406 undergraduate students university students from five faculties at the School of Health and Allied Sciences affiliated with Pokhara University. Data on sociodemographic information, clinical characteristics and sources of health information were collected. Health literacy was assessed using the 44-item measure that captures the concept of health literacy across nine distinct domains. Associated factors were examined using a one-way analysis of variance followed by stepwise backward multiple linear regression analysis at the level of significance of 0.05. The mean score for the health literacy questionnaire was 3.13 ± 0.26. Outcomes of multivariable analyses demonstrated various factors associated with health literacy scores, including age (β = 0.10; p = 0.001), physical exercise (β = −0.13; p < 0.001), monthly household income (β = 0.05; p = 0.029) and routine health checkup (β = −0.14; p < 0.001). The study showed that there is a need to understand and address sociodemographic factors and clinical factors, including age, physical exercise, monthly household income and routine health checkups to improve health literacy levels among undergraduate students in western Nepal. More research, including longitudinal studies, is needed to better understand factors that influence health literacy among undergraduate students in Nepal. [ABSTRACT FROM AUTHOR]

Objectives Life experiences that are complex, sustained, and intense, such as active participation in music and speaking multiple languages, have been suggested to contribute to maintaining or improving cognitive performance and mental health. The current study focuses on whether lifetime musical and multilingual experiences differentially relate to cognition and well-being in older adults, and tests whether there is a cumulative effect of both experiences. Methods A total of 11,335 older adults from the population-based Lifelines Cohort Study completed a musical and multilingual background and experience questionnaire. Latent class analysis was used to categorize individuals into subgroups according to their various musical and multilingual experiences resulting in a (1) nonmusical, low-multilingual group; (2) nonmusical, high-multilingual group; (3) musical, low-multilingual group; and (4) musical high-multilingual group. To determine whether the groups differed in terms of cognition or emotional affect, differences in Ruff Figural Fluency Test (RFFT) and Positive and Negative Affect Schedule scores were investigated by means of multinomial logistic regression analysis. Results Having high-multilingual, and not musical, experience was related to better RFFT performance compared to no experience, but not to more positive affect. Having both musical and high-multilingual experiences is related to better RFFT performance and more positive affect in advanced age compared to having only one experience or none. Importantly, these results were found independently of age, level of education, and socioeconomic status. Discussion Musical and multilingual experiences are related to healthy aging, especially when combined, which supports the suggestion that a broader spectrum of lifetime experiences relates to cognitive reserve. [ABSTRACT FROM AUTHOR]

Objectives: Older inmates are the fastest growing segment of the prison population; however, the reasons for this are not well understood. One explanation is that the general population is aging, driving prison age distributions to change. For this article, we study the role of population aging in prison growth by investigating how the baby boom phenomenon of post-World War II has contributed to the growth of older inmate populations. Method: We identify the impact of population aging using simulation methods that explain prison growth as the combination of criminal justice processes. Results: Overall, we find evidence that population aging has played a significant role in explaining the growth of older inmate populations, in particular among inmates aged between 50 and 64 years, contributing to as much as half of the observed increase in these groups since 2000. Discussion: This finding stands in contrast to the notion that population aging has little explanatory power in describing the growth of prison populations and implies that older inmate groups are more sensitive to compositional changes in the general population. We argue that prediction-based modeling of prison growth should more seriously consider the impacts and consequences of demographic shifts among older prisoner populations. [ABSTRACT FROM AUTHOR]

