Social participation, loneliness, and physical inactivity over time: evidence from SHARE.

OBJECTIVES: We aimed to explore the reciprocal effects of social participation, loneliness, and physical inactivity over a period of 6 years in a representative sample of European adults over 50 years old. DESIGN: A longitudinal study with a six-year follow-up period was conducted. SETTING: Four waves of the Survey of Health, Ageing and Retirement in Europe project were used. PARTICIPANTS: This study includes 64,887 participants from Europe and Israel, who were aged 50 or older at the first time. MEASUREMENTS: The relationship between participation in social activities, loneliness and physical inactivity was analyzed, controlling for age, gender, and disability. A series of cross-lagged panel models (CLPMs) were applied to analyze the relationships among these variables. RESULTS: A CLPM with equal autoregressive cross-lagged effects across waves was the best fit to the data (χ2 = 7137.8, CFI = .972, RMSEA = .049, SRMR = .036). The autoregressive effects for the three variables showed high stability across waves, and all the cross-lagged effects in the model were statistically significant. Social activity and physical inactivity maintained a strong negative cross-lagged effect, while their cross-lagged effects on loneliness were comparatively smaller. Social activity had a positive cross-lagged effect on loneliness, while physical inactivity had a negative cross-lagged effect on loneliness. CONCLUSIONS: These findings highlight the importance of promoting physical activity and social participation and addressing loneliness through targeted interventions in older adults.

Exploring social network typologies and their impact on health and mental well-being in older adults: Evidence from JAGES.

BACKGROUND: The types of social networks, their prevalence, and their relationship to health outcomes in older age have been different across countries and cultures. Most of the literature has focused on USA or in European countries and little is known about the social network typologies among older adults from Japan. This study aimed to identify these patterns of social network typologies and examine the differences in sociodemographic and related to health variables. METHODS: 23894 participants from the JAGES project (2019), aged 65 or older (M = 74.74, DT = 6.39) from Japan. Statistical analyses included Latent Profile Analysis (LPA) followed by ANOVAs, Chi square and multinomial logistic regressions tests to compare the profiles. RESULTS: Four profiles were identified: family (66.9%), spouse (16.6%), diverse (14.5%), and neighbor/others (1.9%). The profiles differ statistically (p < 0.001) in all sociodemographic characteristics and in the means of depression, loneliness, self-perceived health, and happiness. Compared with the "family" network, younger men, with fewer chronic illnesses but higher levels of depression and loneliness were more likely to be in the "spouse" profile, older women with lower socioeconomic status, but less lonely and happier in the "diverse" profile and adults who still working, have lower socioeconomic status and are less happy into the "neighbors/others" group. DISCUSSION: We discuss the differences between the profiles found, the potential differences with previous studies and the specific cultural Japanese nuances that may explain the characteristics of the network types founded.

Psychometric properties of the Entrepreneurial Intention Questionnaire (EIQ) in Dominican Republic adolescents

Introduction: This work represents the first attempt to obtain evidence of the validity of an entrepreneurial intention questionnaire in the adolescent population of a Latin American or Caribbean country. The objectives are to study the factor structure, the reliability, the external validity and to test the gender invariance of the Entrepreneurial Intention Questionnaire, in its adaptation for adolescents. Method: The sample consisted of 708 adolescents from the Dominican Republic with a mean age of 15.49, 65.2% of whom were women and 35.8% were men. Analyses included confirmatory factor analysis, Cronbach's Alpha and Omega scores for reliability, correlations, and a gender invariance routine. Finally, latent means of females and males are compared. Results: The confirmatory factor analysis showed a good fit to the data and the reliability results were adequate. In addition, the correlations with the Entrepreneurial Attitudes Scale for Students were positive and statistically significant. Also, strict gender invariance was successfully verified. Although males presented a higher subjective norm, females showed higher entrepreneurial intentions. Conclusions: The Entrepreneurial Intention Questionnaire shows adequate psychometric properties and proves useful in conducting research on the promotion of entrepreneurship in early stages.

