With an aging population, the prevalence of geriatric diseases is increasing, especially among older individuals who live alone. This study investigates the potential of using TV viewing patterns to detect these diseases by analyzing variables such as daily average viewing time, peak viewing hours, and channel-switching behaviors. Significant correlations between TV viewing patterns and early indicators of geriatric diseases (depression, activities of daily living (ADL) performance, and cognitive function) were found. The correlations between the Korean form of the Geriatric Depression Scale (KGDS) and daily average viewing time and excessive channel switching were 0.320 and 0.308, respectively. The Korean version of the Modified Barthel Index (KMBI) showed correlations of -0.313 with daily average viewing time and -0.352 with excessive channel switching. Participants were divided into groups based on scores, and significant differences in peak viewing hours were observed among the different groups. The Korean version of the Mini-Mental State Examination (MMSE-K) groups showed significant differences at 3, 4, and 5 PM. The KGDS and KMBI groups showed significant differences at 8 PM and midnight and 1 AM and 2 AM, respectively. These findings suggest that TV viewing patterns can serve as effective early diagnostic indicators for geriatric diseases.

Background: Pleural effusion (PE) is often classified as either a transudative or an exudative process. The aim of the study was to examine the causes of pleural effusions and the short- and long-term survival in the older patients hospitalized in the acute geriatric and internal medicine wards. Methods: Patients aged ≥ 65 years, who underwent thoracentesis, were included in this retrospective study. To distinguish between exudate and transudate PE, the Light’s criteria were applied. We compared medical indices and mortality in patients with exudate PE to those with transudate effusion according two age groups (65 - 85 vs. > 85 years). Results: The rates of the main etiologies of PE were congestive heart failure (CHF), 46%, lung infections, 25%, and malignancy, 12%, of the whole study population. Lung infections accounted for 53% of the exudate PE patients, with a higher presence among the >85 group of patients. The etiology of transudate PE was primarily CHF, more common among the patients of the >85 group. In malignancy, CHF and lung infections patients, the chances of dying within one year were 80.3%, 63.2%, and 45.5%, respectively. In transudate PE patients, ten-year survival of the 65-85 group of patients was significantly higher. In the exudate PE patients, there was no difference in survival between the two age groups. Right-sided and bilateral pleural effusions were associated with worse prognosis. Conclusion: Clinicians encountering patients with PE should be aware of their heightened mortality risks, and should carefully monitor their underlying etiology and employ appropriate optimal management.

Background: Depressive symptoms are a serious public health problem that are associated with BADL and IADL disabilities in Chinese adults.Objective: The limitation of activities of daily living (ADL) affects the mental health of older adults. We distinguished activities of daily living into basic activities of daily living (BADL) and instrumental activities of daily living (IADL) to explore the relationship between these two limitations and depressive symptoms among older Chinese adults using nationally representative cross-sectional data. In addition, this study explored the relationships between BADL, IADL and depression risk in elderly people at the individual and provincial levels and in rural and urban subgroups.Methods: The China Health and Retirement Longitudinal Study(CHARLS) survey used a multistage probability‒proportional‒to-size (PPS) sampling technique. Province-level socioeconomic characteristics were merged with microdata for respondents over 60 years of age from the 2020 China Health and Retirement Longitudinal Study (CHARLS 2020) Wave 5 (n=10,036) by the author. The respondents were asked whether their BADL and IADL were limited . The risk of depression was assessed using the 10-item Center for Epidemiological Studies Depression Scale(CES-D 10). The chi-squared test was used to explore whether having a disability that limits BADL and IADL were associated with mental health status. A binary logistic regression model was used to evaluate this association further after controlling for confounding factors.Results: Overall, 27.5% (2759/10036) and 25.7% (2776/10036) of the participants over 60 years of age were limited in their BADL and IADL, respectively. Regression analyses revealed that older adults whose BADL were not limited (OR=1.942, 95% CI: 1.638–2.303, P < .001) and whose IADL were not limited (OR=1.775, 95% CI: 1.485–2.122, P < .001) had a lower risk of depression than older adults whose BADL and IADL were limited. In addition, older adults who were female (P <.001), were 60-69 years (P < .005), had a partner (P <0.001), were literate (P <.001), lived in a rural area (P <.001), had a retirement pension (P <.001), had 3 or more children (P < .001), did not have any chronic diseases (P < .001), had a fair SRH score (P < .001), drank alcohol (P < .001), exercised (P < .005), did not participate in social activities (P < .001), or had an above average per capita household consumption (P < .001) lived in provinces with the first quartile of GDP per capita (P < .001) and lived in provinces with the second quartile of the number of beds in medical institutions per 10,000 persons (P < .001) were more likely to experience depressive symptoms, while smoking had no effect. In a binary logistic regression, older adults who were single (OR=0.669, 95% CI=0.551, 0.812), illiterate (OR=0.646, 95% CI=0.504, 0.828), living in rural areas (OR=1.485, 95% CI=1.270, 1.735), without retirement pensions (OR=0.671, 95% CI=0.582, 0.819) and with very bad SRH scores (OR=0.411, 95% CI=0.311, 0.544) had a greater risk of depressive symptoms. In the binary logistic regression analysis of the urban and rural subgroups separately, the results indicated that old people whose BADL or IADL were not limited were associated with a risk of depression, especially rural (P < .001) and urban (P < .001) participants.Conclusions: The present study provides evidence of an association between BADL, IADL and depression in older Chinese adults. This study revealed that individuals with limited BADL and limited IADL were predominantly depressed older adults. Binary logistic regression models suggested that disabilities limiting BADL and IADL were more likely to be associated with depressive symptoms in rural Chinese older adults. Older adults should be encouraged to participate in moderate physical and social activities to prevent physical dysfunction. The government and social work organisations should pay attention to the mental health of older adults in rural areas.

An increase in plant-sourced (PS) nutrient intake is promoted in support of a sustainable diet. PS dietary minerals and proteins have bioactive properties that can affect bone health and the risk of fracture. In a group randomised, cross-over, design, this study evaluated the post-ingestion, temporal pattern of change in arterialised ionised calcium (iCa), parathyroid hormone (PTH), C-terminal crosslinked telopeptide of type I collagen (CTX) and procollagen type 1 amino-terminal propeptide (P1NP) for 4 hours following ingestion of a novel supplement (SUPP) containing a PS marine multi-mineral + PS protein isolate. A diurnally matched intake of mineral water was used as a control (CON). Compared to baseline, the change in iCa concentration was 0.022 (95%CI, 0.006 to 0.038, p = 0.011) mmol/l greater in SUPP than CON, resulting in a -4.214 (95%CI, -8.244 to -.183, p = 0.042) pg/mL mean reduction in PTH, a -0.64 (95%CI, -0.199 to -0.008, p = .029) ng/mL decrease in the biomarker of bone resorption, CTX, and no change in biomarker of bone formation, P1NP. Used as a dietary supplement, or by incorporation into a food matrix, the promotion of PS marine multi-mineral and PS protein isolates may contribute to a more sustainable diet and overall bone health.

Misophonia, characterized by strong emotional reactions to specific sounds, poses significant challenges, particularly in academic settings. This study investigates the prevalence and psychometric properties of the MisoQuest, a tool designed to assess misophonia, in a sample of 549 high school and university students (Mean age = 23.2 years, SD = 9.3). The sample included 285 females, 260 males, and four individuals who did not disclose their gender. Using a predefined cutoff score of 61 on the MisoQuest, 4.5% of the participants were identified as positive for misophonia. Psychometric evaluation of the MisoQuest involved both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA results indicated a dominant single-factor structure, with the first factor explaining the majority of the variance. The scree plot further supported this unidimensional model. CFA confirmed the single-factor structure, with most items showing factor loadings between 0.36 and 0.58. Despite some non-significant factor loadings, the model indicated a substantial relationship between the items and the underlying factor. The high internal consistency of the MisoQuest was demonstrated by a Cronbach’s alpha coefficient of 0.93. These findings are consistent with previous studies on misophonia prevalence and support the use of the MisoQuest as a reliable assessment tool. Given the observed prevalence and the significant impact of misophonia on students’ academic and social lives, early identification and targeted support are essential. This study contributes to the understanding of misophonia in young adults and underscores the need for further research and tailored interventions.

Sarcopenia is associated with clinical complications, which increase mortality. Effective sarcopenia risk screening in the elderly should be grounded in a comprehensive assessment, encompassing both nutritional status and medication use. Current screening tools, while emphasizing muscular per-formance, exhibit limited sensitivity in identifying elderly individuals at risk of sarcopenia. This cross-sectional study aimed to develop a sarcopenia risk screening tool, named Sarc-Global, with enhanced sensitivity, incorporating factors pertinent to the overall health of the elderly. Utilizing the criteria established by EWGSOP2 for diagnosing sarcopenia, we evaluated 395 communi-ty-dwelling elderly individuals. This evaluation served as a reference for assessing the efficacy of two validated questionnaires, Sarc-F and Sarc-CalF, and our newly developed Sarc-Global. Con-structed through multiple logistic regression, Sarc-Global integrates variables such as sex, age, medication use, body mass index, arm circumference, and handgrip strength – all significantly associated with sarcopenia (p

Background: The association between the individual and combined effects of moderate-to-vigorous physical activity (MVPA) and sleep quality with physical frailty in community-dwelling older adults is still unknown. Subjects and Methods: A cross-sectional study was conducted with a participants pool comprising older adults who had not been officially assessed as requiring nursing care or support services.. Physical frailty was assessed using Liu's definition based on Fried's concept. MVPA was measured by a triaxial accelerometer, and individuals who meet either MPA for ≥300 min/week, VPA for ≥150 min/week, or both of them were defined as "MVA+." "SLP+" was defined as a Pittsburgh Sleep Quality Index score &lt;5.5 points. We performed an ordinal logistic regression analysis to calculate the odds ratios (ORs) and 95% confidence intervals (CI) regarding the relationship between MVPA and sleep quality with physical pre-frailty and frailty. Results: The final analysis included 811 participants. After multivariate adjustment, compared to the MVA+SLP+, the MVA−SLP+ (OR 2.56, 95%CI: 1.80–3.62) and the MVA−SLP− (OR 3.97, 95%CI: 2.33–6.74) participants showed significantly higher ORs for physical pre-frailty and frailty. Conclusion: Community-dwelling older adults who did not meet MVPA criteria, regardless of sleep quality, had a higher risk of physical pre-frailty and frailty.

ackground: This study aimed to examine the effects of a woodworking program on psychosocial health in older adults who had mild cognitive impairment (MCI) or mild dementia (MD) in Korea. Setting: The study was carried out in a dementia center in Seoul in Korea. Population: A total of 61 participants who had MCI or MD were allocated into two groups: the experimental group (EG, n = 35) and the control group (CG, n = 26). Methods: This study was carried out using a nonequivalent control group pre-test–post-test design. The EG participated in the woodworking program a total of 10 times for 120 min per session twice a week for 5 weeks, and the CG did not participate in the woodworking program. Both groups completed the same survey before and after the intervention. In the survey, demographic characteristics, psychological health (life satisfaction, depression, self-efficacy, and resilience), and social health (social isolation and social support) were measured. Results: In the within-group comparison, there was no significant difference between any factors of the CG before and after the intervention. In contrast, the EG had a significant improvement before and after the woodworking program. Participants in the EG with MCI and MD significantly improved their social support (p < 0.05). Psychological factors (life satisfaction, depression, and self-efficacy) were positively changed, although not significantly. Conclusions: The woodworking program promoted psychosocial health, such as life satisfaction, resilience, and social support, among older adults with mild cognitive impairment and mild dementia.

