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Context: Rehabilitation after an anterior cruciate ligament injury is recommended to be started soon after the injury. When surgery is required, research supports the delivery of physiotherapy before anterior cruciate ligament reconstruction (prehabilitation) to optimize recovery and positive outcomes. Individuals attending prehabilitation have never been questioned regarding their adherence to prehabilitation, perception of utility in meeting needs, upcoming events, or anticipated recovery goals. Design: Mixed methods cross-sectional study: Methods: 25 individuals before anterior cruciate ligament reconstruction (43% of eligible individuals from 12 clinics during the delivery period) were surveyed on their mindset and recovery expectancies. Semistructured interviews conducted in 9 of 25 participants assessed their lived experience of prehabilitation. Results: Participants reported that preventing a reinjury (96% of responses) and feeling confident during daily activities about their knee (92%) were the higher rating expectations at this stage of their treatment course. Three themes were developed from the interviews and analyses. (1) Participants reported that prehabilitation was a period full of challenges with memories of the injury and uncertainties. (2) They viewed prehabilitation as a step to move forward by finding support and self-motivating. (3) They believed that prehabilitation would have positive impacts on the treatment outcomes. Participants were confident that prehabilitation would accelerate the recovery of muscle volume (88%) and strength (84%). Conclusion: Participants had positive experiences of prehabilitation, aligning with the findings on functional outcomes in the existing literature on prehabilitation. [ABSTRACT FROM AUTHOR]

Context: Imbalances in upper-extremity soft tissue stiffness may play a role in the development of shoulder and elbow musculoskeletal injuries in tennis players. Ultrasound shear wave elastography provides quantifiable and specific data regarding muscle stiffness. The purpose of this study was to compare tendon and muscle stiffness in healthy tennis players to nontennis players. Design: Cross-sectional study. Methods: The shear wave modulus, measured in kilopascals, was obtained for the dominant pectoralis major, pectoralis minor, and common wrist-extensor tendon using 2-dimensional shear wave elastography ultrasound imaging (GE Logiq S8, L9 linear transducer). Independent t test was run to compare age, body mass index, and the activity index score between both groups. Within-day intrarater reliability was assessed using a within-examiner intraclass correlation coefficients (ICC [3, 1]) with 95% confidence intervals. A multivariate general linear model was run to compare the mean differences between the tennis and nontennis players for each of the soft tissues. Results: Twenty-six individuals (13 tennis players and 13 nontennis players) were recruited. Within-day ICCs were very good (ICC >.78 for the pectoralis musculature) and excellent (ICC >.94 for the common wrist extensor). Common extensor tendon stiffness was significantly higher in tennis players compared to nontennis players (mean difference = 114.8 [61.8], confidence interval, −22.8 to 252.5 kPa for the dominant arm [P =.039]). Mean pectoralis major and minor stiffness differences were not significant (P >.214). Conclusions: Common wrist-extensor stiffness in healthy recreational tennis players is higher than those who do not play tennis. Therefore, clinicians may need to facilitate a greater soft tissue stiffness response with resistance training when rehabilitating recreational tennis players as compared to those not playing tennis. Additional normative data on a larger sample of recreational tennis players should be collected. [ABSTRACT FROM AUTHOR]

Most people with intellectual disabilities have comorbid health conditions, which will impact optimization of sporting performance. Classification is used in Paralympic events to ensure that those with similar levels of functional ability compete fairly against each other. An evidence-based approach needs to be developed for athletes with intellectual disabilities to be classified in relation to their overall functional capacity into competition groups of similar ability. This research builds on previous work using the taxonomy of The International Classification of Functioning, Disability and Health (ICF) to group athletes with intellectual disabilities into comparable competition groups as an approach to Paralympic classification. Three groups of athletes—Virtus, Special Olympics, and Down syndrome—are compared using the ICF questionnaire indicating functional health status in relation to sporting performance. The questionnaire was found to discriminate between athletes with Down syndrome and other athletes, and an approach to using a cutoff score to develop competition classes is explored. [ABSTRACT FROM AUTHOR]

This study aimed to examine physical activity (PA) levels and mental health status (i.e., anxiety and depression) among parents of children with autism spectrum disorder (ASD). Secondary data analysis was conducted using the 2018 National Health Interview Survey. We identified 139 parents of children with ASD and 4,470 parents of children with no disability. Their PA levels, anxiety, and depression were analyzed. Compared with parents of children with no disability, parents of children with ASD were significantly less likely to meet the PA guideline for Americans and had lower odds of vigorous PA (aOR = 0.702), strengthening PA (aOR = 0.885), and light to moderate PA (aOR = 0.994). Parents of children with ASD reported significantly higher odds of anxiety (aOR = 1.559) and depression (aOR = 1.885). This study revealed lower PA levels and higher risks of anxiety and depression in parents of children with ASD. [ABSTRACT FROM AUTHOR]

Background: Low-intensity resistance exercise therapy (LIRET) based on myofascial chains, applied to both affected and nonlocal joints, is an effective method for knee osteoarthritis (OA) rehabilitation. This study applied LIRET in a comparison of prevalues and postvalues of lower-limb tension in female patients with knee OA and asymptomatic participants. Methods: Twenty-four female participants with knee OA and 20 asymptomatic women took part in a 3-month long application of LIRET. Participants' ankle passive torque and ankle range of motion in the sagittal plane were assessed with an isokinetic dynamometer. The collected values were used to estimate the sagittal-plane lower-limb tension. Results: Compared with the asymptomatic group, participants with knee OA presented decreased maximum ankle dorsiflexion (P <.001), decreased ankle plantar flexion range (P =.023), ankle resting position more inclined to dorsiflexion (P =.017), increased ankle dorsiflexion stiffness (P =.005), and lower ankle plantar flexion stiffness (P =.034). After exercise intervention, the knee OA group self-reported less knee pain (P <.001), improved physical function (P <.001), increased maximum dorsiflexion (P =.021), and increased plantar flexion range (P <.001). While plantar flexion stiffness increased (P =.037), dorsiflexion stiffness decreased (P =.015) and ankle resting position moved toward dorsiflexion (P =.002). Results suggest possible decreased anterior leg tension and possible increased posterior leg tension in patients with knee OA. Conclusions: The results supported that knee OA patients present imbalanced myofascial tension of lower limbs. LIRET based on myofascial chains appears to decrease pain, and stiffness, and improve physical function of patients with knee OA and change their lower-limb tension. [ABSTRACT FROM AUTHOR]

This systematic review of literature aimed to synthesize the multilevel factors related to physical activity (PA) among adults (age 18–65) with intellectual disability living in group homes. Keyword searches were used to identify articles from electronic databases, resulting in the inclusion of 10 articles for full-text review. Data were extracted relating to study and sample characteristics and study findings. Methodological quality of the studies was also evaluated. Factors related to PA in group homes were identified at all levels of the social–ecological model. Intrapersonal factors (e.g., health and functional status, attitude to PA), interpersonal factors (e.g., staff attitude, encouragement for PA, and coparticipation in PA), and organizational factors (e.g., program offerings, staff education, and staff–client ratios) were prominent findings in the reviewed studies. The findings support a social–ecological approach for PA promotion in group homes that target intrapersonal, interpersonal, and organizational factors. [ABSTRACT FROM AUTHOR]

We aimed to investigate health care needs, health service utilization, and their socio-economic and health-related determinants in people with spinal cord injury (SCI) living in Jiangsu and Sichuan Provinces of China. A total of 1355 participants with SCI living in the community were recruited using a multi-stage stratified random sample and surveyed by telephone or online. Outcomes evaluated included the presence of health care needs, mode of health service utilization, and specific provider types seen within 12 months preceding the survey. The prevalence of healthcare needs was 92%. Needs were higher in Sichuan (98%) as compared to Jiangsu (80%). Of those in need of health care, 38% reported not having utilized care, more in Sichuan (39%) than in Jiangsu (37%). In Jiangsu, inpatient care was more often used than in Sichuan (46% vs. 27%), while in Sichuan outpatient services were utilized more often (33% vs. 17%). On average, 1.6 provider types were seen, with Sichuan reporting fewer different provider types. Considerable differences in the prevalence of health care needs and service utilization patterns were found between provinces, mostly in favour of the economically more developed Jiangsu Province. People with low income, particularly those below the World Bank poverty line for middle-income countries, had increased health care needs but utilized health care less often. Moreover, environmental barriers contributed significantly to unmet health care needs. This implies the necessity to provide better accessible and more affordable rehabilitation services for people with spinal cord injury (SCI) in China such as community-based rehabilitation programming. Policies for alleviation of poverty in the case of SCI including insurance for catastrophic health expenditure should also be reviewed and adapted where applicable. [ABSTRACT FROM AUTHOR]

