Associations between health anxiety, eHealth literacy and self-reported health: A cross-sectional study.

OBJECTIVE: To explore the associations and gender differences between health anxiety, eHealth literacy and self-reported health in Chinese university students. METHODS: 1,205 university students aged 18-22 years were voluntarily recruited to respond to an online self-report questionnaire. RESULTS: The severity level of health anxiety among university students was ranked as lifestyle anxiety, psychological anxiety, appearance anxiety, physical anxiety. There were significant gender differences in appearance anxiety, and yet no in eHealth literacy of university students. eHealth literacy was positively associated with self-reported health; health anxiety was negatively associated with self-reported health. Female's eHealth literacy, lifestyle, psychological and physical anxiety, and male's eHealth literacy, appearance anxiety significantly impacted on their self-reported health. CONCLUSION: The lower eHealth literacy or the more health anxiety, the worse their self-reported health. The findings underscored the importance for university students to improve eHealth literacy and reduce health anxiety. Appropriate interventions with gender differences were urgently needed.

Physical performance in the health environment: an undervalued practical and inexpensive tool.

In this article, Festa et al. highlight that the assessment of physical performance is not currently valued as a simple and practical tool for estimating health status in the general population. Consequently, the purpose of this opinion article is to highlight the importance of testing and classifying physical performance as an indicator of overall health, encouraging health professionals to consider them as an accessible and inexpensive tool for the public health context, in contrast to laboratory assessments.

Patterns of self-rated health trajectories and associated factors in ELSA-Brasil. / Padrões de trajetórias de autoavaliação de saúde e fatores associados no ELSA-Brasil.

To describe patterns of self-rated health (SRH) trajectories and investigate their association with sociodemographic, occupational, and health factors.The sample consisted of 7,738 active public servants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), evaluated from 2008 to 2020. The patterns of SRH trajectories were obtained by eleven time points, using the latent class growth curve. A multinomial logistic model was used to test associations between the exposures and patterns of trajectories of SRH.Three patterns of trajectories of SRH were identified: i- good, ii- moderate, and iii- poor (29%, 61%, and 10% of the participants, respectively). Adjusted results showed that women, mixed-race, frequent work to family or family to work conflict were associated with a greater chance of poor pattern of trajectory of SRH, compared to good pattern. Besides, high school, low income, passive work, high strain, low social support, lack of time selfcare and leisure, overweight, obesity, unhealthy lifestyle, and the presence of comorbidities were associated with a greater chance of moderate and poor pattern of trajectory of SRH, when compared with a good pattern.Adverse socioeconomic and occupational conditions, as well as unhealthy lifestyle and comorbidities were associated with worse SRH patterns of trajectories.

Descrever padrões de trajetórias de autoavaliação de saúde (AAS) e investigar sua associação com fatores sociodemográficos, ocupacionais e de saúde.Amostra composta por 7.738 servidores públicos ativos do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) avaliados entre 2008 e 2020. Utilizando-se a curva de crescimento de classe latente, foram definidos os padrões de trajetórias da AAS, obtidos em 11 pontos no tempo. Modelos logísticos multinomiais foram testados para analisar associações entre as exposições e os padrões de trajetórias de AAS.Três padrões de trajetórias de AAS emergiram: i- boa, ii- regular e iii-ruim (29%, 61% e 10% dos participantes, respectivamente). Após ajustes, tiveram maiores chances de serem classificados com padrões de trajetória de AAS ruim, comparado à boa, o sexo feminino, a raça/ cor autorreferida parda, referir frequente conflito do trabalho para a família ou da família para o trabalho. Além disso, os fatores associados a maiores chances de apresentar padrão de trajetória de AAS ruim ou regular, comparados à boa, foram escolaridade até o ensino médio, menor renda, trabalho passivo, alto desgaste no trabalho, baixo apoio social, ocupação manual, percepção de escassez de tempo para o autocuidado e lazer, ter sobrepeso ou obesidade, um estilo de vida não saudável e comorbidades.Condições socioeconômicas e ocupacionais adversas, estilo de vida não saudável e comorbidades foram associadas ao pior padrão de trajetórias de AAS.

Fear of Crime During Years of Street Violence Is Associated With Worsening Cardiovascular Health Status.

