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Sexual minorities in the United States have often reported a higher likelihood of forgoing healthcare than heterosexuals, but whether this occurred during the COVID-19 pandemic remains underexplored. This study applies and extends the Andersen model to examine different-sex and same-sex families' likelihood of forgoing healthcare during the pandemic using nationally representative data from the 2020 (May-October) Current Population Survey (N = 139,636). Results are that during the early stage of the pandemic (1) same-sex families overall are more likely than different-sex families to forgo medical care, (2) cohabitating same-sex families were less likely to forgo healthcare than their married counterparts, and (3) state policy environments will moderate only some of the differences in healthcare utilization by family types. Findings provide partial support for hypotheses and suggest a more careful consideration of the role of partnership and state policy in the Andersen model. Policy implications are also discussed.
Subject(s)
COVID-19 , Pandemics , Humans , United States/epidemiology , COVID-19/epidemiology , Delivery of Health Care , Marital Status , PolicyABSTRACT
Background/purpose: The accuracy of a full-arch scan by using an intraoral scanner should be validated under clinical conditions. This study aimed to compare the accuracy of full-arch digital impressions in the maxilla and mandible using two intra oral scanners with three different scan segmental sequential ranges. Materials and methods: A dental model with 28 teeth in their normal positions served as the reference. Sixty full-arch scans were performed using Trios 3 and Trios 4, employing scanning strategy O (manufacturer's original method), OH (segmental sequential ranges one half), and TQ (segmental sequential ranges third quarter). Trueness was evaluated by comparing digital impressions with a reference dataset using specialized software. One-way ANOVA and Tukey tests assessed differences between the groups. Results: For Trios 3 on the maxilla, no significant difference was found among the groups of trueness; in the mandible, strategy O exhibited a significant difference (P = 0.008) with the highest deviation. For Trios 4 on the maxilla, strategy TQ demonstrated the lowest deviation with a significant difference (P = 0.006); in the mandible, no significant difference was found among the groups of trueness. Conclusion: Strategy TQ exhibited the best trueness for Trios 3 and Trios 4, suggesting it may be preferred for higher accuracy. Clinicians should consider these findings when selecting scanning strategies and intraoral scanners for specific cases.
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OBJECTIVES: Shared time with family and friends is crucial for older adults' health and well-being. This study examines how a public health crisis affects older adults' social connectedness through their shared time with known persons. METHODS: The study used data from the 2019-2020 American Time Use Survey (Nâ =â 9,697) to assess older adults' (aged 50+) social structure of shared time before and during the coronavirus disease 2019 pandemic. Logistic regression and hurdle model with state-fixed effects were used to estimate the relationships between state-level pandemic severity and measures of older adults' shared time while controlling for sociodemographic characteristics. RESULTS: There were small, statistically significant effects of pandemic severity on older adults' shared time. State-level incidence rates and policy stringency indexes were correlated with a lower likelihood of, and a decline in, older adults' shared time in public places and interactions with individuals outside their immediate family. State policy stringency was associated with more shared time in immediate family interactions. Furthermore, pandemic severity was not associated with a decrease in likelihood and older adults' shared time with nonresident immediate family. Policy stringency was more consequential than the incidence rate for older adults' social structure of shared time during the pandemic. DISCUSSION: Results indicate a place-based and role-based restructuring of older adults' daily shared time during the pandemic. Despite small effect sizes, the substantial old age population implies significant changes in shared time and patterns of daily connection at the population level. Theoretical and policy implications of the findings are discussed.
Subject(s)
COVID-19 , Pandemics , Humans , Aged , COVID-19/epidemiology , Environment , Friends , Social StructureABSTRACT
While filial piety has been widely studied in Confucian-influenced societies, little is known about how it may influence the development of emerging adults' independence and interdependence. Using a population-based longitudinal study in Taiwan (N = 3,149; 49.5% females), this study examined the association between filial piety in adolescence (aged 13-15) and independence and interdependence in emerging adulthood (aged 22). Results show that greater adherence to filial piety in adolescence predicts higher independence in emerging adulthood. Additionally, greater adherence to filial piety predicts higher interdependence for females, but not males, when parents hold traditional gender-role attitudes. This study underscores the significance of cultural norms and parental gender-role attitudes in shaping individuals' development during emerging adulthood.
