Adverse childhood experience and young adult's problematic Internet use: The role of hostility and loneliness.

BACKGROUND: Few studies have explored the relationship between adverse childhood experiences (ACEs) and problematic Internet use (PIU) during young adulthood. Moreover, even fewer studies have explored the roles of loneliness (social and emotional) and hostility in this relationship. METHODS: This study used data from the Taiwan Youth Project (2011-2017). The analytical sample included 1885 participants (mean age = 31.3 years). PIU was measured using the short form of Chen's Internet Addiction Scale (2017). ACEs were assessed at the baseline of the adolescent phase (mean age = 14.3 years); this indicator has undergone recent revision. Hostility (three items from the Symptom Checklist-90-Revised) and loneliness (six items from the De Jong Gierveld scale) were measured in 2011 and 2014, respectively. RESULTS: ACEs were associated with hostility and loneliness (emotional and social). Additionally, hostility (ß = 0.62, p < .01) and emotional loneliness (ß = 0.44, p < .01) were significantly associated with PIU. Most mediating paths (e.g., ACE → hostility → PIU) were significant, based on the bootstrapping results. CONCLUSIONS: This study suggests that ACEs have a long-term shadow effect on PIU in young adults. ACEs show an indirect association with PIU through both hostility and loneliness, as well as involving the relationship between them.

Association of atypical anti-neutrophil cytoplasmic antibody with comorbidities and outcome in a hospital-based population.

Introduction: Atypical anti-neutrophil cytoplasmic antibody (a-ANCA) is characterized by a positive fluorescence staining other than typical cytoplasmic or perinuclear ANCA. ANCA is associated with increased risk of dialysis and mortality in patients with ANCA vasculitis. However, comorbidities related to a-ANCA and whether a-ANCA exhibits an increased risk for renal failure and mortality remain unclear. This study aimed to explore the comorbidities and outcome associated with a-ANCA. Materials and methods: This retrospective study enrolled 164 and 170 patients with typical ANCA and a-ANCA positivity, respectively, who visited Taichung Veterans General Hospital, Taiwan from January 2016 to March 2021. Logistic regression analysis was used to determine risk factors and the rheumatological diagnosis associated with a-ANCA. Cox proportional hazard regression and Kaplan-Meier curves were employed to identify variables associated with 5-year renal survival and mortality. Results: Patients with a-ANCA had lower chance of ANCA-associated vasculitis (OR: 0.02, 95 % CI: 0.01-0.07 p < 0.001), and systemic lupus erythematosus (OR: 0.23, 95 % CI: 0.11-0.48, p < 0.001), but a higher risk of rheumatoid arthritis (OR: 2.99, 95 % CI: 1.15-7.83, p = 0.025) and ulcerative colitis (OR: 5.50, 95 % CI: 1.20-25.29, p = 0.028). Patients with a-ANCA had a better renal survival (OR: 0.14, 95 % CI: 0.08-0.24, p < 0.001) and lower mortality (OR: 0.31, 95 % CI: 0.16-0.60, p = 0.001) than patents in the typical ANCA group. The 5-year renal survival and mortality was 89.3 % and 8.8 %, respectively, in patients with a-ANCA. Conclusion: Patients with a-ANCA had better renal survival and lower mortality rates compared to patients with typical ANCA. These real-world data provide evidence of the long-term outcome and shed light on avenues for the strategic management of patients with a-ANCA.

Adverse childhood experience and persistent insomnia during emerging adulthood: do positive childhood experiences matter?

