Food sufficiency status and sleep outcomes in older adults: the National Health and Aging Trends Study (NHATS).

BACKGROUND: Studies investigating the relationship between food insecurity and sleep among older populations are limited. This study aimed to cross-sectionally examine the associations between food sufficiency status and sleep outcomes in a nationally representative sample of older adults. METHODS: Our study included 1,665 older adults (≥ 65 years), using data from the 2013 and 2014 National Health and Aging Trends Study (NHATS). Food insufficiency was determined via participants' experience and utilization of food assistance programs (FAP). Sleep outcomes, including nighttime and total sleep hours, sleep latency, and sleep quality, were derived from self-reported data. Multivariable linear regression and logistic regression models were used to estimate the associations between food sufficiency status and sleep outcomes. RESULTS: In 2013-2014, 86.1% of older adults were classified as food sufficient without FAP, 9.85% as food sufficient with FAP, and 4.08% as food insufficient. Adjusting for sociodemographic characteristics, food sufficient older adults with FAP reported more total sleep hours (𝛽 = 0.31, 95% CI: -0.02, 0.64) than those participants who are food sufficient without FAP. Further adjusting for health factors, food sufficient participants with FAP had more nighttime sleep hours and greater total sleep hours compared to those participants food sufficient without FAP. Compared to those deemed as food sufficient without FAP, food sufficient participants with FAP had lower odds of having longer sleep latency (OR = 0.50, 95% CI: 0.28, 0.89), after further adjusting for physical function performance. CONCLUSIONS: Among older adults, food sufficiency with FAP is associated with greater total sleep hours, greater nighttime sleep hours, and lower odds of longer sleep latency. Our findings may help inform nutrition food assistance programs targeting older populations.

Use of integrative and complementary health practices by Brazilian population: results from the 2019 National Health Survey.

BACKGROUND: In 2006, Brazil implemented the National Policy on Integrative and Complementary Practices of the SUS. and in 2015, the Brazilian Ministry of Health issued a reinforcement to this policy to increase access to integrative and complementary health practices (ICHP). In this study, we described the prevalence of ICHP in Brazilian adults according to their sociodemographic characteristics, self-perceived health, and chronic diseases. METHODS: This is a nationally representative cross-sectional survey including 64,194 participants from the 2019 Brazilian National Health Survey. Types of ICHP were categorized according to their purposes: health promotion (Tai chi/Lian gong/Qi gong, yoga, meditation, and integrative community therapy) or therapeutic practices (acupuncture, auricular acupressure, herbal treatment and phytotherapy, and homeopathy). Participants were classified as non-practitioners and practitioners, who in turn were grouped according to use of ICHP in the last 12 months: only used health promotion practices (HPP); only used therapeutic practices (TP); used both (HPTP). Multinomial logistic regressions were performed to estimate the associations of ICHP with sociodemographic characteristics, self-perceived health status, and chronic diseases. RESULTS: Brazilian adults showed an ICHP use prevalence of 6.13% [95%CI = 5.75-6.54]. Compared to non-practitioners, women and middle-aged adults were more likely to use any ICHP. Afro-Brazilians were less likely to use both HPP and HPTP, whereas Indigenous people were more likely to use both HPP and TP. We found a positive gradient of association among participants with higher income and educational attainment and access to any ICHP. People from rural areas and those with negative self-perceived health were more likely to use TP. Participants with arthritis/rheumatism, chronic back problems, and depression were more likely to use any ICHP. CONCLUSIONS: We found that 6% of Brazilian adults reported using ICHP in the previous 12 months. Women, middle-aged individuals, chronic patients, people with depression, and wealthier Brazilians are more likely to use any type of ICHP. Of note, rather than suggesting to expand the offer of these practices in the Brazilian public health system, this study diagnosed Brazilians' behavior of seeking for complementary healthcare.

Impact of a Long Lockdown on Mental Health and the Role of Media Use: Web-Based Survey Study.