Subject(s)
Gender Role , Parent-Child Relations , Parents , Adolescent , Female , Humans , Male , Asian People , Longitudinal Studies , Young AdultABSTRACT
Background/purpose: Immediate implant placement (IIP) with and without immediate provisionalization (Ipro) may yield satisfactory results in appropriate indications and treatment, especially in the esthetic zone. The aim of this study was to compare implant stability, marginal bone loss (MBL), survival rates, and patient satisfaction between IIP with Ipro and IIP without Ipro. Materials and methods: Seventy patients, each with a failed maxillary anterior tooth, were randomly assigned to IIP with Ipro (Group A: n = 35) or IIP without Ipro (Group B: n = 35). Implant stability quotient (ISQ) and standardized periapical radiographs were performed at surgery and at 3, 6, 9, and 12 months postoperatively to investigate implant stability and MBL, respectively. Survival was assessed 1 year after surgery. Patient satisfaction was evaluated with a visual analogue scale (VAS). Results: Primary ISQ and MBL were not significantly different between groups A and B immediately after surgery (P ï¼ 0.05). Implant survival was 100% in both groups, and only one mechanical complication was observed. Patient satisfaction was good at definitive crown delivery and postoperatively 1-year in both groups. However, the immediate postoperative VAS score in Group A was significantly higher than that in Group B (P < 0.05). Conclusion: Group A revealed significantly higher secondary ISQ than Group B at postoperatively 3, 6, 9, and 12 months. There were no significant differences between groups A and B in terms of MBL and survival. Notably, patient satisfaction in Group A was significantly higher than in Group B immediately after surgery.
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Background/purpose: Implant stability is crucial for successful osseointegration. Marginal bone level is considered an important indicator of long-term implant success and stability. The purposes of this study were to investigate 1) the effect of age, gender, bone density, implant length, and implant diameter on insertion torque (IT), primary implant stability quotient (ISQ), and secondary ISQ, 2) the impact of age, gender, bone density, implant length, implant diameter, IT, and ISQ on marginal bone loss (MBL). Materials and methods: Ninety patients who needed implant therapy were enrolled and overall 156 implants were installed to support single crowns. IT and ISQ were recorded for all implants during surgery and ISQ measurements were performed at follow-up visits. Age, gender, bone density, implant length and diameter were also registered. Radiographic evaluation of MBL was performed postoperative immediate (baseline), 3, 6, 9, 12, 18, and 24 months using digital periapical radiographs. Results: Age had little effect on IT and primary ISQ (P > 0.05). Generally, males had higher IT and primary ISQ, but no significant differences between genders were detected. Bone density showed significant effects on IT and primary ISQ. Correlation analysis revealed high positive correlations between IT/bone density and primary ISQ/implant diameter. Significant impacts of bone density and IT on MBL were found. Conclusion: Implant diameter had a more profound impact than length on IT/primary ISQ. Bone density played a considerable role in IT/primary ISQ determination. Bone density and IT had more impacts than primary ISQ on MBL.
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AIM: To investigate the relationship between the prevalence of antinuclear antibody (ANA) -associated rheumatic diseases (AARD) and the presence of dense fine speckled (DFS) and homogeneous patterns in ANA tests. METHODS: This retrospective study enrolled adult patients with either a DFS or homogeneous pattern in their ANA test. A mixed pattern was defined as the presence of more than one pattern reported in the test. The presence of anti-DFS70 antibodies and other common autoantibodies were detected using EUROLINE ANA Profile 23. A 1:2 propensity score matching was applied to control for demographic and other interfering factors. RESULTS: A total of 59 patients with a DFS pattern were enrolled and compared with a matched homogeneous group. The DFS group had a significantly lower prevalence of AARD (3.4% vs. 16.9%, p = .008) and the subgroup with anti-DFS70 antibodies showed an even lower prevalence (2% vs. 20%, p = .002). Among the 33 patients with monospecific anti-DFS70 antibodies, five had a mixed pattern, and all patients with common autoantibodies had an isolated DFS pattern. CONCLUSIONS: The findings of this study suggest that patients with a DFS pattern in their ANA test may have a lower prevalence of AARD compared with those with a homogeneous pattern. However, an isolated DFS pattern in ANA testing does not necessarily indicate the presence of monospecific anti-DFS70 antibodies or AARD. Confirmatory testing for the monospecific anti-DFS70 antibody is mandatory to exclude AARD.