Enhance®Fitness (EF) is an evidence-based exercise program recommended for management of osteoarthritis (OA). However, access to EF is limited in rural areas. Accordingly, we evaluated the feasibility and acceptability of remotely delivered EF in rural, community-dwelling older adults with symptomatic knee OA. A single arm pilot trial of remotely delivered EF classes was conducted. Videoconferencing was used to livestream the instructor-led, 1-hour EF classes 3 days/week for 12 weeks. Outcomes were assessed at baseline and immediately post-intervention. A total of 15 participants were enrolled with a median age of 70 years (interquartile range [IQR]: 67-75) and 14 (93%) were women. Median EF class attendance rate was 91% (IQR: 85-94%). Knee pain, as measured by the Knee injury and Osteoarthritis Outcome Score (KOOS), improved significantly from baseline to 12-week endpoint (mean difference=-11.4 [95% CI:-20.9, -2.0); P=0.02). In addition, participants’ self-reported knee function improved significantly (mean difference in KOOS Function score=-11.8 [95% CI:-18.4, -5.2]; P&lt;0.01) as well as their physical capacity (mean difference in Timed Up and Go test time=1.8 seconds [95% CI: 0.2, 3.4]; P=0.03). All participants (100%) were very satisfied with remotely delivered EF classes and there were no serious adverse events. Findings from this pilot trial indicate that remotely delivered EF is feasible and acceptable in rural older adults with knee OA.

The use of vitamin D (VitD) supplements has become widespread in the last decade due not only to the dissociation between the blood levels recommended as "optimal" and those shown by the healthy population, but also to its presumed beneficial effects on multiple disorders. This work evaluated the levels of 25-hydroxyvitamin D [25(OH)D] in a healthy population of European origin living in a region with high solar irradiation. In serum samples from a population-based study conducted in the Canary Islands, levels of 25(OH)D were analyzed. In 876 individuals who had no history of kidney or malabsorption disorders and who had not been treated with calcium and/or VitD supplementation, the median 25(OH)D level was 26.3 (5th;95th percentile, 14.3;45.8)ng/mL. Notably, 65.4% of the population had 25(OH)D blood levels below 30ng/mL, 23.4% below 20ng/mL and 6.4% below 15ng/mL. Based on the lack of evidence supporting causality between 25(OH)D levels below what is recommended as optimal (≥20ng/mL, or even ≥30ng/mL) and major skeletal and non-skeletal diseases, and in light of the distribution of the concentration of this vitamin in healthy adults living under optimal conditions of solar irradiation, it seems reasonable to consider 25(OH)D levels below 20ng/mL and close to 15ng/mL as adequate for the general population.

Problem gambling among young people is an emerging trend globally. The online environment in particular offers various possibilities for gambling engagement. This is the first cross-national survey study using the social ecological model to analyze problem gambling, especially in the online context. The aim was to analyze how different social ecological spheres explain problem gambling. Participants were young people aged 15–25 in the United States (n = 1,212), South Korea (n = 1,192), Spain (n = 1,212), and Finland (n = 1,200). The South Oaks Gambling Screen (SOGS) instrument was used as a measure for problem gambling. Regression models predicted problem gambling with measures of intrapersonal, interpersonal, organizational, and societal spheres. Spanish participants had the highest SOGS score for problem gambling. Out of the spheres, organizational-sphere measures best explained the variation in problem gambling in all countries (26%) when compared to the societal (3%), interpersonal (5%) and intrapersonal (11%) spheres. In the full model, organizational-sphere measures had strong associations with problem gambling. These included consumer debt, online gambling community participation, online casino participation, and exposure to online pop-up advertisements. Other robust predictors of problem gambling included conformity to group norms in the interpersonal sphere and male gender and impulsivity in the intrapersonal sphere. Cross-national results were similar in different countries. The online context plays a major role in problem gambling behavior. The social ecological model is a useful tool by which to tackle problem gambling and develop preventative measures.

Background: The associations between long-term exposure to particulate matters (PM) in residential ambiance and obesity are comparatively less elucidated among young adults. Methods: Using 2017 Community Health Survey data with aged 19−29 participants in 25 communities, Seoul, the relationship between obesity and long−term PM10 levels of living district was examined. We defined obesity as overweight (25≤BMI&lt;30) or obese (30≤BMI) using Body Mass Index (BMI) from self-reported anthropometric information. Analysis was conducted sampling weighted logistic regression models by fitting municipal PM10 levels according to individual residence periods with 10 years and more residing in a current municipality. Socio-demographic factors were adjusted over all models and age−specific effect was explored among aged 19–24 and 25–29. Results: Total study population are 3,655 [men 1,680 (46.0%) and aged 19–24 1,933 (52.9%)] individuals. Among the communities with greater level of PM10; 2001–2005, associations with obesity were increased for overall with residence period; 10 years ≤ [Odds ratio, OR 1.071, 95% Confidence interval (CI) 0.969–1.185], 15 years ≤ [OR 1.118, 95% CI 1.004–1.245], and 20 years ≤ [OR 1.156, 95% CI 1.032–1.294]. However, decreased associations were detected for PM10; 2006–2010, and age–specific effects were modified according to the residence period. Conclusions: Although currently PM10 levels are decreasing, higher levels of PM10 exposure at the residential area during the earlier life-time may contribute in increasing obesity among young adults.

This study explored the effects of a comprehensive health care program (CHCP) on blood pressure, blood glucose, body composition, and depression in older adults living alone. We used a quasi-experimental, two-group, pre-posttest design. The CHCP consisted of open lectures, health counseling, exercise classes, nutrition counseling, and self-help group meetings at a local senior welfare center. Fifty-eight subjects participated in this study, with thirty subjects in the experimental group and twenty-eight subjects in the control group. Data were analyzed using the descriptive statistics, χ²-test, and t-test. Comparisons of the pretest and posttest systolic blood pressure (t = - 2.530, p < .016) and blood glucose (t = 3.089, p < .004) between the experimental and control groups showed significant differences. In both the experimental (t = 3.949, p < .001) and control groups (t = 3.816, p < .002), depression symptoms showed a significant decrease post-test, compared with pre-test. Our findings infer that older adults require physical and psychosocial healthcare and that more efforts must be made to improve the general health and wellbeing of this population group.

A recent research has identified an inverse amplitude link between obliquity damping and short eccentricity amplification during Mid-Late Pleistocene based on LR04 δ18O and equatorial Pacific Site 846 sea surface temperature records, which is associated with the Earth's long-term cooling. In the present study, new evidence of this anticorrelation is presented from Antarctic D-CO2-CH4 records, global benthic-planktic δ18O, and regional (Atlantic, Pacific, Mediterranean, and Indian) climate-related proxies. Based on a critical review of theoretical constrains (Earth's oblateness changes and ice-volume phase lag in the obliquity band <5.0 kyr), this widespread and symmetric (bipolar) obliquity response damping has been interpreted as an effect of the obliquity-oblateness feedback, which could be the latent physical mechanism at the origin of the Mid-Pleistocene Transition (MPT). Indeed, results and considerations of the present work suggest that fast and positive/negative net variation of the Earth's oblateness in the obliquity band was controlled by dominant glacio-eustatic water mass component and, assuming a rapid response of the ice-volume to surface temperature changes, the mean obliquity lag response is estimated to be <5.0 kyr over the past 800 kyr. These elements may explain the interglacial/glacial damping observed in the obliquity response. The consolidation of the Earth's long-term icy-state in the subtrend IV, culminated with the post-MPT obliquity damping, might have contributed to the strengthening of the short eccentricity response by mitigating the obliquity ‘ice-killing’ during obliquity maxima (interglacials), favouring the obliquity-cycle skipping and a feedback amplified ice-growth in the short eccentricity band (obliquity damping hypothesis). This could suggest a different impact of the climate friction than what is generally believed, which is presumably the latent physical mechanism that triggers transient ‘competitive’ interaction between obliquity and short eccentricity started early during the Piacenzian.

This paper presents a numerical study on the vertical (axial) and lateral (flexure) behavior of CFST (Concrete-Filled Steel Tube) columns with active hoop prestress; this transverse prestressing effect is achieved by bolting together two steel half-tubes. This study refers to new construction only (i.e., no retrofit). 12 prototype CFST column specimens (segments) are analyzed. These specimens differ in the prestressing force (3 levels) and in the gravity loading ratio (4 levels); they are selected to represent typical ground columns of mid-rise buildings. The structural behavior of these column specimens is simulated with a nonlinear model implemented in Abaqus; the concrete and steel behavior are described with a damage-plasticity and a plasticity model, respectively. Finally, the interface concrete-steel interaction is represented by a hard (compression-only) surface-to-surface contact model. The calculations involve three consecutive loading steps: (i) transverse prestress, (ii) axial force, and (iii) lateral loading (shear force and bending moment). The structural behavior of the CFST columns is deeply examined and discussed; the results show that their axial-flexural capacity is adequate. Noticeably, it is concluded that the overall benefits of prestressing the columns are only modest. Preliminary studies on the aforementioned mid-rise buildings equipped with the CFST columns show that their gravity and wind capacities are largely enough; conversely, their seismic capacity is sufficient for moderate seismic ground motions only.

Introduction: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss, predominantly affecting older adults. Understanding the multifaceted factors contributing to AD is crucial for developing effective prevention and intervention strategies. This narrative review synthesizes current literature on the various factors influencing the development and progression of AD in older adult populations.Methods: A comprehensive search was conducted across electronic databases including PubMed, Web of Science, and PsycINFO using relevant keywords such as "Alzheimer's disease," "risk factors," "genetics," "environmental factors," and "lifestyle." Studies published between 2000 and 2023 were included, focusing on factors associated with AD in individuals aged 65 years and older.Results: The review identified several key factors contributing to AD in older adults. Genetic predisposition, particularly the presence of apolipoprotein E (APOE) ε4 allele, emerged as a significant risk factor. Environmental factors such as air pollution, pesticides, and heavy metals were also implicated. Furthermore, lifestyle factors including physical inactivity, poor diet, and smoking were associated with increased AD risk. Chronic conditions such as diabetes and cardiovascular diseases were found to exacerbate cognitive decline in older adults.Conclusion: This narrative review highlights the complex interplay of genetic, environmental, and lifestyle factors in the development and progression of Alzheimer's disease among older adults. Understanding these factors is crucial for targeted interventions aimed at reducing AD risk and improving cognitive health outcomes in aging populations. Future research should focus on longitudinal studies and personalized medicine approaches to elucidate specific mechanisms underlying AD pathogenesis and to develop effective preventive strategies.

Many middle-aged and older adults (MAOA) do not engage in sufficient physical activity (PA) despite its well-documented benefits for healthy aging. Existing PA interventions often fail to reach or engage the target population effectively. This study investigates MAOA's preferences for recruitment strategies to optimize the reach and uptake of PA interventions, thereby enhancing their impact on healthy aging and public health. Qualitative interviews were conducted with 39 MAOA participants (69% female, mean age = 69.46, SD = 7.07), guided by McGuire's Theory on Persuasive Communication. Factors related to the source, message content, channel, receiver characteristics, and target behavior of recruitment strategies were analyzed. Findings suggest a preference for trustworthy sources (e.g., healthcare professionals over commercial entities) and positive, non-ageist messaging. MAOA vary in channel preferences but emphasize the importance of personalization. Despite heterogeneity, MAOA commonly perceive themselves as sufficiently active, necessitating improving knowledge on what constitutes sufficient PA, and easy enrollment or trying-out interventions. Tailoring recruitment strategies to diverse MAOA segments, based on age, seems crucial for effective engagement. Future research could explore quantitative research into how communication factors relate to various target population characteristics.