BACKGROUND: Adverse childhood experiences (ACE) have been documented to have long-term impacts on sleep disturbances. However, less is known about how ACE co-occurs with positive childhood experiences (PCE) and modulate their effects on adult sleep disturbances, particularly in the context of persistent insomnia. Building on resilience theory, this study aims to examine the interplay between ACE and PCE and their effects on persistent insomnia during emerging adulthood. METHODS: A total of 2,841 emerging adults were recruited from the Taiwan Youth Project. Persistent insomnia during emerging adulthood was assessed using two adult surveys (mean age = 19.8 and 21.9). The ACE (10 items) and PCE (7 items) were obtained from the baseline survey (mean age = 13.8). A series of logistic regression analyses were conducted. RESULTS: Among the emerging adults, 29.22% had persistent insomnia. Consistent with the compensatory model, ACE and PCE exerted opposing effects on persistent insomnia during emerging adulthood. In line with the protective model, the negative effect of ACE is mitigated when individuals have high PCE. However, consistent with the challenge model, the protective effect of PCE on persistent insomnia was inhibited in individuals with four or more ACE. CONCLUSIONS: PCE serves as a protective factor, shielding emerging adults from the adverse effects of ACE on persistent insomnia. It is essential to prioritize positive experiences during early life to promote lifelong sleep health.

Associations between forced non-consensual first-sex and HIV among sexually active women in the Kingdom of Eswatini.

Studies continue to underscore the profound impact of sexual violence on women's health. Yet, little is known about the impact, via a complex matrix of behavioural and social factors, of first intercourse, namely forced non-consensual on HIV status, particularly among sexually active women (SAW) in low-income countries where HIV prevalence remains high. Using a national sample from Eswatini, we employed multivariate logistic regression modelling to estimate the associations between forced first-sex (FFS), subsequent sexual behaviour and HIV status among 3555 SAW aged from 15 years to 49 years. The results found that women who experienced FFS had a greater number of sexual partners compared to those who had never experienced FFS (aOR = 2.79, p < .01), although there were no significant differences in condom use, early sexual debut and casual sex involvement between these two groups. FFS remained significantly associated with a higher risk of having HIV (aOR = 1.70, p < .05) even after controlling for risky sexual behaviours and various other factors. These findings further reinforce the relationship between FFS and HIV, and suggest that addressing sexual violence is a critical component of HIV prevention among women in low-income countries.

Voluntary medical male circumcision and educational gradient in relation to HIV infection among sexually active adult men in Eswatini: evidence from the national surveys in 2006-2007 and 2016.

BACKGROUND: To address knowledge gaps, this study examined social determinants, such as education attainment and HIV prevention, among sexually active men (SAM), with a focus on voluntary medical male circumcision (VMMC). METHODS: Two nationally representative surveys, the Eswatini Demographic and Health Survey 2006 and the Eswatini HIV Incidence Measurement Survey 2016, were used to estimate whether or not VMMC at the individual and community levels contributes to HIV disparities to any meaningful extent. Multilevel logistic regression models further explored the educational gradient in HIV infection for 2006-2007 and 2016 with regard to VMMC among SAM, while adjusting for household poverty, sexual practices and individual characteristics. RESULTS: Among SAM with tertiary education, HIV prevalence declined from 25.0% in 2006-2007 to 10.5% in 2016. A 51% decrease in HIV prevalence was found to be associated with an increase in VMMC (adjusted odds ratio 0.49; 95% CI 0.40 to 0.60). Compared with SAM with tertiary education, those who had a lower level of education were more likely to have HIV infection and this education gradient effect had become particularly profound in 2016. CONCLUSIONS: VMMC began to be promoted in 2008 in Eswatini and results suggest its effect, along with the education attainment effect, significantly resulted in a meaningful reduction in HIV prevalence among SAM by 2016.

Triggering Magnets for Wiegand Sensors: Electrodeposited and Origami-Magnetized CoNiP Micro-Magnets.

