scholarly journals Differences by Race, Religion, and Mental Health in Preferences for Life-Prolonging Treatment in Adverse Health States: Results from a National Sample of Medicare Beneficiaries (TH322C)

2019 ◽  
Vol 57 (2) ◽  
pp. 378-379
Author(s):  
Justin Sanders ◽  
Anna Berrier ◽  
Leonce Nshuti ◽  
Charlotta Lindvall ◽  
James Tulsky
Keyword(s):  
Mental Health ◽  
National Sample ◽  
Medicare Beneficiaries ◽  
Health States ◽  
Adverse Health

Validation to Spanish version of the COVID-19 Stress Scale

2020 ◽  
Author(s):  
Edgar Guillermo Pulido
Keyword(s):  
Mental Health ◽  
Goodness Of Fit ◽  
National Sample ◽  
Mitigation Strategies ◽  
Dimensional Structure ◽  
Psychosocial Effects ◽  
Stress Scale ◽  
Global Consensus ◽  
Reliability Indicators ◽  
Effective Assessment

There is a global consensus about the potential of the COVID-19 pandemic to affect people's mental health. In this context, and prior to the formulation of mitigation strategies, tools are required that allow an objective and effective assessment of mental health risk. The purpose of this study was to evaluate the psychometric characteristics of COVID-19 Stress Scale, formulated by Taylor et al. (2020), based on the concept of COVID-19 Stress Syndrome. A national sample of 1214 participating adults was taken in Colombia, who answered a translated version of the scale. Evidence of a hexa-dimensional structure was obtained whose goodness of fit indicators were Chi2 = 1215,759, Sig. =. 000, CMIN / DF = 2.202, RMSEA = .044, NFI = .943, TLI = .964, CFI =. 968 and FMIN = 1,967. Regarding reliability, an α = .924 and Spearman-Brown = .824 were obtained for the entire scale; the reliability indicators of the 6 subscales were also high. The similarities and differences in the findings with respect to the original psychometric study of the scale are discussed, as well as the utility and importance of the instrument as a tool in future efforts to mitigate the psychosocial effects of the pandemic.

scholarly journals Income-related health inequality among Chinese adults during the COVID-19 pandemic: evidence based on an online survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Peng Nie ◽  
Lanlin Ding ◽  
Zhuo Chen ◽  
Shiyong Liu ◽  
Qi Zhang ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Outcomes ◽  
Family Member ◽  
Health Inequalities ◽  
Online Survey ◽  
Mainland China ◽  
Decomposition Analysis ◽  
National Sample ◽  
Vulnerable Groups

AbstractBackgroundPartial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic.MethodsThe 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for this analysis. Concentration Index (CI) and Corrected CI (CCI) were used to measure income-related inequalities in mental health and self-reported health (SRH), respectively. Wagstaff-type decomposition analysis was used to identify contributors to health inequalities.ResultsMost participants reported their health status as “very good” (39.0%) or “excellent” (42.3%). CCI of SRH and mental health were − 0.09 (p < 0.01) and 0.04 (p < 0.01), respectively, indicating pro-poor inequality in ill SRH and pro-rich inequality in ill mental health. Income was the leading contributor to inequalities in SRH and mental health, accounting for 62.7% (p < 0.01) and 39.0% (p < 0.05) of income-related inequalities, respectively. The COVID-19 related variables, including self-reported family-member COVID-19 infection, job loss, experiences of food and medication shortage, engagement in physical activity, and five different-level pandemic regions of residence, explained substantial inequalities in ill SRH and ill mental health, accounting for 29.7% (p < 0.01) and 20.6% (p < 0.01), respectively. Self-reported family member COVID-19 infection, experiencing food and medication shortage, and engagement in physical activity explain 9.4% (p < 0.01), 2.6% (the summed contributions of experiencing food shortage (0.9%) and medication shortage (1.7%),p < 0.01), and 17.6% (p < 0.01) inequality in SRH, respectively (8.9% (p < 0.01), 24.1% (p < 0.01), and 15.1% (p < 0.01) for mental health).ConclusionsPer capita household income last year, experiences of food and medication shortage, self-reported family member COVID-19 infection, and physical activity are important contributors to health inequalities, especially mental health in China during the COVID-19 pandemic. Intervention programs should be implemented to support vulnerable groups.

