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The COVID-19 pandemic has led to an increase in the digitalisation of services that poses the risk of digital exclusion, especially among older adults. We examined the predictors of Internet use for services and its increase or decrease among a longitudinal population-based sample of 1426 older adults from Finland aged between 70 and 100 years, gathered in 2017 and 2020. High education and high income positively predicted the use of the Internet for services, and age, deteriorated health and deteriorated memory negatively. High age, low education and a change to living alone predicted a decrease in use. High education predicted the increased Internet use due to COVID-19. Thus, it seems that those older adults who have low education level are very old, whose health or memory has deteriorated and those who have changed to living alone are particularly in danger of digital exclusion. Actions targeted to these people are needed. [ABSTRACT FROM AUTHOR]

Age-related changes shape social connectedness, isolation and loneliness among older adults. Ageing often accompanies decisions about ageing in place or moving (i.e. senior living facility). Scant research compares these two living arrangements and even sparser research focuses on older women. This study, thus, poses the following questions: How do older women (aged 75+ years) experience social connectedness and perceived isolation? How does this experience vary between older women living alone in private homes and those living in assisted living facilities? Data include semi-structured interviews with women aged 75+ years who live alone in a private home or in an assisted living facility (N = 16). Findings revealed differences in three aspects of social connectedness: interactions, relationships and belonging. Private home participants' interactions underscored intentionality, with minimal investment in forging new or deeper relationships and an emphasis on belonging to the world through awareness, contribution and cognitive ability. The experiences of participants living in assisted living were characterised by availability of interactions and casual relationships. They emphasised belonging to the facility community, while positioning themselves between the status of resident and staff. Surprisingly, most participants in both groups did not express feelings of perceived isolation. Both had adapted their social connectedness expectations to reflect their current situation. [ABSTRACT FROM AUTHOR]

Road trauma (RT) survivors have reduced health-related quality of life (HRQoL). We identified phases and predictors of HRQoL change following RT injury. In a prospective cohort study of 1480 Canadian RT survivors aged 16 to 103 years (July 2018 – March 2020), physical component (PCS) and mental component (MCS) summary scores from the SF-12v2 were measured pre-injury and 2, 4, 6, and 12 months post-injury and their trajectories were analyzed with piecewise latent growth curve modeling. Potential predictors of HRQoL changes included sociodemographic, psychological, medical, and trauma-related factors. PCS and MCS scores worsened from pre-injury to 2-months (phase 1) and then improved (phase 2), but never regained baseline values. Older age, somatic symptoms and pain catastrophizing were associated with lower preinjury PCS and MCS scores. Psychological distress was associated with lower preinjury MCS scores and higher preinjury PCS scores. Phase 1 PCS scores decreased most in females, participants with fewer pre-injury somatic symptoms and those without expectations for fast recovery. Phase 1 MCS decreases were associated with younger age, female sex, living alone, lower psychological distress, lack of expectation for fast recovery and higher injury pain. In phase 2, MCS improved most in participants not using recreational drugs; PCS improved most in participants with higher education and longer recovery expectations. There may be recall bias with reporting pre-injury HRQoL. Selection bias is possible. Many factors influence HRQoL following RT. These findings may inform measures to minimize HRQoL reduction following RT and speed up subsequent recovery. • We studied changes in health-related quality of life (HRQoL) following road trauma. • After an initial decrease, HRQoL improved but never regained pre-injury values. • HRQoL trajectories are influenced by demographic, psychological and injury factors. • Mental health decreased more in females, younger people and those living alone. • Mental health decreased more in people with less pre-injury psychological distress. [ABSTRACT FROM AUTHOR]

This study addresses the satisfaction of housing-related needs in single-person households across European countries. The primary objective is to assess the housing satisfaction of single-person households in European countries, specifically within the Visegrad Group. The study seeks to identify trends in housing conditions, create a ranking of countries based on these conditions, and categorize countries with similar levels of unmet housing needs. The study employs statistical measures and methods to achieve its objectives. Time series are constructed for European countries, and linear trends are analyzed to identify statistically significant changes in selected housing aspects from 2005 to 2022. Various research tasks, including ranking countries and grouping them based on housing conditions, are accomplished using established methods like linear ranking and Ward's cluster analysis. Key findings include significant variations in financial burdens related to housing costs, thermal comfort, environmental pollution, and safety issues across European countries. The study reveals both improvements and challenges in housing conditions from 2005 to 2022 in one-person households. For instance, financial stress due to housing costs decreased in some countries, while thermal comfort issues improved in several nations. The results also highlight the heterogeneity within the Visegrad Group. The study concludes that there is a need for targeted actions to address housing-related issues in single-person households. The findings underscore the importance of investments in building energy efficiency, initiatives for affordable housing construction, and environmental policies. The research emphasizes the impact of housing conditions on health, well-being, and overall community life, urging policymakers to consider these factors for holistic improvement in the housing sector. [ABSTRACT FROM AUTHOR]

Background: The healthcare needs of People living with Dementia (PlwD) (such as Alzheimer's disease) are often unmet. Information about the needs of community-dwelling PlwD and their association with sociodemographic and clinical characteristics is needed to fill the knowledge gap regarding factors influencing unmet needs among PlwD and to conduct a comprehensive needs assessment to develop tailored interventions. Objective: To describe sociodemographic and clinical characteristics of the InDePendent study population with particular reference to determinants of unmet needs. Methods: We analyzed baseline data of the multi-centre cluster-randomized controlled trial (InDePendent) using descriptive statistics to describe patients' sociodemographic and clinical characteristics and Poisson regression models to predict unmet needs, separated by sex. Data were collected personally via face-to-face interviews. Results: Most of the n = 417 participating PlwD were mild to moderately cognitively impaired, were not depressed, had an average of 10.8 diagnoses, took 6.7 medications, and had, on average, 2.4 unmet needs (62% of PlwD had at least one unmet need) measured by the Camberwell Assessment of Need for the Elderly (CANE). Low social support, a high body-mass-index, a lower education, functional impairment, and worse health status were associated with more unmet needs, regardless of sex. In women, higher unmet needs were associated with more depressive symptoms, a poor financial situation, living alone and not being recently treated by a general practitioner. In males, unmet needs increased with the number of medications taken. Conclusions: PlwD had a broad array of unmet healthcare needs, indicating primary healthcare provision improvement potentials. The results underscore the significance of early assessment of patient's clinical characteristics and unmet needs as a basis for individualized gender-sensible intervention strategies.∥ClinicalTrials.gov Identifier: NCT04741932, Registered on February 5, 2021 [ABSTRACT FROM AUTHOR]