Miniature sensors are key components for applications in the Internet of Things (IoT), wireless sensor networks, autonomous vehicles, smart cities, and smart manufacturing. As a miniature and self-powered magnetic sensor, the Wiegand sensor possesses advantageous traits including changing-rate-independent output, low cost, and remarkable repeatability and reliability. A typical Wiegand sensor requires hard magnetic pole pieces that provide external fields for triggering voltage outputs that are called Wiegand pulses. However, the wire-shaped sensing element of Wiegand sensors is the critical issue that limits the design, selection, and adoption of the external triggering magnets. Currently, the widely used pole piece materials are rare-earth magnets. However, adopting rare-earth magnets brings strong stray fields, causing an electromagnetic interference (EMI) problem. In this study, patterned CoNiP hard magnets were electrodeposited on flexible substrates through microfabrication. Origami magnetization was utilized to control the resultant stray fields and thus the pole piece of CoNiP magnets can successfully trigger the output of the Wiegand pulse. In comparison, the output voltage of the triggered pulse acquired through the patterned CoNiP magnets is comparable to that acquired by using the rare-earth magnets. Furthermore, both the volume (and hence the weight) of the Wiegand sensor and the EMI issue can be significantly reduced and mitigated, respectively, by the CoNiP magnets.

A longitudinal study on the changes in the self-efficacy of breast cancer patients during adjuvant chemotherapy.

AIM: We aimed to investigate the changes in the self-efficacy of patients with breast cancer (BC) during adjuvant chemotherapy. DESIGN: A longitudinal study was conducted. METHODS: One hundred thirty patients with BC who underwent postoperative adjuvant chemotherapy at a medical centre in northern Taiwan were evaluated using self-efficacy survey tools before the first (T1), second (T2) and last (T3) cycles of adjuvant chemotherapy. The independent t-test, Kruskal-Wallis test, one-way analysis of variance, Pearson's correlation coefficient and generalized estimating equation were used for data analysis. RESULTS: The self-efficacy measures of patients with BC were significantly higher at both T2 and T3 than at T1 (p < 0.001). Religious beliefs and changes in self-efficacy showed a significant correlation (p = 0.04). These findings will facilitate timely interventional measures to improve self-efficacy in patients with maladaptive behaviours, alleviate psychological distress and reduce the risk of future disease recurrence.

Relationship between adverse childhood experiences and problematic internet use among young adults: The role of the feeling of loneliness trajectory.

Backgrounds and aims: Given problematic Internet usage's (PIU) negative impact on individual health, this study evaluates how adverse childhood experiences (ACEs) affect young adults' PIU and the possible underlying mechanism of the "feeling of loneliness" (FOL) trajectory. Methods: Analyzing a retrospective cohort sample from the Taiwan Youth Project, 2,393 adolescents were interviewed from the average ages of 14-28. We constructed ACE in 2000 using six categories (e.g., abuse and low family socioeconomic status) and 5-item PIU in 2017 from Chen's Internet Addiction Scale. FOL trajectories measured eight times, at average ages 14, 16, 17, 18, 20, 22, 25, 28 years-old. Results: Overall, 12.65% of the participants did not have ACEs, and 12.78% exhibited PIU. FOL trajectory analyses yielded three groups: "constant low" (reference group: 53.25%); "moderate decline" (36.81%); and "increasing" (9.94%). Regression models showed a dose-response association between ACE and young adults' PIU (adjusted odds ratio = 1.12; 95% confidence interval [CI] = 1.02-1.23) and the two risky loneliness groups (moderate decline: relative risk ratio [RRR] = 1.42, 95% CI = 1.32-1.54; increasing: RRR = 1.52, 95% CI = 1.37-1.71). Structural equation modeling further found that ACEs increase young adults' risk of being in the increasing group, and consequently, the risk of PIU. Discussion and conclusions: We demonstrated that ACE may be associated with 1) adults' PIU, 2) FOL from adolescence to emerging adulthood, and 3) young adults' PIU through its association with FOL trajectories.

The changes in feeling of loneliness after retirement among baby boomers and pre-boomers in Taiwan: Do work-family conflict before retirement and social engagement after retirement matter?