scholarly journals Adverse health behaviours are associated with depression and anxiety in multiple sclerosis: A prospective multisite study

2015 ◽  
Vol 22 (5) ◽  
pp. 685-693 ◽  
Author(s):  
Kyla A. McKay ◽  
Helen Tremlett ◽  
John D. Fisk ◽  
Scott B. Patten ◽  
Kirsten Fiest ◽  
...  
Keyword(s):  
Mental Health ◽  
Multiple Sclerosis ◽  
Alcohol Dependence ◽  
Smoking Status ◽  
Health Behaviours ◽  
Depression And Anxiety ◽  
Adverse Health ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Anxiety Depression

Background: Depression and anxiety are common among people with multiple sclerosis (MS), as are adverse health behaviours, but the associations between these factors are unclear. Objective: To evaluate the associations between cigarette smoking, alcohol use, and depression and anxiety in MS in a cross-Canada prospective study. Methods: From July 2010 to March 2011 we recruited consecutive MS patients from four MS clinics. At three visits over two years, clinical and demographic information was collected, and participants completed questionnaires regarding health behaviours and mental health. Results: Of 949 participants, 75.2% were women, with a mean age of 48.6 years; most had a relapsing−remitting course (72.4%). Alcohol dependence was associated with increased odds of anxiety (OR: 1.84; 95% CI: 1.32–2.58) and depression (OR: 1.53; 95% CI: 1.05–2.23) adjusting for age, sex, Expanded Disability Status Scale (EDSS), and smoking status. Smoking was associated with increased odds of anxiety (OR: 1.29; 95% CI: 1.02–1.63) and depression (OR: 1.37; 95% CI: 1.04–1.78) adjusting for age, sex, EDSS, and alcohol dependence. Alcohol dependence was associated with an increased incidence of depression but not anxiety. Depression was associated with an increased incidence of alcohol dependence. Conclusion: Alcohol dependence and smoking were associated with anxiety and depression. Awareness of the effects of adverse health behaviours on mental health in MS might help target counselling and support for those ‘at risk’.

Rapid Growth In Mental Health Telemedicine Use Among Rural Medicare Beneficiaries, Wide Variation Across States

2017 ◽  
Vol 36 (5) ◽  
pp. 909-917 ◽  
Author(s):  
Ateev Mehrotra ◽  
Haiden A. Huskamp ◽  
Jeffrey Souza ◽  
Lori Uscher-Pines ◽  
Sherri Rose ◽  
...  
Keyword(s):  
Mental Health ◽  
Rapid Growth ◽  
Medicare Beneficiaries

scholarly journals 972 Predictors and Outcomes of Readmission for Clostridium difficile in a National Sample of Medicare Beneficiaries

2014 ◽  
Vol 146 (5) ◽  
pp. S-1032 ◽  
Author(s):  
Courtney Collins ◽  
M. Didem Ayturk ◽  
Frederick A. Anderson ◽  
Heena P. Santry
Keyword(s):  
Clostridium Difficile ◽  
National Sample ◽  
Medicare Beneficiaries

scholarly journals Gender Differences in 30-Day Re-Hospitalization Among Medicare Beneficiaries With Alzheimer’s and Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 697-697
Author(s):  
Andrea Gilmore-Bykovskyi
Keyword(s):  
Gender Differences ◽  
Cognitive Decline ◽  
Primary Outcome ◽  
African American Men ◽  
White Men ◽  
National Sample ◽  
Medicare Beneficiaries ◽  
Index Hospitalization ◽  
The Impact ◽  
Racial Ethnic

