Speeding Up Time: New Urinary Peptide Clock Associates Greater Air Pollution Exposures with Faster Biological Aging.

A study in Belgium supports earlier findings on associations between higher air pollution exposures and markers of faster biological aging, this time by using urinary peptide levels instead of DNA-based markers.

Satisfaction with health care services in young people with cerebral palsy in the transition period: results from a European multicenter study.

Background: Young people with chronic health conditions and disabilities rely on the healthcare system to maintain their best possible health. The appropriate delivery and utilization of healthcare services are key to improve their autonomy, self-efficacy and employment outcomes. The research question of our study is directed toward investigating if poor availability and accessibility of healthcare services in general, as identified by unmet needs in healthcare, are associated with dissatisfaction with healthcare. Methods: Within a European multicenter observational study, 357 young adults with cerebral palsy aged 19-28 were included. We assessed special healthcare needs, utilization of healthcare services, and satisfaction with healthcare applying the short-form of the YHC-SUN-SF, environmental and social variables (EAEQ) as well as indicators for severity of condition and functionality (e.g., GMFCS) of these participants based on a self-, assisted self- or proxy-reports. We used correlation analyses to explore associations between satisfaction with healthcare and respective indicators related to availability and accessibility of healthcare services as well as severity of the condition. In addition, we included reference values for satisfaction with heath care from young adults with various chronic conditions assessed within population-based surveys from some of the European countries included in the study. Results: We identified several unmet healthcare needs, especially for widely used and established services (e.g., physical therapy). Satisfaction with healthcare (YHC-SUN-SF general and subscale scores) was moderate to high and almost consistently better for the sample of young adults with cerebral palsy as compared to reference values for young adults with various chronic conditions assessed within general population surveys). Correlation coefficients between satisfaction with healthcare and utilization of services and (unmet) healthcare needs were low, also with different indicators for severity of the condition or functionality. Conclusion: Young adults with cerebral palsy reports of unmet healthcare needs varied largely but showed substantial deficits in some aspects. This seems to have no impact on the satisfaction with healthcare those patients currently receive. We conclude that these are two different constructs and somewhat independent indicators to evaluate the quality of healthcare. Clinicians and other practitioners should consider this distinction when monitoring patient needs in their daily practice.

How socio-political change is associated with the number of individually reported negative life events: a population-based study using the German reunification 1989/1990 as an example.

BACKGROUND: Socio-political change often leads to disruptions in employment and social networks, which can exacerbate health issues and increase mortality rates. These consequences are likely observed as an increase in negative life events (NLEs), serving as indicators of the broader social and health impacts. Using the German reunification in 1989/1990 as an example, this study investigates changes in reported numbers of NLEs and differences regarding sociodemographic characteristics. METHODS: We used data from the population-based Study of Health in Pomerania (SHIP-START-0, SHIP-Life-Events and Gene-Environment Interaction in Depression; N=1932). Numbers of NLEs in different categories (work/financial, social/interpersonal, illness (own) and illness/death (others)) were measured retrospectively in 5-year intervals (1980-2004) using a semistructured interview. Pre-reunification and post-reunification changes were modelled using piecewise mixed-effects Poisson regressions with the 1990-1994 interval (reunification) as change point. Interactions with age, sex and education were examined. RESULTS: The number of most NLE categories, except social/interpersonal NLEs, increased at reunification. Whereas work/financial NLEs slightly decreased post-reunification, illness-related NLEs continued to increase. Higher numbers of social/interpersonal NLEs were found with younger age. More illness-related NLEs were reported with older age, lower education (illness (own)) and by women (illness/death (others)). However, the majority reported no NLEs at reunification (68.2%-80.7%, varying by category). CONCLUSION: Our findings suggest that although some individuals experience a marked increase in NLEs due to socio-political changes, many remain unaffected, emphasising the need for a differentiated understanding of these effects. This increase in NLEs may partly account for ongoing health and well-being disparities among countries with differing transformation histories.

Marking Time: Epigenetic Aging May Partially Explain the Arsenic-Cardiovascular Disease Link.