To verify the effectiveness of experimental occupational therapy plus intensive standard rehabilitation compared to intensive standard rehabilitation alone on the reintegration to social activities of complex patients three months after hospital discharge. Patients with a score ≥ 9 on the Rehabilitation Complexity Scale at admission to an intensive rehabilitation ward were randomized to the control or experimental group. Both groups received intensive multidisciplinary rehabilitation aimed at recovering independence in the basic activities of daily life (ADL). The experimental group also received experimental occupational therapy services to address goals identified through the administration of the Canadian Occupational Performance Measure (COPM). Experimental occupational therapy began during the in-hospital phase and continued in the home-based setting. It consisted of teaching strategies, recommending aids, and providing personalized information regarding available community support. Ninety-two individuals with a mean age of 65 years (female 44.6%) were enrolled. The experimental group significantly improved participation measured by the Reintegration to Normal Living Index (mean changes 8.61, 95% CI: 1–16.23, p = 0.027). The performance and satisfaction scores of the COPM, both during hospitalization and after discharge, and independence in ADL also improved. No differences in mood disturbances were found. Early post-discharge occupational therapy integrated with multidisciplinary rehabilitation improves the social participation of complex patients. Future research should investigate the concrete feasibility of implementing this complex intervention cost-effectively and in different contexts. ClinicalTrials.gov Identifier NCT03668938 (first posted date 13/09/2018) Early post-discharge rehabilitation assists patients' transition from hospital to home by improving the management of problems they encounter. In complex patients, occupational therapy initiated during hospitalization and extended to the early post-discharge phase improves social participation, independence in basic and instrumental daily activities, and performance and satisfaction when carrying out relevant occupational activities. The strong partnership between the Occupational Therapist and the patient improves compliance to treatment, enhancing the chances of success of rehabilitation interventions. [ABSTRACT FROM AUTHOR]

Background: Delayed operative fixation of acetabular fractures remains a major problem in many parts of the world. No previous studies have reported the effect of fixation delay on health-related quality of life (HRQOL). We aimed to investigate the effect of delayed operative fixation of acetabular fractures on health-related quality of life, EuroQol-5 Dimension questionnaire (EQ-5D), and other related outcomes. Methods: We retrospectively analysed 117 patients who underwent open reduction internal fixation for displaced acetabular fractures between 2014 and 2021. Patients were divided into groups based on the admission-to-surgery time (interval between injury and definitive surgery): 1–14, 15–21, and >21 days. Patients were analysed for associations between admission-to-surgery time and postoperative outcomes, including operative time, estimated blood loss, blood transfusion, postoperative complication, and quality of reduction. Eighty-five patients with a mean follow-up time of 3.94 ± 1.84 years were analysed for the association between admission-to-surgery time and conversion to total hip arthroplasty, the Modified Merle d'Aubigné and Postel score, EQ-5D score, ability to sit cross-legged, and ability to sit squat. Multivariable linear regression was used for continuous outcomes and logistic regression for categorical outcomes associated with delayed operative fixation. Results: An admission-to-surgery time > 14 days was associated with significantly higher blood loss [785 mL (236–1335), p = 0.006]. For associated fractures, an admission-to-surgery time > 21 days increased the risk of poor reduction [odds ratio (OR), 5.21 (1.42–19.11), p = 0.013]. Further, admission-to-surgery time > 21 days was associated with poor Modified Merle d'Aubigné and Postel scores [OR, 8.46 (1.48–48.29), p = 0.016], EQ-5D pain domain [OR, 3.55 (1.15–11), p = 0.028], and EQ-5D usual activity domain [OR, 4.24 (1.28–14), p = 0.018]. Conclusion: Delayed operative fixation of acetabular fractures after 21 days affected the functional outcomes and HRQOL, independent of the reduction status. Surgical interventions and patient referrals should occur at the earliest and within 21 days from the time of injury. [ABSTRACT FROM AUTHOR]

Rationale: Body image undergoes significant changes during pregnancy, marking a pivotal phase in a woman's life. Aim and Objective: This study aimed to explore the body image perceptions of primiparous pregnant women during their third trimester. Methods: Employing a qualitative research approach grounded in phenomenology, the study involved interviews to explore the experiences of primiparous pregnant women in their third trimester. The interviews were conducted via an online platform, with a sample group of 13 participants chosen through purposive sampling. Data analysis followed a content analysis approach, with the information being transferred to MAXQDA Analytics Pro Qualitative Data Analysis Programme for coding. The study adhered to the reporting guidelines outlined in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: Systematic analysis of the interview transcripts led to the identification of three main themes under the overarching framework of body image experiences among primiparous pregnant women during the third trimester: Physical Changes, Mental Changes, and Behavioural and Social Changes. Among the identified themes, pregnant women demonstrated a relatively lower level of discourse regarding Physical Changes, in contrast to a significant emphasis on Mental Changes. Within the latter theme, pregnant women exhibited significant dissatisfaction with their pregnancy experiences significantly. Conclusion: It was determined that pregnant women experience physical and psychological changes related to body image during pregnancy. [ABSTRACT FROM AUTHOR]

Available statistics show that the population of older adults in Ghana increased from 200,000 in 1960 to two million in 2021, with females comprising 57% of this population. This increase in the size of the older Ghanaian population has research, policy, and practice implications. Qualitative research has rarely explored the psychological health of older Ghanaians by paying attention to the emotions and feelings they experience and the reasons they give for those emotions and feelings. The current study aimed to fill the gap by exploring emotions and feelings that underlay the psychological well-being of older persons in Ghana and the subjective reasons behind their feelings. Twenty-three adults aged 60 years plus (14 male vs 9 female) provided interview data that were analyzed thematically, and psychological well-being perspectives provided a framework to make sense of the data. The findings show that participants' psychological well-being belongs to three subthemes of psychological functioning: high positive functioning; low negative functioning; and high negative functioning. These subthemes translated into three main themes: pride of conquest; being older can be depressing; and, living with regret, respectively. Overall, the findings suggest that participants' psychological well-being is a confluence of flourishing mental health and depression. It is concluded that older Ghanaians experience a mixture of positive and negative emotions and feelings, and, therefore, a blend of good mental health and depression. One reason for positive psychological well-being is that older adults are happy about living longer, and satisfied with what they have accomplished. They are also proud of their continued social contribution, and look forward to health and happiness in retirement. However, fear of death and worries over what the future holds for children, despair over the debilitating effects of sickness, abusive experience, poverty, and the shame of being accused of witchcraft and ostracized, among others are reasons for depression in this population. The research and practice implications of these findings are outlined. [ABSTRACT FROM AUTHOR]

In slum environments, adolescents face unique challenges that can significantly impact their well-being. This study aimed to assess the personal well-being of adolescents living in Delhi- NCR (National Capital Region) slums. Cummins' homeostasis theory states that individuals have a natural tendency to maintain a certain level of well-being and that various psychological mechanisms work to maintain this well-being within a positive and stable range. The study's objectives were to evaluate the normative range of mean scores for PWI domains, examine demographic factors influencing subjective well-being, and to evaluate the psychometric properties of the Personal Well-being Index-School Children (PWI-SC) in the context of slum-dwelling adolescents. A total of 477 slum dwelling adolescents aged 10–19 years participated in the study. The findings revealed that the PWI-SC demonstrated strong internal consistency (Cronbach's α = 0.83) and was a one-factor solution, affirming its reliability and unidimensionality as a measure of subjective well-being. The results indicated that slum-dwelling adolescents reported moderate to high levels of subjective well-being across various PWI domains. Furthermore, the regression analysis demonstrated that various domains, such as standard of living, life achievement, personal relationships, personal safety, community connectedness, and future security, significantly contribute to adolescents' overall life satisfaction. However, the impact of health is unknown in this context. Moreover, Age, family income, household size, and living conditions in the slums were identified as factors influencing subjective well-being among adolescents. Despite confronting challenging circumstances, slum-dwelling adolescents exhibit remarkable well-being, suggesting the presence of homeostatically protected moods. The validated PWI-SC has emerged as a valuable tool for future research and interventions aimed at enhancing adolescent well-being in similar contexts. [ABSTRACT FROM AUTHOR]

