Prevalence and determinants of oral and cervicogenital HPV infection: baseline analysis of the MHOC cohort study

We determined baseline oral and cervicogenital human papillomavirus (HPV) prevalence and determinants of infection in the Michigan HPV and Oropharyngeal Cancer (MHOC) study. We enrolled 394 college-age and older-adult participants of both sexes in Ann Arbor, Michigan and the surrounding area. All participants provided an oral sample at baseline, and 130 females provided a cervicogenital sample. Samples were tested for 18 HPV genotypes using polymerase chain reaction (PCR) MassArray. Participants filled out sociodemographic and behavioral questionnaires. Prevalence ratios for HPV oral or cervicogenital prevalence by predictor variables were estimated in univariable log-binomial models. Analysis was conducted 2018-20. In the full cohort, baseline oral HPV prevalence was 10.0% for any detected genotype (among the 338 valid oral tests at baseline) and 6.5% for high-risk types, and cervicogenital prevalence was 20.0% and 10.8%, respectively (among the 130 first valid cervicogenital tests). Oral HPV prevalence did not vary by sex, with 10.5% of women and 9.0% of men having an infection. We found a high prevalence of oral and cervicogenital HPV infection among those reporting no recent sexual partners compared to those with a single recent sexual partner, but prevalence increased with the number of recent partners for most sexual behaviors. We observed an ecological fallacy masking the direction of impact of vaccination on HPV prevalence in the full cohort compared to the college-aged and older-adult populations considered separately. Substance use was not significantly associated with oral or cervicogenital HPV infection. Many studies report substantially higher oral HPV infection prevalence in men than in women. That difference may not be uniform across populations in the US.

The revictimization of older Mexican women: understanding the accumulation of multiple victimizations throughout a lifetime

Background The victimization of women constitutes a human rights violation and a health risk factor. The central objectives of this study were to analyze the probability of revictimization among older adult Mexican women and to examine whether child abuse (CA) and/or intimate partner violence (IPV) are associated with a greater risk of elder abuse (EA) victimization. Methods We conducted a secondary data analysis of 18416 women 60 and older, based on data from the National Survey on the Dynamics of Household Relationships (2016), which is national and subnational representative. A descriptive analysis was carried out using retrospective self-reports of victimization experiences (CA, IPV, and EA). The prevalence of victimization and multiple victimizations in the various stages of the lives of women, as well as of revictimization among older adult women were obtained. Bayesian logistic regression models were used to examine the associations between victimization, multiple victimization, and EA victimization. Results A total of 17.3% of the older adult women reported EA in the last year; of these, 81.0% had been revictimized and 14.0% reported CA, IPV, and EA. The risk of EA rose among women who reported a combination of psychological and sexual CA, and psychological, physical and sexual CA and psychological and sexual IPV, and a psychological, economic, physical and sexual IPV. EA was higher among women who had suffered more than one type of violence. Conclusion CA and IPV, particularly sexual abuse and psychological violence, can be risk factors for EA. Screening tools used to prevent and detect EA should include questions about domestic violence over the course of a person’s lifetime.

Dance wherever you are: the evolution of multi-modal delivery for social inclusion of rural older adults

Background and Objectives Older adult social inclusion involves meaningful participation that is increasingly mediated by information communication technology (ICT) and in rural areas requires understanding of older adults’ experiences in the context of the digital divide. This paper examines how the multi-modal streaming (live, pre-recorded, blended in-person) of the Sharing Dance Older Adults program developed by Canada's National Ballet School (NBS) and Baycrest, influenced social inclusion processes and outcomes in rural settings. Research Design and Methods Data were collected from on-site observations of dance sessions, research team reflections, focus groups and interviews with older adult participants and their carers in pilot studies in the Peterborough Region of Ontario, and the Westman Region of Manitoba, Canada (2017-2019). There were 289 participants including older adults, people living with dementia, family carers, long-term-care staff, community facilitators, and volunteers. Analytic themes were framed in the context of rural older adult social exclusion. Results Remote delivery addressed barriers of physical distance by providing access to the arts-based program and enhancing opportunities for participation. Constraints were introduced by the use of technology in rural areas and mitigated by in-person facilitators and different streaming options. Meaningful engagement in dynamic interactions in the dance was achieved by involving local staff and volunteers in facilitation of and feedback on the program and its delivery. Different streaming technologies influenced social inclusion in different ways: live-stream enhanced connectedness, but constrained technical challenges; pre-recorded was reliable, but less social; blended delivery provided options, but personalization was unsustainable. Discussion and Implications Understanding different participants’ experiences of different technologies will contribute to more effective remote delivery of arts-based programs with options to use technology in various contexts depending on individual and organizational capacities.

PCV13 Vaccination of Adults against Pneumococcal Disease: What We Have Learned from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA)

The Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA) evaluated older adult pneumococcal vaccination and was one of the largest vaccine clinical trials ever conducted. Among older adults aged ≥65 years, the trial established 13-valent pneumococcal conjugate vaccine (PCV13) efficacy in preventing first episodes of bacteremic and nonbacteremic pneumococcal vaccine serotype (VT) community acquired pneumonia (CAP), and of vaccine serotype invasive pneumococcal disease (VT-IPD). Since the publication of the original trial results, 15 additional publications have extended the analyses. In this review, we summarize and integrate the full body of evidence generated by these studies, contextualize the results in light of their public health relevance, and discuss their implications for the assessment of current and future adult pneumococcal vaccination. This accumulating evidence has helped to better understand PCV13 efficacy, serotype-specific efficacy, efficacy in subgroups, the interpretation of immunogenicity data, and the public health value of adult PCV vaccination.

Association between Agility, Health-Related Quality of Life, Depression, and Anthropometric Variables in Physically Active Older Adult Women with Depression

Introduction. Depressive disorders are mental disorders that last over time, and seriously affect the lives of the people who suffer from them, diminishing their quality of life, reducing their motor capacity, and incapacitating them in their daily lives. It is a major problem worldwide. Objective. To study the association between agility, health-related quality of life (hrqol), anthropometric status, and depression status in older adult women with depression. Design. Data collected from 685 physically active older women with depression were analyzed. Result. A moderate inverse correlation (r = −0.34) is shown between Time Up & Go (TUG) and EuroQol Five-Dimensional Three-Level Version (EQ-5D-3L). Between TUG and Geriatric Depression Scale (GDS), there is a small direct correlation (r = 0.14) between them. Between TUG and anthropometric data, all observed correlations are significant. Conclusions. There is a significant association between agility, health-related quality of life, depression, and anthropometric data in physically active older women with depression.

Bioethics and Nutrition in the Older Adult

At the professional practice of nutrition, as in the rest of the health disciplines, it is necessary to follow high standards in order to establish the best doctor-patient relationship and the greatest benefit in the user's health. In a special way, the factors that are indexed in the nutrition of the elderly must be specified; since, during the stage of old age, individuals present physiological and psychosocial changes that affect their nutritional status, which lead to both overweight and malnutrition, implying malnutrition problems. Thus, recommendations are established for both the ethical aspects and the components that must be considered for the adequate feeding of the elderly, including the ethical considerations involved in the interventions.