Background: Studies have revealed the effects of childhood adversity, anxiety, and negative coping on sleep quality in older adults, but few studies have focused on the association between childhood adversity and sleep quality in rural older adults and the potential mechanisms of this influence. In this study, we aim to evaluate sleep quality in rural older adults, analyze the impact of adverse early experiences on their sleep quality, and explore whether anxiety and negative coping mediate this relationship. Methods: Data were derived from a large cross-sectional study conducted in Deyang City, China, which recruited 6,318 people aged 65 years and older. After excluding non-agricultural household registration and lack of key information, a total of 3,873 rural older adults were included in the analysis. Structural equation modelling (SEM) was used to analyze the relationship between childhood adversity and sleep quality, and the mediating role of anxiety and negative coping. Results: Approximately 48.15% of rural older adults had poor sleep quality, and older adults who were women, less educated, widowed, or living alone or had chronic illnesses had poorer sleep quality. Through structural equation model fitting, the total effect value of childhood adversity on sleep quality was 0.208 (95% CI: 0.146, 0.270), with a direct effect value of 0.066 (95% CI: 0.006, 0.130), accounting for 31.73% of the total effect; the total indirect effect value was 0.142 (95% CI: 0.119, 0.170), accounting for 68.27% of the total effect. The mediating effects of childhood adversity on sleep quality through anxiety and negative coping were significant, with effect values of 0.096 (95% CI: 0.078, 0.119) and 0.024 (95% CI: 0.014, 0.037), respectively. The chain mediating effect of anxiety and negative coping between childhood adversity and sleep quality was also significant, with an effect value of 0.022 (95% CI: 0.017, 0.028). Conclusions: Anxiety and negative coping were important mediating factors for rural older adult's childhood adversity and sleep quality. This suggests that managing anxiety and negative coping in older adults may mitigate the negative effects of childhood adversity on sleep quality. [ABSTRACT FROM AUTHOR]

Introduction: Residency training may lead to the development of depressive conditions with possible academic and professional consequences. We determined the levels of depression in resident medical doctors (RMDs) and assess the factors influencing depression. Methods: This prospective cross-sectional questionnaire study was conducted on RMDs working in tertiary research hospital in İstanbul. Participation in the study was voluntary. A questionnaire was distributed to the RMDs participating in the study, and the Beck Depression Inventory-II (BDI-II) was used to measure depression levels. This study was presented as a paper at the 5th Eurasian Congress on Emergency Medicine and 12th Turkish Emergency Medicine Congress, November 10-13, 2016 (Antalya, Turkey). Results: A total of 161 RMDs were included in the study (participation rate: 68.8%). Of the RMDs, 65 (40.4%) had depressive symptoms (BDI-II >13). An exploratory analysis of possible risk factors showed that working night shifts, length of residency, and department in which the resident worked were factors for the development of depressive symptoms. There was no association between BDI-II scores and age, gender, marital status, number of children, living alone, recent loss of a loved one, presence of chronic illness, diagnosis of depression, or use of antidepressant medication. Conclusion: There is a high prevalence of depressive symptoms among RMDs, especially night workers, who have less experience in their residency. Active assessment of these RMDs to evaluate their depressive symptoms is important. Preventive measures and educational programmes to improve working conditions need to be reviewed. [ABSTRACT FROM AUTHOR]

Background Older adults are prone to live alone and feel lonely. The main objective of this study was to assess the associations of loneliness and living alone with cardiovascular disease (CVD) among community-dwelling older individuals in China. Methods We conducted a longitudinal analysis on 3 661 participants aged older than 65 years from the latest 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazards models were used to assess the associations of loneliness and living alone with CVD risk, with adjustment for confounding factors. Results A total of 616 incident CVD cases were identified during follow-up. Participants who reported feeling lonely experienced a 28% increased risk of developing CVD after adjustment for sociodemographic characteristics, lifestyle factors, and baseline health status (adjusted hazard ratio [HR]: 1.28, 95% confidence interval [CI]: 1.01–1.62; p trend = .046). In contrast, no significant association was observed between living alone and CVD risk. Subgroup analyses showed that among those individuals who lived alone, often feeling lonely doubled the risk of CVD compared to never being lonely (HR: 2.17, 95% CI: 1.20–3.93; p trend = .007). Conclusions Loneliness was an independent risk factor for CVD among Chinese older adults. Our findings underscore the importance of addressing loneliness in the prevention of CVD among older individuals, especially those who live alone. [ABSTRACT FROM AUTHOR]

• This was a large population-based study of working-aged Northern Finns. • Multisite pain was clearly the factor most strongly associated with sciatica. • The effect sizes of the remaining factors were clearly smaller. Sciatica is defined as pain radiating from the low back to the leg, usually below the knee. It is a disabling condition that causes a major burden to health care and society. Previous evidence of the multifactorial etiology of sciatica comes mostly from cross-sectional studies. Larger, longitudinal studies with a multidimensional set of variables are needed. To examine how socioeconomic and lifestyle characteristics, psychological symptoms, multimorbidity, and multisite pain are associated with sciatica. A longitudinal study of the Northern Finland Birth Cohort 1966. In total 6,683 working-aged members of the Northern Finland Birth Cohort 1966. Self-reported sciatic pain status over a 15-year study period. We conducted a 15-year longitudinal study from the age of 31 to 46. We used multivariable generalized estimation equations analysis to examine how socioeconomic characteristics (low education, unemployment, and living alone), lifestyle characteristics (overweight, obesity, current smoking, and physical inactivity), psychological symptoms (depression, anxiety), multimorbidity, and multisite pain were associated with sciatica. At the age of 31, 21.1% of the study population reported sciatic pain and at the age of 46, 36.7%. Multisite pain was clearly the strongest factor associated with sciatica (odds ratio [OR] 2.61, 95% confidence interval [CI] 2.34‒2.92). In descending order of effect size, older age, low education, psychological symptoms, multimorbidity, overweight, obesity, physical inactivity and current smoking were positively associated with sciatica. Their ORs varied between 1.17 and 2.18. Living alone was negatively associated with sciatica (OR 0.81, 95% CI 0.72‒0.90). Multisite pain had the strongest association with sciatica. The effect sizes of the other factors were clearly smaller. To our knowledge this is the first study to evaluate the association of multisite pain with sciatica. This finding may have considerable implications for clinical work treating patients with sciatica. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to confirm the clinical impact of living arrangements on incidence of frequent alcohol consumption in university students. Design: A retrospective cohort study. Setting: A national university in Japan. Subjects: 17,774 university students. Measures: The association between living arrangements on admission and the incidence of frequent alcohol consumption (≥4 days/week) was assessed using multivariable-adjusted Cox proportional-hazards models. Results: Among 5,685, 692, and 5,151 male students living with family, living in the dormitory, and living alone, 5.0%, 6.2%, and 5.8% reported frequent alcohol consumption during the median observational period of 3.0 years, respectively. Living in the dormitory and living alone were identified as significant predictors of frequent alcohol consumption (multivariable-adjusted hazard ratios: 1.00 [reference], 1.39 [1.01-1.92], and 1.21 [1.03-1.42], respectively). On the contrary, living arrangements were not associated with the incidence of frequent alcohol consumption among of 6,091 female students, partly because of low incidence of frequent alcohol consumption (2.3%, 1.4%, and 2.6%, respectively). Conclusions: Living arrangements predicted frequent alcohol consumption among male university students, whereas not among female university students. [ABSTRACT FROM AUTHOR]

Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them. [ABSTRACT FROM AUTHOR]

Introduction: Major Depressive Disorder (MDD) is one of the commonest mental disorders affecting more than 250 million people globally. Patients with chronic illnesses had higher risks for developing MDD than the general population. Neurolathyrism is a chronic illness characterized by lifelong incurable spastic paralysis of lower extremities; causing permanent disability. It is highly prevalent in Dawunt district, Ethiopia; with a point prevalence of 2.4%. Despite this, there were no previous studies assessing the prevalence of MDD among patients with neurolathyrism in Ethiopia. Objective: To assess the prevalence of MDD and to identify its associated factors among patients with neurolathyrism in Dawunt district, Ethiopia. Methods: A community based cross-sectional study was conducted on 260 samples in Dawunt district from February 01 to March 30/ 2021. Multistage sampling technique was used to select study participants. The patient Health Questionnaire-9 (PHQ-9) depression screening tool was used to diagnose MDD. PHQ-9 is a standardized depression screening tool and a PHQ-9 score of ≥ 10 has a sensitivity and specificity of 88.0% [95% CI (83.0–92.0%)] and 85.0% [95% CI (82.0–88.0%)] for screening MDD. Data were collected by interview; entered to EpiData version 4.2.0; exported to SPSS version 25.0 for analysis; descriptive statistics and binary logistic regression model were used; AOR with 95% CI was used to interpret the associations; and finally results were presented by texts, charts, graphs, and tables. Results: A total of 256 adult patients with neurolathyrism were participated; and the prevalence of MDD was found to be 38.7%. Being female [AOR = 3.00; 95% CI (1.15, 7.84)], living alone [AOR = 2.77; 95% CI (1.02–7.53)], being on neurolathyrism stage-3 [AOR = 3.22; 95% CI (1.09, 9.54)] or stage-4 [AOR = 4.00; 95% CI (1.28, 12.48)], stigma [AOR = 2.69; 95% CI (1.34, 5.39)], and lack of social/ family support [AOR = 3.61; 95% CI (1.80, 7.24)] were found to have statistically significant association with an increased odds of MDD; while regular exercise and ever formal counselling were found to have statistically significant association with a decreased odds of MDD. Conclusion: The prevalence of MDD among neurolathyrism patients in Dawunt district was high. Lack of social support, stigma, not getting formal counselling, and not involving in regular exercise were modifiable risk factors. Therefore, social support, reducing stigma, formal counselling, and encouraging regular exercise might help to reduce the burden of MDD among neurolathyrism patients. [ABSTRACT FROM AUTHOR]

Prior studies on Prolonged Grief Disorder (PGD) primarily employed classical approaches to link bereaved individuals' characteristics with PGD symptom levels. This study utilized machine learning to identify key factors influencing PGD symptoms during the COVID-19 pandemic. We analyzed data from 479 participants through an online survey, employing classical data exploration, predictive machine learning, and SHapley Additive exPlanations (SHAP) to determine key factors influencing PGD symptoms measured with the Traumatic Grief Inventory - Self Report (TGI-SR) from 19 variables, comparing five predictive models. The classical approach identified eight variables associated with a possible PGD (TGI-SR score ≥ 59): unexpected causes of death, living alone, seeking professional support, taking anxiety and/or depression medications, using more grief services (telephone or online supports) and more confrontation-oriented coping strategies, and higher levels of depression and anxiety. Using machine learning techniques, the CatBoost algorithm provided the best predictive model of the TGI-SR score (r2 = 0.6479). The three variables influencing the most the level of PGD symptoms were anxiety, and levels of avoidance and confrontation coping strategies used. This pioneering approach within the field of grief research enabled us to leverage the extensive dataset collected during the pandemic, facilitating a deeper comprehension of the predominant factors influencing the grieving process for individuals who experienced loss during this period. This study acknowledges self-selection bias, limited sample diversity, and suggests further research is needed to fully understand the predictors of PGD symptoms. • Grief complications are predicted using an innovative approach of Machine Learning. • The CatBoost algorithm provide the best predictive model of the TGI-SR score. • The best predictors are anxiety, avoidance and confrontation strategies levels. • Machine Learning is a relevant approach to studying grief in a heuristic way. [ABSTRACT FROM AUTHOR]

Objective To understand the current situation and characteristics of chronic disease comorbidities among the elderly living alone in China, to analyze their comorbidity patterns, and to explore the relationship between health-related behaviors and chronic comorbidity in the elderly living alone, so as to provide basis for co-prevention and co-management of multiple diseases in the elderly. Methods Based on the data of the 2018 Chinese longitudinal healthy longevity survey (CLHLS), the network map was used to identify the common binary co-disease patterns of chronic diseases in the elderly living alone, and the Gephi software was used to visualize the chronic disease co-disease network of the elderly. Using Apriorism algorithm, the association rules were used to analyze the correlation between health-related behaviors and co-diseases of the elderly living alone, and multi-factor Logistic regression model was used to analyze the correlation between chronic diseases and health-related behaviors of the elderly living alone. Results A total of 1 905 elderly people living alone over 65 years were included, of whom 766 suffered from two or more chronic diseases, and the co-morbidity of chronic diseases was 40.2%. A total of 45 meaningful binary co-disease patterns with strong links were identified through network map analysis, of which 10 were related to hypertension and 7 were related to heart disease. The strong association rules among the association rules of health-related behaviors and co-diseases of the elderly living alone were poor sleep quality, no physical activity, no exercise, and no outdoor activity. The multivariate Logistic regression model showed that the elderly living alone with smoking (OR =1.791, 95% CI: 1.205-2.664) and alcohol consumption (OR=1.597, 95% CI: 1.084-2.353) had an increased risk of chronic co-disease compared with those without chronic diseases. Elderly people living alone with exercise (OR=0.132, 95% CI: 0.100-0.175), outdoor activities (OR=0.047, 95% CI: 0.035-0.063), good sleep quality (OR=0.469, 95% CI: 0.319-0.688), and adequate sleep (OR=0.648, 95% CI: 0.484-0.867) had a lower risk of chronic comorbidity. Conclusion The comorbidity pattern of the elderly living alone in China is complex and related to health-related behaviors. The risk of comorbidity in the elderly can be reduced by improving health-related behaviors, such as increasing exercise and outdoor activities and adjusting sleep duration and sleep quality. [ABSTRACT FROM AUTHOR]

