Health practices and illness cognition in young, middle aged, and elderly adults

Pain catastrophizing in the elderly: An experimental pain study

OBJECTIVES

Pain catastrophizing in the aging population has not been studied in great detail. Existing investigations have reported conflicting results on the effects of age on pain catastrophizing in relation to pain responses. This study investigated the relationship between pain catastrophizing, and its individual components (rumination, magnification, and helplessness), and the responses to standardized experimental pain stimuli in old and young, healthy adults.

METHODS

Sixty-six volunteers (32 old: 65-87, 18 females; 34 young: 20-35, 17 females) participated in the study. Pain catastrophizing including the components of rumination, magnification, and helplessness was assessed with the pain catastrophizing scale (PCS). Experimental pain was induced by applying predefined pressure stimulations to the trapezius muscle. Pain intensity and unpleasantness were assessed using numerical rating scales. Pain catastrophizing levels and pain responses were statistically compared between the two age groups.

RESULTS

Elderly individuals reported significantly (p = 0.028) lower scores of pain catastrophizing (Med = 5; interquartile range [IQR] = 14) than younger individuals; this difference was driven by the significantly lower components of rumination (Med = 2; IQR = 4; p = 0.017) and helplessness (Med = 2; IQR = 7; p = 0.049). A larger proportion of young (57.8%) rated pain catastrophizing at high levels, with scores above the 75th percentile (Med = 20). Additionally, elderly reported the lowest pain intensity (Med = 5; p = 0.034) and pain unpleasantness (Med = 4.5; p = 0.011) responses to the experimental pressure stimuli. In the elderly group, pain unpleasantness was positively and significantly associated with pain catastrophizing (r s = 0.416, p = 0.021), rumination (r s = 0.42, p = 0.019), and helplessness (r s = 0.434, p = 0.015), respectively. No associations were found in the young group.

CONCLUSIONS

Elderly reported lower PCSs than young adults. Rumination and helplessness were reduced in the elderly group. The elderly population showed positive correlations between catastrophizing levels and pain unpleasantness to standardized pressure pain stimuli. Results supported the view that elderly possess resilience over specific domains of pain catastrophizing that could counteract pain perception due to physiological decline.

Age-Related Association Between APOE ɛ4 and Cognitive Progression in de novo Parkinson's Disease

BACKGROUND

APOE ɛ4 genotype was correlated with exacerbation of pathology and higher risk of dementia in Parkinson's disease (PD). Meanwhile, the differential influence of APOE ɛ4 on cognition in young and old individuals interpreted as antagonistic pleiotropy.

OBJECTIVE

To examine whether the effect of APOE ɛ4 on cognitive progression in de novo PD is age dependent.

METHODS

In this study, 613 de novo PD patients were recruited from Parkinson's Progression Markers Initiative (PPMI). To examine the age-dependent relationship between APOE ɛ4 and cognitive changes, we added 3-way interaction of APOE ɛ4*baseline age*time to the linear mixed-effect (LME) models and evaluated the specific roles of APOE ɛ4 in the middle age group and elderly group separately. Cox regression was utilized to examine the progression of cognition in age-stratified PD participants.

RESULTS

Age significantly modified relationship between APOE ɛ4 and cognitive changes in most cognitive domains (pinteraction <0.05). In the elderly group, APOE ɛ4 carriers showed steeper decline in global cognition (p = 0.001) as well as in most cognitive domains, and they had a greater risk of cognitive progression (adjusted HR 1.625, 95% CI 1.143-2.310, p = 0.007), compared with non-carriers. However, in the middle age group, no significant relationships between APOE ɛ4 and cognitive decline can be detected.

CONCLUSION

Our results indicated that the APOE ɛ4 allele has an age-dependent effect on cognitive decline in PD patients. The underlying mechanisms need to be investigated in the future.

The Association of Internet Use Intensity and Lifestyle Behaviors During the COVID-19 Pandemic: A Cross-Sectional Study in Chinese Adults

The COVID-19 pandemic substantially increased the intensity of internet use in humans, which has made public opinion around health and public perceptions of it more vital, and this phenomenon has had a significant impact on human lifestyle behavior. This study used cross-sectional data during the COVID-19 pandemic to explore how internet use intensity influenced lifestyle behaviors among adults, and compared the differences between samples of different ages. The findings showed that the internet use intensity among adults increased the probability of physical activity, staying up late, and high-quality eating behaviors, and that they had a statistically significant positive association. Such associations were also found in independent younger, middle-aged, and older samples. However, the internet use intensity elevated the probability of body weight gain only in the independent samples of younger, middle-aged, and older adults. Besides, internet use intensity was able to increase the probability of smoking & drinking only among the younger sample. Notably, the effect of internet use intensity on lifestyle behaviors, including body weight gain, physical activity, staying up late, and a high-quality diet, was strongest among the elderly, followed by the middle-aged, and weakest among the younger. In the process of rural and urban governance regarding citizens' health, public health agencies should remind citizens to spend a reasonable amount of time on internet use to reduce the probability of unhealthy lifestyle behaviors and improve their physical health.

