Predicting Symptom Severities in Middle-Aged and Older Adults With Arthritis and Multimorbidity

Introduction Uncertainties increase with disease guideline-driven decision-making for older adults as their numbers of chronic conditions and functional limitations increase. A national study found that people with arthritis plus ≥ one other chronic condition have reported significantly higher social participation restriction, serious psychological distress, and work limitation than those with ≥two non-arthritis chronic conditions. However, how arthritis comorbidities contribute to the symptoms such as pain, fatigue, sleep, depression, anxiety, and cognitive abilities that chronically impair people’s daily functioning remain unexplored. Purpose To explore how arthritis comorbidities predict the symptom severities of pain interference, fatigue, sleep disturbance, depression, anxiety, and cognitive abilities among community-dwelling middle-aged and older adults. Method: 140 community people aged over 50 with arthritis and multimorbidity were recruited. Stepwise regressions predicted the PROMIS symptoms of pain interference, fatigue, sleep disturbance, depression, anxiety, and cognitive abilities with arthritis type and 18 comorbidities measured by the Functional Comorbidity Index checklist after controlling for demographics. Results Obesity, chronic obstructive pulmonary disease, diabetes, and income significantly predicted pain interference (adjusted R2=35%). Marital status, obesity, and peripheral vascular disease significantly predicted fatigue (adjusted R2=17%). Depression diagnosis and income adequacy significantly predicted depressive symptoms (adjusted R2=23%). Depression, income adequacy, and anxiety diagnosis significantly predicted anxiety (adjusted R2=23%). Age significantly predicted cognitive abilities (adjusted R2=12%). Discussion Comorbidities and socio-demographics, especially income, impact symptom experiences of people aging with arthritis and multimorbidity. Future studies should explore the pathogenesis among arthritis, comorbidities, and symptoms for tailored intervention while disclosing health disparities associated with the arthritis multimorbidity.

Self-Care of African Immigrant Adults with Chronic Illness

This cross-sectional study aims to describe the self-care of adult African immigrants in the US with chronic illness and explore the relationship between acculturation and self-care. A total of 88 African immigrants with chronic illness were enrolled. Self-care was measured with the Self Care of Chronic Illness Inventory v3 and the Self-Care Self-Efficacy scale. Scores are standardized 0 to 100 with scores >70 considered adequate. Acculturation was measured using a modified standardized acculturation instrument and predefined acculturation proxies. The self-care scores showed adequate self-care, with the mean scores of 78.6, 77.9, and 75.6 for self-care maintenance, monitoring, and management. Self-care self-efficacy mean score was 81.3. Acculturation was not significantly associated with self-care. Self-care self-efficacy was a strong determinant of self-care maintenance ( p < .0001), monitoring ( p < .0001), and management ( p < .0001). The perception of inadequate income was a significant determinant of poor self-care management ( p = .03). Self-care self-efficacy and perceived income adequacy were better determinants of self-care than acculturation.

Acting Proactively to Manage Job Insecurity: How Worrying About the Future of One’s Job May Obstruct Future-Focused Thinking and Behavior

An increasing number of people experience insecurity about the future of their job, making it more important than ever to manage this insecurity. While previous research suggests that proactive coping is a promising way to alleviate job insecurity, we suggest that, paradoxically, it may be particularly difficult to act proactively when feeling emotionally distressed about the future of one’s job. Drawing on the principle of resource scarcity and the Conservation of Resources theory, we propose that affective job insecurity ignites a scarcity mindset that inhibits workers’ future focus and cognitive functioning, thereby undermining proactive career behavior. Additionally, we examine whether income adequacy can compensate for these negative consequences of job insecurity. Results of a three-wave survey study among 108 self-employed professionals during the COVID-19 pandemic showed that initial affective job insecurity was negatively related to cognitive functioning but unrelated to future focus. Yet, the latter relationship was moderated by income adequacy: affective job insecurity was positively related to future focus when participants reported high income adequacy. In turn, future focus was positively related to proactive career behavior, which was subsequently related to lower cognitive job insecurity. Thus, while replicating the finding that workers can proactively manage their cognitive job insecurity, we also showed that initial affective job insecurity may obstruct people’s cognitive functioning. We discuss how our results signal a Matthew effect, in which job insecure people with sufficient means are able to look ahead and proactively build resources to change their career, while job insecure people with insufficient means may fall behind.