New epigenetic clocks point to DNA methylation as a mechanism in the well-known link between arsenic exposure and cardiovascular disease risk. The results validate the use of these clocks in Native American populations.

Pain Pathways: Linking Environmental Pollutants with Migraine-Associated Pain Signaling.

Using human cells and a mouse study, researchers found that pesticides, phthalates, hormone-like compounds, and other chemicals affected the TRPA1 channel-which is also implicated in migraine.

Collective loneliness: The impact of the social network on loneliness and depression during the coronavirus pandemic in older Europeans.

OBJECTIVES: We examined the impact of the social network before the coronavirus pandemic on loneliness and depressed mood during the pandemic in older European individuals, and how these relationships differ between different European countries. METHODS: Data of N = 19,999 persons (age: M = 69.18 years; 51% female) from the pan-European longitudinal survey of health, ageing and retirement in Europe, interviewed between October 2019 and March 2020 (Wave 8) and between June and August 2020 (Corona Questionnaire 1), were used. To test the models we employed path analyses, controlling for age, gender, education, and occupational status. Models were also run separately in collectivistic (Romania, Slovenia, Croatia, and Greece) and individualistic (Netherlands, Belgium, Denmark, and France) country groups. RESULTS: A larger social network before the pandemic reduced the probability of an increase in loneliness and depression. The negative association between social network size and increase in loneliness was stronger in collectivist countries than in individualist ones. Moreover, an increase in loneliness increased the probability of feeling depressed. CONCLUSIONS: It appears that pre-pandemic social networks served as a buffer to negative mental health consequences of the pandemic in older Europeans. In fact, this association was stronger in collectivist than for individualist countries. While this underscores the importance of social connectedness, it also stresses the vulnerability of socially isolated individuals regarding loneliness and depression. Future work should thus focus on supporting social networks in older adults.

Transition competence as an indicator of health outcomes related to transition.

BACKGROUND: Adolescents and young adults (AYAs) with chronic conditions face a transfer, defined as an actual shift from paediatric to adult-oriented health care. Transition competence as the self-perceived knowledge, skills and abilities regarding the transition process was considered extremely useful. AIM: This study was designed to investigate the impact of transition competence before and after the transfer on disease-specific quality of life (QoL) and health care satisfaction of AYAs with diabetes. RESULTS: In total, a sample of N = 90 AYAs with diabetes self-reported their transition competence, diabetes-specific QoL and satisfaction with care. Multiple linear regressions were used to analyse the impact of transition competence on satisfaction with care and QoL. Transition competence positively influenced the outcomes of satisfaction with care and QoL. CONCLUSION: Young adults with diabetes showed higher transition competence scores than adolescents with diabetes.

Differences in participation between young adults with cerebral palsy and their peers: A cross-sectional multicentre European study.

BACKGROUND: Children and adolescents with disabilities are known to participate less in most areas of life than their non-disabled peers. OBJECTIVES: (1) To estimate differences in participation between young adults with cerebral palsy (CP) and their non-disabled peers; (2) to test the mediating role of financial difficulties and student status; (3) to test the moderating role of personal factors on participation difference; and (4) to test the moderating role of impairment. METHODS: A cross-sectional study was conducted in young adults [19-28 years] with CP (n = 228) and non-disabled peers (n = 2861) in France, Germany and Sweden. Participation was assessed using the Questionnaire of Young People's Participation adapted for young adults (QYPP-YA). Differences in five domains of participation were estimated using structural equation modeling with WLSMV method and bias-corrected bootstrap confidence intervals. RESULTS: Young adults with CP showed lower participation than others in all domains, with the largest difference in the "intimate relationships" domain (ß = 1.71 bcCI95[1.46; 1.95]). Student status mediated the difference in "intimate relationships", "interpersonal relationships" and "independence". Women showed greater differences than men on "independence". Impairments moderated difference in participation. The less severely impaired young adults showed no difference with their non-CP peers in "interpersonal relationships", "social life" and "independence", but made autonomous everyday decisions more often than their peers. CONCLUSIONS: Young adults with CP do not have the same opportunities to attain the participation level of non-CP people of the same age. Continuance of education could help to reduce participation difference in "interpersonal relationships" and "independence".