Differences in Physical Characteristics of the Lower Extremity and Running Biomechanics Between Different Age Groups

(1) Background: The objective of this study was to determine physical and biomechanical changes in age groups upon running. (2) Method: 75 male adults (20–80s) participated in the study. Bone mineral density and lower extremity joint strength were measured according to age-increase targeting. Based on age, correlations among running characteristics, impulse, impact force, maximum vertical ground reaction force, loading rate, lower extremity joint 3D range of motion, joint moment, and power upon running motion were calculated. (3) Result: Older runners tended to show lower bone mineral density, extremity maximum strength, stride time, and stride distance, with smaller RoM and joint power of ankle and knee joints in the sagittal plane, compared with younger subjects. However, there were no significant correlations between age and impact variables (i.e., impulse, impact force, peak GRF, and loading rate) during running. (4) Conclusion: Older runners tend to show weaker physical strength characteristics, such as bone mineral density and muscle strength and lower joint functionality of ankle and knee joints during running, compared with younger runners. Therefore, strengthening the lower extremity muscle and improving dynamic joint function, especially for ankle joints, can be helpful for injury prevention during running.

Healthy Behavior as a Mediator in the Relationship Between Optimism and Life Satisfaction in Health Sciences Students: A Cross-Sectional Study

Purpose

This study examines the indirect relationship between optimism and life satisfaction via healthy behavior among health sciences students.

Participants and Methods

The cross-sectional study involved 349 health sciences students, including 58% of women, ranging in age between 19 and 30 years (M = 22.15, SD = 1.83). Self-report questionnaires were used to measure dispositional optimism (the Life Orientation Test-Revised, LOT-R), life satisfaction (Satisfaction with Life Scale, SWLS), and health behaviors (Health Behavior Inventory, HBI), with four subscales: healthy diet (HD), preventive behavior (PB), positive mental attitudes (PMA), and healthy practices (HP). In addition, a single mediation model (with the total HBI as mediator) was compared with a parallel mediation model (with four subscales of the HBI). Gender was controlled as a confounding variable.

Results

Women scored higher in the total HBI (p < 0.01), HD (p < 0.001) and PB (p < 0.01) than men, while men scored slightly higher in dispositional optimism (p < 0.01). General health behavior (total HBI) completely mediates the relationship between dispositional optimism and life satisfaction, R² = 0.32. In the parallel model, only PMA was determined as a mediator of the association between dispositional optimism and satisfaction with life, R² = 0.36. The single mediation model showed perfect fit (X²/df = 0.00, RMSEA = 0.00, SRMR = 0.00, CFI = 1.00, IFI = 1.00, NFI = 1.00), better than the parallel mediation model (X²/df = 2.353, p = 0.095, RMSEA = 0.062, SRMR = 0.020, CFI = 0.995, IFI = 995, NFI = 991).

Conclusion

The interplay mechanism between personal resources and behavioral health-related habits may explain 32% of life satisfaction variance. The intervention focused on increasing optimistic expectancies and health behaviors should be implemented in universities to increase students’ well-being and prevent depression.

A mechanistic model for long-term immunological outcomes in South African HIV-infected children and adults receiving ART

Long-term effects of the growing population of HIV-treated people in Southern Africa on individuals and the public health sector at large are not yet understood. This study proposes a novel ‘ratio’ model that relates CD4+ T-cell counts of HIV-infected individuals to the CD4+ count reference values from healthy populations. We use mixed-effects regression to fit the model to data from 1616 children (median age 4.3 years at ART initiation) and 14,542 adults (median age 36 years at ART initiation). We found that the scaled carrying capacity, maximum CD4+ count relative to an HIV-negative individual of similar age, and baseline scaled CD4+ counts were closer to healthy values in children than in adults. Post-ART initiation, CD4+ growth rate was inversely correlated with baseline CD4+ T-cell counts, and consequently higher in adults than children. Our results highlight the impacts of age on dynamics of the immune system of healthy and HIV-infected individuals.

The human immunodeficiency virus (HIV) remains an ongoing global pandemic. There is currently no cure for HIV, but antiretroviral therapies can keep the virus in check and allow individuals with HIV to live longer, healthier lives. These drugs work in two ways. They block the ability of the virus to multiply and they allow numbers of an important type of infection-fighting cell called CD4+ T cells to rebound.

As more patients with HIV survive and transition from one life stage to the next, it is critical to understand how long-term antiretroviral therapies will affect normal age-related changes in their immune systems. The health of an immune system can be evaluated by looking at the number of CD4+ T cells an individual has, though this will vary by age and location. Clinicians use the same metrics to assess the immune health of individuals with HIV, however, as they age, it becomes a challenge to identify if a patient’s immune system recovers normally or insufficiently. Thus, learning more about age-related differences in CD4+ T cells in people living with HIV may help improve their care.

Using data from 1,616 children and 14,542 adults from South Africa, Ujeneza et al. created a simple mathematical model that can compare the immune system of person with HIV with the immune system of a similarly aged healthy individual. The model shows that among individuals with HIV receiving antiretroviral therapies, children have CD4+ T-cell numbers that are closest to the numbers seen in healthy individuals of the same age. This suggests that children may be more able to recover immune system function than adults after beginning treatment. Children also start antiretroviral therapies before their immune system has been severely damaged, while adults tend to start treatment much later when they have fewer CD4+ T cells left.