Adults with Intellectual and Developmental Disabilities (IDD) are aging with chronic health issues. However, little is known about the racial disparities in chronic health conditions among adults with IDD. Do racial and ethnic minority adults with IDD experience elevated risk of chronic health conditions like in the general population? How do factors such as health risk behavior, health status, and residential status impact their risk of chronic health conditions? To answer these questions, the current study examines the racial differences in the prevalence of three chronic conditions: diabetes, hypertension, and asthma, using baseline data from the Longitudinal Health and Intellectual Disability Study. Our sample includes 2,173 adults with IDD. We conducted a multivariable logistic regression to examine racial disparity in prevalence controlling for factors such as demographics, IDD diagnosis, health status, and health risk behaviors. Consistent with established evidence of racial disparities in the general population, being Black was significantly associated with an elevated risk of all three chronic conditions than Whites, even after controlling for a host of demographic, health risk and environmental factors that typically influence health. Our findings contribute to the sparse literature on the intersection of race, ethnicity and disability among racial and ethnic minority adults with IDD and how it relates to health. It also provides important policy and practice implications regarding the urgency of developing culturally appropriate health promotion interventions for racial minority adults with IDD. [ABSTRACT FROM AUTHOR]

Objective: In 2020, amid limited COVID‐19 vaccination access, many nurses from Black, Asian and Minority Ethnic (BAME) groups in the United States of America and United Kingdom succumbed to the virus. No fatalities among Filipino foreign‐born nurses (FBNs) in the BAME groups were recorded in the Nordic region. This study explored the experiences of Filipino FBNs in the Nordic region who, during the initial 2020 pandemic wave, cared for COVID‐19 patients, contracted the virus and subsequently recovered. Methods: The research employed a descriptive phenomenological methodology to explore the experiences of six Filipino FBNs who had recovered from COVID‐19 in various regions of the Nordic countries, including Finland (n = 1), Sweden (n = 1), Denmark (n = 2), Norway (n = 1) and Iceland (n = 1). Data collection occurred through online videoconferencing between September 2020 and February 2021, utilising a semi‐structured approach. The data analysis was conducted following Sundler and colleagues' qualitative thematic analysis, which is grounded in descriptive phenomenology. Results: The data analysis yielded three primary themes and twelve sub‐themes, which explored the experiences of Filipino FBNs with COVID‐19 infection. The study demonstrated that unclear national guidelines impacted nurses' preparedness in caring for COVID‐19 patients, contributing to their susceptibility to contracting the virus. The lack of occupational healthcare services for nurses during and after the pandemic affected their work morale in an unfamiliar setting. Conclusion: The study provided valuable insights into the experiences of Filipino FBNs during the COVID‐19 pandemic, emphasising the need for clearer guidelines, enhanced training and improved support for healthcare workers. It highlighted the psychological impact of COVID‐19, emphasising the importance of mental health support and stigma reduction efforts. The study also emphasised the significance of improving occupational health services to support the well‐being and recovery of healthcare workers during and after the pandemic, with implications for developing comprehensive strategies to protect frontline healthcare workers in health crises. [ABSTRACT FROM AUTHOR]

Background: The field of Advanced Practice Nursing (APN) has developed over the past six decades. However, the definition of roles and responsibilities of APN nurses seem to be contested due to both a lack of a clear definition of the concept and to institutional and cultural barriers that restrict the nurses' opportunities to practise to the full extent of their competencies. Aim: The objective of this scoping review was to identify, examine and conceptually map the available literature on APN nurses' core competencies for general health assessment in primary health care. Method: We performed a scoping review, following the methodological guidance for reporting as it is described by the Joanna Briggs Institute (JBI). Furthermore, the PRISMA‐ScR statement and checklist for reporting scoping reviews were followed. Guiding the initial process for the search, we used the Population, Concept and Context mnemonic (PCC) to clarify the focus and context of the review. Results: We found three areas of core competencies on which APN nurse draw in performing general health assessments in primary health care: (1) 'Collaborative, leadership and management skills' (2) 'Person‐centred nursing care skills' and (3) 'Academic and educational skills'. Furthermore, we found that the three areas are interrelated, because it is crucial that APN nurses draw on collaborative competencies related to leadership and management to meet the service users' needs and deliver high‐quality and person‐centred care. Conclusion: There is a need for a more specific investigation into how APN nurses' core competencies play a role during general health assessments of patients in primary care. We suggest an evaluation of what works for whom in what circumstances looking into the interrelation between competencies, skills and knowledge when an APN nurse performs a general health assessment in a primary healthcare setting. [ABSTRACT FROM AUTHOR]

Psychological distress is a common response to many conditions physiotherapists treat. It is also common for a person's experience of distress to be associated with multiple stressors. This qualitative study explored physiotherapists' perceptions of the types of patient psychological distress they encountered in their clinical practice. A qualitative research approach was adopted. Twenty-three physiotherapists were recruited through purposive maximum variation sampling. To participate, physiotherapists had to self-report having encountered at least one patient they perceived to be experiencing psychological distress in the last 12 months. Data analysis was completed using Iterative Thematic Inquiry. Five themes were identified in the study: 1) distress extends beyond physical health issues; 2) fear of the future; 3) the emotional toll of loss; 4) trauma is often part of the story; and 5) losing hope. The results of this study highlight that patient psychological distress presents in a variety of forms and appears to be multifaceted and multifactorial in nature. As patients' experiences of psychological distress are relevant to physiotherapy practice, mental health capabilities need to be embedded within physiotherapy training. [ABSTRACT FROM AUTHOR]

Tooth autotransplantation (AT) involves the surgical relocation of a tooth from 1 site in the mouth to another site within the same patient. This approach is a good option in a growing patient when dental implant placements or fixed bridges are not suitable and when preserving natural teeth is a priority. Tooth AT is a complex procedure that requires specialized skills from a multidisciplinary team with careful patient and tooth selection and treatment planning. The authors provided a review of the state of knowledge and research on tooth AT and presented a case scenario and barriers to adoption, with a focus on the United States. Success rates for tooth AT can vary depending on several factors, including the patient's overall health, specific tooth involved, skill of the dental surgeon, and postoperative care provided. Long-term outcomes of autotransplanted teeth have been cited in the literature with impressive longitudinal follow-up spanning up to 26 years. Results of several systematic reviews showed survival rates from 75% through 98%. Adoption of tooth AT has grown over the years, owing to advancements in dental techniques, improved patient outcomes, and increased awareness among both dentists and patients. Increasing awareness and availability of tooth AT to replace missing teeth can provide a natural and functional alternative to traditional prosthetic options. Tooth AT helps preserve the alveolar bone in growing patients and can offer excellent esthetic and functional outcomes. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the impact of social determinants of health on physical and mental health outcomes in a UK population. Structural equation modelling was used to hypothesise a model of relationships between health determinants and outcomes within a region in the North of England using large-scale population survey data (6208 responses). We analysed responses from a population survey to assess the influence of a deprivation-based index at the environmental level, education and income on a behaviour index (smoking, alcohol consumption, physical activity, and dietary habits) and the influence of all these factors on self-reported physical health and the influence of the behaviour index and income on mental wellbeing. The proposed model was well supported by the data. Goodness-of-fit statistics, most notably a low value of the root mean square error of approximation (RMSEA), supported the validity of the proposed relationships (RMSEA = 0.054). The model revealed all examined paths to be statistically significant. Income and education were influential in determining an individual's behaviour index score, which, with income was the most important predictor of both the correlated outcomes of physical health and mental wellbeing (P < 0.001 in all cases). Findings challenge the traditional view of singular causal pathways, emphasising that interventions should consider the underlying influencing socio-economic conditions, which would influence behaviour and therefore physical and mental wellbeing. The extent to which the model is supported by the data, and the statistical significance of individual relationships accentuates the imperative for comprehensive public health strategies that integrate multiple socio-economic factors. [ABSTRACT FROM AUTHOR]