BACKGROUND: Due to the COVID-19 pandemic, the Czech population experienced a second lockdown lasting for about half a year, restricting free movement and imposing social isolation. However, it is not known whether the impact of this long lockdown resulted in habituation to the adverse situation or in the traumatization of the Czech population, and whether the media and specific media use contributed to these effects. OBJECTIVE: The aim of this study was to elucidate the effect of the long lockdown on the mental health of the Czech population, and the role of exposure to COVID-19 news reports and specific forms of media news use in mental health. METHODS: We conducted two consecutive surveys in the early (November 2020) and late (March/April 2021) phases of the nationwide lockdown on the same nationally representative group of Czech adults (N=1777) participating in a longitudinal panel study. RESULTS: Our findings showed that the self-reported symptoms of anxiety and depression increased in the second observation period, confirming the negative effect of the pandemic lockdown as it unfolded, suggesting that restrictive measures and continuous exposure to a collective stressor did not result in the strengthening of resilience but rather in ongoing traumatization. The results also suggest a negative role of the media's coverage of the COVID-19 pandemic in mental health during the early, and particularly late, phases of the lockdown. Furthermore, we found several risk and protective factors of specific media news use. The media practice in news consumption connected to social media use was the strongest predictor of exacerbated mental health symptoms, particularly in the late phase of the lockdown. Moreover, news media use characterized by internalization of information learned from the news, as well as negative attitudes toward media news, were associated with higher levels of anxiety and depression. Conversely, the use of infotainment, together with an in-depth and contextual style of reading news articles, were related to improvement of mental health. CONCLUSIONS: Our study showed that the long lockdown resulted in traumatization rather than habituation, and in more pronounced effects (both negative and positive) of media use in mental health.

Reference values of inside leg length and inside leg length to stature ratio for Japanese children, 0-12 years of age.

BACKGROUND: Large datasets of detailed anthropometric measurements are scarce in children. The Japanese Standard Association 1978-1981 survey provides a rare opportunity to use high quality data from Japanese children. AIM: To construct inside leg length (ILL) and inside leg length to stature ratio (ILL/S) reference centile curves for Japanese children. SUBJECTS AND METHODS: The study sample consisted of 14,825 boys and 14,577 girls age 0-18 years for stature and weight measurements, and 9064 boys and 8796 girls age 0-12 years for ILL measurements, who participated in the 1978-1981 national survey on body sizes. LMS method was used to construct the reference centile curves. The reference centile curves for stature, weight, ILL, and ILL/S were compared to those of British children. RESULTS: The L, M, and S reference values for Japanese children are presented for stature, weight, ILL, and ILL/S. Compared with British children of 0-12 years of age, Japanese children of 0-12 years of age had shorter median stature, shorter median ILL, and shorter median ILL/S. CONCLUSION: We present the first reference values for ILL and ILL/S in Japanese children. Japanese children had relatively shorter legs compared to British children from infancy.

Population-based waist circumference reference values in Japanese children (0-6 years): comparisons with Dutch, Swedish and Turkish preschool children.

BACKGROUND: During 1978-1981 the Japanese Standards Association conducted a national survey to collect 64 distinct body measurements for Japanese children and adults. During 1978-1981, the prevalence of childhood obesity was relatively low yet the population was well nourished in Japanese children. The aim of this study is to construct waist circumference and waist circumference to stature ratio reference centile curves for Japanese preschool children. METHODS: We utilized 1978-1981 national survey data on body sizes. There are 4937 boys and 4758 girls age 0-6 years for waist circumference measurements. Waist circumference was measured at the level of the umbilicus. Using LMS method, centile curves were constructed for waist circumference and waist circumference to stature ratio. These reference values were compared with those of Dutch, Swedish and Turkish children. RESULTS: Centile reference curves were made for clinical and epidemiological use. Japanese children had smaller waist circumference centile values as compared to waist circumference measured at the midpoint of the lowest rib cage and the iliac crest of Dutch, Swedish and Turkish children. However, Japanese children had comparable waist circumference to stature ratio centile values to those of Dutch and Turkish children. CONCLUSIONS: This study presents the first age-, sex-, and ethnicity-specific reference values for waist circumference and waist circumference to stature ratio in Japanese preschool children.

Sexual risk behaviors and STDs among persons who inject drugs: A national study.