Introducción: Este trabajo supone el primer intento de obtener evidencias de validez de un cuestionario de intención emprendedora en adolescentes en un país de Latinoamérica y el Caribe. Tiene como objetivos reportar la estructura interna, fiabilidad, validez externa y probar la invarianza de género del Cuestionario de Intención Emprendedora en su adaptación para adolescentes. Método: La muestra está formada por 708 adolescentes de República Dominicana con una media edad de 15.49, un 65.2% de mujeres y un 35.8% hombres. Los análisis incluyeron análisis factorial confirmatorio, resultados de Alfa de Cronbach y Omega para la fiabilidad, correlaciones y una rutina de invarianza por género. Finalmente se compararon las medias latentes de hombres y mujeres. Resultados: El análisis factorial mostró un buen ajuste a los datos y los resultados de fiabilidad fueron adecuados. Además, las correlaciones con la Escala de Actitudes Emprendedoras para Estudiantes fueron positivas y estadísticamente significativas. También, se comprobó satisfactoriamente la invarianza estricta por género. Aunque los hombres presentaron mayor norma subjetiva, las mujeres mostraron una mayor intención emprendedora. Conclusiones: El Cuestionario de Intención Emprendedora muestra adecuadas propiedades psicométricas para que sea de utilidad en las investigaciones sobre la promoción del emprendimiento en etapas tempranas.

Senior volunteers: addressing loneliness in times of COVID-19.

Volunteering in old age plays an important role in addressing feelings of loneliness, but little research has been conducted on the impact of engaging in volunteering activities during the COVID-19 pandemic. This study investigates the longitudinal impact of volunteering on feelings of loneliness. We analyzed data from 31,667 adults aged 50 years and older in the Survey of Health, Ageing and Retirement in Europe (SHARE), across three consecutive waves (one before the pandemic and two during the COVID-19 pandemic). Binary logistic regression analyses were conducted for loneliness, using volunteering and several control variables as independent variables, and found that even after controlling for previous loneliness, volunteering has a protective effect against experiencing feelings of loneliness. Those who participated in volunteering activities before or during the second pandemic period had a lower risk of loneliness during the second pandemic period. Volunteering during the second pandemic period, before and during the second pandemic period, and during all three periods measured in the study was negatively associated with the odds of feeling lonely. Encouraging volunteering among older adults can be a useful strategy to prevent loneliness during future emergency situations like the COVID-19 outbreak.

A Biopsychosocial Model Predicting Myocardial Infarction.

Myocardial infarction is one of the main causes of death, and cardiovascular risk factors (CVRFs) are always considered when studying it. However, although it is known that other social and psychological variables, and especially frailty, can increase the risk of infarction, their simultaneous effect has not been extensively studied. This study is based on data from the SHARE project (latest wave, Wave 8), with a representative sample of 46,498 participants aged 50 or older (M = 70.40, SD = 9.33), of whom 57.4% were females. Statistical analyses included a full structural equation model that predicts 27% of infarction occurrence and evidences the significant effect of well-being, depression, and social connectedness on frailty. Frailty, in turn, explains 15.5% of the variability of CVRFs. This work supports the need to study these physical, social, and mental health factors together to intervene on frailty and, in turn, improve cardiovascular outcomes.

Mapping Protective Performance of Social Network Types on Health and Quality of Life in Older People in European Regions.

Objectives: To identify social network profiles using Latent Profile Analysis (LPA), to study the relationships of these profiles with health markers, mental health, quality of life, and cognitive functioning, and to compare profiles across European regions. Methods: 27,272 participants from the Wave 8 of the SHARE project, aged 65 or older (M = 74.95, SD = 7.17) from Europe. Statistical analyses included LPAs followed by MANOVAs to compare the profiles and the health markers. Results: Five profiles were identified: family, friends, spouse, diverse, and others. A no network group was also added. The prevalence of the specific profiles differed across European regions. Individuals with no network and those categorized into the others profile presented the worst health outcomes. Discussion: The "friends" network is more protective toward cognitive functioning and physical health and the "spouse" and "family" ones are more protective toward mental health. The variability according to European regions is discussed.