This article aims to analyse the evolution of 40 Sustainable Development Goals' (SDGs) health-related indicators in Brazil and Ecuador from 1990 to 2019. Epidemiological study of long-term trends in 40 SDGs' health-related indicators for Brazil and Ecuador from 1990 to 2019, using estimates from the Global Burden of Disease Study. Forty SDGs' health-related indicators and an index from 1990 to 2017 for Brazil and Ecuador, and their projections up to 2030 were extracted from the Institute for Health Metrics and Evaluation's Global Burden of Disease website and analysed. The percent annual change (PC) between 1990 and 2019 was calculated for both countries. Both countries have made progress on child stunting (Brazil: PC = −38%; Ecuador: PC = −43%) and child wasting prevalences (Brazil: PC = −42%; Ecuador: PC = −41%), percent of vaccine coverage (Brazil: PC = +215%; Ecuador: PC = +175%), under-5 (Brazil: PC = −75%; Ecuador: PC = −60%) and neonatal mortality rates (Brazil: PC = −69%; Ecuador: PC = −51%), health worker density per 1000 population (Brazil: PC = +153%; Ecuador: PC = +175%), reduction of neglected diseases prevalences (Brazil: PC = −40%; Ecuador: PC = −58%), tuberculosis (Brazil: PC = −27%; Ecuador: PC = −55%) and malaria incidences (Brazil: PC = −97%; Ecuador: PC = −100%), water, sanitation and hygiene mortality rates (Brazil and Ecuador: PC = −89%). However, both countries did not show sufficient improvement in maternal mortality ratio to meet SDGs targets (Brazil: PC = −37%; Ecuador: PC = −40%). Worsening of indicators were found for violence, such as non-intimate partner violence for both countries (Brazil: PC = +26%; Ecuador: PC = +18%) and suicide mortality rate for Ecuador (PC = +66%), child overweight indicator for Brazil (PC = −67%), disaster mortality rates (Brazil: PC = +100%; Ecuador: PC = +325%) and alcohol consumption (Brazil: PC = +46%; Ecuador: PC = +35%). Significant improvements are necessary in both countries requiring the strengthening of health and other policies, particularly concerning the prevention and management of violence and alcohol consumption, and preparedness for dealing with environmental disasters. [ABSTRACT FROM AUTHOR]

Informed by existing gaps in the research of elder abuse and neglect (EAN) outcomes and very limited knowledge from Central-European cultural contexts, this paper analyzes the link between domestic-based EAN and three measures of well-being, namely subjective loneliness, sense of control over one's life, and a broader outlook on life. To do this, we used recently (2022) collected EAN survey fielded among home-dwelling residents of the Czech Republic aged 65 +. The results show that there is a clear relationship between EAN and these selected outcomes. Controlling for several sets of potential modifying or confounding factors further indicates that this relationship is substantial and direct, rather than weak and indirect. Among controls, only variables related to disadvantage (health, income, dependency, history of abuse) partly account for the link between EAN and its outcomes due to their relation to both heightened risk of EAN and lower well-being. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate factors influencing one's decision to become a live kidney donor under the framework of sociotechnical systems, by expanding the focus to include larger organizational influences and technological considerations. Semi-structured interviews were conducted with live kidney donors who donated through University of Louisville Health, Trager Transplant Center, a mid-scale transplant program, in the years 2017 through 2019. The interview transcripts were analyzed for barriers and facilitators to live kidney donation within a sociotechnical system. The most salient facilitators included: having an informative, caring, and available care team; the absence of any negative external pressure toward donating; donating to a family or friend; and the ability to take extra time off work for recovery. The most recurrent barriers included: short/medium-term (<1 year) negative health impacts because of donation; the need to make minor lifestyle changes (e.g., less alcohol consumption) after donation; and mental health deterioration stemming from the donation process. The sociotechnical systems framework promotes a balanced system comprised of social, technical, and environmental subsystems. Assessing the facilitators and barriers from the sociotechnical system perspective revealed the importance of and opportunities for developing strategies to promote integration of technical subsystem, such as social media apps and interactive AI platforms, with social and environmental subsystems to enable facilitators and reduce barriers effectively. [ABSTRACT FROM AUTHOR]

Food insecurity means that a person does not have access to sufficient nutritious food for normal growth and health. Food insecurity can lead to many health problems such as obesity, heart disease, diabetes, and other long term health conditions. People living with a severe mental illness are more likely to experience food insecurity than people without mental illness. Peer‐led in‐depth interviews were conducted with adults with severe mental illness from Northern England, during which their experiences of food insecurity and strategies to tackle food insecurity were discussed. Interviews took place between March and December 2022, with interviews being transcribed and analysed using deductive and inductive thematic analysis. Thirteen interviews were conducted, finding that food insecurity in adults with severe mental illness was often a long‐standing issue. Unemployment, the cost‐of‐living crisis and fuel poverty impacted on experiences of food insecurity. Difficulties accessing food banks such as transport, stigma, and the limited selection of available food was also discussed. Strategies to tackle food insecurity centred on making food banks more accessible and improving the quality of available food. Future research should aim to eradicate food insecurity for adults with severe mental illness, as limited research and action focuses on this population group over and above 'mental illness' or 'poor mental health'. Removing barriers to accessing food such as lack of transport, and providing food which is of adequate nutritional quality, should be prioritised, as well as tackling the stigma and accessibility issues surrounding food banks use. [ABSTRACT FROM AUTHOR]

Nomophobia, often known as a 21st-century disorder, is a recent condition that has received considerable attention, with numerous studies conducted to better understand it since it was first introduced in 2008. To better understand the present research status and prospects to assist practitioners, policymakers, and funding agencies in protecting the population from nomophobia-related harm, a bibliometric study of nomophobia-related publications was conducted. We used Scopus and dimensions.ai to perform a search between 2008 and 2022. The HistCite, R software, and VOSviewer were used to analyze the data and extract relevant keywords indexed in medical databases using mesh heading phrases. Between January 2008 and April 2022, 1,781 papers, 30 datasets, two grants, six patents, four clinical trials, and five policy documents were identified. The bulk of the articles included in this review were published after 2017 with the majority written in English. Most of the research focuses on determining the prevalence of nomophobia in various populational groups, such as students, clinical samples, and the general adult population. Several studies examined the possible association between nomophobia symptoms and other psychiatric or physical health issues, such as changes in sleep, learning and attention, academic performance, coping strategies, etc. The current body of research knowledge of nomophobia in the main includes epidemiologic and diagnostic effort that has provided mixed results regarding its assessment and prevalence rates, and appreciable data on its treatment and prevention are lacking. [ABSTRACT FROM AUTHOR]

The health and well-being of older parents, especially in low and middle-income countries (LMICs) like India, depend on adult children. As such, using the 2017–18 wave 1 of the Longitudinal Aging Study in India (LASI), we examined (1) the association between adult children's education and older parents' cognitive health in India; (2) the extent to which this association is mediated by (a) parents' empowered status and (b) their active engagement; and (3) whether the associations between (1) and (2) vary for older men and women. Findings reveal that adult children's education was, indeed, positively associated with older parents' cognitive health, and this association was significantly stronger for older mothers. The educational attainment of adult daughters was found to have a relatively stronger association with the cognitive functioning of older parents, particularly their older mothers, compared to their male counterparts. We also found that parents of well-educated children were more empowered and mentally and physically engaged, both factors linked to better cognitive functioning. These findings highlight that educating even one child beyond the 'compulsory' secondary education proves consequential not just for the child but for parents in later life. Given the considerable generational disparities in educational attainment and the proportion of joint families in the country, older Indians may be particularly well-situated to reap the cognitive health dividends of educating the next generation. [ABSTRACT FROM AUTHOR]