Ujeneza et al. show that the fewer CD4+ T cells a person has when they start treatment, the faster the number of these cells grows after starting treatment. This suggests that the more damaged the immune system is, the harder it works to recover. This reinforces the need to identify people infected with HIV as soon as possible through testing and to begin treatment promptly. The new model may help clinicians and policy makers develop screening and treatment protocols tailored to the specific needs of children and adults living with HIV.

The Relationship Between Spirituality, Health-Related Behavior, and Psychological Well-Being

Studies suggest a positive association of spirituality and health behaviors with well-being (especially subjective well-being), but still the precise character of such relationships between all these constructs remains unknown. The present study aims to explore the relations between spirituality, health-related behaviors, and psychological well-being in the context of acquired education. A questionnaire survey was conducted among 595 students from six different universities, whose study programs either focused on the human body or the human mind and spirit. Path analysis and linear regression were used to model the relationship between the examined constructs. The results show that both spirituality and health-related behaviors are positively related to psychological well-being, and that the relationship with spirituality is also mediated by health-related behaviors. Only spirituality is associated with the type of acquired education, especially in the group of students whose studies focus on the human mind and spirit. Moreover, spirituality in this group seems to display a stronger relationship with psychological well-being. These findings may contribute to the better understanding of some significant determinants of psychological well-being. They carry important implications for the faculty members responsible for curriculum preparation to account for teaching contents related to the conduct of a healthy lifestyle and to spiritual development.

Perceived susceptibility to developing cancer and screening for colorectal and prostate cancer: A longitudinal analysis of Alberta's Tomorrow Project

INTRODUCTION

To assess the association between perceived susceptibility of developing cancer and being screened via sigmoidoscopy/colonoscopy and prostate-specific antigen, respectively.

METHODS

Participants aged 35-69, who resided in Alberta, Canada, were enrolled into the study between 2000 and 2008. We used general linear mixed models, adjusted for age, marital status, work status, education, family history and place of residence, to explore the association.

RESULTS

Perceived susceptibility of developing cancer was associated with both screening tests at baseline and a maximum of 14-year follow-up: (i) colorectal cancer screening - adjusted odds ratios were 1.97 (95% CI = 1.52-2.55) per one-unit increase in participants' personal belief in susceptibility to cancer, and 1.03 (95% CI = 1.00-1.04) per one-percent increase in participants' estimate of their own chance of developing cancer; (ii) prostate cancer screening - adjusted odds ratios were 1.36 times greater (95% CI = 1.07-1.72), and 1.02 times higher (95% CI = 1.01-1.03), for each respective perceived susceptibility measure.

CONCLUSION

Health promotion can focus on targeting and heightening personal perceived susceptibility of developing cancer in jurisdictions with low screening rates for colorectal or prostate cancer.

Psychological Predictors of Mortality Awareness: Time Perspective, Contentment With Age and Paternal Antipathy and Neglect

Much research has focused upon the association between mortality awareness and mental ill-health. In this study we attempt to explore positive as well as negative psychological concomitants of mortality awareness. 170 participants were recruited in an online questionnaire study, measuring seven independent variables - marginalisation, childhood adversity, rebelliousness, time perspective, attitudes toward age and stage of life, health attitudes and demographics - and five dependent variables, specifically mortality legacy, mortality fearfulness, mortality acceptance, mortality disempowerment and mortality disengagement. Several significant bivariate associations were found. Follow-up regression analysis observed combined effects of variables accounting for 28% of variance in mortality legacy, 27% for mortality fearfulness, 13% for mortality acceptance, 42% for mortality disempowerment and 25% for mortality disengagement. Time perspective, contentment with age, and paternal antipathy and neglect were the most notable independent predictors. It was concluded that attitudes towards health, stage of life and childhood experiences significantly predict mortality awareness.

Stroke in Older Survivors of Ischemic Stroke: Standard Care or Something Different?

Stroke is one of the leading causes of death and disability and it is more likely to occur in those who are older. Because people are living longer, the definition of "old" continues to evolve. Age alone should not influence the healthcare that a patient receives, however, evidence indicates that this does occur, especially in older patients. On the basis of the available evidence, it is time to reconsider whether or not stroke care should differ in older survivors of stroke and if so, why. This is a narrative review of stroke-related health care in those with a recent ischemic stroke. It seeks to answer the following question: Should patients aged ≥80 years who have experienced a recent ischemic stroke receive standard care or something different, and if they should receive something different, what should they receive and why? The review focusses on long-term survival, hyper-acute care, secondary prevention, and rehabilitation. The authors propose a number of recommendations in relation to stroke care in older survivors of a recent ischemic stroke.

Adulthood Predictors of Health Promoting Behavior in Later Aging

This study investigated adulthood predictors of health-promoting behavior in later aging. The participants were 162 members of the Terman Study of the Gifted (Terman et al., 1925), who responded in 1999 at an average age of 86 to a mailout questionnaire which included questions concerning their positive health behavior. Adulthood variables were obtained for analysis from the study archives. Cross-sectional analyses showed that health-promoting behavior was related to perceived health and well-being in later aging. In longitudinal analyses, “easygoingness” in adulthood was positively related to positive psychosocial behavior and positive health practices, and neuroticism was negatively related to positive psychosocial behavior in later aging. Perceived health in adulthood was related to positive psychosocial behavior, exercise, physical recreation, and other positive health practices. Education, perceived health in adulthood, recalled importance in adulthood of success in sports before the age of 12, and interest in outdoor sports in early adulthood, as well as current health problems, were related to exercise and physical recreation in later aging. Gender played a moderating role in the prediction of positive psychosocial behavior, with the relationship of self-rated health in adulthood and recalled importance of success in sports before the age of 12 with positive psychosocial behavior being stronger for men than for women.