Subject(s)
Autoimmune Diseases , Rheumatic Diseases , Adult , Humans , Autoantibodies , Antibodies, Antinuclear , Retrospective Studies , Cohort Studies , Propensity Score , Adaptor Proteins, Signal Transducing , Transcription Factors , Rheumatic Diseases/diagnosis , Rheumatic Diseases/epidemiology , Fluorescent Antibody Technique, IndirectABSTRACT
Background/purpose: Palladium-silver (Pd-Ag) alloys are important as an alternative to gold-based alloys. The purpose of this study was to investigate the effect of an argon-arc vacuum pressure casting process on the recasting of the Pd-Ag alloy. Materials and methods: The recasting Pd-Ag alloys were compared with conventional horizontal centrifugal (HC) casting to an argon (Ar)-arc vacuum pressure (Ar-arc/VP) casting. The first-generation castings were made from a Pd-Ag alloy purchased from a supplier. Next-generation castings were made from 50 wt% Pd-Ag alloy before casting and 50 wt% from previous castings. This sequence was repeated over three generations to form the 2nd, 3rd and 4th recasting ingots. The ingots were then measured for marginal accuracy, interfacial oxidation, hardness and phase identification. Results: The recasting success rate of recastibility reached 100%. Compared with the HC group, the Ar-arc/VP group had better edge precision, smaller oxide layer thickness and lower hardness. The comparison of X-ray diffraction intensity showed that the relative intensities of Pd and Ag in the first, second and third generations recasting of the Ar-arc/VP group were significantly higher than those of the HC group. Phase analysis showed that the trace elements of indium and tin contents in the Pd-Ag recasting ingots of the Ar-arc/VP group were higher than those of the HC group. Conclusion: The results showed that the casting process used for recasting affected the quality of the Pd-Ag alloy. Therefore, Ar-arc/VP casting process could improve the effect of Pd-Ag recasting and maintain the alloy properties in comparison with HC casting.
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BACKGROUND: The racial and ethnic differences in trajectories of sleep disturbances in later life are crucial for addressing health disparities, but are not well understood. This study examines (a) how trajectories of sleep disturbances vary by race and ethnicity and birth cohort and (b) whether social and health risk factors explain such variations. METHODS: The study uses longitudinal data from the 2002-2018 Health and Retirement Study (N = 21 963) and the multilevel growth curve model to assess trajectories of sleep disturbances and their variations across 6 cohorts of White, Black, and Hispanic older adults. Sleep disturbances are measured using a modified Jenkins Sleep Scale. RESULTS: Without controls, sleep disturbances increased with aging for all racial and ethnic groups, but more rapidly among minorities, particularly younger cohorts of Hispanic older adults. When controlling for social and health risks, sleep disturbances did not change with aging for Whites and Blacks and increased for younger cohorts of Hispanics. Cohort effects were observed among White older adults, with higher sleep disturbances in younger cohorts. Importantly, the racial and ethnic disparities in age and cohort effects were not fully explained by social and health risks. Of the symptoms, the most salient racial and ethnic disparities were found in "waking up at night" and "not feeling rested." CONCLUSIONS: Findings reveal several differences by race and ethnicity and birth cohort in trajectories of sleep disturbances. Efforts should be made to improve sleep health for older adults as they age, especially for younger cohorts of Blacks and Hispanics.