The university's social commitment takes the form of educational activities that bring the academic and social worlds closer together. Furthermore, the university has the responsibility and commitment to identify the needs felt by society and address them. This research aimed to determine the impact of an experiential learning methodology for coping with ageist attitudes of university students. Method. The study involved 151 students and 51 older people. The design consisted of three study groups evaluated in the short term and after three years: 51 students participated in the experiential group in an experiential activity of collecting life stories from 51 older people; 50 students performed the same practice as the experimental group but simulated it among classmates. Of the 50 students in the control group, students did not perform any activity with older people. Results. Repeated measures analyses showed that group 1 significantly decreased stereotypes after participation in the experiential activity (p <.001) and after three years (p <.001). Group 2 maintains ageist attitudes both in the short and long term (p >.05). Group 3 significantly increases negative beliefs toward old age in the long term (p >.05). Post hoc analyses indicate significant benefit (p <.001) of experiential activity in group 1 vs. group 2 and control group. Conclusion. This educational approach is not only limited to the acquisition of practical knowledge about the aging process but also actively encourages conscious evaluation and reconsideration of preconceived perceptions. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is often associated with metabolic disorders. Statin drugs are potent inhibitors of cholesterol biosynthesis. Objective: The aim of this study was to evaluate the effect of atorvastatin on the concentrations of methylglyoxal (MGO), glyoxalase 1 (GLO-1), and aldo–keto reductase family 1 member B10 (AKR1B10) in patients with T2DM and prediabetes. Methods: This study was conducted on 80 subjects with and without T2DM and prediabetics divided into 5 groups: patients with T2DM receiving statins (group A, n = 17), patients with T2DM not receiving statins (group B, n = 17), patients with prediabetes receiving statins (group C, n = 12), patients with prediabetes not receiving statins (group D, n = 17), and healthy controls without T2DM (control group, n = 17). Patients with T2DM and prediabetes received atorvastatin 20 mg/day for 3 months. The measurement of MGO and AKR1B10 was performed with a non-competitive sandwich-type enzyme-linked immunosorbent assay (ELISA) at 450 nm. The measurement of GLO-1 was performed by an enzymatic method at 240 nm. Results: The serum level of MGO was significantly higher in patients with T2DM and prediabetes than that of healthy controls (p = 0.001). In patients with T2DM, statins decreased the serum level of MGO, but in patients with prediabetes, statins increased the serum level of MGO (p = 0.001). The level of GLO-1 activity was significantly higher in healthy controls than that of patients with T2DM and prediabetes (p = 0.001). Furthermore, the level of GLO-1 activity was significantly higher in patients with T2DM and prediabetes receiving statins than that of patients with T2DM and prediabetes not receiving statins (p = 0.002). The serum level of AKR1B10 was significantly higher in groups C and D than that of the other groups (p = 0.001). Conclusion: Atorvastatin can improve the level of GLO-1 activity and thereby prevent diabetic complications. [ABSTRACT FROM AUTHOR]

Individuals vary in their ability to taste, and some individuals are more sensitive to certain tastes than others. Taste sensitivity is a predictor of various factors, such as diet, eating behavior, appetite regulation, and overall health. Furthermore, taste sensitivity can fluctuate within an individual over short to long periods of time: for example, in daily (diurnal) cycles, monthly (menstrual) cycles (in females), and yearly (seasonal) cycles. Understanding these temporal patterns is important for understanding individual eating habits and food preferences, particularly in the context of personalized and precision nutrition. This review provides a summary of the literature on taste sensitivity patterns across 3 temporal dimensions: daily, monthly, and yearly. Good evidence for diurnal patterns has been observed for sweet taste and fat taste, although the evidence is limited to rodent studies for the latter. Obese populations showed limited variation to sweet and fat taste sensitivities over a day, with limited variation in sweet taste sensitivity being linked to insulin resistance. There were mixed observations of temporal variation in sensitivity to sour and umami tastes, and there were no patterns in sensitivity to bitter taste. Menstrual patterns in sweet taste sensitivity were consistent with patterns in food intake. Other taste modality investigations had mixed findings that had little agreement across studies. Hormonal changes in females influence taste sensitivity to some degree, although the overall patterns are unclear. Seasonal patterns have been less well studied, but there is weak evidence that sweet, salty, and bitter taste sensitivities change across seasons. Differences in seasonal taste patterns have been observed in subgroups susceptible to mental health disorders, requiring further investigation. Patterns of taste sensitivity are evident across multiple temporal dimensions, and more research is needed to determine the influence of these patterns on food intake. Dysregulation of these patterns may also be a marker of certain diseases or health conditions, warranting further investigation. Notably, the alimentary tastes (umami, fat, and carbohydrate) are underrepresented in this research area and require additional investigation. [ABSTRACT FROM AUTHOR]

We conducted an analysis to identify factors influencing the use of traditional complementary and alternative medicine (TCAM), with a particular emphasis on ethnic variations. Using the 2015 Asian American Quality of Life survey (N = 2,609), logistic regression analyses were performed, considering acculturation, health status, healthcare accessibility/utilization, and socio-demographic factors. Ethnicity, specifically being Chinese or Korean Americans, having chronic medical conditions, experiencing unmet healthcare needs, and having regular check-ups were significant predictors of TCAM use among Asian Americans as a whole. However, when we delved into sub-ethnic groups, different patterns were found. Among Vietnamese and Filipino Americans, having unmet healthcare needs emerged as the most prominent predictor of TCAM use. Furthermore, acculturation level and English proficiency were significant in predicting Vietnamese and Filipino Americans' TCAM use, with the direction varying by sub-ethnicity. Being old emerged as a predictor of TCAM use for Chinese, Indian, Korean, and 'other' Americans. Our findings underscore the importance of adopting an ethnically sensitive approach when addressing the healthcare needs of diverse Asian American populations. [ABSTRACT FROM AUTHOR]

The prevalence rates and correlates of mental or physical disability among recently resettled refugees, who undergo strenuous journeys before arriving in the US, remain unknown, masking potential health disparities. Self-reported disability was measured by the 2018 Annual Survey of Refugees (ASR), and defined as having a physical, mental, or other health condition for more than 6 months that precluded one from working. Prevalence rates of self-reported disability and sample correlates were investigated using descriptive and logistic regression analyses. Of N = 4259 participating refugees in ASR (Mean Age = 28.2, SD = 17.2; 52.5% male), 2875 responded to the disability question and 21.4% reported disability. About 33.7% were born in the Middle East region, 29.5% had no formal education, and 35% had an income of less than $15,000. Age (OR = 1.06, 95% Confidence Interval (CI) [1.06,1.07], p < 0.001), region of birth (OR = 1.82, 95% CI [1.31, 2.51], p < 0.001), employment status (OR = 3.31, 95% CI [2.67, 4.11], p < 0.001), and receiving food stamps (OR = 2.09, 95% CI [1.66, 2.62], p < 0.001) were associated with self-reported disability. Disability levels among refugees recently resettled in the United States are comparable to national disability rates in the US. Our results suggest that multiple aspects of the refugee experience (i.e., demographics, socioeconomic status, contextual migration history) need to be considered to understand the risk for health outcomes. Future investigations of disabilities in diverse refugee populations over time and tailored public health interventions to mitigate potential risk factors are warranted to promote health equity. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the health status and barriers of people who sought care on a free mobile health clinic for women without insurance in California. Participants were 221 women who attended the Salud para Mujeres (Women's Health) mobile medical clinic between 2019 and 2021. Medical chart abstractions provided data on sociodemographic factors, medical history, barriers to care, depressive symptoms, and dietary factors. Anthropometric measure, blood pressure, and biomarkers of cardiometabolic disease risk were also abstracted. Participants were young adult (29.1 [SD 9.3] years), Hispanic (97.6%), farm-working (62.2%) women from Mexico (87.0%). Prevalent barriers to accessing (non-mobile) medical care included high cost (74.5%), language (47.6%), hours of operation (36.2%), and transportation (31.4%). The majority (89.5%) of patients had overweight (34.0%) or obesity (55.5%), and 27% had hypertension. Among those (n = 127) receiving a lipid panel, 60.3% had higher than recommended levels of low-density lipoprotein and 89% had lower than recommended levels of high-density lipoprotein. Point-of-care HbA1c tests (n = 133) indicated that 9.0% had diabetes and 24.8% had prediabetes. Over half (53.1%) of patients reported prevalent occupational exposure to pesticides and 19% had moderate to severe depressive symptoms. Weekly or more frequent consumption of sugar sweetened beverages (70.9%) and fast food (43.5%) were also prevalent. Mobile health units have potential for reaching women who face several barriers to care and experience major risk factors for cardometabolic disease. Findings suggest a compelling need to assure that Hispanic and Indigenous women and farmworkers have access to healthcare. [ABSTRACT FROM AUTHOR]