Significance: Few studies have analyzed how loneliness-related factors differ across generations for older adults in non-Western societies. Building upon the stress process model, this study aimed to explore the relationships between work-family conflict before retirement, social engagement after retirement and changes in loneliness after retirement among retirees across two birth cohorts (Baby Boomers and pre-Boomers) in Taiwan. Methods: Data from the Taiwan Health and Retirement Study, a nationwide retired cohort sample collected from two waves between 2015/2016 and 2018/2019, was analyzed. A total of 2370 retirees aged 50-74 years were included in the analysis after excluding those who died or were lost to follow-up. Multivariate multinomial logistic models were used to estimate four types of changes in loneliness: (1) remaining not lonely, (2) becoming not lonely, (3) becoming lonely, and (4) remaining lonely. Results: About two-thirds of the retirees remained not lonely, and less than 10% maintained their feelings of loneliness across two waves. Multinomial logit models showed that both cohorts who experienced work-family conflict before retirement and stressful life events after retirement had higher odds of remaining lonely than those who remained not lonely. However, an increase in social engagement, especially social contact, appeared to be a protective factor against becoming and remaining lonely for both cohorts. Yet, work-related characteristics before retirement were significantly related to the changes in loneliness among pre-Boomers rather than Baby Boomers. Conclusions: The results suggest that work-family conflict before retirement produces an exacerbating effect; in contrast, social engagement after retirement is beneficial to not feeling lonely across two birth cohorts in Taiwan. This investigation highlights the importance of social stressors occurring before retirement because these have an effect on retirees' feelings of loneliness beyond individual socioeconomic status.

Perceived Peer Relationships in Adolescence and Loneliness in Emerging Adulthood and Workplace Contexts.

Background: A common life-course hypothesis is that negative early-life experiences contribute to poor health in later-life. However, little is known about perceived peer relationships during adolescence and the feeling of loneliness in emerging adulthood. This study explores the perception of adolescent peer relationships in a school context and its association with loneliness in adulthood and in workplace contexts. Methods: This study used data from a cohort sample of 2,520 adolescents from the Taiwan Youth Project (N = 2,520), consisting of eleven waves of data collected from 2000 to 2017. Major measures included the Loneliness Scale (6-item de Jong Gierveld short scale) and perceived peer relationships (classroom cohesion and perceived popularity among classmates) in middle school. Multivariate multinomial logistic regressions were used to estimate the associations of perceived peer relationships during adolescence and workplace characteristics with loneliness in adulthood. Results: Positive perceived peer relationships in adolescence were significantly related to decreased risk of serious social loneliness [Relative risk ratios (RRR) 0.70, 95% CI: 0.58-0.85] and severe social/emotional loneliness (RRR = 0.76, 95% CI: 0.63-0.91) in adulthood. Workplace satisfaction was a protective factor of severe social/emotional loneliness in employed adults. Conclusion: Adolescents who perceived peer relationships in middle school as positive were less likely to report social and emotional loneliness during adulthood. Satisfaction in the workplace characteristics was also associated with lower risk of loneliness in adulthood. Theoretical and policy implications are discussed.

Accelerated and outdoor weathering of silver nanowire transparent conductors under electrical stress in pseudo-modules.

In realistic applications, silver nanowires (AgNWs) are encapsulated in optoelectrical devices to function as transparent conductors and electrodes. Environmental stressors along with the essential electrical stress are inevitably harmful to the AgNWs inside the devices. Herein, to investigate the degradation behavior discrepancy between materials-level and device-level tests, we adopted pseudo-module to mimic the encapsulation. The pseudo-module allows the application of electrical stress and facilitates the interim specimen access for materials characterization through assembly-disassembly. Indoor accelerated and outdoor weathering tests with applied electrical stress to the pseudo-module encapsulated AgNW networks were performed. The impaired optoelectrical properties and morphological changes of AgNWs due to multiple or individual stressor(s) are investigated. Results indicate UVA exposure at elevated temperature coupled with electrical stress is responsible for the electrical failure of AgNW networks. Sulfidation that depresses optical transparency of AgNW networks is prone to occur at lower temperature. This work provides unambiguous degradation behaviors of AgNWs inside encapsulants, helping to improve the design of AgNWs related optoelectrical devices in the applications of solar irradiation environments.