BACKGROUND: Street violence has detrimental effects on cardiovascular health (CVH). However, the significance of these consequences have not been systematically evaluated. In this study, we aimed to assess the impact of fear of crime on CVH status among community-dwellers aged ≥40 years living in a rural village stricken by violence. METHODS: Participants were selected from individuals enrolled in the Atahualpa Project Cohort, a population-based longitudinal study that aims to reduce the burden of cardiovascular risk factors and diseases in rural Ecuador. Fear of crime was evaluated using a structured scale. The Life's Simple 7 construct of the American Heart Association was employed to assess CVH before the escalation of violence and crime in the village (2019) and at the end of the study (2024). Multivariate logistic regression models were fitted to examine the association between the exposure and outcomes. RESULTS: A total of 648 individuals (mean age = 57.4 ± 11.7 years; 56% women) were included. At the end of the follow-up, significant association between fear of crime levels and worsening CVH status was noted. Participants allocated to the second and third tertiles of fear of crime were 3.27 (95% CI = 2.07-5.19) and 5.46 (95% CI = 3.14-9.48) times more likely to have worsening CVH status at follow-up compared to baseline determinations, respectively. CONCLUSION: This study shows an aggravating impact of fear of crime on the CVH status and identifies interventional targets that may help to reduce the risk of CVH status worsening in community-dwellers living in rural settings afflicted by violence.

Early life circumstances and their impact on health in adulthood and later life: a systematic review.

INTRODUCTION: Certain situations and contexts during early years of life and childhood can have a significant impact on the health of older individuals. Studies have demonstrated that adversities such as poverty, neglect, abuse, and exposure to chronic stress conditions during the early years of life are associated with a range of health problems in adulthood. OBJECTIVE: To systematically identify the literature on the impact of circumstances and/or conditions in early life/childhood on the health of older adults. MATERIALS AND METHODS: A systematic literature review guided by the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was conducted. The databases used were PUBMED, LILACS, Scielo, Embase, and Web of Science. Longitudinal studies published without language or publication date restrictions, related to the proposed theme, were included. Editorial letters, review protocols, reflective studies, literature reviews, and articles without available online abstracts or full texts were excluded. The quality assessment of the studies was conducted using tools and guidelines provided by the Joanna Briggs Institute. The database search conducted between May and August 2023 resulted in 8,224 articles found. After completing the steps of duplicate exclusion and reading titles and abstracts, 35 articles were selected for full reading, culminating in a final sample of 10 eligible articles for this review. RESULTS: These studies highlighted various early-life circumstances, including socioeconomic status, exposure to adverse childhood experiences, and environmental factors, demonstrating significant associations with health outcomes in older adults. The findings collectively emphasize the critical role that early adversities play in influencing chronic diseases, mental health, and overall well-being in later life. FINAL CONSIDERATIONS: Understanding social determinants, early-life adversities, and socioeconomic factors is essential for promoting healthy and equitable aging, with effective interventions and public policies aimed at reducing inequalities and ensuring the well-being of the adults and older adults.

EQ-5D-5L population norms and health inequality for Trinidad and Tobago in 2022-2023 and comparison with 2012.

BACKGROUND: The use of EQ-5D instruments in clinical, policy and economic applications continues to grow internationally. Population norms studies provide baseline values against which demographic and patient groups are compared and inequality is assessed. This study presents updated EQ-5D-5L population norms for 2022-2023, evaluates inequality and compares the results with those of 2012. METHODS: Demographic and EQ-5D-5L data were obtained from mutually exclusive, representative samples of adults in three studies conducted from July 2022 through May 2023. EQ-5D-5L index values, EQ VAS scores, and ceilings (all dimensions at level 1) were calculated for age-sex groups and stratifiers including education, income, ethnicity, marital status, and employment status. For inequality, the Kakwani index was calculated for the EQ VAS scores and index values, and ordered logit models were used to obtain odds ratios for reporting higher levels of problems on each dimension for demographic groups. The results were compared with those from 2012 which included applying the value set that had been used for the 2022-2023 population norms to the 2012 states. RESULTS: Data were obtained form 2,989 respondents. The mean index value was 0.921, EQ VAS was 79.6 and the ceiling was 31.5%. The dimensions with the highest rates of reported problems at any level (2-5) were pain/discomfort (43%) and anxiety/depression (39%). The Kakwani index was 0.113 for EQ VAS and 0.058 for index values, with sex accounting for the largest relative contribution. Mean index values, EQ VAS scores, and ceilings were lower across all demographic groups in 2022-2023 compared to 2012. CONCLUSIONS: This is the first study to investigate how EQ-5D-5L population norms have changed within a country over time. Significant changes were observed in the EQ-5D-5L measures and the relative frequencies of reported problems on the dimensions. Inequality increased, and there were changes in the levels of reported problems on the dimensions for demographic groups. Such changes suggest that national population norms should be updated periodically to capture changes in health status, perceptions of health, and health inequality.