Physical exercise favorably affects visceral adipose tissue (VAT) which is a risk factor for cardiometabolic diseases. However, many people are unable or unwilling to conduct frequent and intensive exercise programs that have favorable effects on VAT. The present study aimed to determine the effect of the time-efficient and joint-friendly whole-body electromyostimulation (WB-EMS) technology on VAT volume in overweight to obese adults with osteoarthritis of the knee. In total 72 women and men 40-70 years old with femuro-tibial knee osteoarthritis were randomly allocated to WB-EMS (n=36) with 1.5 sessions of 20 min/week for 29 weeks or a usual care control group (CG: n=36) with 6 sessions of physiotherapy. Magnetic Resonance Imaging (MRI) using a non-contrast enhanced 2-point Dixon Gradient Echo Volumetric Interpolated Breath-hold Examination determined VAT. Twelve slices covered a total length of approximately 5 cm from mid L2 to mid L3. In summary, VAT volume increased non-significantly in the CG (p=.261) and decreased non-significantly in the WB-EMS group (p=.160). We failed to determine significant WB-EMS-induced effects i.e. group differences for absolute changes on VAT volume (p=.097). Due to the low application volume, present WB-EMS protocols might not be the perfect tool for decreasing VAT in overweight to obese adults.

This study investigates why young adults live with their parents in Sweden. As young adults’ living arrangements affect decisions about marriage, education, childbirth, and participation in the workforce, more knowledge for policy makers is crucial to implementing effective policies to support young adults and promote financial independence and well-being. Using a data set from 1998 to 2021 at the municipal level in Sweden, we used a spatial autoregressive panel data model to examine the proportion of young adults living at home and regional disparities. The study uncovers intraregional variations, illustrating how different municipalities within Sweden exhibit different patterns of young adults living at home. Our findings reveal that economic factors, such as unemployment, significantly impact this pattern. The dynamics of the housing market, demographic factors, cultural differences, and location-specific characteristics also play an essential role in explaining this pattern. The findings suggest that the key drivers are the lack of rental housing, high unemployment rates, a high degree of urbanisation, interregional migration, and lack of social capital.

Background: The validation of measuring instruments in health is a requirement to be able to use them safely and reliably. The Short Physical Performance Battery (SPPB) tool is an instrument widely used in the clinic and validated in numerous countries and languages and for different populations. The objective of this research was to determine the psychometric properties of SPPB for a sample composed of institutionalized Spanish older adults. Methods: Multicenter study of the psychometric properties of the Short Physical Performance Battery tool with a convenience sample of 194 institutionalized older adults. Reliability (internal consistency), validity (construct validity and convergent validity) tests were performed. Results: The results show a very good internal consistency, construct validity and convergent validity. In addition, the factorial structure of the SPPB is provided, which reflects that it is a unidimensional scale. Conclusions: In conclusion, the Short Physical Performance Battery is a valid and reliable tool for use with institutionalized older adults. Its use is recommended as part of the Comprehensive Geriatric Assessment for the evaluation of the physical or functional sphere. Authors should include one of the following statements about the registration status of the manuscript here: This study was prospectively registered and approved by the Ethics Committee of the University of Burgos (IR 11/2018).

Gambling among college students can start as a pastime activity. However, this pastime can lead to problem gambling and pathological gambling. This cross-sectional study aimed to identify and explain gambling behavior among university students using a novel fourth-generation multi-theory model (MTM) of health behavior change. Data were collected from a sample of 1,474 university students at a large southwestern university in the U.S. between January 2023 and February 2023, utilizing a validated 39-item survey. The statistical analyses employed in this study encompassed descriptive statistics, independent samples t-tests, and hierarchical regression modeling. Among students who engaged in gambling in the past month, the constructs of participatory dialogue (β = 0.052; p &lt; 0.05), behavioral confidence (β = 0.073; p &lt; 0.0001), and changes in the physical environment (β = 0.040; p = 0.0137) accounted for 27.7% of the variance in the likelihood of initiating the behavior change. Furthermore, the constructs of emotional transformation (β = 0.104; p = 0.0003) and practice for change (β = 0.060; p = 0.0368) accounted for 22.6% of the variance in the likelihood of sustaining quitting gambling behavior. The Multi-Theory Model (MTM) can be employed to design interventions aimed at reducing problem gambling among college students.

Tryptophan is an essential nutrient required to produce niacin (vitamin B3), which is needed for energy metabolism and DNA production. Alterations in tryptophan metabolism could have significant effects on aging and musculoskeletal health. The kynurenine pathway, the main catabolic route of tryptophan, is modulated by inflammatory factors, which are increased in older persons, a process known as inflammaging. Osteoporosis, sarcopenia, osteosarcopenia and frailty have also been linked with chronic increased levels of inflammatory factors. Due to the disruption of the kynurenine pathway by chronic inflammation and/or changes in the gut microbiota, serum levels of toxic kynurenines are increased and have been associated with osteoporosis, sarcopenia and frailty. In contrast, anabolic end products of this pathway, such as picolinic acid, have demonstrated a beneficial effect on bone and muscle. In addition, recent studies have shown that physical activity can modulate this pathway by promoting the secretion of anabolic kynurenines. According to the evidence collected, kynurenines could have a promising role as biomarkers for osteoporosis sarcopenia, osteosarcopenia and frailty in older persons. In addition, some of these metabolites could become important targets for developing new pharmacological treatments for these conditions.

Several studies have reported a relationship between autonomic dysfunction　 during tasks and Internet addiction. Changes within 24 h regarding heart rate variability (HRV) may be a more sensitive indicator than short term observations. We evaluated the influence of excessive Internet usage on HRV using a 24 h electrocardiogram (ECG) and examined acute changes during computer game tasks. A total 13 high school students and 22 young adults were recruited, and divided into excessive Internet user and non- excessive user groups based on Internet addiction test scores. The ECG was recorded continuously for 24 h by a wearable sensor and during two computer games (the Iowa gambling task and each participant’s preferred game) using a standard type ECG system. Multiple psychometric tests were also conducted. The excessive Internet user group exhibited clinically significant depressive symptoms, and higher self-reported scores for anxiety, impulsivity, autistic tendencies, and sleep problems than the non- excessive internet user group. There were weak differences within the 24 h high-frequency (HF) band power between two groups. During the Iowa gambling task, younger participants exhibited a reduced HF response, which may be related to weaker top- down self- regulatory mechanisms.

World statistics demonstrate that around 970 million people around the globe suffer from mental health problems (Ritchie & Roser, 2019), a major proportion of which comprised of adolescents and young adults (UNODC, 2018). Also, because of increased mental health issues the problems like substance use, suicide, depression, anxiety, and stress are also increasing (Armstrong, 2019; Bandelow & Michaelis, 2015; Ritchie & Roser, 2018; United Nations Office on Drugs and Crime [UNODC], 2019). It is thus a dire need to address the issue. The present coneptual paper proposed the role of transpersonal gratitude, emotional intelligence, and life contentment for reducing mental health risk among the adolescents and young adults.

This purpose was to compare the ability of body shape index (ABSI) and body roundness index (BRI) with waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body adiposity index (BAI) to predict metabolic risk. The cross-sectional study was conducted in 17,360 Chinese subjects (were aged 18-95 years old) who escaped cardiovascular disease (CVD) or diabetes. Biochemical and anthropometric variables were measured by trained staff. Receiver operating characteristic curve (ROC) and optimal cutoff values of obesity indices were recruited to compare the predictive ability for metabolic risk factors. The mean age of subjects was 53.7(13.1) years, 41.6 % were males. Within young group (<60 years), the areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to similarly predict high metabolic risk in males (0.74 vs. 0.74 vs. 0.73 vs. 0.73 vs. 0.73) and in females (0.73 vs. 0.73 vs. 0.71 vs. 0.73 vs. 0.73), while the approximate predictive ability were only acquired in males (0.73 vs. 0.73 vs. 0.70 vs. 0.73 vs. 0.73) within elder group (≥60 years). The optimal cut-off values of BRI for high metabolic risk were calculated in males (<60 y: 3.49 vs. ≥60 y: 3.46) and females (<60 y: 3.47 vs. ≥60 y: 3.60). Meanwhile, BRI displayed a strong prediction to elevated BP and elevated TG in males (AUC = 0.64; AUC = 0.70) and to elevated BP, elevated TG and elevated SUA in females (AUC = 0.67; AUC = 0.69; AUC =0.70). BRI was able to similarly predict high metabolic risk compared to WC, BMI, WHR, WHtR and BAI, while ABSI was not. Moreover, BRI revealed specific predictive ability for elevated BP, elevated TG and elevated SUA.

The aim of this study was to identify the differences in functional fitness and quality of life among women over 60 years of age depending on their level of objectively measured physical activity (PA) according to Global Recommendations on Physical Activity for health. The study used cross-sectional design with 213 volunteered women over 60 years of age. Physical activity was monitored for 7 days of the week using Actigraph Gt3x monitor. The Senior Fitness Test battery and Hand-grip strength tests were performed to assess functional fitness. Quality of life was self-reported using short version of WHOQOL-brief questionnaire. Women who met the PA recommendations achieved slightly better results in most functional tests and all domain of quality of life. The significant differences were found in upper body strength, dynamic balance and social relationships domain of quality of life. Physical activity programs developed on the basis of WHO recommendations have the potential to improve functional capacity and quality of life. However, further experimental studies in this area are required.

Background: Modulator therapies improve weight and body mass index (BMI) in cystic fibrosis (CF) patients. We aimed to compare the nutritional risk index (NRI) in adult CF patients receiving modulator (MT) or only non-modulator (conventional) therapies (non-MT). Methods: A single-center prospective cohort study was conducted between June-December 2023. The NRI based on weight gain and albumin was calculated at beginning and end of a 12 weeks period in both groups. This design was pragmatic, since based on individual patient access to MT for 12 weeks. Results: 107 patients were included [mean (SD) age: 23.85 (4.98) years, 54.7% male, 46.7% MT]. In the MT group, mean (SD) weight (kg) and albumin (g/dL) increased significantly [changes: +3.09 (2.74) and +0.17 (0.37); p

This rapid review aims to present a comprehensive overview of barriers and facilitators or factors, and, effective interventions that promote immunisation uptake by older people in the Asia-Pacific region. Rapid review methodology was applied using two databases (PubMed, Embase). Articles were included if studies were conduced in Australia, Singapore, Indonesia and the Philippines, included human population ≥50 years old, used original data, adopted quantitative, qualitative, and mixed-method designs, and published from 2016 to August 2022. The study selection yielded 1424 articles. A total 23 papers met the inclusion criteria, of which 19 reported on barriers and facilitators, while, 4 articles reported on effective interventions to promote vaccination uptake. Among the 19 studies that identified barriers and facilitators to vaccination uptake, the more common factors were social influences (n=8/19), perceived benefits of vaccine (n=7/19), and perceived vaccine safety (n=6/19). Strategies that focussed on supporting clinicians were found to be effective in leading them to recommend vaccinations among older adults such as creating awareness on the low baseline vaccination rates among older adults, provision of structured health assessment, and nurse reminders. More studies are needed ascertain the factors, and effective interventions influencing vaccine uptake among older people in the Asia-Pacific region.

