BACKGROUND: Suicide rates in older adults are much higher than those in younger age groups. Given the rapid increase in the proportion of older adults in Korea and the high suicide rate of this age group, it is worth investigating the mechanism of suicidal ideation for older adults. Generally, adverse childhood experiences are positively associated with suicidal ideation; however, it is not fully understood what mediating relationships are linked to the association between these experiences and current suicidal ideation.
METHODS: The data from 685 older Korean adults were analyzed utilizing logistic regression, path analyses, and structural equation modeling. Based on our theoretical background and the empirical findings of previous research, we examined three separate models with mental health, physical health, and social relationship mediators. After that, we tested a combined model including all mediators. We also tested another combined model with mediation via mental health moderated by physical health and social relationships.
RESULTS: The univariate logistic regression results indicated that childhood adversity was positively associated with suicidal ideation in older adults. However, multivariate logistic regression results demonstrated that the direct effect of childhood adversity became nonsignificant after accounting all variables. Three path models presented significant mediation by depression and social support in the association between childhood adversity and suicidal ideation. However, combined structural equation models demonstrated that only mediation by a latent variable of mental health problems was statistically significant. Social relationships moderated the path from mental health problems to suicidal ideation.
CONCLUSIONS: Despite several limitations, this study has clinical implications for the development of effective strategies to mitigate suicidal ideation. In particular, effectively screening the exposure to adverse childhood experiences, early identification and treatment of depressive symptoms can play a crucial role in weakening the association between childhood adversity and suicidal ideation in older adults.

The disruption in daily activity performance during COVID-19 lockdowns is widely understood to have impacted health, but a better understanding of how restricted performance of specific activities are associated with health is needed. This cross-sectional study answers the following question: How were changes in the performance of 16 daily activities associated with health during COVID-19 lockdowns? A total of 116 participants completed an online survey rating their health before and during COVID-19 lockdowns and comparing their recollection of the performance of 16 activities before COVID-19 with their performance during lockdowns. Multiple stepwise linear regression analysis was used to estimate the relationship between self-reported changes in activities during lockdowns and concurrent (during-lockdown) health status, while controlling for pre-COVID-19 health status. Only changes in activities that were uniquely and significantly associated with lockdown health status were retained in the final model. Health before COVID-19 accounted for 3.7% (P = 0.039) of the variance in health during COVID-19 lockdowns. After controlling for health before COVID-19, five types of activity were significantly and uniquely predictive of health during lockdowns, together accounting for 48.3% of the variance. These activities and the variances they accounted for were rest and sleep (29.5%, P < 0.001), play and recreational activities (8%, P < 0.001), work (4.8%, P = 0.002), personal hygiene (3.2%, P = 0.01), and healthy eating (2.8%, P = 0.013). The study suggests that these five types of activity should be prioritized in policy or interventions when participation in activity is constrained by lockdowns or comparable factors.