Characteristics and health conditions in older people who work in Mexico. A comparative analysis between cohorts and sex.

BACKGROUND: The study of the work and health of older adults is limited but relevant considering that the living and health conditions in which they age are not the best in Mexico, given the job insecurity that does not access to decent contributory pensions. OBJECTIVE: To analyse the differences in the sociodemographic, labour and health conditions characteristics of two cohorts of older people aged 65 to 74 years who are employed in the labour market. MATERIAL AND METHODS: Analysis of the National Study of Health and Aging in Mexico for 2001 and 2021 of sociodemographic and work characteristics and health conditions by cohort and sex. Logistic regression models, whose dependent variable was the birth cohort, were estimated. RESULTS: 1,115 people from 2001 and 1,189 from 2021 between 65 and 74 years old who worked the week before the study were included. By sex and cohort, findings are presented. CONCLUSIONS: Although the schooling of older people in the most recent cohort has increased, women face more precarious working conditions and a higher prevalence of disability.

ANTECEDENTES: El estudio del trabajo y salud de las personas adultas mayores es limitado, pero relevante si se considera que las condiciones de vida y salud en las que se envejece no son las mejores en México, dada la precariedad laboral que no favorece el acceso a pensiones contributivas dignas. OBJETIVO: Analizar las diferencias en las características sociodemográficas, laborales y de condiciones de salud de dos cohortes de personas de 65 a 74 años que se encuentran ocupadas en el mercado laboral. MATERIAL Y MMÉTODOS: De los estudios nacionales de salud y envejecimiento en México 2001 y 2021, se analizaron las características sociodemográficas, laborales y de las condiciones de salud por cohorte y sexo. Se estimaron modelos de regresión logística, cuya variable dependiente fue la cohorte de nacimiento. RESULTADOS: Se incluyeron 1,115 personas de la encuesta de 2001 y 1,189 de la de 2021, de 65 a 74 años, que trabajaron la semana previa al estudio. Los resultados se presentan por sexo y cohorte. CONCLUSIONES: Si bien se incrementó la escolaridad de las personas mayores en la cohorte más reciente, las mujeres se enfrentan a condiciones laborales más precarias y con mayor prevalencia de discapacidad.

HLA-I and breast cancer prognosis: a systematic review and meta-analysis

BACKGROUND: Breast cancer (BC) is a significant global health issue, accounting for 1 in 8 cancer diagnoses worldwide. HLA class I molecules are typically expressed on the cell surface, but cancer cells can develop mechanisms to evade recognition by CTLs, including the downregulation of HLA class I expression. In this context, we aimed to conduct a systematic review and meta-analysis to clarify the role of HLA class I expression in clinical outcomes for patients with BC. METHODS: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane databases. Effect sizes, along with I2 and Tau2 statistics, were used to assess heterogeneity through a DerSimonian and Laird random-effects model. Statistical analyses were performed using R statistical software, version 4.2.3. RESULTS: Among the 8 included studies, most of the analyzed samples consisted of ductal carcinoma cases (1588, 86.39 %), from the luminal (A or B) intrinsic subtype (1865, 69.07 %), with no lymph node metastasis (2658, 57.24 %), no HER2 overexpression (2594, 67.46 %), negative Ki67 status (1721, 71.26 %), and positive hormone receptor status (4732, 64.05 %). The analysis revealed a significant reduction in disease-free survival (HR 0.57; 95 % CI 0.34 to 0.95; p = 0.034; I2 = 84 %) in the group with low HLA-I expression. However, no significant difference was found between the groups with high and low HLA-I expression regarding overall survival (HR 0.77; 95 % CI 0.28 to 2.14; p = 0.62; I2 = 86 %). CONCLUSIONS: This systematic review and meta-analysis demonstrated that HLA class I expression is associated with a significant improvement in disease-free survival, though no significant effect on overall survival was observed.