Background. The measurement of physical performance constitutes an indicator of physical functional capacity and allows the design of physical exercise programs adapted to the individual abilities and needs of older adults with and without frailty. Aim. To present a synthesis of knowledge on the effect of exercise programs on physical performance in older adults with and without frailty in the community. Method. A systematic review was carried out in accordance with the PRISMA-2020 criteria. The search for articles was made until May 4, 2023 in PubMed, Scopus, Web of Science, Cochrane Library, SciELO and LILACS. The outcome variable was physical performance, measured through the SPPB (Short Physical Performance Battery). The mean difference (MD) was estimated to evaluate the effect. Results. We found 2,483 studies, of which 12 met the eligibility criteria for the systematic review and 9 for the meta-analysis. The effect of exercise on SPPB score was significantly higher in the exercise group compared to control in non-frail older adults with MD=0.51 [95% CI, 0.05 to 0.96, p&lt;0.05]. Likewise, in older adults with frailty, the effect of exercise on the global SPPB score was significantly higher in the exercise group compared to the control with an MD=0.66 [95% CI, 0.09 to 1.24, p&lt;0.05 ]. Conclusion. Our findings suggest that exercise programs are effective in increasing and/or maintaining physical performance in older adults with and without frailty, whose effect is more evident in older adults with frailty, probably due to the greater margin of recovery of intrinsic capacity.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition, characterized by persistent deficits in communication/social interaction and restricted and repetitive patterns of behavior, interests or activities. It is usually identified in childhood, despite late diagnoses in cases of greater functionality. Havighurst proposes a set of fundamental tasks throughout the life cycle, whose achievement is probably compromised in the ASD, even though it lacks scientific evidence. This study innovates, as it is based on Havighurst's theoretical model for understanding the development process of three adults and one young person, diagnosed with ASD level I, at different life stages. Through the methodology of life histories, interviews were subject to content analysis. Results pointed out the early detection and interventions importance, minimizing adversities, above all by those who had late diagnoses. Self-perceived success, not expected, was found in some development tasks (e.g. conscience and morality development). Also were noticed expected limitations related to ASD (e.g. difficulties in relationships with peers and in the labor market inclusion). Probably, in cases of greater severity and less functionality/autonomy, there would be greater failure in development tasks. It is crucial to improve research on this developmental model and on the factors that delay the diagnosis, including cases of different levels of severity.

This cross-sectional study was aimed to investigate the relationship between gratitude and life satisfaction, and the mediation role of social support and enjoyment of life among older individuals. The Gratitude Resentment and Appreciation Test, the Enjoyment of Life Scale, the Satisfaction with Life Scale, and the Multidimensional Scale of Perceived Social Support Scale were administered to a sample of 260 older individuals aged between 60 and 80. The main findings revealed a positive association between gratitude and life satisfaction, and social support was a partial mediator in this relationship. Although enjoyment of life was not a direct mediator in the relationship between gratitude and life satisfaction, the final model indicated a significant serial pathway from gratitude to social support and then through enjoyment of life-to-life satisfaction. In conclusion, enhancing gratitude, promoting enjoyment of life, and social support in older individuals might increase their life satisfaction, which in turn might contribute to their successful aging

Ageing is the strongest known risk factor for many of the neurodegenerative diseases causing cognitive decline and dementia. Identification of cognitive impairment may be a prelude to appropriate treatment, hopefully disease-modifying. Use of cognitive screening instruments may be an equitable way to identify cognitive impairment. This study examined the use of two such instruments, Free-Cog and Mini-Addenbrooke’s Cognitive Examination (MACE), in patient cohorts referred to a dedicated cognitive disorders clinic based at a tertiary neurosciences centre. Results showed that: (1) specificity and positive predictive value increased with patient age for both tests with some loss of sensitivity and negative predictive value. (2) In the oldest age groups (≥75 and ≥70 years respectively) where specificity was at maximum, a positive test result (i.e. below the specified test cut-off) rules in the diagnosis of cognitive impairment. (3) Values of an “Efficiency Index” for each test indicated qualitatively a moderate change in the probability of correct diagnosis and quantitatively an approximately 15-25% increase in the probability of correct diagnosis. These findings show that both Free-Cog and MACE may be used with confidence for the identification of cognitive impairment and dementia in older patient cohorts. These findings may have implications for public health policies directed to case-finding in clinical practice as opposed to population-based screening.

Japan is experiencing a super-aging society faster than is anywhere else worldwide. Consequently, extending healthy life expectancy is an urgent social issue. To understand diet that supports the extension of healthy life expectancy, we studied the relationships among quality of life (QOL: SF-36 questionnaire), physical activity (number of steps and activity calculated using an accelerometer), physical function (muscle strength, movement function, agility, static balance, dynamic balance, and walking function) and dietary intake among 469 older adults living in the Tokyo metropolitan area (65–75 years old, men/women = 166/303) from February 23, 2017, to March 31, 2018. There was a significant positive association between physical QOL and steps, moderate-intensity activity, and high-intensity activity (p &lt; 0.05), and a significant positive association (p &lt; 0.05) between physical activity and movement, static balance, and walking functions, but no association with muscle strength. These three body functions were significantly positively correlated with intake of vegetables, seeds, fruits, and milk, and with magnesium, potassium, vitamin B6, and the dietary fibre/carbohydrate ratio and composition ratios (p &lt; 0.05). Balancing food and nutrition may improve QOL in older adults through increased physical function and physical activity. Future verification of interventions is needed.

Context: COVID-19 pandemic and the Lockdown implemented as a measure to contain the virus spread has taken a toll over the psychological well-being of the people especially the young adults, the confinement along with the environment of a highly infectious pandemic around the induvial are put under great stress.Aims: The current study aims to assess the psychological impact and perceived stress due to COVID-19 lockdown in Young Adult population of India.Settings and Design: It is a cross sectional, observational study.Methods and Material: The survey was conducted using Google forms involving snowball sampling technique which obtained 267 responses in total. (IES-R) and (PSS) scales were used for the study.Statistical analysis used: Descriptive analysis were performed on the sociodemographic parameters and the comparison of means were done by Chi-square test in SPSS Statistic 21.0 (IBM SPSS Statistics, New York, United States). Results: The mean IES-R and PSS scores obtained for the population in this study was 25.64±18.95 and 18.27±6.10 respectively. Out of the 267 respondents in total 61.4% (n=164) of them were males. Maximum of the respondents 62.54%(n=167) belonged to the age group of 18-23 with mean age being 23.14± 2.913. 92.5% of the respondents were unmarried and only 26.6% belonged to the rural part of India. Females, younger individuals were found to have higher IES-R and PSS scores. Conclusions: There is significant psychological burden and stress on the young Indian population with females and younger individuals particularly students are the most vulnerable population.

For older adults, approaching end-of-life (EOL) brings unique transitions related to family relationships. Unfortunately, most families greatly underestimate the need to discuss these difficult issues. For example, parents approaching EOL issues often struggle with receiving assistance from others, avoiding family conflict, and maintaining their sense of personhood. In addition, discussions of EOL issues force family members to face their parents’ mortality, which can be particularly difficult for the adult children to process emotionally. This study explored aging issues identified by aging parents and their families as they traverse these impending EOL changes. Ten focus groups of seniors (n = 65) were conducted. Focus groups were organized according to race (African American/Caucasian), gender, and whether the older adult was living independently or in an assisted care facility. When asked open-ended questions about discussing aging and EOL issues with family members, participants revealed tensions that led us to consider Relational Dialectics Theory as a framework for analysis. The predominant tension highlighted in this report was certainty versus uncertainty, with the two sub-themes of sustained life versus sustained personhood and confronting versus avoiding EOL issues. For these data, there were more similarities than differences as a result of gender, race, or living situation than one might expect, although culture and financial status were found to be influential in the avoidance of EOL discussions. The results of this study help to provide additional insight into relational dialectics related to aging, EOL, and the importance of communication in facilitating family coping.

(1) Background: Environmental and public health research has given considerable attention to the impact of air quality on brain health, with systematic reviews widespread. No literature review has been done for cognitive frailty – a multidimensional syndrome combining physical frailty and cognitive impairment and their apparent co-dependence, linked to increased vulnerability and adverse health outcomes, including dementia. Instead, cognitive decline and frailty is implicitly explored through research on air quality and comorbid cognitive and physical decline in elderly populations. (2) Methods: A scoping review was conducted to explore the need for a systematic review. Combining Arksey and O’Malley [1] and PRISMA-ScR checklist [2], a scoping review of SCOPUS using ‘cogniti*’ + ‘resilience’ + ‘air quality’ or ‘cogniti*’ + ‘ageing’ + ‘air quality’ resulted in N=2503 articles, screened and reduced using inclusion and exclusion criteria, to N=16 articles. (3) Results: Air quality appears to be a critical risk factor for cognitive decline, even at air quality levels below WHO targets. Moderate long-term ambient air pollution appears linked to increased risk of cognitive frailty, suggesting earlier and more active interventions to protect older people. There are varied effects on cognition across the life course, with both emotional and functional impacts. Effects may be more detrimental to elderly people with existing conditions, including economic and health inequalities. Generalisation of results is limited due to the absence of a dose-response, variations in methods, controlling for comorbid effects, and variance across studies. (4) Conclusions: The findings support the need for more research and a more extensive summary of the literature.

Meals on Wheels (MoWs) provide access to daily meals and social contact to adults with care and support needs.MoWs could be essential for the increasing rates of an ageing population and adults living with complex needs in England, yet many do not know that the service exists. This study aimed to explore the perceptions of MoWs service users, and people who refer them to MoWs (‘referrers’), with accessing and setting up the service in England, and what information would be valued when considering accessing MoWs services.Semi-structured interviews were conducted in May-July 2022 with seven service users and 21 referrers, recruited from four MoWs providers across England. Data were analysed using thematic analysis. Participants indicated various pathways into the service, but referrers (family members) were more likely to be the ones enquiring about, and setting up, MoWs for service users. Once an enquiry about MoWs had been made, the service was perceived as straightforward to set up.However, existing preconceptions and stereotypes about the service (e.g. bringing to mind ‘school meals’, aimed solely at older adults) were perceived to act as barriers to accessing MoWs.Information that participants deemed important to have available when deciding on whether to access MoWs related to the meals (e.g. nutritional value, variety, need for any preparation, catering for individual needs), the specific services provided (e.g. wellbeing checks, daily social contact), the reliability and flexibility of delivery, and the cost of services. These findings could inform MoWs providers’ public awareness strategies about MoWs, in order to facilitate referrals to the service for adults with care and support needs.