Method Effects Associated to Item Valence: Evidence From the 10-Item Big-Five Inventory in Older Adults.

The objective of this study is to analyze the factor structure of the BFI-10 considering item valence effects when applied to measure older adults. Likewise, this study aims to estimate the factorial structure, internal consistency of the scale, to assess the nomological validity, and the association of the Big Five traits with age. 75,078 participants with mean age of 68.27 from the 7th Wave of the SHARE study were included. Confirmatory Factor Analyses, omega coefficients and Pearson correlations were estimated. The best-fit model identified a five-factor structure with two valence effects, internal consistency ranged from .26 to .64, the nomological network showed that loneliness is negatively associated to neuroticism and positively with the other four traits, and the opposite direction in the associations with the five traits and satisfaction and quality of life. Consciousness, Extraversion and Openness have been found as dimensions that tend to decrease with age.

Psychometric properties of the EURO-D scale of depressive symptomatology: Evidence from SHARE wave 8.

BACKGROUND: The EURO-D is a short scale to measure symptoms of depression, very used in large population surveys. Although there are numerous validation studies, its psychometric properties remain unclear. The two-factor structure (Affective Suffering and Lack of Motivation) is replicated in several studies but with different item compositions, and none reported reliability indices for both factors. For that reason, the aim of this study is to examine the factorial validity of the scale, the reliability of the dimensions, the gender differential item functioning (DIF), and the nomological validity. METHODS: 46,317 participants aged 50 and over (M = 71.33), from which 57.4 % were females, in Wave 8 of the Survey of Health, Aging and Retirement in Europe (SHARE) were included. INSTRUMENTS: EURO-D, R-UCLA, Self-perceived health index, and indicator of taking drugs for anxiety or depression. Factor Analyses, DIF, Reliability Index and Spearman correlations were estimated. RESULTS: Factor analysis identified a bifactor structure: a general factor of Depression and two specific factors of Affective Suffering and Lack of Motivation, which reliabilities were 0.83, 0.83 and 0.79 respectively. No relevant DIF item by gender was found, but higher scores were found in women in all factors. Both factors had positive relations with loneliness, taking drugs and self-perceived health. LIMITATIONS: this study has a cross-sectional design; future research may consider the longitudinal stability of the scale. CONCLUSIONS: EURO-D shows adequate psychometric properties when a general factor of depression and two specific factors are considered. Women have higher scores on all dimensions.

A simple and readily available inflammation-based risk scoring system on admission predicts the need for mechanical ventilation in patients with COVID-19.

OBJECTIVE: To investigate whether a simplified inflammation-based risk scoring system comprising three readily available biomarkers (albumin, C-reactive protein, and leukocytes) may predict major adverse outcomes in patients with COVID-19. METHODS: Upon admission to the emergency room, the inflammation-based risk scoring system was applied and patients were classified as having mild, moderate, or severe inflammation. In-hospital occurrence of thrombosis, need for mechanical ventilation, and death were recorded. RESULTS: One-hundred patients (55 ± 13 years; 71% men) were included and classified as having mild (29%), moderate (12%), or severe (59%) inflammation. The need for mechanical ventilation differed among patients in each group (16%, 50%, and 71%, respectively; P < 0.0001), yielding a 4.1-fold increased risk of requiring mechanical ventilation in patients with moderate inflammation and 5.4 for those with severe inflammation. On the contrary, there were no differences for the occurrence of thrombosis (10%, 8%, and 22%, respectively; P = 0.142) or death (21%, 42%, and 39%, respectively; P = 0.106). In the multivariate analysis, only severe inflammation (hazard ratio [HR] = 4.1), D-dimer > 574 ng/mL (HR = 3.0), and troponin I ≥ 6.7 ng/mL (HR = 2.4) at hospital admission were independent predictors of the need for mechanical ventilation. CONCLUSION: The inflammation-based risk scoring system predicts the need for mechanical ventilation in patients with severe COVID-19.

Are antiphospholipid antibodies just a common epiphenomenon or are they causative of immune-mediated coagulopathy in COVID-19?