A quasi-experimental study assessing the effectiveness of a community-based egg intervention in the nutritional and health status of young children from rural Honduras.

OBJECTIVE: This community-public-private-academic coalition project implemented and evaluated the effectiveness of a rural, community-based egg intervention that aimed to support the nutrition and health of children living in rural, poor communities from Intibucá, Honduras, during the COVID-19 pandemic. DESIGN: This investigator-blind, non-randomized, controlled study was informed by a community health improvement process and participatory research. Women from 13 communities were given a microloan to start an egg farm that supplied 1 egg daily to 201 children ages 6-24 months for 1 year (intervention group). Control communities (n = 14) were selected from neighboring municipalities with similar sociodemographic backgrounds based on size. Sociodemographic-, anthropometric-, and morbidity data were collected biannually between January 2021 to January 2022. Outcome changes were compared with linear-, generalized- or Poisson- mixed models adjusted by sex, age, maternal education, breastfeeding status, assets, adults living at home, baseline outcomes, and community-cluster. RESULTS: Baseline to 6- and 12-month weekly frequency of egg intake significantly increased in the intervention vs. the control group: 6-month change = 1.86; 95%CI (1.61, 2.14); 12-month change = 1.63; 95%CI (1.42, 1.87 p<0.001), respectively. Baseline to 12-month changes in the intervention group were not significant for length/height-for-age-z-scores = 0.12, p = 0.187; weight-for-length/height-z-scores = -0.02, p = 0.78; and diarrhea prevalence, AOR = 1.69; 95%CI (0.53, 5.42), p = 0.378. Lower odds of respiratory infections were observed for the intervention vs. the control group at 6- and 12-month post: AOR = 0.28; 95%CI (0.12, 0.63), p = 0.002; AOR = 0.30; 95%CI (0.12, 0.75), p = 0.010, respectively. CONCLUSIONS AND RELEVANCE: Children in the intervention group reported consuming eggs more days per week relative to the control group. Lower odds of respiratory infections were observed in the intervention group throughout the study. Ongoing follow-up will offer more insights on the intervention's effectiveness in linear growth, dietary diversity, food security, and other nutritional outcomes.

Cardiovascular Health Among Young Men and Women in Puerto Rico as Assessed by the Life's Essential 8 Metrics.

BACKGROUND: Cardiovascular health (CVH) in young adulthood is associated with CVD in later life, yet CVH in young adults in the United States falls below ideal levels, with noticeable sex differences. Research on CVH in young adults in Puerto Rico is scarce. This study examined CVH and sex differences in CVH in a large cohort of young adults in Puerto Rico. METHODS AND RESULTS: Data from 2162 Puerto Rican young adults aged 18 to 29 residing in PR were obtained from the PR-OUTLOOK (Puerto Rico Young Adults' Stress, Contextual, Behavioral, and Cardiometabolic Risk) study (2020-2023). Participants were recruited through various media and community outreach. CVH scores, graded on a 0 (worst) to 100 (best) scale, were derived from survey responses, physical exams, and laboratory assays. Linear regression with the margins postestimation command was used to determine adjusted means (95% CIs) for CVH scores by sex, controlling for age, marital status, education, childhood material deprivation, subjective social status, health insurance, and depressive symptoms. CVH was less than ideal (score<80) in 72.6% of the cohort (70.5% of women, 75.9% of men, P<0.05). Men had a significantly lower adjusted mean overall CVH score than women (70.7 versus 73.0) and lower adjusted mean scores for nicotine exposure (78.3 versus 86.7), non-high-density lipoprotein cholesterol (80.6 versus 86.4), and blood pressure (79.5 versus 92.2). Women had a significantly lower adjusted mean physical activity score compared with men (50.4 versus 59.5). CONCLUSIONS: Less-than-ideal CVH is notable among young adults, with men having worse CVH than women. These identified sex differences warrant further investigation and the design of interventions to enhance and preserve CVH.

