Search

Older adults often delay seeking professional help, particularly for mental health problems. This is of great concern for older adults with chronic diseases, who are at risk of mental health declines. This study explored barriers to help-seeking among older adults with chronic diseases and identified factors that influence older adults' perceptions of such barriers. This was a cross-sectional study with 106 adults ≥65 years, diagnosed with cardiovascular disease, respiratory disease, and/or type 2 diabetes. Demographic variables and barriers to help-seeking were measured using self-report questionnaires. The most common barriers to help-seeking were wondering whether the mental health problem is significant enough to warrant treatment (51.9%) and not having a regular primary health care provider to speak with (39.6%). Participants who had sought help in the past had less endorsement of these barriers than those who had never sought help. Many older adults with chronic diseases have difficulties knowing when to seek help, and apprehensions about disclosing mental health concerns. Integrated intervention is needed involving the community (e.g., reduce stigma), older adults with chronic diseases (e.g., increase mental health literacy), and physicians (e.g., increase training in ageing and mental health) to alleviate common barriers to help-seeking in this population. What is already known about this topic: Adults aged 65 years and older with chronic diseases are at risk of mental health problems. Many older adults do not seek mental health help or delay seeking help, thus mental health problems often go undiagnosed and untreated. Attitudes and beliefs towards help-seeking influence whether older adults are willing to engage mental health-related services. What this topic adds: The most common barriers to mental health help-seeking among older adults with chronic diseases are perceived need and fears around disclosing mental health concerns. Past use of mental health services, gender, marital status, number of chronic diseases, and quality of life influence perceived barriers to mental health help-seeking. Greater education for older adults and primary health care providers to increase mental health literacy and reduce stigma is likely to alleviate barriers to care and increase mental health help-seeking in this population. [ABSTRACT FROM AUTHOR]

Background: Having a preterm (<37 weeks' gestation) birth may increase a woman's risk of early mortality. Aboriginal and Torres Strait Islander (hereafter Aboriginal) women have higher preterm birth and mortality rates compared with other Australian women.Objectives: We investigated whether a history of having a preterm birth was associated with early mortality in women and whether these associations differed by Aboriginal status.Methods: This retrospective cohort study used population-based perinatal records of women who had a singleton birth between 1980 and 2015 in Western Australia linked to Death Registry data until June 2018. The primary and secondary outcomes were all-cause and cause-specific mortality respectively. After stratification by Aboriginal status, rate differences were calculated, and Cox proportional hazard regression was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and cause-specific mortality.Results: There were 20,244 Aboriginal mothers (1349 deaths) and 457,357 non-Aboriginal mothers (7646 deaths) with 8.6 million person-years of follow-up. The all-cause mortality rates for Aboriginal mothers who had preterm births and term births were 529.5 and 344.0 (rate difference 185.5, 95% CI 135.5, 238.5) per 100,000 person-years respectively. Among non-Aboriginal mothers, the corresponding figures were 125.5 and 88.6 (rate difference 37.0, 95% CI 29.4, 44.9) per 100,000 person-years. The HR for all-cause mortality for Aboriginal and non-Aboriginal mothers associated with preterm birth were 1.48 (95% CI 1.32, 1.66) and 1.35 (95% CI 1.26, 1.44), respectively, compared with term birth. Compared with mothers who had term births, mothers of preterm births had higher relative risks of mortality from diabetes, cardiovascular, digestive and external causes.Conclusions: Both Aboriginal and non-Aboriginal women who had a preterm birth had a moderately increased risk of mortality up to 38 years after the birth, reinforcing the importance of primary prevention and ongoing screening. [ABSTRACT FROM AUTHOR]

This review discusses studies investigating the effects of antioxidant supplementation on exercise-induced oxidative stress with a focus on the health implications. The aim is to determine antioxidant requirements for endurance athletes. Overall, differences in methodology make it difficult to compare the relatively small number of published studies on this topic. The types of studies needed to more adequately assess the health effects of antioxidant supplements in athletes (long-term interventions with hard end points) have not been done. Therefore, there is currently insufficient evidence to recommend antioxidant supplements for endurance athletes. Key words: exercise, dietary supplements, oxidative damage, reactive oxygen species

Background: Permanent bilateral hearing loss (PBHL) is a serious condition in newborns, with a prevalence of at least one per 1000 live births. However, there has been no recent systematic review and meta-analysis of the effectiveness of universal newborn hearing screening programs (UNHS).Methods: We registered our study protocol on PROSPERO CRD42020175451. Primary outcomes were any identification of PBHL (ie, PBHL diagnosed at any time), age of identification of PBHL, and neurodevelopment. Two reviewers searched standard databases to March 2022 and extracted data. We used fixed and random effects meta-analysis to pool data and graded the certainty of evidence using standard methods.Results: The search retrieved 2834 records. We identified five studies reporting on the effects of UNHS vs no UNHS in 1 023 610 newborns. The relative risk of being identified with PBHL before nine months in infants with UNHS compared to infants without UNHS was 3.28 (95% confidence interval (95% CI) = 1.84, 5.85, one study, 1 023 497 newborns, low certainty evidence). The mean difference in the age of identification of PBHL in infants with UNHS compared to infants without UNHS was 13.2 months earlier (95% CI = -26.3, -0.01, two studies, 197 newborns, very low certainty evidence). The relative risk of infants eventually being identified with PBHL in infants with UNHS compared to infants without UNHS was 1.01 (95% CI = 0.89, 1.14, three studies, 1 023 497 newborns, low certainty evidence). At the latest follow-up at 3-8 years, the standardised mean difference (SMD) in receptive language development between infants with UNHS compared to infants without UNHS was 0.60 z scores (95% CI = 0.07, 1.13, one study, 101 children, low certainty evidence) and the mean difference in developmental quotients was 7.72 (95% CI = -0.03, 15.47, three studies, 334 children, very low certainty evidence). The SMD in expressive language development was 0.39 z scores (95% CI = -0.20, 0.97, one study, 87 children, low certainty evidence) and the mean difference in developmental quotients was 10.10 scores (95% CI = 1.47, 18.73, 3 studies, 334 children, very low certainty evidence).Conclusions: UNHS programs result in earlier identification of PBHL and may improve neurodevelopment. UNHS should be implemented across high-, middle-, and low-income countries.Registration: PROSPERO (CRD42020175451). [ABSTRACT FROM AUTHOR]