The coronavirus disease 2019 (COVID-19) is the largest public health emergency in recent times. A significant number of patients develop a severe form of COVID-19 characterized by coagulopathy, organ failure, and elevated mortality. In addition, an unusually high frequency of antiphospholipid antibodies (aPLs) has been found in patients with COVID-19. These clinical and serological manifestations closely resemble those seen in the antiphospholipid syndrome (APS), especially in its catastrophic form, suggesting a role of aPLs in immune-associated coagulopathy. However, government bodies such as the American Society of Hematology have spoken out against the systematic search for aPLs in patients with COVID-19. In an attempt to bridge the gap on this hot topic, we conducted a comprehensive review of currently available cohort studies and case series systematically evaluating aPLs in COVID-19 patients. In this Perspective, we seek to identify both the frequency and the type of aPLs found in patients with COVID-19, as well as the potential association of these aPLs with vascular thrombosis and other distinctive characteristics of COVID-19. Furthermore, we investigated whether there is evidence that allows us to define the occurrence of aPLs in COVID-19 as an epiphenomenon, as has been observed in other systemic viral infections, or as antibodies against self-antigens bearing hallmarks that suggest a pathogenic role in immune-mediated thrombosis. Defining whether aPLs represent an epiphenomenon or they are actually involved in hemostatic abnormalities of COVID-19 is crucial both for uncovering novel mechanisms of immune-mediated thrombosis and for identifying potential prognostic biomarkers in this devastating disease.

Comunidade quilombola na Região Nordeste do Brasil: saúde de mulheres e crianças antes e após sua certificação / A quilombola community in the Northeast region of Brazil: the health of women and children before and after certification

Caracterizar a situação de saúde de mulheres e crianças em uma comunidade quilombola no Nordeste do Brasil, antes e após sua certificação. Métodos: os dados procedem de dois inquéritos com metodologias similares, realizados em 2008 e 2009, no universo de mulheres e crianças residentes. As características socioeconômicas e de saúde das populações nos dois períodos foram comparadas pelo cálculo da Razão de Prevalência (RP), utilizando regressão de Poisson. Resultados: foram estudadas 143 mulheres e 194 crianças e 172 mulheres e 67 crianças nos anos de 2008 e 2012, respectivamente. As prevalências de excesso de peso (59,1 por cento vs. 62,8 por cento) e circunferência da cintura ≥80cm (59,5 por cento vs. 57,4 por cento) foram semelhantes entre os períodos (p>0,05). As características que apresentaram mudanças significantes (p<0,05) foram: renda familiar per capita >2 dólares/dia (23,2 por cento vs. 67,4 por cento; RP=2,90; IC95 por cento: 2,11-4,01), prevalência de diarreia nas crianças (10,3 por cento vs. 26,9 por cento; RP=2,61; IC95 por cento: 1,46-4,62), calendário vacinal atualizado (80,4 por cento vs. 95,3 por cento; RP=1,18; IC95 por cento: 1,08-1,30), frequência de suplementação de vitamina A (70,3 por cento vs. 100,0 por cento; RP=1,42; IC95 por cento: 1,29-1,56), período de amamentação exclusiva ≥6 meses (8,7 por cento vs. 44,6 por cento; RP=5,13; IC95 por cento: 2,95-8,92) e prevalência de anemia em crianças (41,6 por cento vs. 20,0 por cento; RP=0,48; IC95 por cento: 0,27-0,87). Conclusões: ocorreram melhorias na situação de saúde, todavia ainda são necessários investimentos visando o incremento do padrão de saúde na comunidade...