Abstract Hospitalization is associated with accelerated cognitive decline for persons with Alzheimer’s disease and related dementia (ADRD), which disproportionately impacts women. Persons with ADRD are also at higher risk for 30-day rehospitalization, which may compound the impact of hospitalization-related exposures that precipitate decline. Evidence surrounding the intersections between gender and rehospitalization risk among diverse, representative populations with ADRD are lacking. This retrospective cohort study used a 100% national sample of Medicare beneficiaries with a diagnosis of ADRD and qualifying index hospitalization in 2014 (n= 1,033,144 unique beneficiaries and 1,672,238 unique stays). The primary outcome was rate of 30-day rehospitalization by gender and race. Within each racial group, men have higher rehospitalization rates than women: 2.6% higher among white men, 1.7% among African American men, and 2.6% higher among other racial/ethnic minorities. Findings highlight the importance of elucidating mechanisms underlying gender differences in hospital utilization and subsequent impact on cognitive decline.

scholarly journals Dose response association of objective physical activity with mental health in a representative national sample of adults: a cross-sectional study

2018 ◽  
Author(s):  
Paquito Bernard ◽  
Isabelle Doré ◽  
Romain Ahmed Jérôme ◽  
Gabriel Hains-Monfette ◽  
Kingsbury ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Dose Response ◽  
Sedentary Time ◽  
Generalized Additive Models ◽  
National Sample ◽  
Additive Models ◽  
Curvilinear Relationship ◽  
Cross Sectional ◽  
Representative National Sample

Although higher physical activity (PA) levels are associated with better mental health, previous findings about the shape of the dose–response relationship between PA and mental health are inconsistent. Furthermore, this association may differ according to sedentary levels. We investigated the cross-sectional dose-response associations between objectively measured PA and mental health in a representative national sample of adults. We also examined whether sedentary time modified the PA - mental health associations. Based on 2007-2013 Canadian Health Measures Survey data, PA and sedentary time were measured using accelerometry among 8150 participants, aged 20 to 79 years. Generalized additive models with a smooth function were fitted to examine associations between minutes per day of moderate and vigorous PA (MVPA), light PA (LPA), daily steps (combined or not with sedentary time) and self-rated mental health. A significant curvilinear relationship between average daily minutes of MVPA and mental health was observed, with increasing benefits up to 50 minutes/day. For LPA, a more complex shape (monotonic and curvilinear) was found. For daily steps, inverted U-shaped curve suggested increasing benefits until a plateau between 5000 and 16000 steps. The MVPA-LPA combination was significantly associated with mental health but with a complex pattern. The tested PA-sedentary time combinations showed that increasing sedentary time decreased the positive PA-mental health associations. Non-linear dose-response patterns between the PA modalities and self-reported mental health were observed. Optimal doses of daily minutes of MVPA, LPA, MVPA combined with LPA and daily steps are independently associated with better mental health in adults. The results also suggest that PA-mental health associations could be hampered by daily sedentary time.

scholarly journals Barriers to healthcare for autistic adults: Consequences & policy implications. A cross-sectional study

2020 ◽  
Author(s):  
Mary Doherty ◽  
Stuart D Neilson ◽  
Jane D O'Sullivan ◽  
Laura Carravallah ◽  
Mona Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Clinic Appointment ◽  
Autistic People ◽  
Autistic Adults

