-
Chinese Medical Journal Jun 2024Psychological stress has been reported to be a potential risk factor for hypertension among females, but it remains unclear whether spousal chronic stress levels alter...
BACKGROUND
Psychological stress has been reported to be a potential risk factor for hypertension among females, but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women. We examined the associations between stress within the family and hypertension among married women.
METHODS
Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects (NFPCP) across 31 provinces in China in 2016 and 2017. Perceived stress of wives or husbands was measured with a 5-point Likert-type scale, and assessed from three domains: work/life-related stress, economic stress, and overall stress. Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension.
RESULTS
Of 10,027,644 couples, 261,098 (2.60%) women had hypertension. The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women (Pfor trend <0.001). Compared with non-stressed participants, female participants with the highest stress themselves were at a greater risk of hypertension, with adjusted odds ratios (OR) of 1.31 (95% confidence interval [CI]: 1.25-1.37); and compared with participants whose husbands have no stress, those whose husbands have the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24 (95% CI: 1.20-1.29). Moreover, compared with non-stressed status for both couples, only-wife-stressed, only-husband-stressed, and both-stressed couples were found to be significantly associated with increased risks of wives' hypertension, with adjusted ORs of 1.28 (95% CI: 1.25-1.31), 1.19 (95% CI: 1.17-1.21) and 1.28 (95% CI: 1.26-1.31), respectively.
CONCLUSION
Moderate to severe stress in both spouses might be associated with female hypertension prevalence, which highlights the importance of paying attention to the psychological stresses of couples within the family.
PubMed: 38932742
DOI: 10.1097/CM9.0000000000003065 -
Human Vaccines & Immunotherapeutics Dec 2024This study aimed to assess the attitudes and willingness of pregnant women to receive the influenza vaccine and the factors influencing their decisions. A sample survey...
This study aimed to assess the attitudes and willingness of pregnant women to receive the influenza vaccine and the factors influencing their decisions. A sample survey was conducted among pregnant women receiving prenatal care at various medical institutions in Minhang District, Shanghai, from March to June 2023. The survey included inquiries about demographic information, knowledge, and perception of influenza disease and influenza vaccine. Logistic regression models and chi-square tests were used to analyze the data. 6.9% (78/1125) of participants considered receiving the influenza vaccine during pregnancy. Participants with graduate education or above (OR = 4.632, 95%CI: 1.046-20.517), non-office workers (OR = 2.784, 95%CI: 1.560-4.970), and participants whose spouses were not office workers (OR = 0.518, 95% CI: 0.294-0.913) were significantly associated with high intent to vaccinate. Participants with superior knowledge (>30 points) exhibited greater willingness ( < .001). Participants who viewed post-influenza symptoms as mild had a significantly lower willingness to vaccinate during pregnancy (2.3%), compared to those who disagreed ( = .015). Conversely, those recognizing a heightened risk of hospitalization due to respiratory diseases in pregnant women post-influenza were significantly more inclined to vaccinate during pregnancy (8.8%) ( = .007). Participants recognizing benefits uniformly expressed willingness to receive the influenza vaccine during pregnancy ( < .001), while those perceiving barriers uniformly rejected vaccination ( < .001). Higher education, non-office worker status, and having an office worker spouse correlate with greater willingness to receive the influenza vaccine during pregnancy. Enhanced knowledge and accurate perceptions of influenza and its vaccine influenced willingness. Accumulating knowledge about influenza and its vaccine fosters accurate perceptions. Notably, overall willingness to vaccinate during pregnancy remains low, likely due to safety concerns, and lack of accurate perceptions. Targeted health education, improved communication between healthcare providers and pregnant women, and campaigns highlighting vaccine benefits for mothers and children are essential.
Topics: Humans; Female; Health Knowledge, Attitudes, Practice; Pregnancy; China; Adult; Influenza Vaccines; Influenza, Human; Pregnant Women; Patient Acceptance of Health Care; Young Adult; Surveys and Questionnaires; Vaccination; Pregnancy Complications, Infectious; Prenatal Care; Cross-Sectional Studies; Adolescent
PubMed: 38932738
DOI: 10.1080/21645515.2024.2368944 -
Nutrients Jun 2024Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled... (Randomized Controlled Trial)
Randomized Controlled Trial
Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey ( = 68 couples) and focus groups ( = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.