Tattooing, Piercing, Healthy Behaviours and Health Value

This study was designed to investigate whether people who engage more frequently in healthy behaviours, and attach a higher value to health, are likely to engage less frequently in tattooing and piercing. One hundred and eight participants with tattoos and/or piercings completed questionnaires including the Reported Health Behaviours Checklist and the Health Value Scale. There were no significant relationships between healthy behaviours, health value and numbers of tattoos or piercings. A significant proportion of pierced and tattooed participants had not considered possible health risks, and those that had were often unaware of potentially serious health problems. Results are discussed in terms of health guidelines for tattooing and piercing.

Predicting Self-Care Behaviors Among Older Adults Coping With Arthritis

Objective: The purpose of this investigation is to examine correlates and predictors of self-care activities for persons diagnosed with arthritis both cross-sectionally and longitudinally. Method: Data from telephone surveys conducted with 313 older ( M = 68.8, SD = 8.93) individuals, chosen from a larger sample, who reported professionally diagnosed arthritis, were used. Results: A total of 10 of the 11 self-care activities changed significantly during the 1-year interval, with 9 showing increased participation. Results from hierarchical regressions showed that all three blocks of predictors explained significant portions of variance, with gender and perceived importance of general health significantly predicting self-care activities at Time 1, at Time 2, and longitudinally. Discussion: These results highlight the influence of demographic, health status, and health belief variables on self-care both cross-sectionally and longitudinally. Future work should focus on the mediating effects of these and other variables to better understand the processes by which individuals engage in self-care behavior.

Associations among Health Perceptions and Health Status within Three Age Groups

Using data from the 1984 Supplement on Aging to the National Health Interview Survey, the associations among five health perceptions and two indices of functional health status were investigated within each of three age groups (55-64, 65-79, 80+). Greater functional impairment was associated with less favorable health perceptions in all three age groups. However, the strength of association was not consistent for the five indices, leaving room for conflicting assessments of one's health. Efficacy at taking care of health and perceived control over health showed lower strengths of association with functional impairment, raising the possibility that the resilience of some perceptions may be studied in greater detail. Results for persons aged 80 and older were similar in some ways to those for persons aged 55-64; however, there was some evidence of stronger negative association with increasing functional limitation among persons aged 55-64, suggesting a possibly stronger impact of health problems in this group. Future research might usefully examine intraindividual consistency of health perceptions and behavior, in addition to looking for normative interindividual trends.

Health Behaviors and Social Roles among Mature Men and Women

This article explores the relationship between gender, social roles, age, education, number of health problems, and health behaviors in mature adults. Data from a national study focus on women and men ages 54 to 64. Analyses indicate that women are more likely to avoid risk-taking health behaviors; in particular, men are more likely to report that they drink alcohol. There were no gender differences in promotive health behaviors or cancer detection behaviors. Further analyses focus on the relationship of two social roles (marital and employment status), demographic variables (gender, age, education), and number of health problems on promotive health behaviors, risk avoidance behaviors, and cancer detection behaviors. Social roles are related to health behaviors as follows: employed women are less likely to report cancer detection behaviors than are unemployed women; married men are more likely to engage in risk avoidance behaviors than are unmarried men. Demographic comparisons indicate that education and to some extent, age, are associated with promotive health behaviors. Men and women with health problems are more likely to engage in cancer detection behaviors. The small sample size, however, suggests caution in the interpretation and generalization of these findings.

Social Support, Health-Promotive Beliefs, and Preventive Health Behaviors Among the Elderly

A high level of social support was a consistent predictor of preventive health behaviors among 936 elderly members of a health maintenance organization. Beliefs about the importance of preventive health behaviors contributed more toward predicting their performance than did other respondent characteristics. These results suggest that efforts to increase the practice of preventive health behaviors by the elderly might be augmented by strengthening both theirsocial support networks and their health-promotive beliefs.

Why People Experiencing Acute Myocardial Infarction Delay Seeking Medical Assistance

Background: Delay time from onset of symptoms of myocardial infarction to seeking medical assistance can have life-threatening consequences. A number of factors have been associated with delay, but there is little evidence regarding the predictive value of these indices. Aim: To explore potential predictors of patient delay from onset of symptoms to time medical assistance was sought in a consecutive sample of patients admitted to CCU with acute myocardial infarction. Methods: The Cardiac Denial of Impact Scale, Health Locus of Control Scale, Health Value Scale and Pennebaker Inventory of Limbic Languidness were administered to 62 patients between 3 and 6 days after admission. Results: Attribution of symptoms to heart disease and health locus of control had a significant predictive effect on patients seeking help within 60 min, while previous experience of heart disease did not. Conclusion: Assisting individuals to recognise the potential for symptoms to have a cardiac origin is an important objective. Interventions should take into account the variety of cognitive and behavioural factors involved in decision making.

