BACKGROUND: Delirium is a common complication among adults. It is essential to improve the outcomes of delirium.
OBJECTIVE: To systematically synthesize the evidence on the effectiveness of the nurse-led non-pharmacological interventions on outcomes of delirium in adults.
METHODS: Electronic databases including CINAHL, Cochrane Library, MEDLINE, EMBASE, PubMed, Web of Science, PsycINFO, and Clinical Trial Registration were searched comprehensively by the authors. The authors reviewed the full text and assessed the risk of bias using the Cochrane Risk of Bias Tool 2.0. The meta-analysis was performed using RevMan and Stata software. The forest plots showed the overall effect of the included study and the I2 test was used to assess the degree of heterogeneity between studies. Random effects models were used to analyze studies with significant heterogeneity.
RESULTS: A total of 32 studies (10,122 participants) were included in the meta-analysis. Nurse-led non-pharmacological interventions resulted in a significantly lower incidence of delirium compared with the usual care/control group (risk ratio = 0.74, p < .001) and reduced mortality in the hospital compared with usual care (risk ratio = 0.81, p = .04). However, the implementation of nurse-led, non-pharmacological interventions had no significant effect on the duration, severity of delirium, or length of hospital stay.
CONCLUSIONS: Our findings suggest that the nurse-led, non-pharmacological strategy was effective in reducing the incidence of delirium and mortality in the hospital. Multicomponent interventions were the most effective strategy for reducing the incidence of delirium in adults.

UNASSIGNED: To determine the effect of self-distancing, self-transcendence, and family functioning on self-care agency in Mexican older adults.
UNASSIGNED: Correlational-explanatory design, with a sample of 253 elderly, collecting data through a simple random sampling. A personal data questionnaire was applied, the scale of: self-transcendence, the self-distancing subscale, the family APGAR and the ability to self-care in Mexican population from different demographic groups. Descriptive and inferential statistics were applied (Mann-Whitney U and a structural equation model) and the study was approved by a registered ethics committee.
UNASSIGNED: The study had participation from 253 elderly, with a mean age of 68.02 years, with prevalence of the female sex (60.1%); the level of education was primary school or lower (51.4%). It was observed that the group of chronic diseases had lower self-distancing (U = 4.449.5, p = 0.038) and greater self-transcendence (U = 4177.0, p = 0.008), and selfcare (U = 4365.5, p = 0.024) than the group without chronic diseases. It was also found that self-transcendence, self-distancing, and family functionality produce a positive effect of 37% on selfcare.
UNASSIGNED: Self-distancing, self-transcendence, and family functionality explain an important proportion of selfcare in the elderly. Said knowledge permits understanding the care behavior of the elderly and, thus, propose future educational interventions by nursing to prevent or avoid functional, cognitive loss and social effects.

BACKGROUND: Place of residence plays an influential role in shaping individual development, and studies have established links between Childhood migration experience (CME) and health outcomes through maturity. Over the past three decades, China has undergone one of the largest rural-to-urban migrations, however, little is known about the effect of CME on rural migrants\' adult health in China.
METHODS: Data from 7035 members of the 2016 and 2018 China Labor-force Dynamics Survey were analyzed. CME was measured by whether the place of residence and place of birth changed at the age of 14 years. Three measures of health (self-assessed health, BMI, and mental health scale) were obtained. Causal inferential analysis was performed, using the Probit model, the OLS model and the Propensity Score Matching (PSM) method, to explore the impact of CME on the adult health of rural migrants.
RESULTS: Overall, compared to individuals who did not migrate in childhood, the probability of reporting \"very unhealthy\", \"rather unhealthy\", and \"fair\" in the self-assessed health of the rural migrants with CME decreased by 0.23%, 1.55%, and 5.53%, the probability of reporting \"healthy\" and \"very healthy\" increased by 1.94% and 5.38%, the probability of BMI within the normal range was higher by 7.32%, and the mental health test scores were 0.2591 points higher significantly. Furthermore, in comparison with childhood non-migration, both cross-county and cross-city migration promoted the health status of rural migrants, but the positive effect of cross-province migration was not significant; from the gender perspective, CME could more dramatically improve rural women\'s adult health than men, especially in mental health.
CONCLUSIONS: CME can significantly improve adult health, including physical and mental health, and the positive effect is more obvious among women, helping to reduce gender differences in health. For the migration distance, attention can be focused on the long-distance migrating individuals, who should get more support.

Background and Purpose: The Analgesic Adverse Drug Event Measure (AADEM) measures how people respond when they experience analgesic adverse drug events (ADEs). The purpose of this study was to confirm the underlying constructs of the AADEM: attributed ADE, consulted provider, sought care, and continued/discontinued analgesic. Methods: A cross-sectional instrumentation design was used. Three hundred and thirty-two adults who self-reported an analgesic ADE responded to the online AADEM. Confirmatory factor analysis and reliability testing were conducted. Results: Model fit was adequate across all indexes. Internal consistency for the full AADEM was low, while subscale internal consistency was generally acceptable probably due to three significant negative correlations and two positive correlations between the latent factors. Conclusions: The results supported the construct validity of the AADEM. Advanced practice nurses and other primary care providers can use the AADEM to investigate analgesic ADEs. Greater insight into how people respond to an analgesic ADE via the use of the AADEM may help prevent future analgesic ADEs.