The differential influence of self-construal on the effect of self-efficacy on the help-seeking process: A quasi-experimental online study among people with untreated depressive symptoms.

BACKGROUND: Despite available professional healthcare, people often delay or avoid help-seeking. Understanding the underlying reasons is crucial and research has explored the role of self-efficacy in this context. Additionally, studies have highlighted the significance of culturally influenced self-construals in individuals' health behaviour. There seems to be a relationship between self-efficacy and self-construal. The aim of the study is to explore the influence of self-efficacy on help-seeking, considering self-construal as a moderator. Differential experiences of self-efficacy and varying associations among help-seeking variables based on self-construal are posited. METHODS: A quasi-experimental online study is conducted with a baseline assessment, including self-efficacy interventions, and follow-ups at three and six months. Self-construal groups are compared, i.e., independent vs. interdependent individuals. A series of multi-group path analyses are conducted to examine potential variations in the interventional effects and among the help-seeking variables respective of help-seeking instance, i.e. professional mental health care or informal care. Self-construal functions as the global moderator. RESULTS: The study included N = 1'368 participants, 65.6 % identifying as female and an average age of 42.38 (SD = 15.22). More independent compared to more interdependent individuals were older, more frequently identified as male, had higher socioeconomic status, fewer depressive symptoms, and greater self-efficacy. Multi-group path analyses for professional mental health care (CFI = 0.992, RMSEA = 0.018, SRMR = 0.004) and informal help (CFI = 0.999, RMSEA = 0.004, SRMR = 0.006) demonstrated excellent model fits. The analysis for informal help was interpretable, as the unconstrained model had a significantly better fit than the constrained model. There were varying associations among help-seeking variables based on self-construals. The intervention effect was differential, with independent participants benefiting significantly (ß = 0.203), while the effect was non-significant for interdependent participants. DISCUSSION: The study's findings, strengths, and limitations are discussed in relation to current research. Results indicate differential experiences of self-efficacy interventions based on individuals' self-construal. Moreover, varying associations among help-seeking variables suggest self-construal-based differences in their interrelationships. These findings highlight the importance of considering self-construal in health related research.

The effects of causal and self-efficacy beliefs on help-seeking for people with depressive complaints: a quasi-experimental online study.

Background: Only approximately a third of people with depressive symptoms seek professional health care. Furthermore, people labelled as mentally ill may experience stigmatisation, which can impede help-seeking behaviour. Aim: To examine the effects of three vignette-based interventions endorsing biopsychosocial causal beliefs and strengthening self-efficacy on help-seeking intention and behaviour, as well as the predictive values of these variables and previous treatment experience. Method: A quasi-experimental online study utilising a fractioned factorial design was carried out. People were screened for depressive symptoms and their current treatment status. After baseline assessment, they were randomly allocated into one of 24 groups receiving a combination of interventional messages. Actual help-seeking behaviour was measured at follow-ups 3 and 6 months after baseline. Results: Altogether, N = 1,368 participants were included in the final analyses and N = 983 provided data on their help-seeking behaviour within 3 to 6 months after the baseline assessment. The intention to seek help from a general practitioner or a mental health professional was significantly influenced by the interventions. However, help-seeking behaviour was not influenced by the interventions. On a conceptual level, biopsychosocial causal beliefs (ß = 0.09-0.23) and self-efficacy to seek help (ß = 0.16-0.25) predicted help-seeking intention. There was a negative interaction effect of both self-efficacy beliefs on intention and behaviour, which changed depending on depression severity. In all models, the intention was the main predictor of actual behaviour. Treatment experience predicted both help-seeking intention and behaviour. Conclusion: Biopsychosocial causal beliefs and self-efficacy have a direct effect on help-seeking intention. Interventions should include information on how to actually seek help as a means to strengthen self-efficacy beliefs and simulate previous treatment experience. Further research is needed to investigate the respective interaction effects on intention and behaviour. Clinical Trial Registration: https://drks.de/search/de/trial/DRKS00023557, German Clinical Trials Register: DRKS00023557. Registered 11 December 2020. World Health Organization, Universal Trial Number: U1111-1264-9954. Registered 16 February 2021.