Development and preliminary evaluation of the validity and reliability of a revised illness perception questionnaire for healthcare professionals

BACKGROUND

Diverging perceptions between individual patients with somatic diseases and their healthcare professionals might cause problems in communication and decision-making. To date, no measurement tool is available to compare the illness perceptions between these two groups. The Revised Illness Perception Questionnaire (IPQ-R) is a validated, widely used instrument in many patient populations with somatic conditions. The aim of this study was to adapt the IPQ-R to a healthcare professional's version (IPQ-R HP) and to perform a preliminary evaluation of its validity and reliability.

METHODS

After adaptation of the IPQ-R HP, 17 doctors from 3 general hospitals and 9 head nurses from a university hospital evaluated the face and content validity of the IPQ-R HP. The results were quantified using the content validity index (CVI) and a modified kappa index (k*). For the reliability measurements a group of nurses from 4 nursing wards participated at 2 time points with an interval of 4 weeks. Internal consistency and test-retest reliability were calculated.

RESULTS

Twenty-eight of the 38 items demonstrated excellent content validity and four items showed good content validity. Four items had a sufficient k* and two items had a low CVI. The average CVI of the 7 dimensions ranged from 0.66 to 0.89. The Cronbach's alpha scores for the seven dimensions, intraclass coefficients and effect size estimates were acceptable.

CONCLUSIONS

This preliminary evaluation of the IPQ-R HP shows an acceptable to good validity and reliability. Further exploration of the psychometric properties of this questionnaire in a large cohort of healthcare professionals is warranted.

Academic stress, self-efficacy, social support, and health behaviours in female Victorian Certificate of Education (VCE) students

This study examined academic stress in female Victorian Certificate of Education (VCE) students in terms of somatic symptoms and mood disturbance before, during, and after the midyear examination period and also examined the role of self-efficacy, number of social supports, social support satisfaction, and health behaviours in mediating the effects of stress on symptoms and mood disturbance. It was hypothesised that (a) student would report increased somatic symptoms and mood disturbance during the examination period and that (b) self-efficacy, social support (number and satisfaction), and health behaviours would account for a significant proportion of variance for somatic symptoms and mood disturbance before, during, and after the exam period. The participants were 51 VCE students from a large Catholic girls’secondary college in Melbourne. Four weeks before the exam period, the Generalized Self-Efficacy Scale, Reported Health Behaviours Checklist, Short Form Social Support Questionnaire, Symptoms Checklist, and Profile of Mood States were administered.The Symptoms Checklist and Profile of Mood States were administered again during the exam week and four weeks after the exam period. Statistical analyses showed that the VCE examination period was associated with significantly increased self-reports of somatic symptoms and mood disturbances that were strongly indicative of high levels of stress. Self-efficacy was found to have a weak role in mediating the stress response during the exam week. Social support did not account for any of the variation in academic stress. Health behaviours accounted for a small but significant proportion of the variance in stress after the exam period. It was concluded that there is a need to study other factors that may attenuate the academic stress response in adolescent secondary school students. The perceptual and cognitive appraisal of academic stressors is suggested as an area that may be worthy of examination.The implications of the findings are discussed in terms of the impact that academic stress may have on adolescents’ health during this critical period of development.

Self-management goal setting: identifying the practice patterns of community-based physical therapists

PURPOSE

To describe the collaborative goal-setting practices of community-based physical therapists trained in a self-management (SM) approach who work with clients with chronic conditions and to describe clients' goal-achievement rates. Methods : A retrospective chart review was conducted for 296 randomly selected home-care clients from July 2009 through July 2010 using a chart-abstraction form created to capture demographic data and information related to goal setting and achievement. Data were analyzed using frequencies, percentages, and Pearson's chi-square tests.

RESULTS

There was no significant relationship between sex, age, or number of chronic conditions and setting SM or non-self-management (NSM) goals or the type of SM goal set. The majority of goals set were "action" as opposed to "verbal" goals. A high proportion (89-100%) of both SM and NSM goals were met.

CONCLUSIONS

Clinicians should be aware that it is possible to set SM goals regardless of the client's sex, age, or number of chronic conditions. Other possible influences on goal setting, such as severity of chronic conditions and challenges of the health care system, should be further investigated.

A high-salt diet further impairs age-associated declines in cognitive, behavioral, and cardiovascular functions in male Fischer brown Norway rats