Background: Demographic aging is a reality in developed countries, which poses a social challenge of great responsibility. Thus, numerous studies have been developed in an attempt to understand which factors best predict healthy aging. The aim of this study was to investigate and systematize literature on intervention programs that simultaneously include cognitive stimulation and physical activity, understand the importance of the use of new technology in these programs, and understand their impact on cognitive function in older adults, giving indications about their contribution to healthy aging. Methods: A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified from electronic databases such as PubMed, Scopus, Web of Science and Academic Search Complete. Results: Thirty-two articles, involving 2815 participants, were identified. All selected studies were randomized controlled studies. The studies were published between 2011 and 2020. All studies included a combination of cognitive and physical interventions. Many of the studies used technology to administer the cognitive stimulation program. Conclusions: Most of the analyzed studies use new technologies in physical and cognitive interventions, demonstrating that this new form of intervention exerts lasting and stable benefits in cognition.

Frailty, an age-related decline in homeostatic reserves, markedly proceeded during the coronavirus disease 2019 pandemic. To continuously assess frailty status, a remote system is urgently required. We aimed to co-design/co-develop an online frailty check (FC) application alongside FC supporters who were facilitators in a pre-existing onsite FC program. The online FC included a screening measurement for sarcopenia and an 11-item questionnaire covering dietary, physical, and social behaviors. Using prototype applications, 55 opinions obtained from 32 FC supporters (median 74.0 years) were categorized and reflected refinement. Regarding the self-efficacy of FC supporters, a significant increase in social positioning was seen after the mock test (P=.031). For FC supporters and participants, the average system usability scale (SUS) score was 70.2±10.3 points, which was “marginally high” for acceptability and “good” for the adjective range. Multiple regression analysis showed that the SUS score was significantly correlated with online-onsite reliability but not online communication, even after adjusting by age, sex, education level, and ICT proficiency (b=0.400, 95% CI: 0.243-1.951, P=.013). Additionally, a significant association between onsite and online FC scores was observed (R=0.670, P=.001). Our online FC application was evaluated to be a valuable tool to practically assess frailty status remotely.

Triple X syndrome (TXS, also known as trisomy X or 47,XXX) has been associated with impaired overall neurocognitive functioning in children and relatively young adults. However, neurocognitive functioning in adults with TXS is poorly understood. The aim of this study was, therefore, to examine cognitive functioning in adults with TXS. Methods: In this cross-sectional study, data were collected from 34 adult women with TXS (mean age = 32.9; SD = 13.1) and 31 controls (mean age = 34.9; SD = 13.7). General intellectual functioning, semantic/verbal memory, visual/episodic memory, psychomotor speed, and attention and executive functioning were then compared between these two groups. Results: We found that general intellectual functioning was significantly lower in the TXS group compared to the control group. In addition, women with TXS had more attention problems and lower psychomotor speed, particularly motor processing speed. When the analyses were adjusted for IQ, the strength of these associations decreased. The women in the TXS group also scored significantly lower at free recall in the verbal memory test, but not in immediate or delayed recognition. Finally, visual/episodic memory and executive functioning did not differ significantly between groups. Conclusions: Our analysis revealed that women with TXS score lower in general intellectual functioning and have impairments in motor processing speed and attention compared to controls, but do not differ with respect to executive functioning. These results offer new insights for improving the support of adults with TXS both at school and in the workplace.

Early stroke diagnosis remains a big challenge in healthcare partly due to the lack of reliable diagnostic blood biomarkers, which in turn leads to increased rates of mortality and disability. Current screening methods are optimised to identify patients with a high risk of cardio-vascular disease, especially among the elderly. However, in young adults and children, these methods suffer low sensitivity and specificity and contribute to further delays in their triage and diagnosis. Accordingly, there is an urgent need to develop reliable blood biomarkers for triaging patients suspected of stroke in all age groups, especially children and young adults. This review explores some of the existing blood biomarkers, as single biomarkers, or biomarker panels, and examine their sensitivity and specificity for predicting stroke. A review was performed on PubMed and Web of Science for journal articles published in English during the period 2001 to 2021 which contained information regarding biomarkers of stroke. In this review article, we provide comparative information on the availability, clinical usefulness, and time-window periods of eight single blood biomarkers and six biomarker panels that have been used for predicting stroke in emergency situations. The outcomes of this review can be used in future research for developing more effective stroke biomarkers.

Background: Most prevalence surveys on nocturia have focused on older populations. This study aimed to measure the nocturia prevalence across the full spectrum of male adults living in Hong Kong, where severity and associated quality-of-life (QoL) were also explored. Methods: A cross-sectional population-based survey was conducted in men aged 18 or above using the ICIQ-NQoL Questionnaire. Results: With 1,239 respondents at age ranged 18-99, the overall nocturia prevalence were found to be 63.0% (ranged 41.6-84.6% at different age groups) and 31.2% (ranged 13.0-56.3% at different age groups), for ≥1 and ≥2 bedtime voiding episodes, respectively. The chance of nocturia was dramatically increased at age 60 or above while both prevalence and voiding frequency were increased with advancing age. About 83% of the nocturia men experienced 1-2 voiding episodes per night, but many of them had self-rated their QoL poor or very poor and indicated moderate-to-high bothersome. Younger men at age 18-39 were found to have high prevalence as 41.6% and almost 30% of them rated poor or very poor QoL. Conclusions: Nocturia was not only affecting the older populations but also caused significant bothersome and negative impacts on QoL in younger males.

The purpose of this study was to present the challenges faced when implementing a diet and exercise intervention for low-income older Hispanics with type 2 diabetes with an observational study of recruitment, attendance, and characteristics of Hispanic adults with type 2 diabetes in a community congregate meal site pre and post administration of a diet and exercise intervention. This report evaluates retentions and diabetes self-management beliefs Hispanic adults ≥60 years with type 2 diabetes (n=17) at baseline, and completion of the six-month intervention in terms of the Health Belief Model. There was limited interest in controlling diabetes with diet and exercise. Major barriers included lack of perceived vulnerability to diabetes complications and a belief that medication alone is sufficient to stabilize blood glucose. Environmental barriers included lack of transportation, access to exercise groups, access grocery stores, and limited ability to pay for healthy foods. A lesson learned from this intervention was that the diet and exercise intervention given was insufficient as a cue to action for this population interventions to engage low-income, older Hispanics with diabetes in diet and exercise need to consider strategies to overcome barriers such as health beliefs, transportation issues, lack of access to nutritious food and group exercise classes.

This paper reports the findings from a pilot study designed to explore the barriers, facilitators and similarities with the delivery and implementation of two distinct models of Advance Care Planning (ACP) documentation for older adults in their last year of life used by health care professionals in their clinical practice. PACe (Proactive Anticipatory Care Plan): a GP led model and PEACE (Proactive Elderly Persons’ Advisory CarE): a nurse led model with community geriatrician oversight were used by participants in their clinical practice. Telephone interviews were conducted with general practitioners (GPs) to explore their views of using the PACe tool. Hospital admission avoidance matrons took part in face to face interviews and care staff employed in private residential care homes took part in individual telephone interviews to explore their views of using the PEACE tool. GPs and admission avoidance matrons were employed by Clinical Commissioning Groups (CCGs) and all study participants were recruited from the South East of England where data collection took place in 2015. Nine telephone interviews and two face-to-face interviews (one joint and one individual) were conducted with twelve participants. The data was analysed thematically. Participants highlighted the similarity of both tools in providing focus to ACP discussions to inform individual end-of-life care preferences. The importance of relationships was a pivotal theme-established, trusting inter-professional relationships to enable multidisciplinary teamwork and a prior relationship with the older person (or their proxy in the case of cognitive impairment) to enable conversations of this nature. Using both tools enabled participants to think critically and reflect on their own practice was another theme identified. Notwithstanding participants’ views to improve the layout of both tools, using a paper-based approach to deliver streamlined ACP and end-of-life care was a theme to emerge as a barrier which focused on the problems with access to paper-based documentation, accuracy and care co-ordination in the context of multidisciplinary team working. The value of technology in overcoming this barrier and underpin ACP as a means to help simplify service provision, promote integrated professional practice and provide seamless care was put forward as the solution.

Limited observational studies have described the relationship between sleep duration and overall diet. The present study investigated the association between sleep duration at weekdays and empirically derived dietary patterns in a nationally representative sample of UK adults, aged 19-64 years old, participating in the 2008-2012 UK National Diet and Nutrition Survey Rolling Programme. Survey members completed between three to four days of dietary records. Sleep duration at weekdays was categorised into tertiles to reflect short, normal and long sleep duration. Social jetlag was calculated as the difference between sleep duration at weekends and weekdays. The association between sleep duration/ social jetlag and dietary patterns, derived by principal components analysis, was assessed regressing diet on sleep whilst accounting for the complex survey design and adjusting for relevant confounders. Survey members in the highest tertile of sleep duration had on average 0.45 (95% CI -0.78, -0.12) lower healthy dietary pattern score compared to middle tertile (p =0.007). There was an inverted u-shaped association between social jetlag and a healthy dietary pattern, such that when sleep at weekends exceeded weekday sleep by 1h 45min, scores for indicating a healthy dietary pattern declined (p =0.005). In conclusion, long sleep duration at weekdays and an increased social jetlag are associated with a lower healthy dietary pattern score. Further research is required to address factors influencing dietary patterns in long sleepers.

This article discusses the results of fluid inclusions study in barite collected at the Jan Mayen vent field area (Troll Wall and Perle &amp; Bruce) and Loki’s Castle vent field of the Mohns Ridge segment of the Arctic Mid-Ocean Ridge. Three mafic-hosted volcanogenic massive sulfide deposits were examined within the active vent fields that adequately correspond to geological settings of ultraslow-spreading ridges and PT-conditions. Hydrothermal sediments were investigated to determine the temperature and salinity of the fluids responsible for barite precipitation. The hydrothermal origin of the barite was confirmed by its morphology. Fluid inclusions are two-phase and homogenized into the liquid phase on heating at temperatures below 287ºC. The salt concentration in fluids trapped in inclusions is 2.6–4.4 wt.% NaCl eq. The crystallization temperatures varied from 276ºС to 119ºС and from 307ºС to 223ºС for the Jan Mayen and Loki’s Castle vent fields, respectively. The data obtained allowed us to confirm evidence of fluid phase separation in the hydrothermal systems and to expand our knowledge of the temperature and salinity of mineral fluids previously known from recent direct measurements during the cruises within the G.O. Sars research vessel. The fluid inclusions data obtained from barites emphasize the fluid features characteristic of volcanogenic massive sulfide deposits, the similarities and differences for the studied hydrothermal sites, and allow comparisons with similar products from other active hydrothermal systems.

Coronavirus disease 2019 (COVID-19) affected not only individuals but also families. The purpose of this study was to clarify the temporal changes in the impact of the COVID-19 pandemic on entire families with older adults susceptible to infection living on small islands in Japan over the duration of the pandemic. Family ethnographic research was conducted from 2021 to 2023, using the Concentric Sphere Family Environment Theory as the theoretical framework. Formal interviews were conducted with 20 families. In addition, data from informal interviews, participant observation and other sources were compiled into field notes. All data on the impact on the entire family were extracted and content analysis was conducted. Five categories and a total of 85 subcategories were extracted. The results show that COVID-19 exerted not only negative but also positive impacts on the entire family, and their temporal changes are clarified. The impact on families is believed to have been influenced by the family external environment, such as increases and decreases of infection cases or events that occurred outside the family. The knowledge acquired from these studies will help healthcare professionals in providing appropriate family support.