Clinical and Functional Outcomes Associated with Quality of Life in Patients with Lymphangioleiomyomatosis: A Cross-Sectional Study.

BACKGROUND: Lymphangioleiomyomatosis (LAM) is a rare (twenty-one per million female inhabitants) neoplastic cystic lung disease that impairs health-related quality of life (HRQoL). However, the factors associated with impaired quality of life in patients with LAM are poorly understood. OBJECTIVE: To assess the clinical, psychosocial, and functional characteristics associated with impaired quality of life in patients with LAM. METHODS: This was a cross-sectional study performed on two nonconsecutive days. HRQoL (SF-36 and CRQ), lung function tests, anxiety and depression symptoms (HADS), maximal (CPET and ISWT), and submaximal exercise capacity (6MWT) were assessed. Linear associations among outcomes were assessed using Pearson's correlation and multivariate tests. RESULTS: Forty-five women with LAM (46 ± 10.years; FEV1,74%pred) were evaluated. The lowest SF-36 scores were observed for general health and vitality and the highest for the physical and social domains. The lowest CRQ scores were observed for dyspnea and fatigue, and the highest were for the emotional function and self-control domains. Sixteen (35%) women had anxiety, and 8 (17%) had depression symptoms. Most of the SF-36 and CRQ domains were associated with anxiety and depression symptoms (from r = 0.4 to r = 0.7; p < 0.05) and exercise capacity (from r = 0.3 to r = 0.5; p < 0.05). Lung function parameters were weakly or not associated with quality of life domains. After multiple linear regression, HRQoL was independently associated with depression symptoms and physical capacity but not with lung function. CONCLUSION: Our results show that aerobic capacity and depression symptoms are the main factors, rather than lung function, related to quality of life in patients with LAM.

Health, economic and social impacts of the Brazilian cash transfer program on the lives of its beneficiaries: a scoping review.

BACKGROUND: The Bolsa Família cash transfer Program (BFP) aims to break the poverty cycle by providing a minimum income to poor families conditioned on their investment in human capital (such as, education and health) and currently is the largest Program in the world in terms of the number of beneficiaries. Because there is a scarcity of reviews grouping studies on the impacts of the BFP, the objective of this scoping review was to identify and describe studies which evaluate the impact of the BFP on poverty, health, education, and other related outcomes. METHODS: We searched for quantitative, qualitative, and mixed-method articles that assessed the impact of the BFP on any aspect of the beneficiaries' lives between 2003 and March 2021. We included quantitative articles that used experimental, quasi-experimental or pre and post comparison designs. We excluded articles that analyzed impacts on political outcomes. There was no age restriction for the participants. The search was done in seven electronic databases. RESULTS: One thousand five hundred forty-six papers were identified and 94 fulfilled the inclusion criteria. Poverty and health outcomes were the most common outcomes studied. We found consistent evidence of the positive impact of the BFP on poverty reduction, as well as employment outcomes. We also found positive impacts in relation to mortality rates for children and adults, school dropout and school attendance among children and adolescents, and violence related outcomes such as homicide, suicide, crime, and hospitalization. However, we also found some evidence that BFP increased intimate partner violence and gender stereotypes among women and no evidence of impact on teenage pregnancy. CONCLUSIONS: Overall, the studies included found that BFP showed positive impacts on most poverty, health and education outcomes. More studies are needed to confirm some results, especially about violence and stereotype against women as there were few evaluations on these outcomes.

Prognostic value of the duke activity Status Index Questionnaire in predicting mortality in patients with chronic heart failure: 36-month follow-up study.