After the first acute alcoholic pancreatitis (AAP), active repeated brief interventions (BIs) have been shown to protect against recurrent acute pancreatitis (RAP). However, in daily hospital practice the treatment of alcohol problems varies. Our aim was to study BIs performed in the clinic during AAP and whether this prevents from future RAP episodes.~Aims~Unassigned~Data on all patients discharged between 10/2010 and 10/2012 with acute pancreatitis as the primary diagnosis were obtained from the hospital database. Patients with the first attack of AAP were included in the study. Documented BIs during hospitalization for AAP and RAP and the development of RAP and chronic pancreatitis during median (range) follow-up of 4.2 (0.2-6.1) years were analyzed. Patients were also contacted with a mailed questionnaire.~Methods~Unassigned~A total of 74 patients with first AAP during the study period were included. Of these, 32% developed RAP during follow-up. Of the patients, 72% received a documented BI during initial hospitalization, with no difference between patients who later did or did not develop RAP (71 vs. 72%; ns). Younger age (OR = 0.96, 95% CI = 0.92-1.00) and higher AUDIT points (P = 0.044; OR = 5.6; 95% CI = 1.02-30.9 for ¿20 AUDIT points) were associated with RAP. AUDIT test had 70% sensitivity and 71% specificity at a cut-off value of 20 points for predicting RAP.~Results~Unassigned~Only 72% of the patients received a documented BI during the initial hospitalization for AAP. The in-hospital BI as such did not prevent the development of RAP. Young patients with AUDIT points ¿20 are especially at high risk for developing RAP and should be included in a more intense follow-up care program to maximize prevention.~Conclusions~Unassigned~During hospitalization for acute alcoholic pancreatitis (AAP), one third of the patients did not receive brief interventions (BIs). The in-hospital BI by itself was not sufficient enough to prevent disease recurrence in follow-up of 4 years. Young age and higher AUDIT-points were significant risk factors for recurrent attacks of AAP.~Short summary~Unassigned [ABSTRACT FROM AUTHOR]

Context Obesity is a significant risk factor for many pathological conditions. Whether a gluten-free diet (GFD) is a risk factor for overweight or obesity remains controversial. Objective The primary aim of this study was to assess the prevalence of body mass index (BMI) categories at disease presentation and the variation in BMI category from underweight/normal to overweight/obese and vice versa during a GFD. Data Sources PubMed, Scopus, and Web of Science databases were searched through February 2021 for retrospective, cross-sectional, and prospective studies reporting BMI categories at disease diagnosis and during a GFD. Data Extraction Data were extracted by 2 reviewers independently. Disagreements were resolved by consensus; a third reviewer was consulted, if necessary. Risk of bias was assessed with the Cochrane ROBINS-I tool. Data Analysis Subgroup analysis based on age (pediatric/adult patients), study design (prospective, cross-sectional, retrospective), and duration of GFD was performed.. Forty-five studies were selected (7959 patients with celiac disease and 20 524 healthy controls). The mean BMI of celiac patients at presentation was significantly lower than that of controls (P  < 0.001). During a GFD, the mean BMI increased significantly (mean difference = 1.14 kg/m2 [95%CI, 0.68–1.60 kg/m2]; I2  = 82.8%; P  < 0.001), but only 9% of patients (95%CI, 7%–12%; I2  = 80.0%) changed from the underweight/normal BMI category to the overweight/obese category, while 20% (95%CI, 11%–29%; I2  = 85.8%) moved into a lower BMI category. Conclusion Most celiac patients had a normal BMI at presentation, although the mean BMI was significantly lower than that of controls. A GFD does not increase the risk of becoming overweight/obese, especially in children. The quality of several studies was suboptimal, with moderate or high overall risk of bias and heterogeneity. [ABSTRACT FROM AUTHOR]

Background and Objectives Although interest in sexuality in older age has increased over the last decades, few studies have focused on longitudinal change in sexual satisfaction around retirement age. In the present study, we studied change in sexual satisfaction across retirement in a sample of Swedish older adults with a partner. Research Design and Methods Our analyses were based on n = 759 participants (359 male, 400 female) from the longitudinal Health, Aging, and Retirement Transitions in Sweden study. For this study, we used 5 waves spanning over a period of 4 years. Results On average, sexual satisfaction did not change significantly before retirement, but decreased after retirement. Interestingly, women showed higher sexual satisfaction than men, as well as a more positive development of both pre- and postretirement sexual satisfaction. Individuals with higher relationship satisfaction had a higher sexual satisfaction until retirement, but their sexual satisfaction also decreased faster after retirement, whereas those with lower relationship satisfaction showed a stable but lower sexual satisfaction. Discussion and Implications Sexual satisfaction can change in the retirement transition in several important ways and further studies on the impact of retirement and other late-life stage transitions are warranted. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic may have resulted in front line social workers experiencing job stress, burnout and other psychological distress. Little is known about the work-related stress experienced by Chinese social workers during the pandemic. This study focused on the job stress of social workers from Mainland and Macao. The research aims of this study included: (1) testing whether there is a difference in job stress between social workers from Mainland and Macao during the pandemic and (2) identifying mediating factors that helped explain such regional differences. An online survey collected data from 292 social workers in Mainland China and 108 from Macao in 2020. Mainland participants reported significantly higher job stress than Macao participants. Regional differences in job stress amongst Mainland and Macao social workers were partially attributed to their age and professional role identity. More attention needs to be paid to social workers in Mainland China as they experience higher job stress than their counterparts from Macao. Future research is needed to examine other factors (e.g. job demand and financial compensation) that may contribute to such regional differences. [ABSTRACT FROM AUTHOR]

