Resilience and Self-Compassion: Shields Against Age-Related Declines in Oral Health and Shame.

Objective This study aimed to investigate the complex relationships between demographic factors, oral health indicators, self-compassion, and psychological well-being among elderly individuals by using a path model analysis. Methods The findings of this cross-sectional study are derived from data collected from a sample of 204 patients, including 120 females and 84 males, aged between 60 and 92 years, with an average age of 74.2 years (SD = 7.1). Participants took part in assessments including the Geriatric Oral Health Assessment Index (GOHAI) to measure oral health (physical function, psychosocial function, pain/discomfort), self-compassion scale, and measures of shame and "other as shamer" experiences. Demographic information including age and gender was also collected. Path analysis was employed to examine the direct and indirect effects of demographic variables, oral health indicators, and self-compassion on psychological well-being. Results Older age was consistently associated with poorer oral health outcomes across all GOHAI oral health subscales. However, resilience and self-compassion appear to exert a correspondingly large positive influence, neutralizing the negative effects of increasing age on physical and psychosocial aspects of oral health-related quality of life. Additionally, resilience was positively associated with better physical and psychosocial function related to oral health while oral health was confirmed to be related to internal and external (social) shame. However, resilience and self-compassion outperformed oral health as far as their effect on internal and external (social) shame is concerned. Gender had minimal effects on most outcome variables. Conclusions The findings underscore the importance of addressing both physical and psychological aspects of health in elderly care and oral health interventions. By promoting psychological resilience and self-compassion, healthcare providers can potentially enhance oral health-related quality of life and overall well-being among elderly populations. Our results also highlight that promoting social and leisure activities may be a means of improving mental well-being, enhancing oral health outcomes, and reducing shame-related distress among elderly individuals.

Health literacy of older adults with musculoskeletal problems: A systematic review.

INTRODUCTION: People with poor Health Literacy (HL) find it difficult to understand medical information in their daily lives, participate in health-related decision making and comply with medical instructions. The physical effects of ageing on the musculoskeletal system have a direct impact on skills related to the management of health problems. Many older adults have limited HL, which impacts their ability to fully engage in their care and their health status. The aim of this study is to conduct a systematic review of the published research regarding the prevalence of low HL and its impact on health outcomes of older adults with musculoskeletal problems. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English, with specific pre-selected eligibility criteria. RESULTS: The combined searches yielded 1617 records of which 19 articles were eligible for inclusion. The percentage of low HL varied across the studies of this review, ranging from 14% to 67%. In most studies, however, patients with limited HL were about 1/3 of the participants. Patients of lower educational level, male gender, older age, lower income, unemployment and different country of origin had lower HL level. Low HL was also associated with worse health outcomes, especially adherence to treatment, pain, functionality and health status. DISCUSSION: It is of major importance to conduct educational interventions aimed at enhancing HL in this patient group, as these will contribute to the empowerment and the promotion of appropriate health behaviors of these patients.

Association of vitamins B12 and D3 with Balance and Falls in a sample of Greek older people.

OBJECTIVES: Balance disorders and falls are common in the elderly and have a multifactorial etiology. The purpose of the present cross-sectional study is to evaluate a possible association between vitamins D3 and B12 and impaired balance and falls. METHODS: Ninety patients, females and males, were evaluated, from December 2019 to December 2020 during their first ambulatory visit at the Prevention of Falls Clinic of the General University Hospital of Patras. Vitamins B12 and D3 levels were measured. The number of falls during the last 12 months was recorded and patients were assessed using Mini-Balance Evaluation Systems Test (Mini-BESTest), Fried Phenotype, Walking Speed, Hand Grip Strength, Short Physical Performance Battery. RESULTS: A multiple linear regression analysis showed that Mini-BESTest are statistically significantly predicted, F(10,79)=18.734, p<0.001, adj. R2=0.70 from Vit-B12 and FRIED Phenotype (pre-frail vs non-frail). Similarly, in the multiple binary logistic regression analysis, falls were statistically significantly predicted from FRIED Phenotype (pre-frail vs non-frail) χ2(5)=63.918, p<0.001, Nagelkerke R Squared=0.68. CONCLUSIONS: Higher levels of vitamins B12 but not of D3 are associated with better balance but not with less falls in a sample of community-dwelling older people.