AbstractBackgroundAutistic people experience significantly poorer physical and mental health along with reduced life expectancy.AimTo identify self-reported barriers to primary care by autistic adults compared to parents of autistic children and non-autistic adults and link these barriers to self-reported adverse health consequences.Design and SettingFollowing consultation with the autistic community at an autistic conference, Autscape, a quantitative and qualitative survey was developed.MethodThe self-report survey was administered online through social media platforms.ResultsThe 57-item online survey was completed by 507 autistic adults, 196 parents of autistic children and 157 control subjects. 79.7% of autistic adults, 52.8% of parents and 36.5% of controls reported difficulty visiting a GP. The highest-rated barriers by autistic adults were deciding if symptoms warrant a GP visit (72.2%), difficulty making appointments by telephone (61.9%), not feeling understood (55.8%), difficulty communicating with their doctor (53.1%) and the waiting room environment (50.5%).Autistic adults reported a preference for online or text based appointment booking, facility to email in advance the reason for consultation, first or last clinic appointment and a quiet place to wait.Increased adverse health outcomes reported by autistic adults correlated with difficulty attending, including untreated physical and mental health conditions, not attending specialist referral or screening programmes, requiring more extensive treatment or surgery due to late presentations, and untreated potentially life threatening conditions.ConclusionReduction of healthcare inequalities for autistic people requires that healthcare providers understand autistic perspectives and communication needs. Adjustments for autism specific needs are as necessary as ramps for wheelchair users.How this fits inAdverse health outcomes are common among autistic people and so it is important to understand how we can promote access to primary care.This cross sectional study indicates that 79.7% of autistic patients (compared to 36.5% of controls) reported difficulty visiting a GP.Common barriers were: deciding if symptoms warrant a GP visit, difficulty using the telephone to book appointments, not feeling understood and difficulty communicating with their doctor.Common suggestions to promote access included: online or text based appointment booking facility, emailing in advance the reason for consultation, providing first or last clinic appointment and having a quiet place to wait.

scholarly journals National Rates of Warfarin Use in Medicare Patients with Atrial Fibrillation: Results from the National Stroke Project

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 328-328
Author(s):  
David S Nilasena ◽  
Timothy F Kresowik ◽  
Anton F Piskac ◽  
Rebecca A Hemann ◽  
Marian A Brenton ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Warfarin Therapy ◽  
District Of Columbia ◽  
National Sample ◽  
The State ◽  
Medicare Beneficiaries ◽  
Medicare Patients ◽  
Project Data ◽  
Demographic Subgroups ◽  
Univariate Analyses

66 Background: The National Stroke Project is a HCFA initiative to improve stroke related hospital care for Medicare beneficiaries. As part of the evaluation of these efforts, HCFA is measuring performance on a set of quality indicators at the state and national levels. We report the baseline results for a key quality indicator for this project: warfarin at discharge for patients with atrial fibrillation (AF). Methods: Project data were abstracted from a national sample of Medicare inpatient charts with a principal or secondary diagnosis of AF (ICD-9-CM 427.31) and discharged between 4/98 and 3/99. All U.S. states, the District of Columbia, and Puerto Rico were sampled using a systematic random approach. Eligible patients were required to have physician confirmation of AF during the hospitalization and at discharge, or intermittent AF. The main outcome measure was a prescription or physician documented plan for warfarin at discharge. Results: Of 38,925 cases reviewed, 12,303 met the inclusion criteria. Many of the cases (38.3%) were excluded due to a history or current finding of hemorrhage. Nationwide, 6,633 (unadjusted rate, 53.9%) patients were prescribed warfarin at discharge or had a plan to start warfarin after discharge. The state-specific rates ranged from 30.7% to 65.3%. Univariate analyses showed that warfarin was prescribed less frequently (p<0.002) for adults 85 years of age and older (rate=39.9%, OR=0.47, 95% CI=0.43–0.51) and women (rate=52.0%, OR=0.83, 95% CI=0.78–0.90). African-Americans (rate=47.2%, OR=0.76 95% CI=0.63–0.90) and Asians (n=108, rate=37.0%, OR=0.50, 95% CI=0.34–0.74) were also found to have lower warfarin therapy rates. Conclusions: The results from this large national sample confirm the findings from other reports that there is substantial under-utilization of warfarin therapy for stroke prevention among Medicare patients with AF. This is particularly true for demographic subgroups at high risk for stroke. Quality improvement efforts are currently underway through HCFA’s National Stroke Project (AF topic) to increase warfarin use in appropriate AF patients.

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