We assess how immigrant parent legal status shapes children's physical and mental health. Using the Hispanic Community Health Study of Latino Youth—a multi-site dataset—we evaluated mean differences in multiple physical and mental health indicators and parents' and children's stress and resilience by parents' (primarily mothers') legal status (N = 1177). We estimated regression models of two overall child health outcomes—allostatic load and any internalized disorder. Average allostatic load was 28% higher (0.36 standard deviations) and average prevalence of any internalizing disorder was 16% points greater for children of foreign-born unauthorized versus US-born parents. Higher levels of socioeconomic and acculturative stress contributed to children of foreign-born unauthorized parents' heightened health risk, while resilience factors—parental health and familial support—protected their health. Children with unauthorized immigrant parents experience both negative physical and mental health outcomes that can have potential long-term costs. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify studies exploring oral and systemic conditions using Singapore data. Methods: Studies were searched using the databases PubMed, Embase and Web of Science, with no publication date or language restrictions. Studies analysing Singaporean data were included in this review. Results: Six domains were identified: pregnancy and gingivitis; tooth eruption, dental caries and early‐life factors; Crohn's disease and oral microbiome; diabetes and periodontal diseases; number of teeth, chewing ability and cognitive status; and oral health and pneumonia. Using data from Singapore, oral‐systemic studies have prompted reflections on the aetiopathogenesis of oral disorders, such as common causes connecting oral and systemic chronic conditions. Moreover, it is speculated whether oral conditions could be used as a marker to predict future systemic diseases or whether early‐life factors could affect the development of oral and systemic immune responses. Conclusions: While Singapore provides opportunities to explore challenges connected to healthy ageing, it also explores health development in many stages of life. Singapore has been prioritizing investigations on a healthier life, and new initiatives are paving the way for oral health research across the lifespan. [ABSTRACT FROM AUTHOR]

By the year 2030, 19–21 per cent of the population of New Zealand (NZ) is projected to be aged 65 and over. Like many countries, life expectancy in NZ differs by gender but also ethnicity: in 2019, life expectancy for Māori (indigenous) women was 77.1 years compared with 84.4 years for non-Māori women. If Māori and NZ European women are to flourish in later life, examining the factors associated with their wellbeing is paramount. The current study draws on the Life Course Perspective to explore how wellbeing is associated with age-related life events among mid- to later-life NZ women. The women in this study (N = 19,624) are participants in the 2018 wave of the New Zealand Attitudes and Values Study, a national probabilistic 20-year longitudinal study (mean age = 55.62; Māori = 10.8%, NZ European = 89.2%). We found that stressful life events were negatively associated with life satisfaction but positively associated with meaning in life. Māori women exhibited lower levels of life satisfaction but there were no ethnic differences for meaning in life; however, Māori and NZ European women showed different patterns of significant correlates associated with meaning in life. Findings highlight the necessity of an intersectional approach to the study of mid- to later-life wellbeing and the utility of measuring wellbeing in more than one way within NZ's unique cultural-historical context. [ABSTRACT FROM AUTHOR]

The physical and societal characteristics of home have been established as important in influencing the health and wellbeing of older adults, yet these have rarely been explored together. There is also limited research into variation across age groups, with older adults often examined as a homogenous group of those 65 years and over. This study advances the knowledge base by using the concept of person–environment (P-E) fit to analyse differences in personal and home environment (physical and societal) characteristics between young-old (65–74 years) and old-old (75 and above) age groups, and to assess how these characteristics influence their self-perceived health. This cross-sectional study draws upon survey data from 1,999 older adult participants from the Australian Housing Conditions Dataset. Descriptive statistics and inferential analysis were used to assess for significant differences between age groups and a binomial logistic regression was utilised to examine influences on health. The analysis found that the factors which influence health varies appreciably between age groups. For the young-old financial strain, being on the fixed-income pension and hypertension were important contributing factors, in contrast for the old-old gender (being male), having depression and the home being modified for disability were key influences. For both age groups heart disease was a contributing factor to perceived health. The results indicate the important contribution to knowledge of incorporating a wide range of person and environment characteristics when exploring P-E fit for older adults. The inclusion of societal aspects, such as financial strain, fixed-income pension, tenure and access to community aged care services when exploring influences on health, arises as a key conclusion of the study. In terms of impact, this research is significant given rising inequalities globally and specifically in the Australian context, the need for policy measures to address income inequality, and its health and social implications for older households. [ABSTRACT FROM AUTHOR]

Aim: Emerging evidence points to a two‐way relationship between periodontitis and dietary choices and, thus, nutrition. This study aimed to assess the potential cause–effect relationship between the periodontitis stage, loss of functional tooth units (FTUs), masticatory function, and intake of different food groups using path analysis. Materials and Methods: A single calibrated examiner determined the periodontitis stage of a consecutive sample of 241 Chinese subjects reporting for tooth replacement. Their masticatory function was quantified by the mixing ability of a two‐colour chewing gum. Validated food frequency questionnaires were used to calculate the intake of 33 food group items by an experienced calibrated rater. After verification of assumptions, visual structural equation modeling was performed with Amos 23. The consistency of results and the potential modifying effect of age were assessed in 9043 subjects from the NHANES database. Results: Highly significant models were constructed using periodontitis stage and age as exogenous factors. Periodontitis stage diagnosis significantly affected the number of posterior FTUs and oral health‐related quality of life (OHRQoL, path coefficient [PC] = –0.55 and −0.20, p <.05, respectively). In the model, FTUs also had an independent effect on OHRQoL (PC = 0.23, p <.05). FTUs determined the level of masticatory function (PC = –0.38, p <.05), which in turn affected vegetable intake but not fruit or meat intake (PC = –0.18, p <.0.5, PC = 0.06, NS and PC = 0.11, NS, respectively). The effect of age was significant for vegetable and meat intake and was also correlated with periodontitis stage diagnosis. Analysis of the NHANES database confirmed the negative impact of periodontitis on the number of occluding pairs and vegetable consumption for the 18–44, 45–60 and >60 age groups. Conclusions: Periodontitis showed a potential cause–effect pathway affecting vegetable intake across cultures and age groups. The size of the effect is potentially of clinical and public health significance. Additional studies, including intervention trials, are required to test this potential mechanism linking oral health to nutrition. [ABSTRACT FROM AUTHOR]

During COVID‐19 many informal caregivers experienced increased caregiving load while access to formal and informal support systems and coping resources decreased. Little is known about the psychosocial costs of these challenges for an essential yet vulnerable and "hidden" frontline workforce. This study explores and compares changes in psychosocial well‐being (psychological well‐being, psychological ill‐being, and loneliness) before and across up to three stages of the COVID‐19 pandemic among caregivers and non‐caregivers. We also examine predictors of psychosocial well‐being among caregivers during the peak of the pandemic. We use longitudinal data collected online in the Norwegian Counties Public Health Survey (age: 18–92) in four counties and up to four data points (n = 14,881). Caregivers are those who provide care unpaid, continuous (≥ monthly across all time points) help to someone with health problems. Findings show that levels of psychosocial well‐being first remained stable but later, during the peak stages of the pandemic, dropped markedly. Caregivers (13–15% of the samples) report lower psychosocial well‐being than non‐caregivers both before and during the pandemic. Caregivers seem especially vulnerable in terms of ill‐being, and during the peak of the pandemic caregivers report higher net levels of worry (OR = 1.22, p < 0.01) and anxiety (OR = 1.23, p < 0.01) than non‐caregivers. As expected, impacts are graver for caregivers who provide more intensive care and those reporting health problems or poor access to social support. Our study findings are valuable information for interventions to support caregivers during this and future pandemics. [ABSTRACT FROM AUTHOR]