Psychosocial effects of intergenerational learning on primary school children and older Adults: A systematic review.

In recent years there has been increasing emphasis on the importance of intergenerational learning and interaction. People of different ages engage in meaningful and mutually beneficial activities, aimed at developing knowledge, skills, and values. The aim of this systematic review was to examine the psychosocial effects of intergenerational learning in school-age children and older adults. A systematic review of both quantitative and qualitative data was performed according to the PRISMA guidelines. PubMed, Scopus, and ERIC electronic databases were searched up to 26 July 2022 using the following Population (P) -Exposure (E) - Outcome (O) elements: school-age children and older adults (P), intergenerational learning (E), and psychosocial effects (O). Reference lists of included datasets and relevant review articles were also extensively searched. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of eligible studies. A narrative synthesis was used as a framework for data analysis. Seventeen studies met the inclusion criteria. Regarding the psychosocial outcomes of participation in intergenerational activities for children and older adults, the majority of studies highlighted improvements in attitudes, well-being, happiness, and other social and psychological aspects, although methodological flaws are discussed.

Impact of the COVID-19 pandemic on the mental health of hospital staff: An umbrella review of 44 meta-analyses.

BACKGROUND: Hospital staff is at high risk of developing mental health issues during the coronavirus (COVID-19) pandemic. However, the literature lacks an overall and inclusive picture of mental health problems with comprehensive analysis among hospital staff during the COVID-19 pandemic. OBJECTIVES: To ascertain the prevalence of anxiety, depression and other mental health outcomes as reported in original articles among hospital staff during the COVID-19 pandemic. DESIGN: A PRISMA 2020 and MOOSE 2000 compliant umbrella review of published meta-analyses of observational studies evaluating the prevalence of mental health problems in hospital staff during the pandemic. REVIEW METHODS: Systematic searches were conducted in PubMed/Medline, CINAHL, EMBASE, and PsycINFO from December 1st, 2019, until August 13th 2021. The random effects model was used for the meta-analysis, and the I2 index was employed to assess between-study heterogeneity. Publication bias using Egger test and LFK index was examined. Data was analyzed using STATA 17.0 software. AMSTAR-2 was applied for the quality assessment of systematic reviews, while we used GRADE to rate the quality of evidence. RESULTS: Forty-four meta-analyses from 1298 individual studies were included in the final analysis, encompassing the prevalence of 16 mental health symptoms. One-third of hospital workers reported anxiety (Prevalence: 29.9%, 95% CI:27.1% to 32.7%) and depression (Prevalence: 28.4%, 95% CI:25.5% to 31.3%) symptomatology, while about 40% (95% CI: 36.9% to 42.0%) suffered from sleeping disorders. Fear-related symptoms, reduced well-being, poor quality of life, and acute stress symptoms had the highest prevalence among hospital staff. However, the quality of evidence in these areas varied from low to very low. Nurses suffered more often from sleep problems and symptoms of anxiety and depression than doctors, whereas doctors reported a higher prevalence of acute stress and post-traumatic disorders. The burden of anxiety, depression, and sleep disorders was higher among female employees than their male counterparts. Remarkably, acute stress and insomnia affected more than half of first-line medical staff. CONCLUSIONS: The prevalence of mental health problems among hospital staff during the COVID-19 pandemic is generally high, with anxiety, depression and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses. However, there is no strong confidence in the body of evidence for each outcome assessed. REGISTRATION: Not registered. TWEETABLE ABSTRACT: The COVID-19 pandemic is having a major impact on the mental health of hospital staff. The need for support must be different for nurses and doctors @eldi12345.

Exploring the Impact of Shame on Health-Related Quality of Life in Older Individuals.