Communication is considered as one of the basic human needs. For a long time, loneliness and social isolation were mainly considered as a psychosocial problem. However, in the recent years, there has been increasing evidence of the possible impact of loneliness and social isolation on the development and clinical course of somatic diseases. Research objectives were studying and analysis of current literature data about the medical consequences of loneliness and social isolation in the elderly cases. An analysis of the literature data shows that loneliness and social isolation affect not only the psycho-emotional status of elderly patients, but also their physical health. It has been shown that the number of available social connections affects the development and clinical course of diabetes mellitus, cardiovascular diseases, and outcomes of the brain stroke, immune system reactions, average life expectancy, and the risk of death caused by any causes. It has been established that the influence of social ties on the risk and clinical course of chronic non-communicable diseases is comparable to the effect of such generally accepted risk factors like smoking, alcohol consumption, physical inactivity, hypertension, obesity, hypercholesterolemia, environmental pollution, as well as various medical interventions (vaccination, drug therapy, etc.). Social isolation affects the risk of hospitalization and the frequency of outpatient care, poor socialization increases the risk of death from a heart attack. The results of the study show that loneliness and social isolation of the elderly cases have certain medical consequences that need to be taken into account when managing such patients.
Общение считается одной из базовых потребностей человека. Долгое время одиночество и социальная изоляция считались преимущественно психосоциальной проблемой. Однако в последние годы появляется все больше свидетельств о возможном влиянии одиночества и социальной изоляции на развитие и клиническое течение соматических заболеваний. Цель работы — изучение современных данных литературы о медицинских последствиях одиночества и социальной изоляции у лиц пожилого возраста. Анализ данных показал, что одиночество и социальная изоляция влияют не только на психоэмоциональный статус пожилых пациентов, но и на состояние физического здоровья. Показано, что количество имеющихся социальных связей влияет на развитие и течение сахарного диабета, болезней сердца и сосудов, исходы инсульта мозга, реакции иммунной системы, среднюю продолжительность жизни, риск смерти, вызванной любыми причинами. Установлено, что уменьшение объема социальных связей влияет на риск возникновения и течение хронических неинфекционных заболеваний, что сопоставимо с действием таких общепризнанных факторов риска, как курение, употребление алкогольных напитков, гиподинамия, артериальная гипертензия, ожирение, гиперхолестеринемия, загрязнение окружающей среды, а также различные медицинские вмешательства (вакцинация, медикаментозная терапия и т. п.). Социальная изоляция влияет на риск госпитализации и частоту обращений за амбулаторной помощью, плохая социализация увеличивает риск смерти от сердечного приступа. Результаты исследования показывают, что одиночество и социальная изоляция пожилых пациентов имеют определенные медицинские последствия, которые нужно учитывать при ведении данной категории лиц.

Current research indicates a strong association between adverse childhood experiences (ACEs) and adverse health outcomes. Participants in frequently cited ACE research are predominantly heterosexual and cis gendered; the extent to which ACEs affect health outcomes among sexual and gender minorities (SGMs) is unclear. This systematic review examined the frequency of, and relationship between, ACEs and negative health outcomes among SGM. CINAHL, MEDLINE, PsycARTICLES, PsycINFO, Scopus, and PubMed databases were searched with no date restriction. After eliminating duplicates, titles and abstracts were reviewed resulting in 22 articles to be critiqued using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. A total of 22 studies met final inclusion criteria. The frequency of reporting at least one ACE among SGMs ranged from 51.4 to 91.6%, while the frequency of reporting four or more ACEs ranged from 18.1 to 60.7%. SGMs reported a higher frequency of ACEs than non-SGM. ACEs were associated with poorer mental and physical health outcomes, as well as increased risky behavior among SGMs. SGMs report a high frequency of ACEs, but current studies did not include data regarding ongoing stigma and adversities that may further contribute to their negative health outcomes. Further research is needed to fully understand the impact of adversities experienced due to the sexual and/or gender orientation of this minority group.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s40653-023-00576-4.

UNASSIGNED: Sedentary behavior is most prevalent among those aged 80 years and above, referred to as the oldest-old. Current literature emphasizes the significance of sedentary behavior patterns, but further evidence is required to understand how these patterns relate to specific health outcomes and to identify at-risk profiles for tailored interventions in the oldest-old. Therefore, the aim of this study was to identify profiles of adults aged 80+ years based on their sedentary patterns and health outcomes, and to examine associations between profiles and socio-demographics.
UNASSIGNED: A cross-sectional study was conducted in Flanders (Belgium) from February 2021 to December 2022 recruiting 90 older adults (80+) through convenience sampling, employing word of mouth, social media and local service centers. Latent profile analysis identified device-based sedentary patterns and assessed their associations with physical and cognitive functioning, mental health-related quality of life (QoL), and social isolation. Associations of these profiles with socio-demographic factors were analyzed.
UNASSIGNED: Three distinct profiles were identified: (1) the \'cognitively and physically frail\' profile, (2) the \'healthy\' profile and (3) the \'lower mental health-related QoL\' profile. Those in the \'cognitively and physically frail\' profile exhibited the least favorable sedentary pattern, and had a higher likelihood of residing in a nursing home. No significant differences were found for the other socio-demographic variables, being age, sex, educational degree and family situation.
UNASSIGNED: Three distinct profiles in the oldest-old population, based on cognitive and physical functioning, mental health-related QoL, and sedentary behavior patterns, were identified. Lower physical and cognitive functioning was associated with unhealthy sedentary patterns. Further research with larger samples is crucial to uncover potential links between socio-demographics and at-risk subgroups, enhancing our understanding of sedentary behavior and geriatric health outcomes in this population.