When WASHing Is Not Enough: Food Hygiene and Chicken Production in Mozambique.

From egg to market, contamination of poultry products with Campylobacter and Salmonella increases along the "value chain," suggesting opportunities to reduce infection with these enteropathogens and complement WASH approaches to sanitation.

Explorative analyses on spatial differences in the desire for social distance toward people with mental illness in a diverging city.

Introduction: Stigma is an individual and societal process based on attitudes and power and relates to both spatial disparities and social distinction. In this study, we examined differences in desire for social distance toward people with mental illness within a city using social and spatial information. Methods: ANOVAs and Scheffé post-hoc tests analyzed varying desires for social distance toward people with mental illness within Leipzig (East Germany). Joint Correspondence Analyses (JCA) explored correspondences between desire for social distance, socio-economic status, age, life orientation, social support, duration of living in Leipzig, and shame toward having a mental illness in five city districts of Leipzig in LIFE study participants (by Leipzig Research Center for Civilization Disease, data collected 2011-2014 and 2018-2021, n = 521). Results: Stigma varied among Leipzig's districts (F(df = 4) = 4.52, p = 0.001). JCAs showed that a higher desired social distance toward people with mental illness corresponded with spatial differences, high levels of pessimism, high shame of being mentally ill, low social support, low socio-economic status, and older age (75.74 and 81.22% explained variances). Conclusion: In terms of stigma, where people with mental illness live matters. The results identified target groups that should be addressed by appropriate intervention and prevention strategies for mental health care.

[Life events related to the German reunification and their associations with psychosocial health in a sample of northeast Germany]. / Nach-Wende-Ereignisse und deren Assoziation mit psychosozialer Gesundheit in einer nordostdeutschen Stichprobe.

Objectives: The aim of the present study was to investigate (1) the type and frequency of reported life events of the East German population related to the German reunification and (2) their associations with psychosocial health. Methods: Data of 2247 participants of the Study of Health in Pomerania was used.These qualitative responses were analysed using quantitative content analysis. Their associations with subjective physical and mental health, optimism, social support, depressive symptoms, and chronic stress were examined. Results: Eight life event categories were identified (education, employment-related changes, material changes, new opportunities, personal life events, politics, separations, reunifications). Especially, experiencing new opportunities was associated with a higher level of optimism as well as a lower level of depressive symptoms and chronic stress. Conclusions: In this study, events frequently described in the literature (e.g., employment-related and social changes) were confirmed and systematized.The observed associations of these events with psychosocial factors should be examined further in future studies.

Ecological momentary assessment of parent-child attachment via technological devices: A systematic methodological review.

Despite extensive research about parent-child attachment using observational and self-report studies, complementary measures are needed to assess this construct objectively with ecological validity, as well as less obtrusiveness and reactivity than traditional measures. This systematic review describes existing technology-based ecologically momentary assessment (EMA) tools examining attachment-related emotions, cognition, and behaviors between the child and its parents. From the study's inception until March 2021, four databases were searched resulting in 11,910 screened citations. Finally, 18 records were included, characterized by a broad variety of assessment tools, sample characteristics, study designs, and attachment outcomes. Technology-based EMA methods comprised audio, video, diary, and sensory assessment modalities, each occuying its methodological niche. When reported, the psychometric properties of the EMA methods were evaluated as very good; however, the included studies' psychometric data was not completely examined. The main attachment outcomes assessed by EMA were emotional and cognitive reactions and actions of the children, the parents, and the dyad. Cognition was rarely assessed using EMA methods. Future research should focus on the complexity of attachment considering different ethnic backgrounds, multiple caregivers' viewpoints, gender aspects, as well as cognitive and dyadic contents in the naturalistic environment.

Quality of Life after Brain Injury in Children and Adolescents (QOLIBRI-KID/ADO)-The First Disease-Specific Self-Report Questionnaire after Traumatic Brain Injury.