Subject(s)
Dyssomnias , Aged , Humans , Black or African American , Ethnicity , Hispanic or Latino , Sleep , United States/epidemiology , White , Dyssomnias/epidemiology , Dyssomnias/ethnologyABSTRACT
Camphorquinone (CQ) and resin monomers are included in dentin bonding agents (DBAs) and composite resin to restore tooth defects due to abrasion, crown fracture, or dental caries. DBAs, CQ, and bisphenol A-glycidyl methacrylate (BisGMA) applications influence the biological activities of the dental pulp. The current investigation aimed to delineate the effect of DBAs, CQ, and BisGMA on cathepsin L production/expression, lysosomal activity, and autophagy induction in human dental pulp cells (HDPCs). HDPCs were exposed to DBAs, CQ, or BisGMA with/without inhibitors for 24 h. Enzyme-linked immunosorbent assay was employed to determine the cathepsin L level in culture medium. The cell layer was utilized to measure cell viability by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl -tetrazolium bromide (MTT) assay. Real-time PCR was used to evaluate the mRNA expression. Western blotting or immunofluorescent staining was used to study protein expression. Lysosomal density was evaluated by lysotracker red staining. We found that DBAs, CQ, and BisGMA stimulated cathepsin L mRNA, protein expression, and production in HDPCs. In addition, CQ and BisGMA induced lysosomal activity, Beclin1, ATG12, LC3B, Bax, and p53 expression in HDPCs, indicating the stimulation of autophagy. Glutathione (GSH) prevented CQ- and BisGMA-induced cytotoxicity. Moreover, E64d, cathepsin L inhibitor (two cathepsin inhibitors), and Pifithrin-α (a p53 inhibitor) showed little preventive effect toward CQ- and BisGMA-induced cytotoxicity. Autophagy inhibitors (NH4Cl, Lys05) mildly enhanced the CQ- and BisGMA-induced cytotoxicity. These results indicate that DBAs stimulated cathepsin L, possibly due to their content of CQ and BisGMA that may induce cathepsin L in HDPCs. CQ and BisGMA stimulated lysosomal activity, autophagy, and apoptosis, possibly via induction of Beclin 1, ATG12, LC-3B, Bax, and p53 expression. In addition, CQ and BisGMA cytotoxicity was related to redox change and autophagy. These events are important role in pulpal changes after the restoration of tooth decay using CQ- and BisGMA-containing DBAs and resin composite.
Subject(s)
Dental Caries , Tumor Suppressor Protein p53 , Humans , Bisphenol A-Glycidyl Methacrylate , Cathepsin L , Dental Pulp , bcl-2-Associated X Protein , Composite Resins , Dentin-Bonding AgentsABSTRACT
INTRODUCTION: Basic fibroblast growth factor (bFGF) plays a critical role in odontoblast differentiation and dentin matrix deposition, thereby aiding pulpo-dentin repair and regeneration. OBJECTIVES: The purpose of this study was to clarify the effects of bFGF on plasminogen activation factors, TIMP-1), ALP; and SPARC (osteonectin) expression/production of stem cells from apical papilla (SCAP) in vitro; and the involvement of MEK/ERK, p38, Akt, and TAK1 signaling. METHODS: SCAP were exposed to bFGF with/without pretreatment and co-incubation with various signal transduction inhibitors (U0126, SB203580, LY294002, and 5Z-7-oxozeaenol). The expression of FGF receptors (FGFRs), PAI-1, uPA, p-ERK, p-TAK1, and p-p38 was analyzed via immunofluorescent staining. The gene expression and protein secretion of SCAP were determined via real-time PCR and ELISA. ALP activity was evaluated via ALP staining. RESULTS: SCAP expressed FGFR1, 2, 3, and 4. bFGF stimulated the PAI-1, uPA, uPAR, and TIMP-1 mRNA expression (p < 0.05). bFGF induced PAI-1, uPA, and soluble uPAR production (p < 0.05) but suppressed the ALP activity and SPARC production (p < 0.05) of SCAP. bFGF stimulated ERK, TAK1, and p38 phosphorylation of SCAP. U0126 (a MEK/ERK inhibitor) and 5Z-7-oxozeaenol (a TAK1 inhibitor) attenuated the bFGF-induced PAI-1, uPA, uPAR, and TIMP-1 expression and production of SCAP, but SB203580 (a p38 inhibitor) did not. LY294002, SB203580, and 5Z-7oxozeaenol could not reverse the inhibition of ALP activity caused by bFGF. Interestingly, U0126 and 5Z-7-oxozeaenol prevented the bFGF-induced decline of SPARC production (p < 0.05). CONCLUSION: bFGF may regulate fibrinolysis and matrix turnover via modulation of PAI-1, uPA, uPAR, and TIMP-1, but bFGF inhibited the differentiation (ALP, SPARC) of SCAP. These events are mainly regulated by MEK/ERK, p38, and TAK1. Combined use of bFGF and SCAP may facilitate pulpal/root repair and regeneration via regulation of the plasminogen activation system, migration, matrix turnover, and differentiation of SCAP.