Adverse childhood experiences (ACE) are important for chronic diseases yet their association with multimorbidity remains understudied. Few studies consider the complexity of multimorbidity or observe multimorbidity development over time.
We investigated whether ACE were associated with multimorbidity at baseline and over a 12-year follow-up period.
5326 participants aged over 50 were obtained from the English Longitudinal Study of Ageing (ELSA).
An ACE summary score was derived using eight ACE items measuring abuse, social care, and household dysfunction. From repeated measurements of 29 chronic conditions over a 12-year period (2008-2019) we derived two multimorbidity measures: number of chronic diseases and number of chronic disease categories. We used multinomial logistic regression to assess associations between ACE and both measures. Mixed effects models were estimated to examine trajectories of multimorbidity by ACE over time.
Graded associations between ACE and multimorbidity were observed. Compared to those without ACE, participants with ≥3 ACE had three times the risk of having ≥3 chronic diseases (RRR 3.06, 95 % CI 1.85-5.05) and falling into ≥3 chronic disease categories (RRR 2·93 95 % CI 1·74-4·95). Graded associations persisted during 12-year follow-up, though differences in multimorbidity between those with ≥3 ACE and those without ACE remained constant (B 0.02, 95 % CI 0·01-0·03, and B -0·01, 95 % CI -0·02-0·00, number of chronic conditions and chronic condition categories respectively).
ACE are associated with multimorbidity risk and complexity, associations arising before the age of 50. Early intervention amongst those with ACE could attenuate this association.

On average, incarcerated people have higher rates of poor health, mental illness, and histories of adverse childhood experiences (ACEs) than the general population. This mixed-methods analysis examines the relationship between ACEs and poor adult health among a sample of formerly incarcerated people. The quantitative analysis (N = 122) shows childhood adversity is associated with various health conditions in adulthood, although the strength of this relationship varies by the kinds of ACEs respondents encountered. The qualitative analysis of life history timelines (N = 42) reveals two pathways relating ACEs to poor health and legal system involvement: (1) violence and victimization and (2) drug use as a coping mechanism. Unaddressed mental health challenges in the aftermath of adversity emerged as an important precursor to both pathways. Prisons lack a meaningful consideration of these early life events and the social structures that result in the high rates of vulnerable people in its care.

Childhood maltreatment is linked with health problems in adulthood. Theoretical models suggest that maltreatment leads to dysregulation in several bodily systems, and this has been corroborated using measures of physiological function (i.e., biomarkers). Methodological decisions involving the measurement of maltreatment and dimension reduction with respect to biomarkers (i.e., combining information across multiple measures) may influence research findings.
The present study compares associations between childhood maltreatment and adult physiological dysregulation using multiple dimension reduction approaches and measures of maltreatment.
Participants were recruited, as children, to a prospective study of the correlates and consequences of childhood maltreatment. 253 participants were retained and provided biomarker data at midlife. Physiological dysregulation was operationalized with a conventional allostatic load approach and a novel statistical distance approach.
Regression models were employed with allostatic load or statistical distance as the outcome and prospectively or retrospectively measured child maltreatment as the primary predictor.
When using allostatic load as the outcome, prospectively measured childhood maltreatment was positively associated with physiological dysregulation (b = 0.70, SE = 0.31, p = 0.02). When using statistical distance as the outcome, retrospectively measured childhood maltreatment was positively associated with physiological dysregulation (b = 0.69, SE = 0.19 p < 0.001).
We report a positive association between childhood maltreatment and physiological dysregulation at midlife. However, the significance and magnitude of effects varied with different maltreatment and physiological dysregulation measures. Further review of the methods used to study adult health conditions and their relation to childhood maltreatment is needed.