In Norway, many communities offer low-rent plots of land on which city dwellers can build summer cottages and grow crops. These allotment gardens serve as recreational escapes from urban life. However, little is known about the impact these gardens have on their members. This study attempts to shed light on today\'s impact of allotment gardens in a public health setting in Norway. The study was based on 17 semi-structured interviews and 2 in-depth interviews with allotment house owners. Informants were mainly recruited by \"snowball sampling\". Our data show that maintaining an allotment promotes exercise and provides a positive impact on self-perceived well-being and physical health through outdoor activities. Spending time in the garden contributes to new knowledge and experiences. Owning an allotment garden has provided new knowledge, new skills, new hobbies, and thereby an improvement in lifestyle. The allotment garden has a strong impact on perceived health, well-being, and sense of coherence (SOC) for the individuals. It promotes outdoor activities along with social interaction and can prevent feelings of loneliness and isolation.

Currently, an increasing number of Chinese urban citizens are participating in daily physical exercise. Existing research has shown that physical exercise can increase life satisfaction. However, some studies also suggest that the relationship between the two is unstable. The purposes of this study are to examine physical exercise and to test its correlation with life satisfaction of urban residents in China. Data are obtained from the 2018 China Family Panel Studies, and we focus on urban residents. Our overall sample size is 7423 people, including 3641 females (49.05%) and 3782 males (50.95%), with an average age of 49.55 years old. Because the dependent variables are continuous variables, the multiple linear regression model is used for data analysis. We find that the life satisfaction of Chinese urban residents is on the high side. Our core discovery is that there is a significant positive relationship between the frequency and duration of physical exercise and life satisfaction. Our further discovery is that the frequency of physical exercise affects life satisfaction by influencing popularity and positive emotions. Similarly, the duration of physical exercise affects life satisfaction by influencing popularity and positive emotions. Whether it is the frequency or the duration of physical exercise, it can reflect the residents\' attention to physical exercise. Physical exercise habits not only promote physical health by strengthening physical fitness but also promote mental health by alleviating depression and promote social communication by increasing social activities in the Chinese context. All of these can improve people\'s life satisfaction. Our research suggests that the improvement in life satisfaction not only needs the abundance of external material conditions but also needs the individual to improve their physical and mental health through physical exercise.