The study investigates the associated factors with psychological disorders and treatment-seeking behavior among older adults in India. The dataset used in this study is the Longitudinal Ageing Study in India (LASI) Wave 1 during the year 2017 - 2018. Descriptive statistics was used in this study to present the preliminary results. Further, the Heckman probit model selection model was employed to fulfill the research objectives. The results revealed that the oldest old category (75 years and above) has a higher percentage of psychological disorder (3.60%) and their treatment seeking is 23.43 percent. It was found that older adults(60-74 years) who belong to the urban area, live alone, are more educated, belong to a scheduled caste, currently don't work, have 1+ADL and 1+IADL impairments possess a higher percentage of psychological disorders. It was also found that older adults who belong to the oldest old groups are less likely to seek treatment for psychological disorders. The findings of the present study urge that greater attention be paid to detecting and preventing late-life psychological disorders, particularly among those who are at greater risk. [ABSTRACT FROM AUTHOR]

People living alone encounter well-being challenges due to unnoticed personal situations. Thus, it is essential to monitor their activities and encourage them to adopt healthy lifestyle habits without imposing a mental burden, aiming to enhance their overall well-being. To realize such a support system, its components should be simple and loosely coupled to handle various internet of things (IoT)-based smart home applications. In this study, we propose an exercise promotion system for individuals living alone to encourage them to adopt good lifestyle habits. The system comprises autonomous IoT devices as agents and is realized using an agent-oriented IoT architecture. It estimates user activity via sensors and offers exercise advice based on recognized conditions, surroundings, and preferences. The proposed system accepts user feedback to improve status estimation accuracy and offers better advice. The proposed system was evaluated from three perspectives through experiments with subjects. Initially, we demonstrated the system's operation through agent cooperation. Then, we showed it adapts to user preferences within two weeks. Third, the users expressed satisfaction with the detection accuracy regarding their stay-at-home status and the relevance of the advice provided. They were also motivated to engage in exercise based on a subjective evaluation, as indicated by preliminary results. [ABSTRACT FROM AUTHOR]

Reducing food waste could lower pressures on land resources and thereby contribute to the mitigation of global biodiversity loss. The reduction of food waste and biodiversity loss are also specified in the Sustainable Development Goals 12.3 and 15 of the United Nations. However, which supply chain stages and food products to target with policy measures is hardly known. Especially, a differentiation of the impact after sub‐stages and taxa is still missing and is therefore quantified in the present study. The food waste mass at five supply chain stages and seven sub‐stages in Germany was calculated and differentiated after 204 food products. All products were traced back to their countries of origin, in which their land use impact on mammals, birds, amphibians, reptiles, and plants was quantified. A new approach was developed to calculate the detailed feed demand for animal products. Germany's avoidable food waste (food that was edible before its disposal) leads to 0.3 vertebrate and 1.5 plant species being potentially lost globally. Household‐level waste is responsible for 47% of this species loss, while food services show the largest impact per mass, with individual catering being as influential as one‐person households. The most influential products are obtained from pigs and cattle. Among vertebrate taxa, mainly amphibians are affected, occurring in the mainly affected country Brazil. The results can be used to formulate policies that target, for example, individual catering or display the impact of animal products and their feed demand. [ABSTRACT FROM AUTHOR]

Background: Russia's military aggression against Ukraine set in motion a large number of refugees. Considerable amount of them came and stayed in Czechia. Refugees represent special vulnerable individuals often affected by war physically and psychologically. Due to the national regulations not allowing most of Ukrainian men aged 18–60 to leave the country, nowadays Ukrainian forced migration is relatively young and strongly gendered. Evidence suggests the higher probability for searching the safe refuge abroad among Ukrainian women with small children as well as those with relatively higher economic and cultural capital. The aim of this study is to identify the structural features of systemic risks associated with war migration by examining determinants of self-rated health among forcibly displaced highly educated Ukrainian women of productive age residing in Czechia. Methods: Data from one wave of the panel survey among Ukrainian refugees in Czechia conducted in September 2022 was used. Determinants of self-rated health including self-reported diseases and healthcare factors, lifestyle, human and social capital, economic factors, and migration characteristics were analysed using binary logistic regression. Results: About 45% highly educated Ukrainian women refugees in Czechia assessed their health as poor. The poor self-rated health was mostly associated with the number of diseases and depressive symptoms, and by social capital and economic factors. Having four and more diseases (OR = 13.26; 95%-CI: 5.61–31.35), showing some severe depressive symptoms (OR = 7.20; 95%-CI: 3.95–13.13), experiencing difficulties to seek help from others (OR = 2.25; 95%-CI: 1.20–4.23), living alone in a household (OR = 2.67; 95%-CI: 1.37–5.27), having severe material deprivation (OR = 2.70; 95%-CI: 1.35–5.41) and coming originally from the eastern part of Ukraine (OR = 2.96; 95%-CI: 1.34–6.55) increased the chance of these refugees to assess their health as poor. Conclusion: Social and economic determinants such as lack of social contacts for seeking help and material deprivation were found to be crucial for self-rated health and should be tackled via migration policies. Further, qualitative research is needed to better understand the mechanisms behind the factors affecting subjectively assessed health. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the distinct yet interconnected aspects of social isolation, namely living alone and loneliness, and their individual and combined effects on predicting health-related quality of life (HRQoL). Methods: A comprehensive analysis, encompassing both cross-sectional and longitudinal approaches, was conducted using a nationally representative sample of 5644 community-dwelling adults aged 55 and older from the Healthy Aging Longitudinal Study in Taiwan (HALST). Results: Baseline data revealed that 9% of the sample reported living alone, while 10.3% reported experiencing loneliness, with 2.5% reporting both living alone and feeling lonely. Regression analyses consistently demonstrated that loneliness was significantly associated with concurrent and subsequent lower physical (PCS) and mental (MCS) component of HRQoL. Conversely, additional analyses indicated that living alone could indirectly exacerbate the adverse effects of loneliness or contribute to prolonged feelings of loneliness, subsequently predicting lower HRQoL after 3.2 year. Conclusion: In terms of practical implications, interventions and policies aiming to enhance HRQoL in older adults should give particular attention to those who report feelings of loneliness, especially individuals living alone. [ABSTRACT FROM AUTHOR]

Considering the increasing number of older people and one-person households of older people in South Korea as well as the importance of social support among older people, there is a need to develop an instrument that assesses both the structural and functional social support of older people. Accordingly, this is the first study to validate the Korean version of the 10-item Duke Social Support Index (DSSI-10), which is composed of the social interaction and satisfaction with social support subscales. A total of 293 respondents who were over 65 years old and attended welfare centers located in the surrounding area of Seoul participated in this study. We found that the Korean version of the DSSI is a reliable and valid social support instrument that exhibits a two-factor structure like its English version. The DSSI also has the advantage of being able to measure structural and functional social support simultaneously. Developing the Korean version of the DSSI will provide a valuable social support instrument for researchers and practitioners in South Korea, where social support scales measuring both types of social support for older people do not yet exist. [ABSTRACT FROM AUTHOR]