Background The clinical high-risk (CHR) period offers a temporal window into neurobiological deviations preceding psychosis onset, but little attention has been given to regions outside the cerebrum in large-scale studies of CHR. Recently, the North American Prodrome Longitudinal Study (NAPLS)-2 revealed altered functional connectivity of the cerebello-thalamo-cortical circuitry among individuals at CHR; however, cerebellar morphology remains underinvestigated in this at-risk population, despite growing evidence of its involvement in psychosis. Study Design In this multisite study, we analyzed T1-weighted magnetic resonance imaging scans obtained from N = 469 CHR individuals (61% male, ages = 12–36 years) and N = 212 healthy controls (52% male, ages = 12–34 years) from NAPLS-2, with a focus on cerebellar cortex and white matter volumes separately. Symptoms were rated by the Structured Interview for Psychosis-Risk Syndromes (SIPS). The outcome by two-year follow-up was categorized as in-remission, symptomatic, prodromal-progression, or psychotic. General linear models were used for case-control comparisons and tests for volumetric associations with baseline SIPS ratings and clinical outcomes. Study Results Cerebellar cortex and white matter volumes differed between the CHR and healthy control groups at baseline, with sex moderating the difference in cortical volumes, and both sex and age moderating the difference in white matter volumes. Baseline ratings for major psychosis-risk dimensions as well as a clinical outcome at follow-up had tissue-specific associations with cerebellar volumes. Conclusions These findings point to clinically relevant deviations in cerebellar cortex and white matter structures among CHR individuals and highlight the importance of considering the complex interplay between sex and age when studying the neuromaturational substrates of psychosis risk. [ABSTRACT FROM AUTHOR]

Background and Hypotheses A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. Study Design Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. Study Results At the within-person level, AHs were associated with subsequent SIB over the observation period (12y–14y: β =.118, P <.001; 14–16y: β =.086, P =.012). The reverse SIB->AHs relationship was non-significant at 12–14y (β =.047, P =.112) but emerged from 14y to 16y as the primary direction of influence (β =.243, P <.001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. Conclusions A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress. [ABSTRACT FROM AUTHOR]

Background This study aimed to assess the specific associations between stroke and all-cause and cause-specific mortality among Korean adults. Methods We used data extracted from the Korean National Health Insurance claims database from 2002 to 2013, including information on individuals with or without stroke aged 20 years and older. Patients with intracerebral hemorrhage, ischemic stroke or unspecified stroke were classified as stroke patients, while a reference population matched in terms of sex and age were also selected. The outcomes were all-cause mortality, natural causes of death (i.e. all natural causes, death by stroke and death by other diseases) and suicide. Survival analysis was performed using the Cox proportional hazards model. Results Of the 73 150 eligible participants—including 14 630 stroke patients and 58 520 age- and sex-matched controls—11 121 (15.2%) died during the study period. Of them, 10 513 participants (94.5%) died of natural causes, including 1653 (14.5%) who died due to stroke and 8860 (79.7%) who died due to other diseases. Two hundred and fifty patients (2.2%) died by suicide. Stroke patients showed higher adjusted hazard ratios (HR) for all-cause (HR = 6.48, 95% CI, 3.87–10.86), all-natural-cause (HR = 2.68, 95% CI, 2.53–2.84), stroke (HR = 21.16, 95% CI, 17.49–25.61), other disease (HR = 1.69, 95% CI, 1.58–1.81) and suicide mortality (HR = 3.34, 95% CI, 2.24–4.98) than those without stroke. The effect size of stroke for suicide mortality was greater than that for other causes of mortality (except stroke mortality). Conclusions Stroke was associated with a higher risk of all-cause, natural cause and suicide mortality; stroke was more strongly associated with risk of suicide mortality than with any mortality for any other causes. From a policy standpoint, these results suggest the need for greater supportive care to prevent unnatural deaths among stroke patients. [ABSTRACT FROM AUTHOR]