Judo is a popular Japanese martial art and an Olympic sport. Recently, an increasing interest has been observed in the application of judo as a multicomponent exercise, with a growing body of evidence showing that multicomponent exercise improves physical and cognitive performance in older adults. Therefore, this review highlights the benefits of judo training in preventing physical and cognitive decline in older adults. Specifically, first, this review outlines the basic characteristics of judo (philosophy, match, and training). Next, previous studies investigating the effects of judo training on physical and cognitive aspects of older adults are reviewed. Thereafter, the brain mechanisms underlying the effects of judo training in improving physical and cognitive performance are discussed. Throughout this review, judo training demonstrated some positive effects on physical (gait and balance, among others) and cognitive (memory and executive function) function in older adults. These positive effects are attributed to a variety of changes in the brain (e.g., increased neurotrophic factor expression and increased cerebral blood flow, among others), that affect different brain regions and networks both functionally and structurally. From these findings, this review concludes that judo training can be an effective way to maintain and prevent physical and cognitive decline in older adults.

This study was designed to extend the literature on multicomponent interventions for the children of deaf adults (CODA) population. This study used two evidence-based behavior intervention strategies: pre-session pairing (PSP) and independent group contingency (GC). These strategies have been successfully used to decrease off-task behavior in elementary school children with various abilities and diverse backgrounds. However, the research on multicomponent interventions has yet to examine their effects on the CODA population in inclusive classrooms. This study used a concurrent multiple baseline design across participants with an ABC sequence to examine teacher-implemented PSP with independent GC in reducing the off-task behavior of three CODAs in an inclusive classroom at a public elementary school. The results show that the intervention successfully decreased off-task behavior for all participating CODAs. The results suggest that CODAs can adapt to classroom rules and expectations when PSP and independent GC are systematically applied to them in classrooms.

The use of smartphones, coupled with different sensors, makes it an attractive solution for measuring different physical and physiological features, allowing for the monitoring of various parameters and even identifying some diseases. The BITalino device allows the use of different sensors, including Electroencephalography (EEG) and Electrocardiography (ECG) sensors, to study different health parameters. With these devices, the acquisition of signals is straightforward, and it is possible to connect them using a Bluetooth connection. With the acquired data, it is possible to measure parameters such as calculating the QRS complex and its variation with ECG data to control the individual's heartbeat. Similarly, by using the EEG sensor one could analyze the individual's brain activity and frequency. The purpose of this paper is to present a method for recognition of the diseases related to ECG and EEG data, with sensors available in off-the-shelf mobile devices and sensors connected to a BITalino device. The data were collected during the elderly's experiences, performing the Timed-Up and Go test, and the different diseases found in the sample in the study. The data were analyzed, and the following features were extracted from the ECG, including heart rate, heart rate variability, the average QRS interval, the average R-R interval, and the average R-S interval, and the EEG, including frequency and variability. Finally, the diseases are correlated with different parameters, proving that there are relations between the individuals and the different health conditions.

Previous research has already examined the relationship between Future Anxiety, a construct recently introduced in Italy, and mental health in young adults, although possible mediating variables in this relationship have so far never been investigated. The present study attempts to fill this gap by exploring the incidence of Future Anxiety on psychological distress in a group of 302 young Italian adults (18 - 30 years; M = 21.9; SD = 2.6), presenting and evaluating the simultaneous mediating effect of Intolerance of Uncertainty and Non-Pathological Worry.Findings highlighted how Future Anxiety had a positive and significant direct effect on Stress and Depression, but not on Anxiety. In the three serial mediation models proposed, Intolerance of Uncertainty and Non-Pathological Worry mediated the relationship between Future Anxiety and mental health outcomes. The results also confirmed the hypothesized serial mediation effect by highlighting how young adults with greater Future Anxiety experienced more Intolerance of Uncertainty, which positively affected Non-Pathological Worry levels and, in turn, exacerbated psychological distress. Finally, results indicated that female participants experienced more Stress, Anxiety, and Depression in relation to Future Anxiety compared to males. Starting from the review of main references on this subject, the results discussed provide new insights for understanding youth psychological distress. Finally, practical implications for the design of supportive interventions for this study’s target group are proposed.

Medical Self-service Terminals (MST) offer potential for process optimization and enhanced patient convenience in hospitals, including the elderly. However, the behavioral inclination (BI) of elderly Chinese individuals towards MST adoption remains suboptimal. This study aims to elucidate BI determinants for MST among the aging demographic, focusing on User Interface (UI) attributes within the extended Unified Technology Acceptance and Use Theory (UTAUT) Model. The empirical inquiry examines seven factors, comprising three key UI attributes and four fundamental UTAUT factors. Results reveal significant positive associations of Performance Expectancy (β=0.40, p&lt;0.001), Effort Expectancy (β=0.50, p&lt;0.001), and Social Influence (β=0.25, p&lt;0.05) with BI. Notably, User Interface Design positively correlates with Performance Expectancy (β=0.89, p&lt;0.001) and Effort Expectancy (β=0.81, p&lt;0.001). These findings emphasize the interplay between objective UI attributes and subjective UTAUT determinants. This research enhances understanding of UI's impact on MST BI and acceptance, particularly within the Chinese elderly population, urging MST researchers to prioritize elderly attitudes for effective technological integration in healthcare.

Anti-islet autoantibodies serve as key markers in immune-mediated type 1 diabetes (T1D) and slowly-progressive T1D (SPIDDM), also known as latent autoimmune diabetes in adults (LADA). Autoantibodies to insulin (IAA), glutamic acid decarboxylase (GADA), tyrosine phosphatase-like protein IA-2 (IA-2A), and zinc transporter 8 (ZnT8A) are currently employed in the diagnosis, pathological analysis, and prediction of T1D. GADA can also be detected in non-diabetic patients with autoimmune diseases other than T1D and may not necessarily reflect insulitis. Conversely, IA-2A and ZnT8A serve as surrogate markers of pancreatic β-cell destruction. Combinatorial analysis of these four anti-islet autoantibodies demonstrated that 93-96% of acute-onset T1D and SPIDDM cases were diagnosed as immune-mediated T1D, while the majority of fulminant T1D cases were autoantibody-negative. Evaluating the epitopes and immunoglobulin subclasses of anti-islet autoantibodies help distinguish between diabetes-associated and non-diabetes-associated autoantibodies and is valuable for predicting future insulin deficiency in SPIDDM (LADA) patients. Additionally, GADA in T1D patients with autoimmune thyroid disease reveals the polyclonal expansion of autoantibody epitopes and immunoglobulin subclasses. Recent advancements in anti-islet autoantibody assays include nonradioactive fluid-phase assays and the simultaneous determination of multiple biochemically defined autoantibodies. Developing a high-throughput assay for detecting epitope-specific or immunoglobulin isotype-specific autoantibodies will facilitate more accurate diagnosis and prediction of autoimmune disorders.

The weakness of the dispersion-managed link combined with optical phase conjugation to compensate for optical signal distortion caused by chromatic dispersion and nonlinear Kerr effect of standard single mode fiber is its limited structural flexibility. We propose dispersion map that can simultaneously compensate for the distorted wavelength division multiplexed signal while increasing the configurational flexibility. Each residual dispersion per span (RDPS) in the former half of the proposed link is randomly determined, and in the latter half, the arrangement order of RDPS is the same as or inverted in the former half. We confirm that the dispersion maps in which the RDPS distribution pattern in the latter half is opposite to the arrangement order in the former half are more effective in compensation, and rather, the compensation effect is better than in the dispersion map of the conventional scheme. The notable result of this paper is that the increase of flexibility can be achieved through random arrangement of RDPS in the former half, and the compensation improvement can be achieved by through inverse arrangement in the latter half which make the distribution profile of each half link roughly symmetric with respect to the midway optical phase conjugator.

Mortality in children accounts for 15% of all AIDS-related deaths globally, with a higher burden among Cameroonian children (25%), likely due to poor virological response. We sought to evaluate viral suppression (VS) and its determinants in a nationally representative paediatric and young adult population receiving antiretroviral therapy (ART). A cross-sectional and multicentric study was conducted among Cameroonian children (

Detecting suicidal ideation in adults with major depression is crucial for timely intervention and prevention of self-harm. As suicide is influenced by various biological, socio-cultural and psychological factors, traditional screening methods have accuracy and efficiency limitations. In certain cultures, societal stigma and marginalization can compel individuals with depression to conceal their suffering. Such individuals often turn to online social media platforms and share their experiences with peers under the protection of anonymity. Our research explored the potential of machine learning detection of suicidal ideation among Romanian adults with major depression that contributed to a web-based depression support forum. A trained algorithm (C4.5 decision tree) analyzed 125 posts fed to on a free access online support forum over 5 years (2014 – 2018) and classified them based on suicidal ideation content. 32 texts (25%) were identified as having a high probability of suicidal ideation content. 65% of the authors were male, with a mean age of 36.7±10.3 years and an average duration of illness of 3.4±1.4 years. Texts indicating positive suicidal ideation were generally shorter and elicited more general responses but fewer professional responses compared to those without suicidal ideation content. The study's main limitations include the relatively small number of classified texts, the absence of prospective information and the lack of qualitative evaluation of the excerpts' content. As socio-demographic and linguistic actuarial results were comparable to data reported by real life studies, we may consider basic text mining techniques as a screening tool that is able to detect suicidal ideation in texts written in unstructured Romanian language.

Background: Carers (or care partners) of adults in LTC contribute substantially to the health and well-being of their loved ones by providing physical care, emotional support, and companionship. Despite their critical role, little is known about how caregivers have been impacted by the pandemic. The purpose of this study was to explore the lived experiences of caregivers of people living in long-term care (LTC) homes during the initial phases of the COVID-19 pandemic and potential supports and resources needed to improve caregivers’ quality of life.Design: An interpretive descriptive approach that incorporated photovoice method was used. Methods: Using purposive sampling strategy, six family carers in Ontario, Canada were recruited between September and December 2021. Over a four-week period, caregivers took pictures depicting their experience of the pandemic that were shared in a virtual focus group. Visual and text data were analyzed using thematic analysis with an inductive approach.Findings: Caregivers expressed feelings of frustration, confusion, and joy. Emerging themes included: (i) feeling like a “criminal” amidst visitor restrictions and rules; (ii) experiencing uncertainty and disappointment in the quality of care of long-term care homes; (iii) going through burnout; and (iv) focusing on small joys and cherished memories.Conclusions: The combination of visual and textual methods provided unique insight into the mental distress, isolation, and intense emotional burdens experienced by caregivers during the pandemic. Impact: Our findings underscore the need for LTC organizations to work in unison with caregivers to optimize the care of residents and support mental health of caregivers.

Background: Heat waves are correlated with increased mortality in the aged population. Social isolation is known as a vulnerability factor. This study aims at evaluating the correlation between an intervention to reduce social isolation and the increase in mortality in the population over 80 during heat waves. Methods: The study adopts a retrospective ecologic design. We compared the excess mortality rate (EMR) in the over 80 population during heat waves in urban areas of Rome (Italy), where a program to reduce social isolation was implemented compared to others where it was not implemented. We measured mortality of the summer periods from 2015 to 2019 compared with 2014 (a year without heat waves). Winter mortality, cadastral income and proportion of over 90 were included in the multivariate Poisson regression. Results: The EMR in the intervention and controls was 2.70% and 3.81%, respectively. Rate ratio 0.70 (c.i. 0.54 - 0.92, p-value 0.01). The Incidence Rate Ratio (IRR) of the interventions with respect to the controls is 0.76 (c.i. 0.59 - 0.98). After adjusting for other variables, the IRR was 0.44 (c.i. 0.32 - 0.60). Conclusions: Reducing social isolation could limit the impact of heat waves on the mortality of the elderly population.