Many elements associated with aphasia, its assessment and treatment, and its effects on individuals living with this disorder have been examined. However, the implications for people with aphasia of living alone has not been a focus. Factors such as living alone, ageing, aphasia, gender, depression (and suicide), comorbid physical impairments and mortality converge and intersect with each other to have a profound effect on those individuals with aphasia who live alone. This study aimed to explore the research relating to people with aphasia living alone (PWALA), as well as to identify knowledge gaps and the key characteristics related to this topic. The PRISMA scoping review methodology was selected to search the current literature. Online databases (Google Scholar and five electronic journal databases) were used to identify relevant papers, predominantly published since the year 2000. From 1201 papers initially identified, 115 relating to the topic were imported into NVivo Qualitative Research Software and analysed into themes. From the 74 papers directly relating to the topic, seven themes emerged: emotional status, communication, identity, independence, family relationships, friends/visitors and daily activities. It was unclear how the experiences of PWALA compared to those not living alone from these papers as the information provided mainly reflected the studies' research questions, not specifically the fact that the person concerned was living alone. There is an obvious and urgent need to investigate the lived experience of PWALA. However, two key areas require immediate attention. PWALA require early and ongoing assessment, monitoring and intervention for depression, and also the implementation of strategies and programs to decrease loneliness and social isolation. This scoping review relating to PWALA revealed that insufficient attention has been paid to the specific issues and implications of aphasia for this sub-population. An urgent investigation of a diverse sample of PWALA using in-depth supportive interviewing techniques is needed to explore the personal experiences and perceptions of living alone. Based on this, strategies and programs can be developed or adapted to address and ameliorate the specific exigencies of PWALA. [ABSTRACT FROM AUTHOR]

The study aimed to explore and compare effects of lockdown, due to the COVID-19 pandemic in 2020, on frail older people living alone at home in Brescia and Ancona, two urban cities located respectively in Northern and Central Italy. This country was the Western epicenter of the first wave of the pandemic (February-May 2020), which affected the two cities differently as for infections, with a more severe impact on the former. A follow-up study of the IN-AGE research project (2019) was carried out in July-September 2020, by means of telephone interviews, involving 41 respondents. Semi-structured questions focused on the effects of the first wave of the pandemic on their mobility and functional limitations, available care arrangements, and access to health services. The lockdown and social distancing measures overall negatively impacted on frail older people living alone, to a different extent in Ancona and Brescia, with a better resilience of home care services in Brescia, and a greater support from the family in Ancona, where however major problems in accessing health services also emerged. Even though the study was exploratory only, with a small sample that cannot be considered as representative of the population, and despite differences between the two cities, findings overall suggested that enhancing home care services, and supporting older people in accessing health services, could allow ageing in place, especially in emergency times. [ABSTRACT FROM AUTHOR]

Background: WHO statistics show that someone attempts suicide every three seconds and commits suicide every 40 seconds somewhere in the world. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of suicidal ideation, attempts, and associated factors among adult HIV/AIDS patients in Ethiopia to fill this gap. Methods: We extensively searched the bibliographic databases of PubMed, MEDLINE, Scopus, Google Scholar, and the Web of Science to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. To check heterogeneity, the Higgs I2 and Cochran's Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger's test and funnel plots were used. Results: The pooled prevalence of suicidal ideation and attempts among adult HIV/AIDS patients in Ethiopia was 20.3 with a 95% CI (14, 26.5) and 11.1 with a 95% CI (6.6, 15.5), respectively. Living alone (AOR 4.98; 95% CI: 2.96–8.37), having comorbidity or other opportunistic infection (AOR 4.67; 95% CI: 2.57–8.48), female sex (AOR 2.86; 95% CI: 1.76, 4.62), having WHO clinical stage III of HIV (AOR 3.69; 95% CI: 2.15, 6.32), having WHO clinical stage IV of HIV (AOR 5.43; 95% CI: 2.81, 10.53), having co-morbid depression (AOR 5.25; 95% CI: 4.05, 6.80), having perceived HIV stigma (AOR 2.53; 95% CI: 1.67, 3.84), and having family history of suicidal attempt (AOR 2.79; 95% CI: 1.38, 5.66) were significantly associated with suicidal ideation. Being female (AOR 4.33; 95% CI: 2.36, 7.96), having opportunistic infections (AOR 2.73; 95% CI: 1.69, 4.41), having WHO clinical stage III of HIV (AOR 3.78; 95% CI: 2.04, 7.03), having co-morbid depression (AOR 3.47; 95% CI: 2.38, 5.05), having poor social support (AOR 3.02; 95% CI: 1.78, 5.13), and having WHO clinical stage IV (AOR 7.39; 95% CI: 3.54, 15.41) were significantly associated with suicidal attempts. Conclusion: The pooled magnitude of suicidal ideation and attempt was high, and factors like opportunistic infection, WHO clinical stage III of HIV, WHO clinical stage III of HIV, and co-morbid depression were related to both suicidal ideation and attempt. Clinicians should be geared towards this mental health problem in HIV patients during management. [ABSTRACT FROM AUTHOR]

Given a well-known overlapping prevalence of social isolation with loneliness and depression among older adults, this study aimed to contextually investigate the relationship of these constructs with weight loss of more than 5kg in a year, with a special focus on the intersection of living alone and marital dissolution as key dimensions of isolation. The data were obtained from the Korean Longitudinal Study of Aging (KLoSA) from 2006, 2008, 2010, 2012, 2014, 2016, and 2018, with an adult sample of those aged 65 and older (n = 5,481). The study evaluated several critical dimensions of social isolation: living alone, transition to living alone, infrequent social contact with children or friends, and infrequent social participation. These dimensions were examined individually and as a composite scale, along with loneliness and depressive symptoms, to determine their association with weight loss of 5kg or greater among older men and women. Generalized Estimating Equation (GEE) regression models enabled investigation of whether socially isolated men and women tended to lose 5kg or more in weight, given other confounding factors. Surprisingly, the results showed no evidence of such a trend. However, significant associations were found between weight loss and changes in living alone and marital status. For older men, transitioning to living alone without a change in marital status was linked to significant weight loss. For older women, transitioning to living alone following widowhood or divorce was the risk factor. These relationships remained significant even after adjusting for depression and a wide range of covariates. Additional analysis testing a cumulative effect revealed that only depression was a risk factor for being underweight at the last observation. Therefore, to prevent a clinically risky extent of weight loss, health policies for older Koreans should focus on those who transition to living alone, especially due to spousal bereavement or divorce (among women) and separation from living with children (among men). [ABSTRACT FROM AUTHOR]