Opioid use and the rising case reports of STDs represent co-occurring epidemics; research indicates that persons who inject drugs (PWID) may be at increased risk for acquiring STDs. We use the National Survey of Family Growth (NSFG, 2011-2015) to examine the prevalence of risky sexual behaviors and STD diagnoses among PWID. We describe demographic characteristics, sexual behaviors, and self-reported STD diagnoses of sexually active women and men, separately, by whether they had ever engaged in injection-related behaviors (age 15-44; N = 9006 women, N = 7210 men). Results indicate that in 2011-15, 1.4% of women and 2.6% of men reported ever engaging in injection-related behaviors. Examining the full logistic regression models indicate that for women, sex with a PWID in the past 12 months (AOR = 5.8, 95% CI: 2.9, 11.7), exchanging money/drugs for sex in the past 12 months (AOR = 3.6, 95% CI: 1.2, 10.9), chlamydia and/or gonorrhea diagnosis in the past 12 months (AOR = 2.6, 95% CI: 1.2, 5.3), ever having a syphilis diagnosis (AOR = 8.5, 95% CI: 3.1, 23.4), and ever having a herpes diagnosis (AOR = 3.3, 95% CI: 1.0, 10.3) were associated with increased odds of engaging in injection-related behaviors. For men, sex with a PWID in the past 12 months (AOR = 10.9, 95% CI: 4.3, 27.7), ever being diagnosed with syphilis (AOR = 5.8, 95% CI: 1.8, 18.0), and ever being diagnosed with herpes (AOR = 2.7, 95% CI: 1.0, 7.1) were significantly associated with increased odds of engaging in injection-related behaviors. Future research may examine critical intervention points, including co-occurring factors in both STD acquisition and injection drug use.

Predicting the Pursuit of Post-Secondary Education: Role of Trait Emotional Intelligence in a Longitudinal Study.

Trait Emotional Intelligence (EI) is a constellation of emotional self-perceptions and dispositions related to perceiving, understanding, using, and managing emotions of self and others. Although higher trait EI has been implicated in post-secondary success among university students. There is lack of evidence for whether it predicts the pursuit of post-secondary education (PSE) in emerging adulthood. This was the first study to investigate the role of trait EI in PSE pursuit using a large, nationally-representative sample of Canadian young adults who participated in the National Longitudinal Survey for Children and Youth (NLSCY). Participants in this dataset reported on their PSE status at three biennial waves (age 20-21, 22-23, and 24-25), and completed a four-factor self-report scale for trait EI (Emotional Quotient Inventory: Mini) at ages 20-21 and 24-25. Higher trait EI subscale scores were significantly associated with greater likelihood of PSE participation both concurrently, and at 2- and 4-year follow-ups. Overall, these associations were larger for men than women. The finding that these links persisted over a multi-year period is particularly promising, as it represents an important validation step toward further investment in socioemotional competencies as part of youth development interventions.

Child and Adolescent Suicidal Ideation and Suicide Attempts: Evidence from the Healthcare Cost and Utilization Project.

OBJECTIVES: To examine the trends associated with child and adolescent suicidal ideation and suicide attempts and to compare these trends to those among the adult population. STUDY DESIGN: A nationally representative sample of administrative billing data was used for the analysis, which included descriptive statistics, trend data, and logistic regression. RESULTS: There were 874 872 (95% CI, 810 574-939 169) children and adolescents and 5 561 197 (95% CI, 5 271 426-5 850 968) adults admitted to an emergency department who experienced suicidal ideation or suicide attempts between 2010 and 2014, representing 1.20% of admissions for children (95% CI, 1.13-1.37) and adolescents and 1.09% of admissions for adults (95% CI, 1.05-1.13). Children and adolescents were more likely to be female (aOR, 1.74; 95% CI, 1.71-1.78) and to have private insurance (aOR, 1.75; 95% CI, 1.68-1.83) as compared with adults. Although the percentage of admissions increased for adults 25 and older (18.95%) the greatest increases were found among children and adolescents (5-11 years of age, 37.87%; 12-14 years of age, 82.03%; 15-17 years of age, 51.59%; and 18-24 years of age, 26.77%). There is a seasonal trend for children and adolescents such that higher rates are associated with the school year, which is not present for adults. CONCLUSION: Practitioners should be cognizant of the fact that suicidal ideation and suicide attempts for youth present differently than they do for the greater population and they should be vigilant in identifying risk factors, especially during seasons where risk of self-harm increases.

Food insecurity in veteran households: findings from nationally representative data.

OBJECTIVE: The present study is the first to use nationally representative data to compare rates of food insecurity among households with veterans of the US Armed Forces and non-veteran households. DESIGN: We used data from the 2005-2013 waves of the Current Population Survey - Food Security Supplement to identify rates of food insecurity and very low food security in veteran and non-veteran households. We estimated the odds and probability of food insecurity in veteran and non-veteran households in uncontrolled and controlled models. We replicated these results after separating veteran households by their most recent period of service. We weighted models to create nationally representative estimates. SETTING: Nationally representative data from the 2005-2013 waves of the Current Population Survey - Food Security Supplement. SUBJECTS: US households (n 388 680). RESULTS: Uncontrolled models found much lower rates of food insecurity (8·4 %) and very low food security (3·3 %) among veteran households than in non-veteran households (14·4 % and 5·4 %, respectively), with particularly low rates among households with older veterans. After adjustment, average rates of food insecurity and very low food security were not significantly different for veteran households. However, the probability of food insecurity was significantly higher among some recent veterans and significantly lower for those who served during the Vietnam War. CONCLUSIONS: Although adjusting eliminated many differences between veteran and non-veteran households, veterans who served from 1975 and onwards may be at higher risk for food insecurity and should be the recipients of targeted outreach to improve nutritional outcomes.