Topics: Humans; Female; Male; Pilot Projects; Middle Aged; Interoception; Spouses; Aged; Exercise; Feeding Behavior; Focus Groups; Surveys and Questionnaires; Hunger; Eating; Satiation
PubMed: 38931304
DOI: 10.3390/nu16121949 -
Medicina (Kaunas, Lithuania) May 2024This study aimed to identify the incidence of sarcopenia and disease risk factors in Korean adults and to provide data for sarcopenia prevention. Based on the Korea...
This study aimed to identify the incidence of sarcopenia and disease risk factors in Korean adults and to provide data for sarcopenia prevention. Based on the Korea National Health and Nutrition Survey, 2008-2011, we selected 14,185 adults over the age of 20 who participated in sarcopenia diagnostic tests and health surveys. We analyzed sarcopenia risk factors using complex sample multi-logistic regression analysis. The prevalence of sarcopenia in Korea was 31.3%, with 20.2% in men and 40.4% in women. In men, there was a higher risk of sarcopenia in those of older age, without a spouse, with a low body mass index (BMI), who never engage in resistance exercise, or who do mid-level intensity resistance exercises. In women, sarcopenia risk was higher in those in their 20s compared to those in their 60s, and risk factors included a low BMI, high-density lipoprotein cholesterol and waist circumference measurements, alcohol consumption, aerobic exercise, and resistance exercise. Interventions and lifestyle improvements will help prevent the onset of sarcopenia in elderly men and young women with risk factors such as a low BMI.
Topics: Humans; Sarcopenia; Republic of Korea; Female; Male; Cross-Sectional Studies; Risk Factors; Middle Aged; Prevalence; Adult; Aged; Body Mass Index; Sex Factors; Epidemiologic Studies; Exercise; Logistic Models
PubMed: 38929514
DOI: 10.3390/medicina60060899 -
International Journal of Environmental... Jun 2024Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors...
Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one's own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.
Topics: Humans; Male; Female; Adult; Blood Pressure; Marriage; Young Adult; Blood Pressure Monitoring, Ambulatory; Sleep; Circadian Rhythm; Spouses
PubMed: 38928969
DOI: 10.3390/ijerph21060723 -
European Journal of Ageing Jun 2024While the link between self-perceptions of aging (SPA) and healthy aging is well established, less is known about the association between social factors and SPA. The...
While the link between self-perceptions of aging (SPA) and healthy aging is well established, less is known about the association between social factors and SPA. The present study investigated whether higher social network diversity is associated with more positive and less negative SPA and whether this association is moderated by age. We examined cross-sectional data from the German Ageing Survey of 2008 (DEAS; N = 6205, 40-85 years, 49.5% female). Network diversity was assessed as the number of social roles in an individual's network (such as spouse, friend and colleague). Three domains of SPA were measured using the Aging-Related Cognitions Scale (AgeCog): ongoing development (positive SPA), social losses (negative SPA) and physical losses (negative SPA). We conducted multiple linear regression models and tested for a moderator effect of age using an interaction term of age and network diversity. Results showed that at higher ages older adults with higher network diversity reported more positive SPA related to ongoing development and more negative SPA related to social losses than those with less diverse networks, indicating that age has a moderating effect. We found no association between network diversity and negative SPA related to physical losses and no indication that age was relevant to this relationship. The present study adds to evidence on the role of social networks in SPA. Our findings suggest that in certain SPA domains and depending on age, network diversity is related to both more positive and more negative SPA, which emphasizes the importance of considering domain-specific SPA.
PubMed: 38926182
DOI: 10.1007/s10433-024-00815-z -
The Urologic Clinics of North America Aug 2024Penile cancer is a rare malignancy with a poor prognosis. Studies with single-agent immune checkpoint inhibitors (ICIs) have demonstrated efficacy, but response rates... (Review)
Review
Penile cancer is a rare malignancy with a poor prognosis. Studies with single-agent immune checkpoint inhibitors (ICIs) have demonstrated efficacy, but response rates are low. Studies combining ICIs with both chemotherapy and targeted therapy are ongoing. Up to 50% of penile cancer cases are associated with human papillomavirus (HPV). HPV-targeting therapies, such as HPV-targeting vaccines and T-cell receptor therapies, are an area of active investigation. Penile cancer cells also express cell surface antigens that may be targeted by the emerging class of antibody-drug conjugates.