BACKGROUND: The Duke Activity Status Index (DASI) questionnaire has been the focus of numerous investigations - its discriminative and prognostic capacity has been continuously explored, supporting its use in the clinical setting, specifically during rehabilitation in patients with chronic heart failure (CHF).However, studies exploring optimal DASI questionnaire threshold scores are limited. OBJECTIVE: To investigate optimal DASI questionnaire thresholds values in predicting mortality in a CHF cohort and assess mortality rates based on the DASI questionnaire using a thresholds values obtained. METHODOLOGY: This is a prospective cohort study with a 36-month follow-up in patients with CHF. All patients completed a clinical assessment, followed by DASI questionnaire, pulmonary function, and echocardiography. The Receiver Operating Characteristic (ROC) curve analysis was used to discriminate the DASI questionnaire score in determining the risk of mortality. For survival analysis, the Kaplan-Meier model was used to explore the impact of ≤/>23 points on mortality occurring during the 36-month follow-up. RESULTS: One hundred and twenty-four patients were included, the majority being elderly men. Kaplan Meier analysis revealed that ≤/> 23 was a strong predictor of CHF mortality over a 36-month follow-up. CONCLUSION: A score of ≤/>23 presents good discriminatory capacity to predict mortality risk in 36 months in patients with CHF, especially in those with reduced or mildly reduced ejection fraction. Age, ejection fraction, DASI questionnaire score and use of digoxin are risk factors that influence mortality in this population.

[The study of migrant and immigrant population from the syndemic point of view]. / Lo studio delle popolazioni migranti e immigrate dal punto di vista sindemico.

The study of health of migrant and immigrant populations is of particular interest and actual in recent years, and there is a lack of research assessing aspects of aging of permanently resident immigrants, chronic non-communicable diseases, multimorbidity, and study of second generations. This contribution proposes to describe the relationship between health and immigration and their association with frailty through the anthropological concept of syndemics. Syndemics represents a set of closely interconnected and mutually enhancing health problems, significantly influencing the overall health status of a population. This occurs within the context of a perpetual pattern of harmful social conditions. Among the syndemics described in the literature, the most interesting in this area is the one concerning the increased frailty due to the interaction among diabetes, depression, immigration, and social distress, called VIDDA (Violence, Immigration, Depression, Diabetes, and Abuse), first identified in Mexican immigrant women in the United States. The main limitation of using the syndemic approach to study the health of immigrant populations is the difficulty in moving from the anthropological, primarily qualitative approach to the epidemiological-quantitative approach. Despite this, the epidemiological study of immigrant populations could benefit from the syndemic approach, because it can better describe complex causal relationships and provide evidence for modification of the clinical approach.

Associations between retirement, social security policies and the health of older people: a systematic review.

BACKGROUND: As people age, they are more likely to experience several health conditions which are circumstances that arise throughout life that can interfere with an individual's ability to work, leading them to demand the social security system. This research aims to systematically review and synthesize studies related to health conditions in the aging process with social security policy reforms. METHODS: A systematic review was performed across Embase, Web of Science, Scopus, Pubmed, CINAHL, ASSIA (Proquest) and APA PsycNet from 1979 to 2022. Methods are outlined in a published protocol registered a priori on PROSPERO (CRD42021225820). Eligible studies include original empirical articles published in English, Spanish, French and Portuguese, using the search terms "aging" and "social security". Identified outcomes were organized into categories and a meta-ethnography was completed following the phases proposed by Noblit and Hare and the eMERGe meta-ethnography reporting guidance. RESULTS: There were 17 eligible studies from 4 continents with 10 cross-sectional, 1 both cross-sectional and longitudinal and 5 longitudinal data analysis. These assessed the relationship of health conditions that occur in the aging process related to social security policies, in particular, to retirement. The categories included (i) health as a way to promote an active working life for the elderly; (ii) health as an indicator for reforms in social security policies; (iii) retirement planning as a strategic element for coping with post-retirement life; and (iv) the relationship between social security policies and psychological health. CONCLUSIONS: This review showed that health and retirement defined in social security policies are related and have an impact on people's lives, especially in the decision to leave the labor market. Therefore, measures to assess the possible consequences of this relationship when promoting reforms on social security policies should be encouraged.

Design, develop, and implement the strategic information system on health, dependence, and healthy aging: an analysis of the Mexican experience.

BACKGROUND: The Decade of Healthy Aging (2021-2030) emerges as a 10 years strategy to improve the lives of older adults, their families, and the communities in which they live. One of the actions defined in this framework is related to improving the measurement, monitoring, and understanding of characteristics, factors, and needs related to aging and health. The aim was to analyze and assess the process of construction and development of the Strategic Information System on Health, Funcional Dependence and Aging (SIESDE, for its acronym in Spanish). SIESDE will provide strategic information in Mexico at the municipal, state, and national levels that support the public policies on healthy aging. METHODS: The system processes and analyzes the data sources of the Health Information Systems and the National System of Statistical and Geographical Information. SIESDE comprises three components: (1) Design, construction, and evaluation of the indicators; (2) storage, management, and visualization, and (3) diffusion and translation of information. RESULTS: A total of 135 indicators were built on seven themes: (1) demographic, socioeconomic, and aging conditions, (2) health, (3) functional dependence, (4) healthy aging, (5) health services, (6) social and physical environments, and (7) complex indicators. CONCLUSIONS: SIESDE is an effective system for providing an overall view of health, aging, and functional dependence.