Abnormalities in emotion recognition (ER) are frequently reported in depression, with lower recognition accuracy in patients with major depressive disorder (MDD) when compared to healthy individuals. Mindfulness was found to directly impact the severity of depressive symptoms, by recognizing negative cognitions and dysfunctional reactions. The aims of this study were to compare ER and mindfulness levels between MDD patients and healthy controls (HCs), as well as to examine whether ER and mindfulness are related to symptom severity in MDD patients. Sixty‐eight patients with MDD and 93 HCs participated in the study. A sociodemographic form, reading the mind in the eyes test (RMET), five facet mindfulness questionnaire‐short form (FFMQ‐S) and the Montgomery–Asberg depression scale (MADRS) were administered. Group comparison in ER and mindfulness was performed using the multivariate analysis of covariance (MANCOVA). Bivariate correlations and hierarchical linear regression analyses were performed to assess the associations between depression severity, ER and mindfulness in the patient group. Higher level of mindfulness was found in HCs relative to MDD group, however, no ER difference was present between the groups. A positive association between depression severity and the non‐reactivity facet of mindfulness was found. On the other hand, ER was not significantly associated with symptom severity among individuals with MDD. Non‐reactivity, unlike other dimensions of mindfulness, seems to increase with the severity of depressive symptoms among MDD patients. A particular focus on this subdimension in mindfulness techniques may yield better outcomes in alleviation of depressive symptoms. [ABSTRACT FROM AUTHOR]

Humanitarian organizations in Bangladesh introduced emergency services to protect Rohingya refugees from COVID-19. This article aims to explore the roles front-line leaders from those organizations played in reducing the spread of the infection and protecting the refugees. By using in-depth interviews with 42 first-line managers (FLMs), it explores the innovative actions and strategies adopted by these managers to implement COVID-19-related programs and services. Initiatives such as training and engaging Rohingya volunteers and developing services promptly in order to raise awareness and manage testing, treatment, and psychosocial interventions contributed significantly to pandemic management in Rohingya refugee camps. Humanitarian groups must realize the crucial role first-line managers (FLMs) play in managing their staff while providing high-quality services in times of crisis. FLMs must be both leaders and managers in order to deal with a pandemic, in which uncertainty and a lack of knowledge create a complicated and demanding environment. Both functions are critical to providing quality services when resources are limited and only a few workers are available. The FLMs focused on mass-level awareness programs with active community engagement and participation, counseling for behavioral change, the provision of information in order to address socio-cultural barriers to community engagement, better utilization of agency services and resources, and pandemic management so as to reduce the spread and the rate of infection of COVID-19 among Rohingya refugees. Senior and middle management commitment was required to help FLMs manage a pandemic, even in the face of uncertainty, unpredictability, ambiguity, and a lack of information about the virus and its cure. They must serve as role models. FLMs should be empowered to fulfill their leadership roles through the better use of community strengths and resources during pandemics or other crises by strengthening local leadership skills, community capabilities, and an overall sense of communal responsibility. [ABSTRACT FROM AUTHOR]

Aims: To explore the feasibility and potential benefits of a peer support programme for adults with insulin‐treated type 2 diabetes (T2D) starting continuous glucose monitoring (CGM). Methods: This part of the Steno2tech study is an exploratory, single‐centre, open‐labelled, prospective, randomised controlled trial (RCT). A total of 60 participants were randomised 2:1 to 12 months of CGM with or without peer support. All participants received a 3‐h diabetes self‐management education course including a CGM part on how to use the CGM and interpret the CGM‐derived data. Peer support consisted of three 3‐h peer support meetings over the first 6 months of the study period with groups of three to six people. The exploratory outcomes included the acceptability and feasibility of the peer support intervention, and the between‐group difference in change in several glycaemic, metabolic and participant‐reported outcomes measured at baseline, 6 and 12 months. Results: The peer support intervention was found acceptable and feasible. Participants shared their experiences of using and interpreting CGM data and its association with health behaviour. While both groups had improvements in glycaemic, metabolic and participant‐reported outcomes, there were no significant between‐group differences. Conclusions: Although feasible, we found no measured additional benefits when adding a peer support programme after starting CGM in this exploratory RCT including adults with insulin‐treated T2D. Understanding the perceived effect of and preferences for a peer support intervention from the participants' points of view, including why individuals declined to participate, would be of value for future research. [ABSTRACT FROM AUTHOR]

Background: Pregnancy provides a privileged and opportune moment to implement interventions promoting healthy lifestyle behaviors and significantly improving perinatal outcomes. The Healthy Lifestyle Behaviors Scale (HLBES) can be used to assess health promoting behaviors, such as diet, physical activity, and mental health. Purpose: This study aimed to examine the psychometric properties of the HLBES in Portuguese pregnant women. Methods: A methodological study was conducted on a convenience sample of 192 pregnant women receiving prenatal care. After cross-cultural adaptation, an exploratory factor analysis and internal consistency assessment were carried out to evaluate the psychometric properties of the scale. Data collected included the Healthy Lifestyle Beliefs Scale to assess the HLBES' criterion validity. Results: Exploratory factor analysis with Varimax rotation yielded 2 subscales that explained 45.23% of the total variance. The scale revealed an overall internal consistency of 0.78 and a good criterion validity with the Healthy Lifestyle Beliefs Scale (r = 0.65, P <.01). Conclusion: Our results suggest that the HLBES is an instrument for reporting healthy lifestyle behaviors in Portuguese pregnant women; however, further studies are recommended. This scale can be used to not only describe healthy lifestyle behaviors in pregnant women but also to determine the effects of health promoting interventions. [ABSTRACT FROM AUTHOR]

In countries where population census data are limited, generating accurate subnational estimates of health and demographic indicators is challenging. Existing model‐based geostatistical methods leverage covariate information and spatial smoothing to reduce the variability of estimates but often ignore the survey design, while traditional small area estimation approaches may not incorporate both unit‐level covariate information and spatial smoothing in a design consistent way. We propose a smoothed model‐assisted estimator that accounts for survey design and leverages both unit‐level covariates and spatial smoothing. Under certain regularity assumptions, this estimator is both design consistent and model consistent. We compare it with existing design‐based and model‐based estimators using real and simulated data. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an autoimmune condition managed by strict adherence to a gluten-free diet. Dietary choice has gendered connotations, and men with CD may face judgment from others when following a gluten-free diet. However, little is known about health-related stigma in men with CD. The study aim was to explore the health-related stigma and challenges faced by men with CD, and the influence of CD on their lives. Qualitative semistructured online interviews were conducted with men living with CD. Twenty adults (aged 18 years or older) identifying as men living in the United Kingdom, with self-reported CD, were recruited using social media and opportunistic sampling. Participants provided rich, detailed discussions about aspects of their experience of living with CD. Reflexive thematic analysis was used, with a critical-realist lens that enabled researchers to connect men's experiences within wider sociocultural constructs such as masculinity and social identity. Three themes were identified: CD threatens social inclusion; others' assumptions about CD and microaggressions have a psychological influence, and masculine norms, health-related stigma, and power dynamics influence men's health behaviors and everyday experience. Health-related stigma was found to be interconnected with these men's gendered social environment, suggesting that may be an important social and structural determinant of dietary, health-related, and health support-seeking behaviors in men diagnosed with CD. Contrary to prior assumptions, health-related stigma influences men with CD of all ages, particularly in social settings. The study unveils the complex interplay of individual beliefs, social norms, and power dynamics, in particular with other men, that influence individual beliefs and emphasize the performative aspect of food consumption. Internalized stigma and microaggressions influence men's well-being. To better support men with CD, health providers, charitable organizations, and the food industry should address the social influence of adherence to a gluten-free diet, in particular perceived threats to social status and inclusion, which may cause concern, influence food choice, and influence dietary adherence. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the accuracy of an intraoral scanner with near‐infrared imaging (NIRI) feature in the diagnosis of interproximal caries and to compare it with the visual‐tactile method (VTM), bitewing radiography (BWR), and panoramic radiography (PR). Materials and Methods: Six hundred thirty‐nine interproximal surfaces (mesial‐distal) of posterior teeth from 22 volunteers were examined. Results were scored by VTM, BWR, PR, and NIRI. Lesions were scored as 0 for no‐caries, 1 for early‐enamel lesion (EEL), and 2 for lesions involving dentino–enamel junction (DEJ). McNemar, Kappa, and Fleis Kappa tests were used to evaluate the agreement levels. Pearson's Chi‐square test was used to determine the matching rates after validation. Results: A good level of agreement was observed between examination methods (Ƙ = 0.613; p < 0.001). In pairwise comparisons, a moderate agreement was seen between all the methods for lesions with DEJ involvement, while a statistically good agreement was observed between BWR and NIRI (Ƙ = 0.675; p < 0.001). As a result of validation, the accuracy of NIRI for molars was considered 85.2% and 75.7% for premolars in EELs, 85.2% for molars, and 70% for premolars regarding the lesions involving DEJ. Conclusions: Intraoral scanners with the NIRI feature may be used for diagnosing interproximal caries, especially for permanent molars. Clinical Significance: Early detection of proximal caries is one of the most essential topics forming the basis of preventive dentistry. This study investigates a caries diagnostic tool integrated into intraoral scanners to diagnose interproximal caries. A caries diagnostic tool integrated into an intraoral scanner may prevent the harmful effects of ionizing radiation in early caries diagnosis and may improve the patient's oral health status. [ABSTRACT FROM AUTHOR]