BACKGROUND: The COVID-19 pandemic has profoundly impacted the economic, psychological, and social well-being of people in Ethiopia. Pandemic-related fears can exacerbate anxiety and depression symptoms among those with pre-existing physical and mental health conditions as well as those with prior exposure to traumatic events.
METHODS: We used data from the Ethiopia NeuroGAP-Psychosis study (898 cases and 941 controls with and without a diagnosis of psychosis respectively, 66% male, mean age = 37 years). Data was collected between November 2021 and June 2022 during the COVID-19 pandemic from four hospitals in Ethiopia (three in Addis Ababa and one in Jimma city). Structural equation modeling analysis was conducted to examine the associations between trauma exposure, physical health conditions (like arthristis, neurological disorders, diabetes), COVID-19 stress, and psychological distress (depression and anxiety symptoms). We assessed direct and indirect effects for mediation, and conducted multigroup analysis to examine moderation by case control status.
RESULTS: We found evidence that the impact of greater trauma exposure and physical health conditions on higher psychological distress was mediated through higher COVID-19 stress. Sociodemographic characteristics (older age and being maried) were associated with higher psychological distress, with these associations mediated through greater trauma, physical health conditions, and COVID-19 stress. Case-control status also moderated the associations between these variables, with the mediation effects being stronger in cases and weaker in controls. Further, cases reported greater trauma and psychological distress, while controls reported more physical health conditions and COVID-19 stress.
CONCLUSIONS: Our findings uniquely assess the interaction of health and emergency related factors in understudied settings like Ethiopia. They underscore the importance of including daily hardships and environmental stressors, along with prior trauma exposure, as risk factors for the assessment of mental health symptoms. This study has key implications for mental health screening and intervention research in response to complex emergency contexts like Ethiopia with a history of armed conflict in addition to the COVID-19 pandemic. Our findings can aid the development of targeted services that address the mental health of at-risk groups with pre-existing mental and physical health conditions.

UNASSIGNED: Under the system of health decentralization, there are differences in the level of expenditure decentralization at different levels of government, and their impact on residents\' health may also be different. This paper is one of the first to evaluate the effect of decentralization of health services at the municipal level from a multi-dimensional health perspective.
UNASSIGNED: This paper uses the data of expenditure decentralization of health services at the municipal level to match the panel data from the China Household Panel Survey (CFPS) from 2010 to 2018, and uses the logit model, ordered logit model and two-way fixed effects model to empirically analyze the impact of health decentralization at the municipal level on health outcomes.
UNASSIGNED: Based on the perspective of multi-dimensional health, from the three aspects of physical health, depression status and cognitive ability, the six sub-indicators of self-rated health, BMI standards, depression scores (summation method), depression scores (factor method), phrase test scores and mathematics test scores are discussed separately. The results show that the decentralization of health services at the municipal level has a significant promotion effect on the multi-dimensional health of residents.
UNASSIGNED: The decentralization of health services at the municipal level has important theoretical significance for promoting the reasonable division of medical and health powers and expenditure responsibilities between provincial and municipal governments, improving the efficiency of health expenditure funds, and establishing a fiscal system that matches financial resources.

UNASSIGNED: Caring for a child with long-term functional limitations can have a negative impact on the physical and psychological well-being of the caregiver. Family-centered care (FCC) interventions have the potential to empower caregivers and contribute to their well-being. This systematic review aimed to synthesize existing evidence on the effectiveness of FCC interventions in improving the well-being of caregivers of children with cerebral palsy (CP), and identify the key components of such interventions that are most commonly practiced and deemed effective.
UNASSIGNED: This review systematically searched seven databases for randomized controlled trials that evaluated the effectiveness of any FCC intervention on the well-being of caregivers of children with or at risk of CP. We used the Cochrane RoB 2.0 tool to assess risk of bias and Critical Appraisal Skills Programme (CASP) checklist for critical appraisal. Due to high heterogeneity of studies, narrative synthesis was used to summarize the data.
UNASSIGNED: The review consists of 11 studies which were categorized into five sections based on the components of FCC intervention provided in each individual study: 1. Information provision, and Enabling and partnership (n= 5); 2. Information provision, and Respectful and supportive care (n= 1); 3. Enabling and partnership (n= 2); 4. Enabling and partnership, and Respectful and supportive care (n= 2); 5. Information provision, Enabling and partnership and Respectful and supportive care (n= 1). Risk of bias was low in four studies, unclear in two studies, and high in five studies.
UNASSIGNED: FCC interventions were found to be effective in improving caregivers\' satisfaction with attainment of child and caregiver goals. Evidence from multiple studies does not strongly support the effectiveness of FCC interventions on caregiver\'s mental health, parenting and personal outcomes. Limited evidence precludes a conclusion on the effectiveness of the components of FCC on well-being of caregivers of children with CP.