UNASSIGNED: The economic and political crisis experienced by Brazil, together with the COVID-19 pandemic, may have negatively impacted the food consumption of Brazilian families over recent years. This study aimed to analyze trends in food consumption among adults in a Brazilian northeastern state.
UNASSIGNED: This was an epidemiological study which involved the analysis of data from the Food and Nutrition Surveillance System (SISVAN) relating to the food consumption of adults (20-59 years-of-age) in the state of Ceará in 2015 and 2020. Data are presented by frequency distribution.
UNASSIGNED: In the year 2015-2020, the food consumption of 14,840 adults were registered in SISVAN. There was evidence of a decline in the habit of having three main meals a day (-63.5%), mainly among women (-67.9%). Between 2015 and 2020, there was a decline in the consumption of beans (-7.4%) and an increase in the consumption of fruits (68.2%) and vegetables (82.9%). When considering ultra-processed foods, there was a significant increase in the consumption of hamburgers and sausages (83.3%), cookies (39.1%) and sweetened beverages (25.5%).
UNASSIGNED: Our findings indicate that the habit of having three main meals a day decreased between 2015 and 2020 in the adult population of Ceará, as determined by public data available in SISVAN, especially among women. In addition, there was an increase in the consumption of ultra-processed foods. Therefore, health interventions aimed at nutritional education and the fight against hunger are essential to face these challenges that affect society.
UNASSIGNED: ربما تكون الأزمة الاقتصادية والسياسية التي تعيشها البرازيل، إلى جانب جائحة كوفيد -19، قد أثرت سلبا على استهلاك الغذاء للأسر البرازيلية في السنوات الأخيرة. هدفت هذه الدراسة إلى تحليل اتجاهات استهلاك الغذاء بين البالغين في ولاية شمال شرق البرازيل.
UNASSIGNED: دراسة وبائية تم إجراؤها من خلال تحليل البيانات من نظام مراقبة الغذاء والتغذية (سيسفان) فيما يتعلق باستهلاك الغذاء لدى البالغين (20 إلى 59 عاما) في ولاية سيارا في عامي 2015 و 2020. تم تقديم البيانات من خلال توزيع التكرار.
UNASSIGNED: في العام 2015 إلى 2020، تم تسجيل ما مجموعه 14840 بالغا في تقييم استهلاك الغذاء. وجد أن عادة تناول ثلاث وجبات رئيسية في اليوم قد انخفضت (-63.5٪)، خاصة بين النساء (-67.9٪). بين عامي 2015 و 2020 كان هناك انخفاض في استهلاك البقوليات (-7.4٪) وزيادة في استهلاك الفاكهة (68.2٪) والخضروات (82.9٪). من بين الأطعمة فائقة المعالجة، كانت هناك زيادة كبيرة في استهلاك الهامبرغر والنقانق (83.3٪)، والكوكيز (39.1٪) والمشروبات المحلاة (25.5٪).
UNASSIGNED: تشير النتائج إلى أن عادة تناول الوجبات الرئيسية الثلاث، وفقا للبيانات العامة المتوفرة في سيسفان، قد انخفضت بين عامي 2015 و 2020 لدى السكان البالغين، وخاصة بين النساء. بالإضافة إلى ذلك، كان هنالك زيادة في استهلاك الأطعمة فائقة المعالجة من قبل السكان الذين تم فحصهم. لذلك، فإن التدخلات الصحية التي تهدف إلى التثقيف الغذائي ومكافحة الجوع ضرورية لمواجهة هذه الظروف التي تؤثر على المجتمع.

Obesity rates have increased across all segments of society since the late 1970s, but the reason behind population-level increases in body weight remains unclear. We used the 1971-2020 NHANES data to examine whether the observed trend in obesity prevalence is attributable to changing public health behaviors (i.e., intracohort change) or changing publics (i.e., cohort replacement). We partitioned total change in mean BMI, and rates of obesity and severe obesity, into its IC and CR components using linear and algebraic decomposition methods. We found that the IC mechanism (i.e., broad sectors of individuals changing) plays a dominant role in the overall increase in mean BMI, and obesity and severe obesity prevalence. Birth cohort membership (i.e., the CR mechanism) is also influencing mean BMI, and rates of obesity and severe obesity, but in differing ways. Specifically, the large positive IC and the small positive CR effects are amplifying one another, thus creating a steep increase in the observed rates of severe obesity. Conversely, the large positive IC effect is offset by a small negative CR effect, which created a more gradual rise in mean BMI and rates of obesity. Furthermore, we computed total change for models that entered separately sociodemographic, lifestyle, nutritional, and physical activity measures to estimate differences in mean BMI, and rates of obesity and severe obesity, among cohorts and time periods. Adjustment for all the compositional differences among the cohorts during the study period indicate that a combination of a more pronounced IC and a less pronounced CR drove the observed increase in mean BMI, and rates of obesity and severe obesity. Thus, \"universal prevention\" (i.e., entire community) strategies for healthy weight promotion may need to be combined with \"selective prevention\" (i.e., at-risk groups) and/or \"targeted prevention\" (i.e., at-risk individuals) approaches in order to reverse the obesity epidemic.

John Bynner is a leading advocate of considering context in life course research. In this paper I review some of the ways contextual information on time and place may enrich the analysis of individual histories, as well as vice versa. I take three examples from my own research: (1) a late 20th century analysis of adult health and mortality in Britain where individual and area level evidence are combined; (2) a cross-national analysis of neighbourhood and family predictors of child outcomes at age five in Britain and the US from the early 2000s; and (3) workplace as the context of segregation and the gender pay gap in Britain as it changed over several decades to 2015. The article ends with a discussion of the pros and cons of incorporating contextual evidence in longitudinal survey data sets with reference to the UK Millennium Cohort Study, which John Bynner helped to bring into existence.