The subjective impact of the consequences of pediatric traumatic brain injury (pTBI) on different life dimensions should be assessed multidimensionally and as sensitively as possible using a disease-specific health-related quality of life (HRQoL) instrument. The development and psychometrics of the first such self-report questionnaire for children and adolescents after TBI are reported here. Focus group interviews with children, adolescents, and their parents, cognitive debriefing, item pool generation and reduction using Delphi expert panels were performed. The resulting version was psychometrically tested on 300 individuals aged 8-17 years. After item reduction based on factor analyses, differential item functioning, reliability, and validity were investigated. The final 35 items were associated with six scales (Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, Physical Problems). Internal consistency and construct validity were satisfactory. Health-related Quality of life (HRQoL) was significantly lower in older and in female participants, as well as those with cognitive disabilities, anxiety, depression and post-concussion symptoms, than in comparative groups. The new QOLIBRI-KID/ADO is a comprehensive, multidimensional, reliable, and valid instrument, comparable in content and items to the QOLIBRI adult version. Therefore, disease-specific HRQoL can now be measured across the lifespan and may support the amelioration of treatment, care, rehabilitation, and daily life of children and adolescents after TBI.

Measuring context that matters: validation of the modular Tele-QoL patient-reported outcome and experience measure.

PURPOSE: A setting-sensitive instrument for assessing Quality of Life (QoL) in Telemedicine (TM) was unavailable. To close this gap, a content-valid "add-on" measure was developed. In parallel, a brief index was derived featuring six items that summarise the main content of the multidimensional assessment. After pre- and pilot-testing, the psychometric performance of the final measures was investigated in an independent validation study. METHODS: The questionnaires were applied along with other standardised instruments of similar concepts as well as associated, yet disparate concepts for validation purposes. The sample consisted of patients with depression or heart failure, with or without TM (n = 200). Data analyses were aimed at calculating descriptive statistics and testing the psychometric performance on item, scale, and instrument level, including different types of validity and reliability. RESULTS: The proposed factor structure of the multidimensional Tele-QoL measure has been confirmed. Reliability coefficients for internal consistency, split-half, and test-retest reliability of the subscales and index reached sufficient values. The Tele-QoL subscales and the index demonstrated Rasch scalability. Validity of both instruments can be assumed. Evidence for discriminant construct validity was provided. Known-groups validity was indicated by respective score differences for various classes of disease severity. CONCLUSION: Both measures show convincing psychometric properties. The final multidimensional Tele-QoL assessment consists of six outcome scales and two impact scales assessing (un-)intended effects of TM on QoL. In addition, the Tele-QoL index provides a short alternative for outcome assessment. The Tele-QoL measures can be used as complementary modules to existing QoL instruments capturing healthcare-related aspects of QoL from the patients' perspective.

An explorative cross-sectional analysis of mental health shame and help-seeking intentions in different lifestyles.

To identify und support particular target groups for mental health prevention, we explore the links between shame and help-seeking intentions concerning mental health in different lifestyles (based on socioeconomic status as well as health-related behaviors). Lifestyles were operationalized by nine confirmatory, homogenous clusters of the sample. These clusters are based on individuals' similarities in sociodemographic aspects and health behavior. Analyses included t tests, Chi-square, ANOVA, regressions investigating in sociodemographic characteristics. Hierarchical linear models examining cross-sectional associations of shame and willingness to seek help for different lifestyles of participants of the Study of Health in Pomerania (SHIP-START-1 and SHIP-START-3, data collected 2002-2006 and 2014-2016; n = 1630). Hierarchical linear models showed small context effects for lifestyle-related associations of shame and willingness to seek help. For younger as well as male participants, lifestyles indicated different associations of shame and help-seeking intentions: Especially the lifestyles with unhealthy behaviors and high as well as low socioeconomic status resulted in higher shame being associated with low help-seeking intentions in case of mental illness. Lifestyle clusters might be a useful tool to identify marginalized groups with unhealthy behaviors, which should be addressed by interventions and prevention programs.