Subject(s)
Alkaline Phosphatase , Fibroblast Growth Factor 2 , Alkaline Phosphatase/metabolism , Alkaline Phosphatase/pharmacology , Butadienes , Fibroblast Growth Factor 2/metabolism , Fibroblast Growth Factor 2/pharmacology , Lactones , MAP Kinase Signaling System , Mitogen-Activated Protein Kinase Kinases/metabolism , Mitogen-Activated Protein Kinase Kinases/pharmacology , Nitriles , Osteonectin/metabolism , Osteonectin/pharmacology , Plasminogen/metabolism , Plasminogen/pharmacology , Plasminogen Activator Inhibitor 1/metabolism , Plasminogen Activator Inhibitor 1/pharmacology , Resorcinols , Signal Transduction , Stem Cells/metabolism , Tissue Inhibitor of Metalloproteinase-1/metabolism , Tissue Inhibitor of Metalloproteinase-1/pharmacology , Zearalenone/administration & dosageABSTRACT
The aims of this study were to identify the microbiological changes in the periodontal pockets following an Er:YAG laser (ERL) irradiation and mechanical debridement to compare the effectiveness of ERL irradiation to mechanical debridement for peri-implantitis treatment through randomized controlled trials. Twenty-three patients with peri-implantitis lesions were treated in either a test group, ERL set at energy level of 100 mJ/pulse, frequency of 10 Hz, pulse duration was 100 µs, and irradiated by three passages, or a control group, with mechanical debridement using an ultrasonic scaler. An examiner measured the following clinical parameters at different stages (a baseline and at 3- and 6-month post-treatment): probing depth (PD), bleeding on probing (BOP), marginal bone loss (MBL), and anaerobic bacteria counts. Linear regression, with generalized estimation equations, was used to compare the clinical parameters and anaerobic bacterial counts at different stages and between groups. The anaerobic bacterial counts significantly decreased within the control group during the follow-ups. At the 6-month follow-up, both groups showed a significant reduction in PD (test group: mean difference of 0.84 mm; control group: mean difference of 0.41 mm), and the test group showed a significantly higher PD reduction on the buccal site (1.31 mm) compared to that of the control group (0.25 mm). Both ERL and mechanical debridement treatments led to significant improvements in PD. When mechanical debridement therapy was used, significant anaerobic bacterial count reductions were observed. Future treatment of peri-implantitis should involve a combination of both of these therapies.