The Relationship Between Adverse Childhood Experience and Heavy Smoking in Emerging Adulthood: The Role of Not in Education, Employment, or Training Status.

PURPOSE: The purpose of this study was to examine the relationship between adverse childhood experiences (ACEs) in early adolescence and heavy smoking in emerging adulthood, focusing on the mediating role of individuals' not in education, employment, or training (NEET) status. METHODS: Using a retrospective cohort sample from the Taiwan Youth Project, 2,903 participants from the age of 14 years until the age of 22 years were surveyed. Respondents' ACEs were assessed at the age of 14 years, their NEET status was assessed at the age of 20 years, and heavy smoking was measured at the age of 22 years. Regression and mediation analyses with resampling were conducted. RESULTS: In a separate model, cumulative ACEs, three or more ACEs, and family dysfunction during early adolescence were significantly related and emerging adults' heavy smoking (adjusted odds ratio [AOR] = 1.32; AOR = 2.91; and AOR = 2.31, respectively) and NEET status (AOR = 1.27; AOR = 2.99; and AOR = 2.09, respectively). In the final model (including both ACE and NEET), these three ACE measures were still significantly related to heavy smoking and NEET status was also significantly related to heavy smoking. Finally, bootstrapping results indicated that the indirect effects from ACEs on heavy smoking through NEET were significant, which indicated significant indirect effects. CONCLUSIONS: ACEs have a profound impact on emerging adults' heavy smoking, both directly and indirectly, through their NEET status. Thus, future research should focus on individuals' NEET status and its association with unhealthy behaviors in emerging adulthood.

A multilevel analysis of the social determinants associated with symptoms of acute respiratory infection among preschool age children in Pakistan: A population-based survey.

BACKGROUND: As advocated by WHO in "Closing the Health Gap in a Generation", dramatic differences in child health are closely linked to degrees of social disadvantage, both within and between communities. Nevertheless, research has not examined whether child health inequalities include, but are not confined to, worse acute respiratory infection (ARI) symptoms among the socioeconomic disadvantaged in Pakistan. In addition to such disadvantages as the child's gender, maternal education, and household poverty, the present study also examined the linkages between the community environment and ARI symptoms among Pakistan children under five. Furthermore, we have assessed gender contingencies related to the aforementioned associations. METHODS: Using data from the nationally representative 2017-2018 Pakistan Demographic and Health Survey, a total of 11,908 surviving preschool age children (0-59 months old) living in 561 communities were analyzed. We employed two-level multilevel logistic regressions to model the relationship between ARI symptoms and individual-level and community-level social factors. RESULTS: The social factors at individual and community levels were found to be significantly associated with an increased risk of the child suffering from ARI symptoms. A particularly higher risk was observed among girls who resided in urban areas (AOR = 1.42; p<0.01) and who had a birth order of three or greater. DISCUSSIONS: Our results underscore the need for socioeconomic interventions in Pakistan that are targeted at densely populated households and communities within urban areas, with a particular emphasis on out-migration, in order to improve unequal economic underdevelopment. This could be done by targeting improvements in socio-economic structures, including maternal education.

Loneliness in older parents: marital transitions, family and social connections, and separate bedrooms for sleep.

OBJECTIVES: This research innovatively analyzed the marital transitions (i.e., divorce and widowhood) of older Taiwanese parents, their sleep problems and spousal specific characteristics (i.e., separate bedrooms for sleep and marital relationships) as well as their social and family connections, all of which were simultaneously reflected in emotional and social domains of loneliness. METHODS: Data are from 1645 older parents from Northern Taiwan. Loneliness was assessed by a De Jong-Gierveld short scale with emotional and social domains. We conducted multivariate logistic regression to examine the associations of marital transitions and family/social connections regarding sleep problems and psychological well-being with loneliness in social and emotional domains. Besides sleep problems and individual socioeconomic status, we included data on couples' sleeping arrangements and marital relationships. RESULTS: Social loneliness was significantly associated with being divorced (AOR = 1.80, 95% CI 1.13-2.86) and living alone (AOR = 1.50, 95% CI 1.02-2.23). In contrast, strong family cohesion and frequent weekly contact with friends were associated with lower social loneliness. Married parents who slept in separate bedrooms were more likely than bed-sharing couples to feel emotional and social loneliness, despite adjusting for their sleep problems. Furthermore, satisfactory spousal relationships significantly decreased the magnitude of associations in the social domain. DISCUSSION: Our findings support significant associations between loneliness in later life and major marital transitions, family and social connections and sleep problems which differ in social and emotional domains. Independent of relationship satisfaction, separate bedrooms relate to higher risks of emotional loneliness in older adults.