Livable environment and ways, as the necessary conditions for the elderly to enjoy their old age, have a significant impact on their mental health and happiness. It's crucial to understand how living arrangements affect depressive symptoms in China. Studies on how various leisure activities modify this association are yet limited. This study relies on panel data derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), collected during waves spanning 2008/2009, 2011/2012, 2014, and 2018. The primary objective is to examine the relationship between living arrangements, leisure activities, and depressive symptoms of elderly individuals. Linear mixed-effects models were used to analyze the data. A total of 26,342 observations aged 65 and over were included in this paper. Older adults living alone (β = 0.66, 95 % CI: 0.55, 0.76) or living in institutions (β = 0.69, 95 % CI: 0.40, 0.98) had more depressive symptoms than those living with family. Leisure activities were negatively associated with depressive symptoms (β = −0.16, 95 % CI: −0.18, −0.15). Moreover, there was significant interactions between living arrangements and leisure activities. No matter which kind of living arrangements, participating in physical, productive or social activity was associated with a lower risk of depressive symptoms. Study design might introduce bias, and it cannot establish causality between the tested variables. Older adults living alone or in institutions have more possibility to develop depressive symptoms than those living with family, and such a relationship among Chinese older adults can be moderated by participating in leisure activities. • Older adults living alone or in institutions had more depressive symptoms than those living with family. • Participation in leisure activities showed a negative association with depressive symptoms. • There were significant interactions between living arrangements and leisure activities. • Whatever the life arrangements, participating in leisure activities was related to a lower risk of depressive symptoms. [ABSTRACT FROM AUTHOR]

Background To propose a community-embedded follow-up management model to provide health services for elderly patients with osteoporosis who live alone. Methods Researchers randomly selected 396 people with osteoporosis living alone from five communities in Nantong, China, for the study. These participants were randomly assigned to control and intervention groups. Twentyfour community physicians in five communities provided professional support based on a community-embedded follow-up management model. Participants completed quantitative questionnaires at baseline and after the 6-month follow-up intervention, and some participants underwent semi-structured face-to-face interviews. The primary outcome is the effectiveness of the community-embedded follow-up management model in improving the quality of life of elderly patients with osteoporosis living alone. Based on an objective quantitative assessment, the qualitative study explains and adds essential components of this community-based follow-up management model. Results The quantitative study showed that scores in physical functioning, ability to perform daily activities, selfefficacy, and mental status were significantly improved in the intervention group compared to the control group (p<0.05). The most significant improvements were found in “mental status” (p=0.012) and “self-care skills” (p=0.003). The qualitative study reported the essential elements of a community healthcare model for older people living alone with osteoporosis, including professional support, personalized services, social support, and empowerment. Conclusions Community-embedded follow-up management meets the need for elderly patients with osteoporosis living alone. It helps to improve health perception, promote physical and mental health, and optimize the quality of life in this population. Personalized services and professional support are two major contributing factors to effective embedded follow-up management in the community [ABSTRACT FROM AUTHOR]

Background: In the wake of China's relaxed zero-COVID policy, there was a surge in coronavirus disease 2019 (COVID-19) infections. This study aimed to examine the infection status and health service utilization among Beijing residents during a widespread outbreak, and to explore the factors that affected utilization of health services due to COVID-19. Methods: A cross-sectional survey was conducted among Beijing residents from 13 January to 13 February 2023, collecting information on socio-demographic characteristics, health behaviours, COVID-19 infection status, utilization of health services and depressive symptoms. Multivariate Tobit regression was used for data analysis. Results: Among the 53 924 participants, 14.7% were older than 60 years, 63.7% were female and 84.8% were married. In total, 44 992 of the 53 924 individuals surveyed (83.4%) contracted COVID-19 during 2020–2023, and 25.2% (13 587) sought corresponding health services. The majority of individuals (85.6%) chose in-person healthcare, while 14.4% chose internet-based healthcare. Among those who chose in-person healthcare, 58.6% preferred primary healthcare institutions and 41.5% were very satisfied with the treatment. Factors affecting health service utilization include being female (β = −0.15, P < 0.001), older than 60 years (β = 0.23, P < 0.01), non-healthcare workers (β = −0.60, P < 0.001), rich self-rated income level (β = 0.59, P < 0.001), having underlying disease (β = 0.51, P < 0.001), living alone (β = −0.19, P < 0.05), depressive symptoms (β = 0.06, P < 0.001) and healthy lifestyle habits, as well as longer infection duration, higher infection numbers and severe symptoms. Conclusion: As COVID-19 is becoming more frequent and less severe, providing safe and accessible healthcare remains critical. Vulnerable groups such as the elderly and those with underlying conditions need reliable health service. Prioritizing primary healthcare resources and online medical services have played a vital role in enhancing resource utilization efficiency. [ABSTRACT FROM AUTHOR]

There are discrepancies between the information patients desire about adverse drug reactions (ADRs) and the information they receive from healthcare providers; this is an impediment to shared decision-making. This study aimed to establish whether patients received information about ADRs resulting from prescribed pharmacotherapy, before hospital discharge, after percutaneous coronary intervention (PCI) and to determine whether receiving information about ADRs was associated with incidence of self-reported ADRs or concerns related to prescribed pharmacotherapy. CONCARDPCI, a prospective multicentre cohort study including 3,417 consecutive patients after PCI, was conducted at seven high-volume referral PCI centres in two Nordic countries. Clinical data were collected from patients' medical records and national quality registries. Patient-reported outcome measures were registered 2 months (T1), 6 months (T2), and 12 months (T3) after discharge. Covariate-adjusted logistic regression yielded adjusted odds ratios (aORs) with 95% confidence intervals (CIs). At discharge, 38% of participants had been informed about potential ADRs. For these patients, the incidence of self-reported ADRs was significantly lower at T1 (aOR 0.61, 95% CI 0.50–0.74; p<0.001), T2 (aOR 0.60, 95% CI 0.49–0.74; p<0.001), and T3 (aOR 0.57, 95% CI 0.46–0.71; p<0.001). Those who were not informed reported higher levels of concern about prescribed pharmacotherapy at all measuring points (p<0.001 for all comparisons). Those living alone (aOR 0.73, 95% CI 0.57–0.92; p=0.008), who were female (aOR 0.57, 95% CI 0.44–0.72; p<0.001), and with three or more versus no comorbidities (aOR 0.61, 95% CI 0.44–0.84; p = 0.002) were less likely to receive information. A substantial proportion of patients were not informed about potential ADRs from prescribed pharmacotherapy after PCI. Patients informed about ADRs had lower incidences of self-reported ADRs and fewer concerns about prescribed pharmacotherapy. [ABSTRACT FROM AUTHOR]

Research studies on academic work and the COVID-19 crisis have clearly shown that the pandemic crisis contributed to exacerbating pre-existing gender gaps. Although the research has been extensive in this regard, it has focused more on the widening of the "motherhood penalty", while other groups of academics are blurred. Even more underinvestigated and not yet fully explained are the intersections between further axes of diversity, often because the research conducted during the pandemic was based on a small volume of in-depth data. By drawing on interview data from a wider national research project, this article aims to contribute to this debate by adopting an intersectional approach. In investigating daily working life and work–life balance during the pandemic of a highly heterogeneous sample of 127 Italian academics, this article sheds light on how gender combines with other axes of asymmetry, particularly class (precarious versus stable and prestigious career positions) and age (individuals' life-course stage), to produce specific conditions of interrelated (dis)advantage for some academics. The analysis reveals three household and family life course types that embody the interlocking of gender, class, and age within a specific social location with unequal, and possibly long-term, consequences for the quality of working life, well-being, and careers of academics, living alone or with parents, couples without children or with grown-up children, and couples with young children and other family members in need of care. [ABSTRACT FROM AUTHOR]