Irruption of Network Analysis to Explain Dietary, Psychological and Nutritional Patterns and Metabolic Health Status in Metabolically Healthy and Unhealthy Overweight and Obese University Students: Ecuadorian Case.

BACKGROUND: The association between dietary nutritional patterns, psychological factors, and metabolic health status has not been investigated in university students. There are studies that include numerous variables to test hypotheses from various theoretical bases, but due to their complexity, they have not been studied in combination. The scientific community recognizes the use of Gaussian graphical models (GGM) as a set of novel methods capable of addressing this. OBJECTIVE: To apply GGMs to derive specific networks for groups of healthy and unhealthy obese individuals that represent nutritional, psychological, and metabolic patterns in an Ecuadorian population. METHODOLOGY: This was a quantitative, non-experimental, cross-sectional, correlational study conducted on a sample of 230 obese/overweight university students, selected through a multi-stage random sampling method. To assess usual dietary intake, a Food Frequency Questionnaire (FFQ) was used; to evaluate psychological profiles (anxiety, depression, and stress), the DASS-21 scale was employed; blood pressure and anthropometric data were collected; and insulin levels, lipid profiles, and glucose levels were determined using fasting blood samples. The International Diabetes Federation (IDF) criteria were applied to identify metabolically healthy and unhealthy individuals. Statistical analysis relied on univariate methods (frequencies, measures of central tendency, and dispersion), and the relationships were analyzed through networks. The Mann-Whitney U test was used to analyze differences between groups. RESULTS: In metabolically unhealthy obese individuals, GGMs identified a primary network consisting of the influence of waist circumference on blood pressure and insulin levels. In the healthy obese group, a different network was identified, incorporating stress and anxiety variables that influenced blood pressure, anthropometry, and insulin levels. Other identified networks show the dynamics of obesity and the effect of waist circumference on triglycerides, anxiety, and riboflavin intake. CONCLUSIONS: GGMs are an exploratory method that can be used to construct networks that illustrate the behavior of obesity in the studied population. In the future, the identified networks could form the basis for updating obesity management protocols in Primary Care Units and supporting clinical interventions in Ecuador.

Validation of the HIV/AIDS-Targeted Quality of Life (HAT-QOL) for Evaluation of Health-related Quality of Life in People Living with HIV/AIDS in Brazil.

HIV/AIDS-Targeted Quality of Life (HAT-QOL) is an instrument for evaluating health-related quality of life (HRQOL) in people living with HIV (PLWHIV). This has been adapted into Brazilian Portuguese, but its dimensional structure has not been analyzed. This study evaluated the psychometric properties of the Brazilian Portuguese version of the HAT-QOL, using a sample of 319 PLWHIV in Salvador, Brazil. The study performed Exploratory Factor Analysis (EFA) to assess the HAT-QOL dimensional structure. The analysis used a polychoric correlation matrix, Robust Diagonally Weighted Least Squares (RDWLS) as an extraction method, Parallel Analysis for factor retention, robust promin as oblique rotation, and Generalized H-index (G-H) for construct replicability of each factor. Model adequacy was assessed using the Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), and Tucker-Lewis Index (TLI). Concurrent validity was evaluated with the 36-item Short Form Health Survey, version 2 (SF-36v2). EFA identified a HAT-QOL six-factor solution: Financial Worries, Sexual Function, Medication Concerns, Life Satisfaction, Health Worries, and Overall Function. This solution showed high G-H indexes, concurrent validity, and satisfactory adequacy indexes (X2 = 231.345, df = 291, p < 0,001; RMSEA = 0.001, CFI = 0.999, TLI = 1.028). HIV Mastery, Disclosure Worries, and Provider Trust domains were not retained in EFA and did not have evidence of concurrent validity. This study proposed a HAT-QOL six-factor model for measuring HRQOL in the Brazilian PLWHIV. Future research could help identify another latent construct from not-included domains.