Application of Supervised Machine Learning to Recognize Competent Level and Mixed Antinuclear Antibody Patterns Based on ICAP International Consensus.

BACKGROUND: Antinuclear antibody pattern recognition is vital for autoimmune disease diagnosis but labor-intensive for manual interpretation. To develop an automated pattern recognition system, we established machine learning models based on the International Consensus on Antinuclear Antibody Patterns (ICAP) at a competent level, mixed patterns recognition, and evaluated their consistency with human reading. METHODS: 51,694 human epithelial cells (HEp-2) cell images with patterns assigned by experienced medical technologists collected in a medical center were used to train six machine learning algorithms and were compared by their performance. Next, we choose the best performing model to test the consistency with five experienced readers and two beginners. RESULTS: The mean F1 score in each classification of the best performing model was 0.86 evaluated by Testing Data 1. For the inter-observer agreement test on Testing Data 2, the average agreement was 0.849 (κ) among five experienced readers, 0.844 between the best performing model and experienced readers, 0.528 between experienced readers and beginners. The results indicate that the proposed model outperformed beginners and achieved an excellent agreement with experienced readers. CONCLUSIONS: This study demonstrated that the developed model could reach an excellent agreement with experienced human readers using machine learning methods.

Associations Between Early Circumcision, Sexual and Protective Practices, and HIV Among a National Sample of Male Adults in Eswatini.

To reduce HIV incidence in countries such as Eswatini (Swaziland), UNAIDS has recommended male circumcision as one possible effective strategy. We analyzed the 2016s Swaziland HIV Incidence Measurement Survey to explore the association between early circumcision and HIV history among 2964 sexually active adult males aged 15 to 64 years old. Early circumcision was defined as circumcision practiced at an age of 15 years old or younger. Results from logistic regression and OLS regression found that male adults with early circumcision are more likely to have multiple sexual partners and to use condoms. Multiple partners and condom use at last sex encounter remained associated with a higher odds of being HIV positive after controlling for all factors. Nevertheless, early circumcision is significantly associated with a lower odds of being HIV positive (AOR 0.53, p < 0.01). These findings suggest that HIV prevention may benefit when early male circumcision is carried out.

RESUMEN: Con el objetivo de reducir la incidencia de VIH en países como Eswatini (Suazilandia), UNAIDS ha recomendado la práctica de la circuncisión como una estrategia efectiva con este fin. A partir del análisis de la Encuesta de Medición de la Incidencia del VIH en Suazilandia (SHIMS 2), la presente investigación tiene como objetivo explorar la asociación entre la circuncisión a edad temprana (practicada a la edad de 15 años o menos) y la infección por el VIH en 2,964 hombres adultos que son sexualmente activos con edades comprendidas entre 15 y 64 años. Mediante la regresión logística y de mínimos cuadrados ordinarios (ordinary least squares), se encontró que los hombres circuncidados a temprana edad tienden más a tener múltiples parejas sexuales y a usar preservativos. El uso de preservativos en la última relación sexual y el hecho de tener múltiples parejas sexuales permaneció asociado con la infección por el VIH tras ajustar por factores de confusión. La circuncisión a temprana edad se asoció con un menor riesgo de infección por el VIH (OR ajustado=0.53, p<0.01). Estos resultados sugieren que la circuncisión a edad temprana debería tenerse en cuenta como estrategia de prevención del VIH.