Aging-associated declines in cognitive, emotional, and cardiovascular function are well known. Environmental stress triggers critical changes in the brain, further compromising cardiovascular and behavioral health during aging. Excessive dietary salt intake is one such stressor. Here, we tested the effect of high salt (HS) on anxiety, learning-memory function, and blood pressure (BP) in male Fischer brown Norway (FBN) rats. Adult (A; 2 mo) and old (O; 20 mo) male rats were fed normal-salt (NS; 0.4% NaCl) or HS (8% NaCl) diets for 4 wk after being implanted with telemeter probes for conscious BP measurement. Thereafter, tests to assess anxiety-like behavior and learning-memory were conducted. The rats were then killed, and samples of plasma, urine, and brain tissue were collected. We found that systolic BP was higher in O-NS (117 ± 1.2 mm Hg) than in A-NS (105 ± 0.8 mm Hg) rats (P < 0.05). Furthermore, BP was higher in O-HS (124 ± 1.4 mm Hg) than in O-NS (117 ± 1.2 mm Hg) rats (P < 0.05). Moreover, anxiety-like behavior (light-dark and open-field tests) was not different between A-NS and O-NS rats but was greater in O-HS rats than in A-NS, O-NS, or A-HS rats (P < 0.05). Short-term memory (radial arm water maze test) was similar in A-NS and O-NS rats but was significantly impaired in O-HS rats compared with A-NS, O-NS, or A-HS rats (P < 0.05). Furthermore, oxidative stress variables (in plasma, urine, and brain) as well as corticosterone (plasma) were greater in O-HS rats when compared with A-NS, O-NS, or A-HS rats (P < 0.05). The antioxidant enzyme glyoxalase-1 expression was selectively reduced in the hippocampus and amygdala of O-HS rats compared with A-NS, O-NS, or A-HS rats (P < 0.05), whereas other antioxidant enzymes, glutathione reductase 1, manganese superoxide dismutase (SOD), and Cu/Zn SOD remained unchanged. We suggest that salt-sensitive hypertension and behavioral derangement are associated with a redox imbalance in the brain of aged FBN rats.

The association of health literacy with illness and medication beliefs among older adults with asthma

OBJECTIVE

Suboptimal health literacy (HL) and asthma beliefs are associated with poor asthma self-management and outcomes. We tested the hypothesis that low HL is associated with inaccurate beliefs.

METHODS

Asthmatics ≥60 were recruited from hospital and community practices in New York, NY and Chicago, IL (n=420). HL was measured with the Short Test of Functional Health Literacy in Adults; validated instruments derived from the self regulation model were used to assess beliefs. The association of beliefs with HL was evaluated with multivariate models.

RESULTS

Thirty-six percent of patients had low HL; 54% believed they only have asthma when symptoms are present, 29% believed they will not always have asthma and 20% believed that their doctor can cure asthma. HL was associated with beliefs of not having asthma all the time and that asthma can be cured (OR: 1.84, 95% CI: 1.2-2.82; OR: 2.22, 95% CI: 1.29-3.82, respectively). Patients with low HL were also more likely to be concerned about medication use (β=0.92, p=.05), despite recognizing their necessity (β=-1.36, p=.01).

CONCLUSIONS

Older asthmatics with low HL endorse erroneous asthma beliefs.

PRACTICE IMPLICATIONS

Health communications for improving self-management behaviors in asthma should employ both health literacy-appropriate strategies and messages to counter illness-related misconceptions.

Correlates of health attitudes among homosexual and bisexual men

There is increased emphasis on physician attention to the overall health and wellness of homosexual and bisexual men, though little is known about the health-related attitudes of these groups. This study determined factors associated with the health attitudes of homosexual and bisexual men and identified preferred sources of health information. For this study, the 2008 ConsumerStyles panel survey was used to create three health attitude scales and to determine factors associated with each scale. The three scales were labeled: (1) health motivation; (2) relationship with health care provider; and (3) self-perception of health literacy. In addition to other factors, higher scores for health motivation and relationship with health care provider were associated with black compared with white men. In contrast, lower scores for self-perception of health literacy were associated with black compared with white men. For information on an unfamiliar health condition, most homosexual and bisexual men chose the Internet. Black homosexual and bisexual men reported being motivated to be healthy and working well with their health care provider to manage their health. However, their perception of their own health motivation was low compared with the white men. Attempts to improve health literacy through Internet sites may be helpful in improving health attitudes and reducing negative health outcomes.

Impact of Race and Diagnostic Label on Older Adults’ Emotions, Illness Beliefs, and Willingness to Help a Family Member With Osteoarthritis

Objective:

To examine how race and the diagnostic label of Osteoarthritis (OA) affects older adults’ emotions, illness beliefs, and willingness to help a family member.

Methods:

African American and White older adults were randomly assigned to read vignettes describing a sister suffering from chronic pain and disability, either with or without the OA label. Race × diagnostic label ANOVAs were conducted.

Results:

Compared to Whites, African Americans were more optimistic that OA could improve with health care, and showed greater willingness to help their sister. The OA label had little impact on emotions, beliefs, or willingness to help. African Americans rated the sister as having more control of their problem than Whites without the OA label, but providing the diagnosis eliminated this difference.

Discussion:

The diagnostic label of OA had little effect on these older adults, but racial differences indicate that cultural values regarding family caregiving are important in arthritis care.

Attitudes, beliefs and perceptions regarding truth disclosure of cancer-related information in the Middle East: a review

The aim of this review is to evaluate the current status concerning attitudes, beliefs and/or practices of patients, family members, health professionals and/or caregivers regarding truth disclosure about a cancer diagnosis in the Greater Middle East countries. A search was done via MedLine for all publications related to this review objective. 55 publications were included emanating from Egypt, Iran, Israel, Jordan, Kuwait, Lebanon, Palestine Pakistan, Saudi Arabia, Turkey, and United Arab Emirates. In the Greater Middle East region, a diagnosis of cancer is still mixed with social stigma and misperceptions related to incurability. Physicians conserve a truth disclosure policy in which from one side they respect some of the historical and cultural misperceptions about cancer and accordingly, tell the truth about cancer to one of the family members and from another side acknowledge the patients' right to know the truth and tend to disclose it for him(or her) when possible. Family members and caregivers' attitudes, perceptions and beliefs about telling the truth to the patient seem to be in favor of concealment. Discrepant results concerning physicians' and patients' evaluation of the quality of truth disclosure exist in the literature. Education programs in breaking bad news are lacking in many countries. Finally, the most important and common problem affecting truth disclosure to a patient suffering from cancer is the lack of codes and legislations concerning the patients' rights in an informed consent. Studies, legislations and training programs are needed in this domain in Middle Eastern societies.