Subject(s)
Dental Implants , Lasers, Solid-State , Peri-Implantitis , Humans , Peri-Implantitis/radiotherapy , Lasers, Solid-State/therapeutic use , Periodontal Pocket , Debridement , Bacterial Load , Treatment Outcome , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: Neutrophil extracellular traps (NETs) play important roles in sepsis and deep-seated infections, but whether NET formation correlates with clinical outcomes of patients with streptococcal bloodstream infections (BSIs) is unclear. METHODS: We analyzed serum levels of complexes of myeloperoxidase and DNA (MPO-DNA) in patients with streptococcal-BSIs. In vitro assay of NET induction by serum from BSI patients was performed. RESULTS: MPO-DNA values for the Streptococci-BSI group (n = 59) were significantly higher than those for healthy controls (p < 0.00001) and matched control groups (n = 59, p = 0.004). The rate of higher MPO-DNA levels (>1.87 µg/mL) were higher in abscess-prone streptococcal groups (streptococcus milleri group) (72.2% vs. 52.5%, p = 0.02). For patients with BSIs due to highly infective endocarditis (IE)-prone pathogens, the values of serum MPO-DNA were also higher in patients diagnosed of IE compared to their counterparts (p = 0.009). Notably, serum from patients with leukopenia could induce higher amounts of in vitro NET formation, despite having low MPO-DNA levels, suggesting that NET formation could be influenced by WBC counts. Therefore, we combined WBC counts with MPO-DNA to predict all-cause 30-day mortality in patients with commensal streptococcal-BSIs. The mortality risk was lowest among patients who had neither high MPO-DNA levels nor abnormal WBC counts (p = 0.058). Furthermore, this group of patients also had a favorable composite outcome consisting of major adverse cardiovascular events (MACE) and all-cause mortality (p = 0.026). CONCLUSION: Together, these study data suggested that serum MPO-DNA can be a biomarker for predicting a composite outcome consisting of MACE and all-cause mortality in patients with commensal streptococcal-BSIs.
Subject(s)
Bacteremia , Cardiovascular Diseases , Extracellular Traps , Sepsis , Humans , Peroxidase , Biomarkers , DNA , NeutrophilsABSTRACT
Objectives: This study examines disparities in older adults' mental health and well-being during the pandemic by sexual minority status. Methods: This study analyzed data on older adults from the Health and Retirement Study's COVID-19 Module (N = 3142 for heterosexuals and N = 75 for sexual minorities). Weighted regressions linked concern about COVID-19, depression, pandemic emotional stress, and changes in loneliness, in-person contacts, income, and work to sexual minority status, controlling for sociodemographic characteristics. Results: Compared to heterosexuals, sexual minority older adults had more concern about the pandemic and emotional stress and showed a decrease in in-person contact during the pandemic-these differences were not explained by sociodemographic characteristics. Sexual minority older adults were also more likely to have changes in income and work during the pandemic, but these differences were explained by sociodemographic characteristics. Discussion: Sexual minority older adults have experienced worse mental health outcomes than heterosexuals during the COVID-19 pandemic, which merits intervention.
Subject(s)
COVID-19 , Health Status Disparities , Mental Health , Pandemics , Sexual and Gender Minorities , Aged , COVID-19/epidemiology , COVID-19/psychology , Heterosexuality/psychology , Heterosexuality/statistics & numerical data , Humans , Mental Health/statistics & numerical data , Sexual and Gender Minorities/psychology , Sexual and Gender Minorities/statistics & numerical dataABSTRACT
Racial gaps in vaccine uptake in the United States have been widely reported. Existing studies, however, have not explored how individuals' concerns about COVID-19 vaccines are clustered. In this study, racial and ethnic background is linked to constellations of COVID-19 vaccine concerns during the early phase of vaccines in the United States, using the Household Pulse Survey (N = 60,492). Latent class analysis reveals five distinct classes of vaccine concerns: general skepticism, distrust of science and the government, safety, a desire to wait and see, and vague uncertainty. Compared to Whites, people of color more consistently report vaccine hesitancy due to safety and a desire to wait and see, rather than distrust of science and the government. Whites, however, more consistently report general skepticism and distrust of science and the government. Our findings suggest that distrust of science and government is not central to racial minorities' vaccine hesitancy, but it is so for Whites.
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Although numerous studies have looked closely at determinants of developmental outcomes for children of immigrants, few studies have examined these children's time use at the national level, and even fewer have focused on early childhood. This study investigates the role of familial immigration background on children's time use using three waves of large-scale data (from age 4-9) from the Longitudinal Study of Australian Children. Results showed that children in immigrant families spent more time reading than children in native families, whereas children in native families spent more time in non-structured social and other activities. Importantly, the differences found between children in immigrant and native families were similar on weekdays and weekends when children are free from institutionalized routines. Furthermore, the differences in time use between children in immigrant and native families were found mostly for children of immigrants from non-Anglophone countries. Finally, differences in time use between children in immigrant and native families did not change as children aged. Policy and theoretical implications are discussed.