Acute ischemic stroke induces magnetic resonance susceptibility signs dominated by endothelial nitric oxide synthase activation.

PURPOSE: Acute ischemic stroke induces deoxyhemoglobin accumulation around the ischemic region while activating endothelial nitric oxide synthase (eNOS) coupling and the subsequent release of nitric oxide (NO). Because deoxyhemoglobin is a natural NO spin trap, its interplay with NO could be prominent during acute stroke. Its interaction with NO has been shown to induce overt paramagnetic signals in vitro; our goal was to investigate whether this interplay can be detected using MRI. METHODS: To verify the in vivo image effects using the deoxyhemoglobin-NO interaction during acute stroke, eNOS states were manipulated in an animal model of acute ischemia, and the susceptibility signals, cerebral perfusion, and infarction were assessed noninvasively via MR susceptibility weighted imaging (SWI). RESULTS: Occlusion of the right middle cerebral artery increased eNOS coupling and susceptibility signals in the ischemic cortex while abolishing regional cerebral blood flow. Pharmacological eNOS blockage led to weakened susceptibility signals in the ischemic cortex as well as worsened tissue survival. Consistently, abolishment of eNOS coupling through genetic editing reduced the regional susceptibility signals in the ischemic cortex, causing large infarcts. CONCLUSION: Upregulation of eNOS during acute ischemia sustains tissue viability through the interaction between NO and deoxyhemoglobin. This interplay can be traced in vivo using SWI and can be considered a sensitive marker revealing the delicate oxygenation status of the ischemic tissue, therefore, guiding the management of acute stroke in clinical settings.

Adverse adolescence experiences, feeling lonely across life stages and loneliness in adulthood / Experiencias adversas en la adolescencia, sentirse solo en las etapas de la vida y soledad en la edad adulta

BACKGROUND/OBJECTIVE: Loneliness is a mental health issue emerging over the life course. This study examines the latent structure of adult loneliness in a non-Western society and its association with adverse adolescence experiences (AAEs) as well as feeling lonely during middle school, high school, and college. METHOD: A cohort sample living in Northern Taiwan (N = 2,289) was analyzed from adolescence to adulthood. The de Jong Gierveld Loneliness Scale operationalized loneliness by a three-cluster model to present the latent structure of loneliness: emotional, serious emotional, and severe emotional/social loners. AAEs (e.g., abuse, neglect, and dysfunctional family) were measured by seven items. Multivariate multinomial logistic regression models were used to explore the longitudinal effects of AAEs and feeling lonely reported during middle school, high school, and college on adult loneliness. RESULTS: AAEs and feeling lonely during adolescence were significantly associated with serious emotional loneliness and severe emotional/social loneliness during adulthood, even after adjusting for the individual’s characteristics. Attendance at a 4-year college was associated with decreased odds of serious emotional loneliness and severe emotional/social loneliness. CONCLUSIONS: Adults with AAEs and feelings of loneliness over life stages are more likely to report loneliness in the emotional and social domains

ANTECEDENTES/OBJETIVO: La soledad es un problema de salud mental que emerge a lo largo de la vida. Se examina la estructura latente de la soledad de adultos en una sociedad no occidental y su asociación con experiencias adversas en la adolescencia (EAAs), además de sentirse solo durante la Secundaria y la Universidad. MÉTODO: Se analizó una muestra de cohorte de Taiwán (N = 2.289) desde la adolescencia hasta la edad adulta. La Jong Gierveld Loneliness Scale operacionalizó la soledad mediante un modelo de tres grupos para presentar la estructura latente de la soledad: emocional, emocional grave y soledad emocional/social severa. Las EAAs (e.g., abuso, negligencia y familia disfuncional) se midieron con siete ítems. Se utilizaron modelos de regresión logística multinomial multivariante para explorar los efectos longitudinales de EAAs y sentirse solo informado durante la Secundaria y la Universidad sobre la soledad adulta. RESULTADOS: Las EAAs y sentirse solo durante la adolescencia se asociaron significativamente con soledad emocional grave y emocional/social severa durante la adultez, incluso después de ajustarse a las características del individuo. Asistir a la Universidad durante cuatro años se asoció con una disminución de las probabilidades de soledad emocional grave y emocional/social severa. CONCLUSIONES: Adultos con EAAs y sentimientos de soledad durante las etapas de la vida tienen más probabilidades de informar soledad en ámbitos emocional y social

Adverse adolescence experiences, feeling lonely across life stages and loneliness in adulthood.