Assessment of health-promoting lifestyle profile in Japanese university students

OBJECTIVES

This descriptive study of 314 students was conducted to determine whether there were any relationships of their demographic variables with a health-promoting lifestyle profile.

METHODS

The Japanese version of the Health Promoting Lifestyle Profile II (HPLP-II) questionnaire was used to investigate students' lifestyles. One-way analysis of variance (ANOVA) and multiple comparison procedures using the Scheffe test were conducted to identify significant differences among university year (first, second, etc.) groups. The t-test independent participants was utilized to compare the HPLP-II scores according to gender and living with family (yes/no). Multiple regression analysis was used to analyze the effects of various demographics on the overall HPLP-II score and the six health-promoting lifestyle subscales.

RESULTS

The whole cohort of participants had an overall HPLP-II mean score of 2.50 (SD = 0.29), with the highest mean score being for interpersonal relations (3.05 ± 0.44), and the lowest mean score being for health responsibility (2.01 ± 0.53). The overall HPLP-II score of the students during the first university year was 2.59 (SD = 0.29), and this score progressively declined in their second year (2.49 ± 0.29), third year (2.47 ± 0.28), and fourth year (2.45 ± 0.30). Female students practiced significantly better health responsibility, interpersonal relations, and nutrition than males, and male students practiced significantly better physical activity than females. The students who were living with family had significantly higher nutrition scores than those not living with family.

CONCLUSIONS

These significant findings linking the HPLP-II, university year level, and living with family (yes/no) in university students will enable healthcare providers to develop interventions to assist students in improving their health lifestyles in the university environment and will help in devising suitable education programs.

Evaluation of the Mental Healthiness Aging Initiative: community program to promote awareness about mental health and aging issues

The objective of this study is to evaluate the Mental Healthiness Aging Initiative, designed to promote community awareness and knowledge about mental health and aging issues. This study occurred during 2007-2009 in 67 of 120 counties in Kentucky. A rural region (11 counties) received the intervention, consisting of focus groups, Extension Agent training, and television-based social marketing campaign. Partial-intervention counties (29 counties) received only the television-based social marketing campaign. The control counties (27 counties) received no intervention activities. Results indicated that the intervention counties agreed more with being able to assist elder adults with a potential mental illness. Also, the intervention counties understood the risk of consuming alcohol and medications better, but had a poorer recognition of drinking problems in elder adults. These findings need to be considered within study limitations, such as measurement error, degree of intervention exposure, and regional differences across intervention groups. The study demonstrates that community interventions on mental health awareness and knowledge are feasible within majority rural regions, with Extension Agents being gatekeepers, for promoting positive messages about mental health and aging issues.

Acceptability of newborn circumcision to prevent HIV infection in the United States

BACKGROUND/PURPOSE

To understand whether information from the African clinical trials about the partially protective effect of male circumcision against human immunodeficiency virus (HIV) infection could influence adults to circumcise a newborn son.

METHODS

Using the 2008 ConsumerStyles panel survey data, multiple regression analysis was performed to identify correlates of (1) inclination toward circumcising a newborn son and (2) being influenced to have a newborn son circumcised if it would reduce the chance of becoming HIV infected later in life.

RESULTS

Response rate was 50.6% (10,108/19,996). Approximately 12% reported not being inclined to circumcise a newborn son. Higher odds of not being inclined to circumcise a newborn son were associated with Hispanic and "other" race/ethnicity, being an uncircumcised man and a man not reporting circumcision status, postgraduate education, region, and negative health-related attitudes. Lower odds were associated with black race and less number of household members. Fifty-three percent of respondents reported that information about the protective effect of circumcision would make them more likely to have a newborn son circumcised. Higher odds of being influenced to have a newborn son circumcised were associated with being ≥45 years of age, black race, living in a household with fewer than 5 members, having high school or some college education, region, and positive health-related attitudes; lower odds were associated with being an uncircumcised man and lower income.

CONCLUSIONS

Our findings suggest that providing educational information about the HIV prevention and benefit of circumcision may increase the inclination to circumcise a newborn son for some people.

Salutogenic Perspectives on Health Maintenance

In this article we explore the impact of resistance resources and the sense of meaningfulness – the central component of the sense of coherence (SOC) – on retaining a health maintenance orientation. In this cross-sectional study, 170 rather healthy individuals of a mean age of 67 years filled out a questionnaire assessing resources (self-esteem, self-efficacy, physical health), SOC components (comprehensibility, manageability, and meaningfulness), and multiple health behaviors. Holding resources constant, the SOC components significantly accounted for additional variance in multiple health behaviors. Meaningfulness as the strongest predictor mediated the influence of both self-esteem and self-efficacy on multiple health behaviors. Feeling that one’s life is meaningful helps an older individual to take responsibility for his or her health and to practice multiple healthful behaviors.