Sarcomas are a heterogenous group of tumours that commonly carry poor prognosis with limited therapeutic options. Adolescents and young adults (AYA) with sarcoma are a unique and under-studied patient population that have only achieved modest survival gains compared to other groups. We present our institutional experience of AYA with sarcoma who underwent comprehensive molecular profiling (CMP) using either large-panel targeted DNA sequencing or whole genome and transcriptome sequencing and evaluated the feasibility and clinical impact of this approach. Genomic variants detected were determined to be clinically relevant and actionable following the Molecular Tumour Board evaluation. Clinicians provided feedback regarding the utility of testing three months after reporting. Twenty-five patients who were recruited for CMP are included in this analysis. The median time from consent to final molecular report was 45 days (interquartile range 37-57). Potentially actionable variants were detected for 14 patients (56%) and new treatment recommendations were identified for 12 patients (48%). Pathogenic germline variants were identified in three patients (12%), and one patient had a change of diagnosis. Implementation for CMP for AYA with sarcoma is clinically valuable, feasible and should be increasingly integrated into routine clinical practice as technologies and turnaround times continue to improve.

Background: The link between nocturia and aging male symptoms (AMS) has not been scientifically established. This study aimed to measure the degree of severity of AMS that impact on the health-related quality-of-life (HRQoL) in adult males living with nocturia, and to determine the predictive values of nocturnal factors on AMS. Methods: It is an extended analysis of new data collected by using the Hong Kong Traditional AMS (HK-AMS) scale and Cantonese version of the Pittsburgh Sleep Quality Index (PSQI) in a recently published cross-sectional population-based survey. Results: Of the 781 respondents that have completed the set of questionnaires, 68% and 61% of men living with nocturia reported clinically significant (at moderate-to-severe levels) somato-vegetative and sexual AMS, whereas the prevalence and severity were increased with advancing nighttime voiding frequency. The nocturia-specific QoL (NQoL) score and nocturnal frequency were found to be significant predictive factors for composite, somato-vegetative and sexual AMS, in addition to age, global OSQI score, and certain metabolic diseases. Conclusions: Current findings suggested the inclusion of nocturia when measuring the male-specific HRQoL related to aging.

In the TANGO study, the long-term noninferior efficacy of switching to dolutegravir/lamivudine (DTG/3TC) compared to continuing tenofovir alafenamide–based regimens was demonstrated in treatment-experienced adults with HIV. However, there is limited real-world data comparing the effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide fumarate (BIC/FTC/TAF) and DTG/3TC in Asia. This retrospective observational study, conducted at a designated HIV-care hospital from March 2019 to January 2023, aimed to address this gap. Demographic, clinical, and laboratory data, including HIV viral loads and lipid profiles, were collected and analyzed. The primary outcome was the proportion of patients with HIV RNA <50 copies/mL at week 48 in both groups, utilizing a snapshot, per-protocol–exposed population. A total of 1086 patients were included, with 511 in the DTG/3TC group and 575 in the BIC/FTC/TAF group. At week 48, 98% of patients in the DTG/3TC group and 94% in the BIC/FTC/TAF group achieved HIV RNA <50 copies/mL (p <0.01). Logistic regression analysis identified risk factors for detectable viral loads at week 48, including HIV RNA >100,000 copies/mL (AOR 5.13, 95% CI 1.42–18.53), low-level viremia (AOR 3.91, 95% CI 1.07–14.25), and record of virologic failure ≥2 times (AOR 4.21, 95% CI 1.64–10.85) before the switch. Furthermore, no significant difference was found between the DTG/3TC and BIC/FTC/TAF regimens (AOR: 1.51, 95% CI 0.70–3.24). In conclusion, the study demonstrates that the effectiveness and safety profiles of DTG/3TC and BIC/FTC/TAF were comparable in treatment-experienced adults with HIV, particularly among those with undetectable viral loads at baseline.

Modern drugs have changed epilepsy, which affects people of all ages. But for young people with epilepsy, the framework of drug development has stalled. In the wake of the thalidomide catastrophe, the misconception emerged that for people <18y antiseizure medications (ASMs) need separate proof of efficacy and safety (E&S), overall called “pediatric drug development.” This has been corrected to some extent. Authorities accept that ASMs are effective in <18y as well, but they still require "extrapolation of efficacy," as if minors were another species. In our view, the real problem is less that relevant parts of pediatric clinical epilepsy research over the past decades were useless, but that this has hampered research on meaningful challenges. We do not need to show that ASMs work also before the 18th birthday. But we need to learn how to best use ASMs to prevent brain damage in young patients and optimize ASMs use considering a broader range of aspects

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

Soil-transmitted helminthiasis (STH), a neglected tropical disease (NTD) remains a major health problem all over the world including Ghana, which has STH prevalence of 25.4%. To control the disease, the government of Ghana currently concentrates on implementing mass drug administration (MDA) efforts focusing only among school-aged children. However, various studies have suggested that focusing on only a specific group for MDA may not be cost-effective. Moreover, some adults such as teachers and school-workers spend large fraction of their time with children, who shed more parasite in environment due to unhygienic behavior, and thus have a higher risk of getting infected as compared to other adults. In this study we use a mathematical model to evaluate age-structured and risk-based policies for implementing MDA while capturing transmission dynamics of STH in Ghana. A cost model was developed that included various costs related to MDA to study cost-effectiveness of current policies of MDA in Ghana against novel policies to control STH in Ghana. We carry out analysis for five different scenarios— I: no MDA (baseline), II: current MDA policy (focusing children) in Ghana, III: MDA for different age groups (adults and children groups) for unlimited budget, IV: MDA for different age groups with limitations of number of individuals treated, and, V: MDA for different groups based on their risk of getting infected (adults school workers (high-risk group), adults non-school workers and children groups). Our results suggest that it might be more cost-effective to allocate treatment through MDA to at least some proportion of adults along with children. In case of unlimited budget, the best strategy in Scenario IV would be to treat approximately 22% of adults and approximately 45% of children. The most cost-effective among the 5 scenarios is suggested through scenario V, where high-risk adults group and children are provided MDA at higher level than low-risk adults. In conclusion, age-structured and risk-based allocation of treatment and resources is crucial to reducing STH load in developing countries.

SARS-CoV-2 virulence is known to increase with lowering of environmental temperature and solar ultraviolet radiation; therefore, we have focused our real-world nationwide study concerning with COVID-19 trends and dynamics on the coldest seasons of the year in Italy, the Western country hardest hit at the onset of the pandemic, comparing the autumn-winter of 2020 (before mass vaccination but when the emergency machinery was fully operative in terms of tracing and swabs) with the autumn-winter of 2021 (after mass vaccination), and analyzing the mortality burden by age groups and life stages in the years 2019 (pre-COVID-19), 2020 (before mass vaccination) and 2021 (after mass vaccination). Methods: During the state of national health emergency, the Civil Defense Department released the aggregate data coming from the Higher Institute of Health, the Ministry of Health, the Italian Regions, and the Independent Provinces, to inform the population (58.85 million people) about the pandemic situation, daily. Among these data there were the number of contagions, performed swabs, hospitalizations in Intensive Care Units (ICU), non-ICU patients, and deaths. By means of a team effort, we have collected and elaborated all these data, comparing the COVID-19 pandemic in Italy during the autumn-winter of 2020 with the autumn-winter of 2021. Moreover, we have extracted from the database of the National Institute of Statistics the total number of annual deaths in Italy during the years 2019, 2020 and 2021, comparing them to each other in order to evaluate the mortality burden attributable to COVID-19. Results: From the autumn-winter of 2020 to the autumn-winter of 2021, the contagions increased by ≈285%, however against a ≈290% increase in the performed swabs; therefore, the mean positivity rate passed from 8.74% before mass vaccination to 8.59% after mass vaccination. The unprecedent vaccination campaign allowed a ≈251% abatement in COVID-19 deaths, and a reduction of ≈224% and ≈228% in daily ICU and non-ICU hospitalizations due to COVID-19, respectively. Regarding COVID-19 deaths, in 2020 there was a mortality excess of ≈14.3% quantifiable in 105,900 more deaths compared to 2019, the pre-COVID-19 year; 103,183 out of 105,900 deaths occurred in older adults (≥60 years), which is equivalent to ≈97.4%, while in adults over 50, the segment of population just below older adults, in 2020 there were 2807 more deaths than in 2019. Surprisingly, from the analysis of our data, it is emerged that under the age of 40 in the years 2019, 2020 and 2021 there were 7103, 6808 and 7165 deaths, respectively. This means that in subjects under 40 during 2020 there were 295 fewer deaths than in 2019, while during 2021 there were 357 more deaths than in 2020, equivalent to ≈5.2% more. Conclusions: COVID-19 is a potential life-threatening disease mainly in older adults, as they are the most vulnerable due to inherent immunosenescence and inflammaging. Extensive vaccination in this segment of population with up-to-date vaccines is the means to reduce deaths, hospitalizations, and ICU pressure in the public interest. In the event of future threats, a new mass vaccination campaign must not be implemented without taking into account the individual age; it should primarily be aimed at people over 60 and at patients of any age with immune deficits, and secondly at people over 50. COVID-19 vaccination shows a favorable benefit-risk balance in older adults, while this balance falls under the age of 40; this younger segment of population should be therefore exempt from any mandatory vaccination.

Background. The markerless motion capture system (MLS) is a new technology that uses deep learning to detect body segments from digital images. This study tested the agreement between the MLS and a force-plate based system (FPS, “gold standard”) to quantify stability control and motor performance (MP) during gait initiation (GI). Methods. Healthy adults (young and elderly) and patients with Parkinson’s disease (PD) performed GI series at spontaneous and maximal velocity on an FPS while being filmed by an MLS. Signals from both systems were used to compute the peak of forward center-of-mass velocity (indicator of MP) and the braking index (BI, indicator of stability control). Results. Descriptive statistics indicated that both systems detected between-groups differences and velocity effects similarly, while a Bland-Altman (BA) plot anal-ysis showed that BI and MP mean biases were virtually zero in all groups and conditions. Bayes factor 01 indicated strong (for BI) and moderate (for MP) evidence that both systems provided equivalent values. However, trial-by-trial analysis of BA plots revealed the possibility of differ-ences > 10% between the two systems. Conclusion. Although non-negligible differences do occur, MLS appears to be as efficient as FPS in detecting PD and velocity condition effects on BI and MP

The electronic cigarette or e-cigarette is the new alternative method to deliver nicotine. In 2007, the United States introduced vaping devices on the market. Due to their attractive taste and lack of adverse effects, these vaping devices have gained popularity among youth and adults. However, there has been increasing evidence that vaping can cause severe lung injury, and these devices release toxic chemicals into the body. E-cigarettes are recognized as a global threat to public health. Nicotine, the most prevalent chemical in vaping devices, is associated with neurological problems and cognitive decline. Long-term use of e-cigarettes can cause adverse health problems, including respiratory illnesses, asthma, bronchitis, and lung inflammation. In 2019, the Centers for Disease Control and Prevention (CDC) officially declared vaping-associated illness EVALI (e-cigarette or Vaping Product Associated Lung Injury). The US Surgeon General published an alarm in December 2016 that e-cigarette consumption among adolescents and teens in the US is a "major public health concern" and that more young people are now vaping than smoking traditional cigarettes and cigars. Since its commercial introduction in 2003, modern electronic cigarettes (or E-cigarette s) have become increasingly popular with smokers, non-smokers, and those who used to smoke who have switched to them. With such a rise in consumption, people are becoming more aware of the irritating, harmful, and perhaps cancer-causing effects on the lungs. (Chadi et al., 2019; Dinardo & Rome, 2019; Lyzwinski et al., 2022; Marrocco et al., 2022; O’Callaghan et al., 2022)

Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effec-tiveness. We performed a systematic review and meta-analysis of the adjusted relative vaccine effectiveness (arVE) of seed cell-cultured influenza vaccines (ccIV) compared to egg-based influ-enza vaccines (eIV) in preventing laboratory-confirmed influenza related outcomes (IRO) or IRO by clinical codes, in subjects 18 and over. We completed the literature search in January 2021; ap-plied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, pub-lication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed us-ing a random approach. International Prospective Register of Systematic Reviews, CRD42021228290. We identified 12 publications that reported 26 adjusted arVE results. Five publications reported 13 laboratory confirmed arVE and seven reported 13 code-ascertained arVE. Nine publications with 22 results were at low risk of bias. Heterogeneity was explained by season and risk of bias. We found a significant 11% (8 to 14%) adjusted arVE favoring ccIV in preventing any IRO in the 2017-2018 influenza season. The arVE was 3% (-01 to 7%) in the 2018-2019 influenza season. We found moderate evidence of a significant advantage of the ccIV in preventing IRO, compared to eIV, in a well-matched A(H3N2) predominant season.