Early monastic communities in Egypt were veritable laboratories for the practice of Christian virtue; perhaps surprisingly, they were also large-scale coordinated communities of labor. That manual labor should have been part of anchoritic life is not obvious; given that hermits were leaving the cities and the usual occupations of life in the world, there might be a question as to why they would seemingly return to such occupations having sought the purity of living alone in the desert. Combining Platonic thought with radical Christianity, the monks found a way to make the maximally spiritual life also a worker's life. The architects of this form of life saw manual labor as a means for achieving self-sustenance, an effective weapon against temptation, a resource for the support of the needy, and a vital component in the monks' ascetic program. The argument of this paper is that this powerful cultural consensus on the centrality of work to monastic life endured for almost a thousand years before it came to be qualified, by Thomas Aquinas among others. When Thomas Aquinas writes on the purposes of manual labor he is entirely traditional. However, Aquinas ends up diminishing the extent to which the pursuit of the traditional goods gained by the practice of manual labor is obligatory for monastics. Aquinas's discussion of manual labor as an element of monastic life is a definite departure from the tradition. In the typically polite fashion of a scholastic theologian, Aquinas shifts away from Augustine and re-interprets St. Paul in unprecedented fashion. His argument is influenced by his own commitment to a new form of monastic life, which was changing not just theologically but as a result of the evolving backdrop of the social and economic realities with which religious life necessarily interacted. [ABSTRACT FROM AUTHOR]

Most people coreside with other kin in private households while others live alone. The incidence of coresidence with kin and solo living varies noticeably across societies. Scholars have long theorized about the role of modernization and cultural change for living arrangements, suggesting a trend toward the nuclearization of households (coresidence only with primary kin) or solo living as societies attain higher levels of development. There is little empirical evidence about global variations in living arrangements and about how such variations unfold at different levels of development. Here we address these fundamental questions. Using IPUMS census microdata for 279 samples and 90 countries, we develop a new metric for assessing the part of the lifetime a person can expect to reside with primary kin, nonprimary kin, or alone assuming exposure rates, from birth to death, to the living arrangements observed in a given year. Results show that coresidence patterns differ substantially across societies, with exposure to primary kin alone and to solo living substantially higher at higher levels of development (as measured with Human Development Index [HDI]). They also reveal a sustained decline in coresidence with nonprimary kin and/or with others nearly everywhere, supporting the idea of an increasing importance of nuclear living arrangements. This trend is most pronounced at medium levels of HDI. At very high levels of development, nuclear family coresidence tends to be stalling or is in decline in favor of more time spent living alone and, rather unexpectedly, to a modest increase in exposure to nonprimary kin within the household. We suggest different interpretations for these results. [ABSTRACT FROM AUTHOR]

In South Africa, households were formed at about twice the rate that the population grew be-tween census 1996 and census 2011 and the number of single-person households ballooned by 150%. Reweighted household survey data shows a surge in household formation in the late 1990s was driven by prime-aged and older women and Black African men, likely connected to new freedoms afforded to these groups after the transition to democracy. Household formation steadied in the 2000s, hiding variation in who formed what types of households. Astonishing growth in the rate at which South Africans live alone was led by Black African men, a group historically associated with circular labour migration. Women instead are heading up complex households including children. These changes connect to long-term marital decline. By 2011, most female heads were never-married and the growing majority population group of never-married adults increased their rate of household formation. [ABSTRACT FROM AUTHOR]

Aim: This study explores the intricate relationship between social interactions and the development of persecutory delusions among older women living alone in Japan. Focusing on the unique perspective of individuals experiencing delusions outside clinical settings, the aim was to understand the impact of interpersonal interactions on delusion formation. Methods: Cases of older women living alone with persecutory delusions were selected from records of municipal psychogeriatric services and medical consultations within a community space. This study employed a descriptive approach to propose a hypothesis regarding the possible connection between social interactions and the development of persecutory delusions within this demographic. Results: Two relevant cases were identified, from which a three‐step hypothesis emerged regarding the potential link between social interactions and the development of persecutory delusions in this demographic. Insights from these cases suggest that anxiety can trigger hallucinations, which, when unaddressed, evolve into delusional interpretations. Addressing these unmet needs could mitigate the progression of persecutory delusions. Conclusions: The findings of this study underline the critical relationship between social interactions and persecutory delusions among older women living alone. The unmet need for empathy influences the progression from anxiety‐driven hallucinations to fully formed delusions. Early intervention can prevent the escalation of delusions and involuntary psychiatric hospitalization. This study underscores the importance of recognizing the link between social isolation and delusion emergence. It advocates for compassionate environments to meet the psychological needs of older individuals grappling with delusions. Geriatr Gerontol Int 2024; 24: 118–122. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic causes serious threats to people's mental health, particularly it has huge negative mental health outcomes for adolescents. However, there is lack of studies examining COVID-19-related anxiety among adolescents in Ethiopia. Hence, this study was aimed to examine COVID-19-related dysfunctional anxiety and its associated factors among adolescents in Mettu town. Methods: Community-based cross-sectional study was conducted from September 1 to 30, 2020 among 847 adolescents selected by stratified sampling technique. IBM SPSS Statistics Version 26.0 was used for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were computed. Bivariate and multivariate binary logistic regression analyses were done to identify factors associated with COVID-19-related dysfunctional anxiety. The statistical significance was declared at p ≤ 0.05; and the strength of association was described in terms of adjusted odds ratio. Results: Out of the total sample, 819 adolescents participated in this study. The mean age of the participants was 14.9 (SD = 2.798) years. The magnitude of COVID-19-related dysfunctional anxiety was found to be 20.9% (95% CI (18.1, 23.9)). The finding indicates that sex [(AOR (95% CI)); (0.724 (0.502, 1.043))], having both parents deceased [(AOR (95% CI)); (2.981 (1.138, 7.814))], living alone [(AOR (95% CI)); (2.363 (1.050, 5.321))], having unemployed mothers [(AOR (95% CI)); (1.943 (1.194, 3.163))], absence of close friend [(AOR (95% CI)); (0.377 (0.225, 0.630))], and medical problem [(AOR (95% CI)); (0.408 (0.278, 0.597))] were significantly associated with COVID-19-related anxiety. Conclusion: The magnitude of COVID-19-related dysfunctional anxiety was found to be high in the study area. The findings have shown that the likelihood of developing COVID-19-related dysfunctional anxiety was linked to several factors. Provision of continued psychological support for adolescents is extremely encouraged. [ABSTRACT FROM AUTHOR]