Loneliness is a mental health issue emerging over the life course. This study examines the latent structure of adult loneliness in a non-Western society and its association with adverse adolescence experiences (AAEs) as well as feeling lonely during middle school, high school, and college. METHOD: A cohort sample living in Northern Taiwan (N = 2,289) was analyzed from adolescence to adulthood. The de Jong Gierveld Loneliness Scale operationalized loneliness by a three-cluster model to present the latent structure of loneliness: emotional, serious emotional, and severe emotional/social loners. AAEs (e.g., abuse, neglect, and dysfunctional family) were measured by seven items. Multivariate multinomial logistic regression models were used to explore the longitudinal effects of AAEs and feeling lonely reported during middle school, high school, and college on adult loneliness. RESULTS: AAEs and feeling lonely during adolescence were significantly associated with serious emotional loneliness and severe emotional/social loneliness during adulthood, even after adjusting for the individual's characteristics. Attendance at a 4-year college was associated with decreased odds of serious emotional loneliness and severe emotional/social loneliness. CONCLUSIONS: Adults with AAEs and feelings of loneliness over life stages are more likely to report loneliness in the emotional and social domains.

ANTECEDENTES/OBJETIVO: La soledad es un problema de salud mental que emerge a lo largo de la vida. Se examina la estructura latente de la soledad de adultos en una sociedad no occidental y su asociación con experiencias adversas en la adolescencia (EAAs), además de sentirse solo durante la Secundaria y la Universidad. MÉTODO: Se analizó una muestra de cohorte de Taiwán (N = 2.289) desde la adolescencia hasta la edad adulta. La Jong Gierveld Loneliness Scale operacionalizó la soledad mediante un modelo de tres grupos para presentar la estructura latente de la soledad: emocional, emocional grave y soledad emocional/social severa. Las EAAs (e.g., abuso, negligencia y familia disfuncional) se midieron con siete ítems. Se utilizaron modelos de regresión logística multinomial multivariante para explorar los efectos longitudinales de EAAs y sentirse solo informado durante la Secundaria y la Universidad sobre la soledad adulta. RESULTADOS: Las EAAs y sentirse solo durante la adolescencia se asociaron significativamente con soledad emocional grave y emocional/social severa durante la adultez, incluso después de ajustarse a las características del individuo. Asistir a la Universidad durante cuatro años se asoció con una disminución de las probabilidades de soledad emocional grave y emocional/social severa. CONCLUSIONES: Adultos con EAAs y sentimientos de soledad durante las etapas de la vida tienen más probabilidades de informar soledad en ámbitos emocional y social.

A global analysis of the regional variation in the symptoms of acute respiratory infection during childhood: Epidemics and their association with environmental vulnerability.

Using Demographic and Health Surveys from 48 low-income and middle-income countries (N = 432,860), we investigated whether or not the presence of symptoms of acute respiratory infection (ARI) are contingent on environmental vulnerabilities such as the region, the level of ambient air pollution, community orphanhood status, and household poverty among young children under five. In addition, we also examined whether such an effect may be a consequence of socioeconomic development and/or lifestyle. Using multilevel logistic regression models, environmental vulnerability was found to be significantly associated with the likelihood of childhood ARI symptoms and this association seemed to be related to the level of ambient air pollution. Our findings suggest that important roles are played by both geographic region and ambient air pollution, and that these factors may disproportionately shape a child's risk of ARI symptoms in a global context.