Self-Care Among Older Adults

Cette synthèse de la documentation sur les soins personnels chez les personnes ^gées définit le concept en termes des comportements préventifs et des réponses à la maladie adoptés par les profanes à leur propre bénéfice. Après avoir placé les soins personnels dans leur contexte historique, l'auteur examine les perspectives théoriques et les principales constatations sur son incidence ainsi que les corrélats et les barrières. Cet examen est suivi d'une revue du processus et des résultats des interventions destinées à promouvoir les soins personnels. L'auteur termine en présentant des recommandations en vue du développement de la recherche, des politiques et de la pratique.

Attitudes towards the male contraceptive pill in men and women in casual and stable sexual relationships

BACKGROUND AND METHODOLOGY

Men's and women's attitudes towards the male contraceptive pill and their trust in the effective use of the male pill were investigated, as well as the associated variables of reported health behaviours, perceived self-efficacy and type of sexual relationship, using a questionnaire survey.

RESULTS

Although both sexes had a favourable attitude towards the male pill, females had a more positive attitude than men. Conversely, women had less trust that men would use the male pill effectively. Males in stable sexual relationships were more positive about the male pill than those in casual sexual relationships. Gender, relationship type and trust in the effective use of the male pill reliably predicted attitude towards the male pill. High perceived self-efficacy was related to engaging in more health behaviours, and in men a positive association between health behaviours and attitude towards the male pill has been found.

DISCUSSION AND CONCLUSIONS

A positive attitude towards the male pill does not automatically imply that the individual is confident about its effective use. Once the male pill is widely available, promotional campaigns could target not only men but also their female partners, as the latter tend to come into contact with health services more frequently. In order to increase confidence in effective implementation, a variety of presentations of the male pill should be made available in line with individual needs and lifestyles.

Effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on depressive symptoms of the caregivers of children with leukemia

The present study examined the effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on the depressive symptoms of the caregivers of children with leukemia. The sample was composed of 71 caregivers of children with leukemia living in Turkey. The obtained data were analyzed by path analysis. The results show that caregivers of children with leukemia experience higher levels of depressive symptoms when they have negative illness representation and lower levels of depressive symptoms when they perceive higher levels of social support. Moreover, they perceive higher social support when they perceive high quality of information provided by health-care professionals. It can be suggested that intervention programs which aim to increase caregivers' social support and change their illness representation in a positive way would be helpful for the caregivers showing depressive symptoms.

A coping and communication support intervention tailored to older patients diagnosed with late-stage cancer

As our society ages, increasing numbers of older Americans will be diagnosed and eventually will die of cancer. To date, psycho-oncology interventions for advanced cancer patients have been more successful in reaching younger adult age groups and generally have not been designed to respond to the unique needs and preferences of older patients. Theories and research on successful aging (Baltes and Baltes 1990; Baltes 1997), health information processing style (Miller 1995; Miller et al 2001) and non-directive client-centered therapy (Rogers 1951, 1967), have guided the development of a coping and communication support (CCS) intervention. Key components of this age-sensitive and tailored intervention are described, including problem domains addressed, intervention strategies used and the role of the CCS practitioner. Age group comparisons in frequency of contact, problems raised and intervention strategies used during the first six weeks of follow up indicate that older patients were similar to middle-aged patients in their level of engagement, problems faced and intervention strategies used. Middle-aged patients were more likely to have problems communicating with family members at intervention start up and practical problems as well in follow up contacts. This is the first intervention study specifically designed to be age sensitive and to examine age differences in engagement from the early treatment phase for late-stage cancer through end of life. This tailored intervention is expected to positively affect patients' quality of care and quality of life over time.

Factors influencing health behaviors in the National Health and Nutritional Examination Survey, III (NHANES III)

This study investigated the influence of age, gender, race, place of residence, social networks, and socioeconomic status (SES) on health behaviors in the NHANES III, a large public domain database of approximately 16,000 subjects. Multiple regression analysis indicated that age, gender, social networks, and SES were statistically significant predictors of both positive and negative health behaviors, while race and place of residence were not. These results suggest an influence of age, gender, SES, and social support factors on health behaviors and reinforce the need for social work to take into account these factors at both the individual and public policy levels.

Planning and strategy use in health behavior change: a life span view

Exercise-related strategy use and planning were investigated in younger (18-49 years) and older individuals (50-80 years) in orthopedic rehabilitation who were supposed to adhere to a strict exercise regimen. As part of a longitudinal study, N=368 individuals completed questionnaires assessing the amount of physical activities performed pre-rehabilitation and 6 and 12 months after discharge. In addition, the extent of strategy use (selection, optimization, and compensation) and planning after discharge was assessed. Planning was subdivided into two constructs: action planning (planning when, where, and how to exercise) and coping planning (planning how to exercise in the face of barriers). Two-sample structural equation modeling was used. For both age groups, strategy use improved prediction of exercise goal attainment on top of planning, while strategy use mediated the relationship between coping planning and goal attainment. Interventions fostering strategy use as well as planning might enhance exercise adherence across age groups.