RESUMEN: El HIV/AIDS-Targeted Quality of Life (HAT-QOL) es un instrumento que evalúa calidad de vida relacionada con la salud (CVRS) en personas que viven con VIH (PVVIH). Éste ha sido adaptado al portugués brasilero, pero su estructura dimensional no ha sido analizada. Se evaluaron las propiedades psicométricas de la versión en portugués brasilero del HAT-QOL, en una muestra de 319 PVVIH en Salvador, Brasil. Se empleó un Análisis Factorial Exploratorio (AFE) para evaluar la estructura dimensional del HAT-QOL. El análisis utilizó una matriz de correlación policórica, mínimos cuadrados ponderados robustos diagonalmente (RDWLS) para extraer factores, análisis paralelo para retener factores, promin robusto como rotación oblicua y el índice H generalizado (G-H) para la replicabilidad de constructo de cada factor. La adecuación del modelo fue evaluado con el error cuadrático medio de aproximación (RMSEA) y los índices de ajuste comparativo (CFI) y Tucker-Lewis (TLI). Se evaluó la validez concurrente con el cuestionario 36-item Short Form Health, versión 2 (SF-36v2). El AFE identificó una solución de seis factores para el HAT-QOL: Preocupaciones Financieras, Función Sexual, Preocupaciones por la medicación, Satisfacción con la vida, Preocupaciones por la salud y Función general. Esta solución mostró altos índices G-H, validez concurrente e índices de adecuación satisfactorios (X2 = 231.345, df = 291, p < 0,001; RMSEA = 0.001, CFI = 0.999, TLI = 1.028). Los dominios Aceptación del VIH, Preocupaciones por el sigilo y Confianza en el profesional no fueron retenidos en el AFE y no evidenciaron validez concurrente. Se propone un modelo de seis factores del HAT-QOL para evaluar CVRS en PVVIH brasileras. Futuras investigaciones ayudarían a identificar otros constructos latentes a partir de los dominios no incluidos en la estructura.

Functional status and quality of life after ICU discharge in severe COVID-19 patients.

PURPOSE: To assess the health status of individuals affected by COVID-19 after discharge from the ICU. METHOD: Cross-sectional study, with patients discharged from the ICU due to severe COVID-19, in which Quality of Life (QoL) was assessed using the 12-Item SFHF, functionality using the Post-COVID-19 FSS, and the level of physical activity using the IPAQ. RESULTS: Of the sixty patients, 51.7 % were male, with a mean age of 58 years. The physical component of QoL scored worse than the mental component and older patients had worse QoL in the physical component. These patients were shown to have low functionality scores and an irregularly active level of physical activity B. A lower level of physical activity was associated with individuals who remained in the prone position during hospitalization, while worse functionality was associated with the 70+ age group, although all age groups had functional losses. There was no association between QoL, functionality and level of physical activity and the clinical characteristics of the patients during hospitalization or the time they were discharged. CONCLUSION: The majority of patients discharged from the ICU after severe COVID-19 have altered functional capacity, QoL and physical activity levels, which is not associated with the clinical characteristics during hospitalization.

Young nurses' perceptions about their employment, working and health conditions.

OBJECTIVE: to interpret young nursing professionals' perceptions about the relationship between working, employment and health conditions. METHOD: a qualitative study with an interpretive approach regarding the work-related experiences of 15 young nurses, who took part in the research through voluntary snowball sampling. The data from the interviews and the focus group were analyzed to reach an approximation to the realities inherent to the nurses' work life. RESULTS: the relevant study findings pointed out that work precariousness is a characteristic feature in the population group, mainly related to hiring modalities and to wages. According to the participants, the psychosocial working conditions (which were intensified during the COVID-19 pandemic) were the ones that caused the most effects on their mental and physical health. CONCLUSION: from the young nurses' perspective, this study reports how the macro- and micro-structural working conditions and their relationship with health are perceived, pointing out the key elements to devise interventions focused on life paths that foster decent and healthy work postulates in their work environments, as well as actions to prevent injuries or harms to nurses' health.