To characterize the health status of women and children in a quilombola community in the Northeast region of Brazil before and after certification. Methods: the data are taken from two investigations using similar methodologies carried out in 2008 and 2009, among women and children residing in the community. The socio-economic and health characteristics of these populations in the two periods were compared by calculating the Prevalence Ratio (PR), using Poisson regression. Results: the studies covered 143 women and 194 children in 2008 and 172 women and 67 children in 2012. The prevalence of overweight (59.1 percent vs. 62.8 percent) and waist circumference ≥80cm (59.5 percent vs. 57.4 percent ) were similar in the two periods (p>0.05). The characteristics that exhibited significant changes (p<0.05) were: per capita family income > 2 US dollars/day (23.2 percent vs. 67.4 percent ; PR=2.90; CI95 percent: 2.11-4.01), prevalence of diarrhea in children (10.3 percent vs. 26.9 percent; PR=2.61; CI95 percent: 1.46-4.62), up-to-date vaccination record (80.4 percent vs. 95.3 percent ; PR=1.18; CI95 percent : 1.08-1.30), frequency of receipt of vitamin A supplements (70.3 percent vs. 100.0 percent ; PR=1.42; CI95 percent : 1.29-1.56), duration of exclusive breastfeeding ≥6 months (8.7 percent vs. 44.6 percent; PR=5.13; CI95 percent : 2.95-8.92) and prevalence of anemia among children (41.6 percent vs. 20.0 percent ; PR=0.48; CI95 percent : 0.27-0.87). Conclusions: there have been improvements in the health status of the population, but investment still needs to be made to ensure that health standards in the community continue to rise...

Prevalência e fatores de risco para anemia em crianças pré-escolares do Estado de Alagoas, Brasil / The prevalence of and risk factors for anemia in preschool children in the State of Alagoas, in Brazil

OBJETIVO: estimar a prevalência e os fatores de risco associados à anemia na população de pré-escolares do Estado de Alagoas, Brasil. MÉTODOS: estudo transversal com amostra probabilística de 666 crianças de 6 a 60 meses de idade. Por meio de inquérito domiciliar, realizado de novembro de 2005 a fevereiro de 2006, coletaram-se dados antropométricos, ambientais, demográficos, socioeconômicos, de saúde, de utilização de serviços públicos e a presença de morbidades. A concentração de hemoglobina (Hb) foi mensurada em fotômetro HemoCue®, considerando-se como anemia o nível <11 g/dL. Para identificar correlações usou-se o teste de Pearson. O teste X2 foi usado para analisar associações entre variáveis categóricas. A associação da anemia com as variáveis preditoras foi verificada por meio de análise de regressão logística múltipla. Adotou-se p<0,05 como nível crítico para definir significância estatística. RESULTADOS: a prevalência de anemia foi de 45,0 por cento. O nível de Hb se correlacionou de forma positiva e significativa à idade (r=0,44; p<0,01). A prevalência máxima ocorreu na faixa etária de 6 a 12 meses (75,2 por cento). A análise multivariada identificou as seguintes variáveis associadas à anemia: idade da criança <36 meses (p<0,001) e domicílio com cinco ou mais pessoas (p=0,031). CONCLUSÕES: a prevalência de anemia apresentou magnitude que a caracteriza como grave problema de saúde pública em Alagoas. As famílias mais numerosas e com crianças menores de três anos são aquelas que devem receber maior nível de atenção.

OBJECTIVE: to estimate the prevalence and establish risk factors associated with anemia in children in the Brazilian State of Alagoas. METHODS: a cross-sectional study with a probabilistic sample of 666 children aged between 6 and 60 months. Anthropometric, environmental, demographic, socio-economic data were collected during home visits, along with information on health, the use of public services and the existence of diseases. The concentration of hemoglobin (Hb) was measured using a HemoCue® photometer, and a level of <11 g/dL was taken to indicate anemia. Pearson's test was used identify correlations and the X2 test to analyze associations between the category variables. The association of anemia with the predictor variables was confirmed by multiple logistic regression, with statistical significance set at p<0.05. RESULTS: the prevalence of anemia was 45.0 percent. Hb levels were positively and significantly associated with age (r=0.44; p<0.01). The highest prevalence was found in the 6-12 month age-group (75.2 percent). Multivariate analysis identified the following variables associated with anemia: age <36 months (p<0.001) and a household with five or more occupants (p=0.031). CONCLUSIONS: the degree of prevalence of anemia found indicates that this is a serious public health problem in the State of Alagoas. Larger families and those with children aged under three years should receive greater attention.