Topics: Humans; Penile Neoplasms; Male; Immune Checkpoint Inhibitors; Papillomavirus Infections; Immunotherapy; Neoplasm Metastasis; Molecular Targeted Therapy
PubMed: 38925739
DOI: 10.1016/j.ucl.2024.03.005 -
The Urologic Clinics of North America Aug 2024Penile cancer is a rare cancer, where patients not only need to deal with the anxiety around a cancer diagnosis, but also manage the consequences of treatment on their... (Review)
Review
Penile cancer is a rare cancer, where patients not only need to deal with the anxiety around a cancer diagnosis, but also manage the consequences of treatment on their self-esteem, body image, and intimate relationships. Many find it embarrassing and difficult to talk to family and friends. Due to this, changes in urination and other physical effects of treatment, many will withdraw from social activities too. Patients need psychosocial support and more needs to be done to address this unmet need. Holistic and multidisciplinary approaches in clinic, with access to counseling, may help patients adjust to their new situation.
Topics: Humans; Male; Communication; Penile Neoplasms; Psychosocial Support Systems; Social Interaction; Spouses; Suicide; Recurrence; Counseling
PubMed: 38925735
DOI: 10.1016/j.ucl.2024.03.004 -
The Journal of Allergy and Clinical... Jun 2024Omalizumab is a newly FDA approved anti-IgE therapy for allergen agnostic treatment of single or multiple food allergies in patients ages >1 year.
BACKGROUND
Omalizumab is a newly FDA approved anti-IgE therapy for allergen agnostic treatment of single or multiple food allergies in patients ages >1 year.
OBJECTIVE
Evaluate the cost-effectiveness of omalizumab as a food allergy treatment.
METHODS
Health and economic outcomes were evaluated in Markov cohorts of simulated food allergic infants randomized to receive omalizumab using a 15-year time horizon. Monte Carlo simulation was used (n=40,000 subjects) to evaluate cost-effectiveness from a societal perspective, incorporating both a family-level and individual-level analysis. Family-level analysis was included to incorporate broad perspective for health utility change, given treatment effects likely benefit all parties at home (e.g., caregivers, siblings, spouses), not just the patient, representing the sum of changes in all such persons. Supplemental analyses explored lower omalizumab cost and home initiation. Deterministic and probabilistic sensitivity analyses were performed.
RESULTS
In the family-level cohort analysis, omalizumab exceeded cost-effectiveness thresholds ($185,183/QALY). Comparing the omalizumab strategy (OMA) to the non-omalizumab strategy (NOMA), the cost of OMA exceeded NOMA ($315,020 vs $136,609) with greater incremental effectiveness (12.668 QALY vs 11.699 QALY). In the individual-level analysis, the cost-effectiveness of OMA was $573,698/QALY. In base-case assessments, OMA was cost-effective (WTP, $100,000/QALY) at a health state utility improvement of 0.265. OMA's value-based cost ranged from $14,166-$23,791 when considered at the individual and family-unit levels. Requiring OMA administration in-clinic was not cost-effective (ICER, $260,239).
CONCLUSIONS
In the base-case and at current pricing, omalizumab is not cost-effective, but could be at a lower retail price or if use creates large health utility shifts in the family and patient.
PubMed: 38925250
DOI: 10.1016/j.jaip.2024.06.023 -
AIDS (London, England) Jun 2024:Mass screening for human immunodeficiency virus (HIV) and preexposure prophylaxis (PrEP) may be effective measures for reducing the probability of HIV transmission. Our...
OBJECTIVE
:Mass screening for human immunodeficiency virus (HIV) and preexposure prophylaxis (PrEP) may be effective measures for reducing the probability of HIV transmission. Our study aimed to determine the cost-effectiveness of preliminary screening in the general population, PrEP for HIV-negative spouses in serodiscordant couples, or both approaches in Zhejiang Province.
DESIGN
:From a policy-maker's perspective, a Markov model was constructed to compare 4 strategies over a 30-year horizon.
METHODS
:In the Markov model, the implementation intensities of the strategies varied from 50% to 100%. Different strategies were evaluated by the reduction of unfavorable clinical outcomes, saved life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and net monetary benefits (NMBs).
RESULTS
:The PrEP-Screening strategy reduced the most unfavorable clinical outcomes and saved the most LYs and QALYs from 2023 to 2052. It always gained the maximum QALYs and NMB, while its ICER was always lower than the willingness-to-pay (WTP). The NMB of the PrEP-Screening strategy gradually increased as the implementation intensity increased.
CONCLUSIONS
:With adequate manpower and policies, we suggest implementing the PrEP-Screening strategy in Zhejiang Province, suggesting that the broader the population coverage of the strategy, the better. In addition, the PrEP strategy is an alternative.
PubMed: 38923427
DOI: 10.1097/QAD.0000000000003968