PURPOSE: To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people. DESIGN AND METHODS: A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software. RESULTS: Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women bW = -0.173, pW = .004, effect on men bM = -0.138, p​M = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (bW = -0.392, pW = .002 and bM = -0.384, pM = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033). CONCLUSION: Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame. CLINICAL RELEVANCE: These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.

Need for comprehensive management of frailty at an individual level: European perspective from the advantage joint action on frailty.

OBJECTIVES: ADVANTAGE Joint Action is a large collaborative project co-founded by the European Commission and its Member States to build a common understanding of frailty for Member States on which to base a common management approach for older people who are frail or at risk of developing frailty. One of the key objectives of the project is presented in this paper; how to manage frailty at the individual level. METHODS: A systematic review of the literature was conducted, including grey literature and good practices when possible. RESULTS: The management of frailty should be directed towards comprehensive and holistic treatment in multiple and related fields. Prevention requires a multifaceted approach addressing factors that have resonance across the individual's life course. Comprehensive geriatric assessment to diagnose the condition and plan a personalized multidomain treatment increases better outcomes. Multicomponent exercise programmes, adequate protein and vitamin D intake, when insufficient, and reduction in polypharmacy and inadequate prescription, are the most effective strategies found in the literature to manage frailty effectively. CONCLUSION: Frailty can be effectively prevented and managed with a multidomain intervention strategy based on comprehensive geriatric assessment.

Economic Recession and Attendances in the Pediatric Emergency Department.

The economic recession has been shown to have a negative impact on health services worldwide. The purpose of this study was to examine whether the recent financial crisis in Greece that started in 2009 has affected the attendances in the pediatric emergency department of a University Hospital covering for a large geographical area in Greece. The study was based on a retrospective analysis of the cases presented to the paediatric emergency department and compared the attendances in 2008 (i.e., before the beginning of the economic crisis) with those in 2013 and 2017. Data on demographics and characteristics of emergency department visits, such as timing, reason, and outcome were recorded for each child. There were a total of 35.572 children seeking examination in those three years and data were collected for 5662 (17.36%) of them. Overall, the attendance rate has increased up to 20% without an increase to the hospital admission rates which remained stable throughout the study periods. Between 2008 and 2017, the percentage of febrile children attending the ED increased by 33.8% and of those with respiratory disorders by 63.1%. Our results indicate that the need for pediatric hospital services has changed following the economic crisis which could reflect gaps in the primary care setting and could well also result from financial constraints.

Efficacy of a support group intervention on psychopathological characteristics among caregivers of psychotic patients.

BACKGROUND: Families of individuals with psychotic disorders are playing a major role in the care of their relatives, but report poorer physical competence, elevated symptoms of psychological distress and more psychopathological characteristics. AIM: To compare psychopathological characteristics demonstrated by caregivers of psychotic patients in Greece who participated in support groups organized by non-governmental mental health organizations (NGOMH) compared to caregivers who did not. METHODS: Participants were caregivers of a psychotic patient assigned to either the intervention group (n = 165) or the non-intervention group (n = 345) according to specific criteria. Participants were assessed for psychopathological characteristics through clinical interviews and with the Symptom Checklist 90-Revised (SCL-90-R). RESULTS: Participants who did not take part in the support groups had higher levels of psychopathological characteristics on the dimensions of interpersonal sensitivity (t = -2.065, p = .003), depression (t = 1.043, p = .007), anxiety (t = 1.001, p = .010), hostility (t = -4.345, p < .001), phobic anxiety (t = -2.845, p < .001) and paranoid ideation (t = -1.091, p < .001). Psychotic relatives of participating caregivers show higher compliance rates in taking their medications, and female caregivers tend to be more involved in the support groups. CONCLUSION: Participation in support groups and sharing of emotional expression, thoughts and ideas help the caregivers deal with their physical and psychological demands related to the caregiver load. As such, intervention strategies offered to caregivers in the support groups appear to positively contribute to the family with a psychotic patient and improve the quality of life of both patients and their main caregivers.