Sustaining learners’ motivation to keep learning has been concerned for over 60 years in education and SLA. Most research focusing on Japanese university students has contributed lots of theoretical and practical developments, but research focusing on motivations of non-traditional adult learners and those under 18-year-old to learn Chinese is still little even though previous research findings have proved age is one of the key variables influencing learning besides nationalities and Chinese language levels. In order to find an effective treatment for sustainable Chinese language learning in Japan, this study utilized a survey method to analyze the types of Japanese learners’ motivation to learn Chinese via analysis of a moment structures (AMOS), and to compare the differences of the motivation via one-way ANOVA. This study revealed that Japanese learners’ motivation to learn Chinese consists of eight common types, which are “instrumental motivation”, “personal orientation”, “identified regulation”, “Chinese cultural productions”, “integrating into Chinese community”, “external regulation”, “social responsibility”, and “Chinese for academic purposes”. Also, there are similarities and differences existing in the eight motivation types among the Japanese children, adolescents, (non-) traditional adult learners of Chinese as a foreign language (CFL). The findings contribute the understanding of motivation types and differences among the four aged Japanese learners to teachers of teaching Chinese to speakers of other languages (TCSOL), and to future research further exploring how differently aged Japanese learners can have and use a higher motivation as a main drive to learn Chinese language as a lifelong business.

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical, geographic variables, and neighborhood socio-economic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to patients who received home health care within the recommended first two days, patients who received delayed services (3-7 days after discharge) had higher odds of rehospitalization (OR 1.28, 95% CI 1.25-1.32). Among patients who received late services (8-14 days after discharge), the odds of rehospitalization were four times greater than for patients receiving services within 2 days (OR 4.12, 95% CI 3.97-4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.

The simplified, combined protocol admits children with a mid-upper-arm circumference (MUAC) of <125 mm or edema to malnutrition treatment with ready-to-use therapeutic food (RUTF) prescribing 2 daily RUTF sachets to children with MUAC <115 mm or edema and 1 daily sachet to those with MUAC ≥115 mm but <125 mm. This treatment has previously been shown to result in non-inferior programmatic outcomes compared to standard treatment. We aimed at observing its effectiveness in a routine setting at scale, including via delivery by community health workers (CHW). A total of 27 601 children were admitted to the simplified, combined treatment. Treatment resulted in 96% overall recovery with a mean LOS of 40 days and a mean RUTF consumption of 63 sachets per child treated. Among children admitted with MUAC <115 mm or edema 94% recovered with a mean LOS of 55 days and consuming an average of 97 RUTF sachets. Recovery in all sub-groups studied exceeded 90%.Treatment by CHWs resulted in similar (96%) recovery as treatment by formal health care workers (96%). The simplified, combined protocol results in high recovery and low RUTF consumption per child treated, and can safely be adopted by CHWs to provide treatment in the community-level.

This study examines the association of sociodemographic risk factors and the comorbidities of COVID-19. Most COVID-19-related studies were conducted in inpatient settings among patients with severe infection during the first and second waves of the pandemic. The third wave with less severe Omicron variant presented a unique opportunity to observe the adult patients treated in outpatient settings. We conducted a cross-sectional study (117 patients aged &gt; 40 years presented with symptomatic COVID-19). We employed the Charlson Comorbidity Index (CCI) to compute comorbidity burden, Medical Outcomes Survey Short form (SF-12) to measure general health, and Self-care Self- Efficacy Scale (SCSES) to assess self-care ability. Fisher’s exact test and analysis of variance (ANOVA) were used to compute the relationship between comorbidities and demographics. This study report focuses on the distribution of the comorbidities and its relationship to demographic variables. The top five comorbidities were hypertension (42%), diabetes (31%), pulmonary disease/asthma (19%), depression (14%), and cancer (11%). Depression was significantly higher among younger age groups (p&lt;0.01) and women (p&lt;0.05). Age (p&lt;0.0001) and income (p&lt;0.01) were the most significantly associated demographics with the comorbidity burden. Incidence of pulmonary disease showed a positive association to educational status (p=0.05). This was the first study to report a significant prevalence of depression among adults with symptomatic COVID-19.

High average power narrow-linewidth tunable solid-state lasers in the wavelength region between 2 to 3 μm are attractive light sources for many applications. This paper reports a narrow-linewidth widely-tunable laser system based on the polycrystalline Cr2+:ZnSe elements pumped by the repetitively-pulsed 2.1 µm Ho3+:YAG laser operating at the tens of kilohertz pulse rate. An advanced procedure of ZnSe-element doping and surface improvement was applied to increase the laser-induced damage threshold, which resulted in an increase of the output power of the Cr2+:ZnSe laser system. The high-average-power laser system comprised double master-oscillators and power amplifiers: Ho3+:YAG and Cr2+:ZnSe laser oscillators, and Ho3+:YAG and Cr2+:ZnSe power amplifiers. The output wavelength was widely tuned within 2.3-2.7 µm by an acousto-optical tunable filter inside the Cr2+:ZnSe master oscillator cavity. The narrow-linewidth operation at the pulse repetition rate of 20-40 kHz in a high-quality beam with the average output power up to 9.7 W was demonstrated.

Cognitive impairment in older adults is associated with poor gait performance, physical decline, falls and poor quality of life. This paper analyzes the feasibility and efficacy of a tango-based in-tervention in older people with cognitive impairment living in nursing homes. A multicenter study, with pre and post-test, was carried out. Intervention attendance, well-being, physical abilities (Short Physical Performance Battery), walking performance, functional capacities (Katz Index), and quality of life (Quality of Life in Alzheimer’s Disease) were assessed. Fifty-four participants (84.9 ± 6.7 years, Mini Mental State Examination 14.5 ± 7.4) completed the protocol. Intervention attendance was 92%, and the mean subjective well-being after each session was 4.5 ± 0.5 (on a five-point scale). Statistically significant improvement was found in the quality of life (p = 0.030). Non statistically significant changes were found in walking performance, physical abilities, or in functional capacities. The study shows feasibility and suggests evidence for the effects of Tango therapy on well-being and quality of life. Further studies are necessary to contrast these findings and to verify the role of Tango interventions as a holistic approach to prevent functional decline in older people with cognitive impairment.

Healthy aging among older adults requires the maintenance of good physical and cognitive activity. However, in the natural course of aging, older adults usually experience a decline in their physical and cognitive activity, causing an increasingly sedentary lifestyle. Some older adults may not have a choice but to become increasingly sedentary as they age due to injury or deteriorated physicality. As such they require a manner of assistive technologies to aid in their daily lives and activities to maintain healthy cognitive function. Social Robots are a newer form of assistive technology, specifically designed for social interactions and gameplay. As with other assistive technologies, compliance barriers to the acceptance and use of social robots and types of meaningful, seated activities among older adults are expected. To better explore this phenomenon, improve quality of life and understand what drives older adults to accept and use newer forms of technology like social robots, this research conjoins two conceptual frameworks: The Activity Theory of Aging (ATA) and the Unified Theory of Acceptance and Use of Technology (UTAUT). As social robots hold great promise for improving the quality of life for older adults, exploring what driving factors could enable their greater acceptance and use is essential to furthering this field of study within Australia.

The Gilles de la Tourette syndrome (GTS) and Non-Coeliac Gluten Sensitivity (NCGS) may be associated. We analyse the efficacy of a gluten-free diet (GFD) in 29 patients with GTS (23 children; 6 adults) in a prospective pilot study. All of them followed a GFD for one year. The YGTSS, Y-BOCS/CY-BOCS and GTS-QOL questionnaires were compared before and after the GFD. 74% of children and 50% of adults were males, not significant (NS). At the beginning of the study, 69% of children and 100% of adults had associated OCD (NS). At baseline, the YGTSS scores were 55.0 ± 17.5 (children) and 55.8 ± 19.8 (adults) (NS), the Y-BOCS/CY-BOCS scores were 15.3 (SD = 12.3) (children) and 26.8 (9.2) (adults) (p = 0.043), and the GTS-QOL scores were 42.8 ± 18.5 (children) and 64 ± 7.9 (adults) (p = 0.000). NCGS was frequent in both groups, with headaches reported by 47.0% of children and 83.6% of adults (p = 0.001). After one year on a GFD there was a marked reduction in measures of tics (YGTSS) (p = 0.001), and the intensity and frequency of OCD (Y-BOCS/CY-BOCS) (p = 0.001), along with improved QOL (p = 0.001) in children and adults. In conclusion, a GFD maintained for one year in GTS patients led to a marked reduction in tics and OCD both in children and adults.

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD), which has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as an ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 &amp; 0.91, p values = 0.001, 95% CI: 0.80-0.92 &amp; 0.87 to 0.94, sensitivity = 0.85 &amp; 0.87, specificity = 0.73 &amp; 0.83, Youden index = 0.58 &amp; 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by the irritability expressed stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability resulted from direct and indirect effects of key PTSD symptoms (intrusion, hyperarousal, and numbing). Irritability contributed to traumatic symptoms of sleep disturbance in both samples while the opposite was not true. The findings suggest usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/ co-morbidities (sleep disturbance) in both healthy and diseased groups.

The SARS-CoV-2 virus that causes the COVID-19 disease has wreaked havoc on the world community in terms of every imaginable parameter. The research output on COVID-19 has been nothing short of phenomenal, especially in the medical and biomedical sciences, where the search for a potential vaccine is being conducted in earnest. Much of the advanced research has been distributed in the leading medical journals, including the Journal of the American Medical Association (JAMA), where the latest research is distributed on a daily basis. The purpose of this paper is to provide some perspectives on 44 interesting and highly topical research papers that have been published in JAMA, at the time of writing, within the past two weeks. The diverse topics include public health, general medicine, internal medicine, oncology, paediatrics, geriatrics, and biostatistics.