The research we fund today will improve the health of people who will live tomorrow. But future people will not all benefit equally: decisions we make about what research to prioritize will predictably affect when and how much different people benefit from research. Organizations that fund health research should thus fairly account for the health needs of future populations when setting priorities. To this end, some research funders aim to allocate research resources in accordance with disease burden, prioritizing illnesses that cause more morbidity and mortality. In this article, I defend research funders' practice of aligning research funding with disease burden but argue that funders should aim to align research funding with future—rather than present—disease burden. I suggest that research funders should allocate research funding in proportion to aggregated estimates of disease burden over the period when research could plausibly start to yield benefits until indefinitely into the future. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic in the United Kingdom, many health services were withdrawn from people with learning disabilities, with negative impacts on people's health. What has happened to people's health and healthcare as we move beyond the pandemic? Methods: Access to health services and health status were tracked for 550 UK adults with learning disabilities, using structured online interviews with people with learning disabilities and online surveys with family members or paid carers. Information was provided four times, from Wave 1 (in the winter 2020/2021 'lockdown') to Wave 4 (autumn 2022, over a year after public health protections stopped). Findings: By Wave 4, most people with learning disabilities had had COVID‐19, although high vaccination rates limited the number of people hospitalised. There was little evidence that use of GP services, community nurses, other therapists or annual health checks had increased over time, and at Wave 4 more people were having difficulty getting their medicines. People's health did not substantially improve over time. People with profound and multiple learning disabilities had poorer health and were less likely to be accessing health services. Conclusions: Improvements in access to health services for people with learning disabilities after the pandemic have not yet happened. Accessible Summaries: Many health services stopped for people with learning disabilities in the COVID‐19 pandemic, with a bad impact on people's health. What has happened to people's health and how they use health services through the COVID‐19 pandemic and beyond?People and families told us about the health of over 500 people with learning disabilities living in the United Kingdom four times, from the national lockdown in winter 2020/2021 through to autumn 2022.A lot of people were still not getting the health services they needed after the end of the pandemic, and people's health was not getting better.People with profound and multiple learning disabilities had worse health but were not in contact with health services as much as other people with learning disabilities. [ABSTRACT FROM AUTHOR]

The article sketches how the interaction between partisanship and polarization shapes health policy in the U.S. Topics discussed include partisan struggles over health care laws such as the Affordable Care Act, American Rescue Plan Act and Inflation Reduction Act, influence of partisan conflict on a law's implementation and post-enactment political trajectory, expansion of conflict across institutions and issues, effect of partisanship on health behaviors, outcomes, and state health policies.

The article thoroughly examines the dynamics of coronary circulation, shedding light on its functionality in healthy individuals and those with various health conditions. It delves into the effects of anaesthesia, the intricacies of cardiac surgical procedures, and the complexities surrounding coronary vessels, offering valuable insights into these critical aspects of cardiovascular health.

The purpose of this study was to explore the usage patterns of USA subscribers of an online religious/spiritual application (i.e., app; Pray.com) and the associations of app usage with physical health, mental health, spiritual health, and well-being outcomes. A total of 1031 subscribers participated in the survey about their engagement with the Pray.com app. Most of the respondents had been using the app between one and two years, and more than half were high-frequency users. Although many individuals engaged with the app experienced spiritual growth, many also reported retrospective improvement in mental and physical health. This research serves as an initial examination of how religious-based apps may be associated with self-reported improvements in physical, mental, and spiritual health outcomes. [ABSTRACT FROM AUTHOR]

Objective: As the participation of dental professionals in multidisciplinary care is often limited, instructions on oral health management provided by dental professionals to other professionals are important to achieve transdisciplinary oral health management; however, the effectiveness of such instructions remains unclear. In this longitudinal study, we aimed to determine the impact of oral health management provided by dental professionals and nurses instructed on oral health management by dental professionals on the oral health of inpatients eligible for a Nurition Support Team (NST). Methods: The study participants were 117 patients (66 men and 51 women, mean age: 71.9 ± 12.5 years) who received oral health management during the NST intervention period. The participants received oral health management from nurses (Ns group) or dental professionals (D group). The nurses who conducted the oral health management received instructions from dental professionals. Oral health was assessed at the beginning and end of the NST intervention using the Oral Health Assessment Tool (OHAT). Result: The Ns and D groups showed significant improvements in the total OHAT scores at the end of the NST intervention. Both groups showed significant improvements in the OHAT subitems of lip, tongue, gums and tissues, saliva, oral cleanliness and dental pain, while only the D group showed a significant improvement in the denture subitem. Conclusion: Effective oral health management provided by dental professionals or by nurses trained by them improved the oral health status of inpatients eligible for NST at an acute‐care hospital. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between rheumatoid arthritis (RA) and oral hypofunction (OHF) using propensity score matching (PSM) to adjust for differences between older adults with RA and the general older adult population. Methods: We conducted a cross‐sectional survey among 189 older adults with RA in 2019 (mean age, 71.9 ± 3.6) and 47 178 independent older adult residents in 2016 (mean age, 71.6 ± 4.0), respectively. The questionnaire covered information on socio‐demographic characteristics and OHF for both groups. Age, sex, educational level and smoking history were used to determine PSM. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of self‐reported OHF (fewer remaining teeth, decreased masticatory function, deterioration of swallowing function and oral dryness) were estimated using Poisson regressions. Result: OHF was observed in 44.4% of patients with RA and 27.5% of residents. Before PSM, the prevalence of OHF among patients with RA was higher than that of residents (PR, 1.75; 95% CI, 1.50–2.05). After PSM, there were 189 patients with RA and residents, and the prevalence of OHF among patients with RA was still higher (PR, 1.61; 95% CI, 1.22–2.13). Poisson regression showed that the prevalence of 19 or fewer teeth (PR, 1.06; 95% CI, 0.82–1.36), difficulties eating tough foods (PR, 1.18; 95% CI, 0.90–1.55), difficulties swallowing tea or soup (PR, 1.77; 95% CI, 1.19–2.63), and dry mouth (PR, 2.79; 95% CI, 1.90–4.07) was higher among patients with RA than residents. Conclusion: Compared with the general older adult population, patients with RA have a higher prevalence of self‐reported OHF. [ABSTRACT FROM AUTHOR]