Subject(s)
Emigrants and Immigrants , Emigration and Immigration , Australia , Child , Child, Preschool , Humans , Longitudinal Studies , PolicyABSTRACT
Pharmaceutical patent analysis is the key to product protection for pharmaceutical companies. In patent claims, a Markush structure is a standard chemical structure drawing with variable substituents. Overlaps between apparently dissimilar Markush structures are nearly unrecognizable when the structures span a broad chemical space. We propose a quantum search-based method which performs an exact comparison between two non-enumerated Markush structures with a constraint satisfaction oracle. The quantum circuit is verified with a quantum simulator and the real effect of noise is estimated using a five-qubit superconductivity-based IBM quantum computer. The possibilities of measuring the correct states can be increased by improving the connectivity of the most computation intensive qubits. Depolarizing error is the most influential error. The quantum method to exactly compares two patents is hard to simulate classically and thus creates a quantum advantage in patent analysis.
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OBJECTIVES: Early in the coronavirus pandemic, U.S. states implemented several different types of containment measures to slow the disease's spread. Early evidence indicates containment measures were associated with changes in individuals' mental health. This study explores the associations between U.S. state containment measures and older adults' mental health and importantly, whether the associations vary by living arrangement and gender. METHODS: The study analyzed national sample of adults aged 50 or older from 12 waves (April-July 2020) of the U.S. Household Pulse Survey (N = 394,934). State fixed-effects models linked four state containment measures (stay-at-home order, restaurant closure, bar closure, and movie theater closure) to levels of depression and anxiety across different types of living arrangements, net of controls. Men and women were analyzed separately. RESULTS: Stay-at-home order and restaurant and bar closure, but not movie theater closure, were associated with higher levels of depression and anxiety in older adults. Living arrangements moderated the associations for women but not men. For women, compared to living alone, living with a spouse or intergenerational family was associated with higher levels of anxiety and depression during stay-at-home order and restaurant closure. CONCLUSION: The associations between containment measures and mental health vary by type of living arrangement and were gendered, likely because household situations create different demands and supports that men and woman experience differently. Although containment measures are necessary to protect public health, paying attention to these underlying dynamics can inform policymakers' efforts to implement policies that balance harms and benefits for older adults.
Subject(s)
COVID-19 , Mental Health , Aged , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Pandemics , Residence CharacteristicsABSTRACT
OBJECTIVES: An oral health disparity exists between native and immigrant children in Taiwan. This study evaluated the long-term effectiveness of a lay health advisor (LHA) intervention on immigrant children's dental caries and maternal preventive behaviours. METHODS: Fifty-one immigrant mother-child pairs were randomly assigned to LHA intervention (n = 23) and control (n = 28) groups. Mothers in the LHA group received a four-chapter one-on-one lesson plan, which included dental caries-related knowledge, brushing techniques, caries prevention and free preventive services, from the LHA over 4 weeks. Mothers in the control group received only a health brochure. Baseline and 1-week, 2-month, and 8-month follow-up information was collected using dental examinations and questionnaires. RESULTS: The mean ages of the children in the LHA and control groups were 4.0 ± 1.4 and 4.2 ± 1.5, respectively. The decayed, missing due to caries, filled teeth (dmft) index in the LHA and control groups was 4.8 ± 6.0 and 5.4 ± 5.4, respectively, at baseline. At the 8-month postintervention follow-up, the number of filled teeth (ft) in the LHA group was higher than that in the control group (ß = 8.3, P = .033). The effect size (ES) demonstrated an upward trend at 1-week, 2-month and 8-month follow-ups in ft (ES = 0.21, 0.50 and 0.59, respectively) and a decrease in the number of decayed teeth (dt) (ES = 0.30, 0.43 and 0.57, respectively). The mothers in the LHA group were observed to be 10.9 times more likely than control mothers to assist their children in toothbrushing for 3 min at the 1-week follow-up (95% CI = 1.98-59.40, P = .006). CONCLUSIONS: The LHA intervention strategy had positive effects on the immigrant children's new dt and ft and on maternal preventive behaviour, such as assisting their children in toothbrushing.