This study examines undocumented Latinx older adults' perceptions and experiences regarding their economic security in the United States. In-depth semistructured interviews were used to facilitate dialogue with older undocumented adults about their economic security in the United States (N = 25). Participants were on average 61 years old (SD = 4.52), Latinx, and had resided in the United States an average of 23 years (SD = 7.05). More than 70% of the participants were employed; the remaining participants were not working due to poor health (n = 5), advanced age (n = 1), or being in between jobs (n = 1). Authors present a model to illustrate participants' narratives on their economic (in)security in the United States. Some participants discussed having long-term security in their jobs while others described a cycle of job insecurity due to their status. Their precarious status limited their employment opportunities and earning potential. Their savings capacity is narrow; many did not have savings for emergencies, and less so for a time when they are no longer able to work. Many participants believe they will work until they are physically unable to continue working; others believe their children will be a source of support. Practitioners can engage undocumented immigrants in economic empowerment interventions and advocacy efforts to eliminate exploitation in the workplace. Policy change is needed to provide undocumented older adults the opportunity to achieve financial security. [ABSTRACT FROM AUTHOR]

Objectives Age-related memory decrements correlate with metacognitive declines, including knowledge and deployment of effective mnemonic encoding strategies. However, whether imparting such strategy suffices for mitigating memory differences is unclear. Method In a longitudinal study of 276 healthy adults aged 18–79 years, we tested associative and working memory, and assessed beliefs regarding mnemonic strategies. Testing was repeated every 2 years, 5 times. Starting with the third occasion, we instructed participants to use an effective mnemonic strategy (sentence generation). Using continuous-time dynamic modeling, we assessed changes in the item and associative recognition, intervention effects, and their relations with age, sex, meta-memory beliefs, working memory, and metabolic health. Results Younger age, better working memory, and stronger belief in effective mnemonic strategies predicted better recognition, whereas instructional intervention attenuated associative memory deficits, with some persistence over time. Discussion The present findings show merely imparting effective strategies holds promise for mitigating age-related associative memory deficits. [ABSTRACT FROM AUTHOR]

Objectives How does risk preference change across the life span? We address this question by conducting a coordinated analysis to obtain the first meta-analytic estimates of adult longitudinal age differences in risk-taking propensity in different domains. Methods We report results from 26 longitudinal samples (12 panels; 187,733 unique respondents; 19 countries) covering general and domain-specific risk-taking propensity (financial, driving, recreational, occupational, health) across 3 or more waves. Results Results revealed a negative relation between age and both general and domain-specific risk-taking propensity. Furthermore, females consistently reported lower levels of risk taking across the life span than males in all domains, but there is little support for the idea of an age by gender interaction. Although we found evidence of systematic and universal age differences, we also detected considerable heterogeneity across domains and samples. Discussion Our work suggests a need to understand the nature of heterogeneity of age differences in risk-taking propensity and recommends the use of domain-specific and population estimates for applications interested in modeling heterogeneity in risk preference for economic and policy-making purposes. [ABSTRACT FROM AUTHOR]

Aims The amount and pattern of cigarette and alcohol consumption are highly associated with cardiovascular risk. The aim of the present study was the assessment of changes in arterial stiffness and classical risk factors for cardiovascular disease after alcohol withdrawal and detoxification in persons with alcohol use disorder. Methods Two hundred and forty-one individuals (men and women) participated in the investigation. The photoplethysmographic method was applied to assess arterial stiffness in three stages within 6 weeks. Participants were divided into subgroups based on age and sex. Analyses were performed using analysis of variance with repeated measures. Results Different variations in time of stiffness index (SI) and reflection index (RI) values were recorded. Some increases in triglycerides, total cholesterol, low-density lipoprotein and a decrease in high-density lipoproteins were observed in all analyzed groups. Both systolic and diastolic blood pressure (DP) changed significantly during the 3 weeks of the study only in a group of younger men. The SI is correlated with age and gender. No correlation of RI with sex was found; however, RI was strongly correlated with age, pulse and DP. Conclusions The presented study shows that some groups of patients (older women and younger men) after detoxification may be particularly vulnerable to vascular system disorders, i.e. arterial stiffness, making it suggested to include additional observation during therapy. [ABSTRACT FROM AUTHOR]