Social Media Use and Perceived Emotional Support Among US Young Adults.

Low emotional support is associated with poor health outcomes. Engagement with face-to-face social networks is one way of increasing emotional support. However, it is not yet known whether engagement with proliferating electronic social networks is similarly associated with increased emotional support. Thus, the purpose of this study was to assess associations between social media use and perceived emotional support in a large, nationally-representative sample. In October 2014, we collected data from 1796 U.S. adults ages 19-32. We assessed social media use using both total time spent and frequency of visits to each of the 11 most popular social media platforms. Our dependent variable was perceived emotional support as measured by the brief Patient-Reported Outcomes Measurement Information System (PROMIS) emotional support scale. A multivariable model including all sociodemographic covariates and accounting for survey weights demonstrated that, compared with the lowest quartile of time on social media, being in the highest quartile (spending two or more hours per day) was significantly associated with decreased odds of having higher perceived emotional support (AOR 0.62, 95 % CI 0.40, 0.94). However, compared with those in the lowest quartile, being in the highest quartile regarding frequency of social media use was not significantly associated with perceived emotional support (AOR 0.70, 95 % CI 0.45, 1.09). In conclusion, while the cross-sectional nature of these data hinder inference regarding directionality, it seems that heavy users of social media may actually feel less and not more emotional support.

Waist circumference centiles by age and sex for Japanese children based on the 1978-1981 cross-sectional national survey data.

AIM: The aim of this study was to establish reference values for waist circumference among Japanese youths using the 1978-1981 nationally representative data. SUBJECT AND METHODS: Growth charts were derived using Cole's LMS method, which adjusts the waist circumference distribution for skewness and allows waist circumference to be expressed as centile or standard deviation score. The sample population consisted of 19 233 children aged 6-18 years. Waist circumference was measured at the level of maximum waist narrowing in girls and at the level of the top of the iliac crest in boys. RESULTS: Comparison was made between the 1978-1981 and 1992-1994 waist circumference charts, showing a large increase in waist circumference over time; the mean difference was 1.1 and 0.5 SD score units in boys and girls, respectively. Defining cut-offs for central fatness as the 90th and 95th centiles of the 1978-1981 reference, the prevalences in 1992-1994 were, respectively, 42.3% and 25.2% in boys and 19.1% and 10.9% in girls. The corresponding prevalences in 1978-1981 were 10% and 5% by definition. CONCLUSION: This study showed increasing trends in waist circumference, particularly in boys during the period of the two surveys and that the 1978-1981 charts serve as better baseline references for waist circumference among Japanese youth.

Patterns of hospice care among military veterans and non-veterans.

CONTEXT: Historically, hospice use by veterans has lagged behind that of non-veterans. Little is known about hospice use by veterans at a population level. OBJECTIVES: To determine whether veteran and non-veteran hospice users differ by demographics, primary diagnosis, location of care, and service utilization. METHODS: Using the 2007 National Home and Hospice Care Survey, we identified 483 veteran and 932 non-veteran male hospice users representing 287,620 hospice enrollees nationally. We used chi-square and t-tests to compare veterans and non-veterans by demographic characteristics, primary diagnosis, and location of hospice care. We used multivariate regression to assess for differences in hospice diagnosis and location of care, adjusting for demographic and clinical factors. We also compared length of stay and number of visits by hospice personnel between veterans and non-veterans using multivariate regression. RESULTS: Veteran hospice users were older than non-veterans (77.0 vs. 74.3 years, P = 0.02) but did not differ by other demographics. In adjusted analyses, cancer was a more common primary diagnosis among veterans than non-veterans (56.4% vs. 48.4%; P = 0.02), and veteran hospice users were more likely than non-veterans to receive hospice at home (68.4% vs. 57.6%; P = 0.007). The median adjusted length of stay and number of nurse or social worker visits did not differ by veteran status (all P > 0.10), but veterans received fewer home health aide visits than non-veterans (one every 5.3 days vs. one every 3.7 days; P = 0.002). CONCLUSION: Although veteran and non-veteran hospice users were similar on most demographic measures, important differences in hospice referral patterns and utilization exist.