Background: Mild behavioral impairment (MBI) and loneliness are associated with cognitive decline and an increased risk of dementia. Objective: Our aim was to examine the validity of the Japanese version of the MBI checklist (MBI-C) and investigate the relationship between loneliness and MBI. Methods: The participants in this cross-sectional study included 5 cognitively normal persons and 75 persons with mild cognitive impairment. MBI-C and the revised University of California at Los Angeles loneliness scale (LS) were used to assess MBI and loneliness, respectively. Diagnostic performance of MBI-C was examined using receiver operating characteristic analysis. The relationship between MBI-C and LS was examined using multiple linear regression in 67 subjects who were assessed with both scales, with MBI-C total or domain score as the dependent variable and LS as the independent variable, adjusted for age, gender, living situation, presence of visual and hearing impairment, and Mini-Mental State Examination score. Results: Per the Youden index, in this mostly MCI sample, the optimal MBI-C cut-off score was 5.5 with sensitivity 0.917 and specificity 0.949. In multiple linear regression analysis, LS score was detected as a significant predictor of MBI-C total scores, and MBI-C decreased motivation, affective dysregulation, and abnormal thought and perception scores. Conclusions: The caregiver-rated Japanese MBI-C has excellent diagnostic performance. Loneliness is associated with a greater MBI burden, especially in the decreased motivation, affective dysregulation, and abnormal thought and perception domains. Interventions for loneliness in older people may have the potential to improve MBI. [ABSTRACT FROM AUTHOR]

Background: Adults living alone represent a growing population group in China. Understanding the prevalence of body mass index (BMI) categories and their associations with demographic and lifestyle factors among this group is essential for informing targeted interventions and public health policies. Methods: In this population-based cross-sectional study, we used individual-level data from the 2011–2021 China General Social Survey. Main outcomes were prevalence of BMI categories adjusted for gender and age, using logistic regression and model-predicted marginal prevalence to estimate BMI categories prevalence. Results: We analyzed 9,077 single-living Chinese adult participants. The primary-adjusted prevalence of BMI categories varied across different genders and age groups. Underweight was more prevalent in females (12.73%; 95% CI: 12.31% - 13.14%) than in males (7.54%; 95% CI: 7.19% - 7.88%), while overweight and obesity were higher in males. Primary-adjusted underweight prevalence was highest among the 18–24 years age group (22.09%; 95% CI: 20.17% - 24.01%) and decreased with age. Primary-adjusted overweight prevalence increased with age, peaking in the 45–54 years age group (41.94%; 95% CI: 40.96% - 42.93%). Primary-adjusted obesity prevalence exhibited a fluctuating pattern across age groups, with the highest prevalence observed in the 45–54 years age group (9.81%; 95% CI: 9.19% - 10.44%). Conclusion: Our findings reveal significant associations between BMI categories and demographic and lifestyle factors among adults living alone in China. These results can inform targeted interventions and public health policies aimed at promoting healthy weight management and addressing the unique health challenges faced by single-living individuals in China. [ABSTRACT FROM AUTHOR]

All over the world, marriage rates are declining and more people have no partner. How should the church respond? This article, by a theologian and participant in the WEA's singles initiative, elucidates Paul's endorsement of the single life in the context of a broader argument that under the new covenant, marriage and family are not necessary to experience the full blessings of life in Christ. [ABSTRACT FROM AUTHOR]

Health monitoring systems based on the internet of things (IoT) improve patient well-being and reduce mortality risks. Machine learning techniques are most helpful in early fall prediction and detection. In this paper, fall prediction analysis and decision-making are done with existing benchmark clinical records. Classification techniques are incorporated to track the consistency and precision of data acquired by the IoT-based remote health monitoring for elderly people, especially those who are living alone. This work undertakes two approaches to early predicting a patient’s acute illness. The first approach has analyzed the existing benchmark patient activity data with different features. This approach builds the classification model for fall incidence with the help of machine learning models. In second approach, we collect real-time sensor data such as blood pressure and heart rate from IoT sensor gadgets which are transmitted to the prediction model for early prediction. Experimental results prove that the random forest (RF) classifiers and XGBoost provides the maximum accuracy. [ABSTRACT FROM AUTHOR]

Background: We aimed to study the source of infection for recently SARS-CoV-2-infected individuals from October 2020 to August 2022 in France. Methods: Participants from the nationwide ComCor case–control study who reported recent SARS-CoV-2 infection were asked to document the source and circumstances of their infection through an online questionnaire. Multivariable logistic regression was used to identify the factors associated with not identifying any source of infection. Results: Among 584,846 adults with a recent SARS-CoV-2 infection in France, 46.9% identified the source of infection and an additional 22.6% suspected an event during which they might have become infected. Known and suspected sources of infection were household members (30.8%), extended family (15.6%), work colleagues (15.0%), friends (11.0%), and possibly multiple/other sources (27.6%). When the source of infection was known, was not a household member, and involved a unique contact (n = 69,788), characteristics associated with transmission events were indoors settings (91.6%), prolonged (> 15 min) encounters (50.5%), symptomatic source case (64.9%), and neither the source of infection nor the participant wearing a mask (82.2%). Male gender, older age, lower education, living alone, using public transportation, attending places of public recreation (bars, restaurants, nightclubs), public gatherings, and cultural events, and practicing indoor sports were all independently associated with not knowing the source of infection. Conclusion: Two-thirds of infections were attributed to interactions with close relatives, friends, or work colleagues. Extra-household indoor encounters without masks were commonly reported and represented avoidable circumstances of infection. Trial registration: ClinicalTrials.gov registration number: NCT04607941. [ABSTRACT FROM AUTHOR]

Background: In Japanese medical practice, older stroke survivors are overwhelmed with information regarding their discharge locations, creating more decision-making challenges. A randomized controlled trial evaluated the influence of decision aids (DAs) for matching older stroke patients and their families' values concerning decisional conflict and participation in discharge destination decisions. Methods: Participants were randomly allocated to intervention and control groups. The intervention spanned two months, from admission to discharge, at which times participants were surveyed. DAs were provided to the intervention group, and brochures to the control group. The primary endpoint was decisional conflict, assessed using the Decisional Conflict Scale (DCS). The secondary endpoint decision-making participation was assessed using the Control Preference Scale (CPS) decision-making roles and a 10-point Visual Analog Scale for participation rate. An independent t-test analyzed decisional conflict scores and participation rates to examine between-group differences. The chi-square independence test evaluated roles in decision-making scores. Post hoc subgroup analyses were performed. Results: Ninety-nine participants (intervention group n = 51; control group n = 48) were included in the full analysis set, with a dropout rate of 38.4%. No significant group differences were found in decision-making conflict [t (99) = 0.69, p = 0.49, d = 0.14] and roles in decision-making scores [χ2 (5) = 3.65, p = 0.46]. However, a significant group difference was found in the participation rate [t (99) = 2.24, p = 0.03, d = 0.45]. DA tended to reduce uncertainty and promote participation rates, especially in participants living alone and unable to decide their discharge destination. Conclusions: The use of DA with older stroke patients did not significantly decrease decisional conflicts. In addition, the participation rate in decision-making increased, but their active role did not. Further studies should be conducted to understand the methods of offering DA, their ideal durations, and identify their beneficiaries. [ABSTRACT FROM AUTHOR]