Pain and satisfaction: the case of isolated COVID-19 patients of Pakistan

Background Over 3 million people lost their lives across the globe due to the COVID-19 related pandemic. The unprecedented restrictions on mobility have imposed in the form of isolation, quarantines, and lockdowns to curb the profound effects of the pandemic and retain physical health. This study examined the relationship between various pain levels, demographic variables and patient satisfaction with COVID-19 during isolation. Methods The primary data in this study were collected from isolated patients during their isolation and treatment in a public hospital. We obtained information from patients with COVID-19 (N = 100) about their demographic characteristics, varying levels of pain, and satisfaction with the services provided during the isolation period. We computed the descriptive statistics to explain the profile of participants, ANOVA was used to find out the difference between various groups on patient satisfaction, and structural equation modeling was performed to examine the link between pain levels, demographic factors, and patient satisfaction. This analysis was performed with STATA and SmartPLS-3. Results The findings of this study ascertained that respondent’s education (Beta, β = 2.961, p = 0.003), assets such as possession of a house (β = 4.563, p = 0.000), perception of income adequacy during the lockdown (=2.299, p = 0.022), and negligence in prevention (β = 1.975, p = 0.049) significantly affects patient satisfaction during the isolation period. Moreover, satisfaction with life, physicians and medicine, income adequacy, and fear of the participants was significantly linked to the pain level (Model F-stat = 86.323, p = 0.0001). Patients who were satisfied with their treatment had significantly lower odds of having pain (OR 0.023, 95% CI [0.001–0.0452]). Patients who had enough income to meet their basic necessities were found to have significantly lower odds of having pain (OR 0.155, 95% CI [0.032–0.740]. Discussion and Conclusion We conclude that a higher level of education, low income, and living in a rented house contributes significantly to the feeling of more satisfaction with the provided services. This implies that people with more affluent backgrounds are less likely to be satisfied with the provided services as low-income and living in rented house groups are more satisfied during isolation than others. The pain level is also affected by subjective factors such as fear and satisfaction which need to be considered while doing patient management. This study can be helpful in improving the delivery of public services of isolation centers by considering various characteristics and demographic factors of patients.

COVID-19 Preparedness and the Anxiety of Thai Citizens

The outbreak of COVID-19 has brought sickness and fatality to Thai citizens. In addition, it left a tremendous psychological impact on mental health as they experienced panic and anxiety about controlling situations and preserving their physical and mental well-being. This study aimed to analyze the factors influencing COVID-19 preparedness and anxiety based on groups of Thai citizens. Online questionnaires were employed to collect data from 2,768 respondents selected through convenience sampling and snowball sampling on Facebook, having shared questionnaires with 190 other users. Data were collected from March 29 to April 3, 2020. The acquired data were analyzed using percentage and logistic regression analyses. It found that the influencing factors of preparedness included citizens’ sex, residing province, and work or off-house conditions. In contrast, the influencing factors of anxiety included their sex, age, residing province, and income adequacy. The results conveyed that Thai citizens were anxious about the pandemic and had been attempting to cope. In addition, issued policies should respond to the public promptly to prevent unnecessary panic and to maximize public cooperation against future situations put forth by the pandemic.

Does Stress-Related Poor Diet Quality Explain Socioeconomic Inequities in Health? A Structural Equation Mediation Analysis in Women and Men

Objectives Individuals with a lower socioeconomic position (SEP) have poorer health than their more advantaged counterparts. Psychosocial stress and diet quality have been shown to individually mediate associations between SEP and health, however studies have not yet investigated whether psychosocial stress and diet quality jointly mediate these associations. This is an important research question as stress-related unhealthy eating is often invoked as an explanation for diet-related health inequities, particularly among women, seemingly with no empirical justification. This study examined whether psychosocial stress and diet quality jointly mediate associations between SEP and self-rated health (SRH) in women and men. Methods Adults living in Canada who participated in the 2018 or 2019 International Food Policy Study were included (n = 5645). Participants reported SEP using indicators that reflect materialist (educational attainment, perceived income adequacy) and psychosocial pathways (subjective social status) underlying health inequities. Participants also reported psychosocial stress, dietary intake (to estimate diet quality via the Healthy Eating Index-2015) and SRH. Structural equation modelling simultaneously modelled multiple pathways linking the three indicators of SEP (educational attainment, perceived income adequacy, subjective social status) with SRH mediated by psychosocial stress and diet quality, stratified by gender. Results There was no evidence that psychosocial stress and diet quality jointly mediated associations between SEP and SRH in women or men. Diet quality mediated associations between educational attainment and SRH in women and men, and between subjective social status and SRH in men. Psychosocial stress mediated associations between perceived income adequacy and SRH in women and men, and between subjective social status and SRH in women. Conclusions Although often invoked as an explanation for diet-related health inequities, stress-related poor diet quality did not mediate associations between SEP and SRH in women or men. However, psychosocial stress and diet quality individually mediated some of these associations, indicating that SEP was partially embodied via these pathways, with some differences by gender. Funding Sources Canadian Institutes of Health Research.

Recall of government healthy eating campaigns by consumers in five countries

ABSTRACT Objective: To examine awareness and recall of healthy eating public education campaigns in five countries. Design: Data were cross-sectional and collected as part of the 2018 International Food Policy Study. Respondents were asked whether they had seen government healthy eating campaigns in the past year; if yes (awareness), they were asked to describe the campaign. Open-ended descriptions were coded to indicate recall of specific campaigns. Logistic models regressed awareness of healthy eating campaigns on participant country, age, sex, ethnicity, education, income adequacy and BMI. Analyses were also stratified by country. Setting: Online surveys. Participants: Participants were Nielsen panelists aged ≥18 years in Australia, Canada, Mexico, UK and US (n=22,463). Results: Odds of campaign awareness were higher in Mexico (50.9%) than UK (18.2%), Australia (17.9%), US (13.0%) and Canada (10.2%) (P<0.001). Awareness was also higher in UK and Australia versus Canada and US, and US versus Canada (P<0.001). Overall, awareness was higher among males versus females and respondents with medium or high versus low education (P<0.001 for all). Similar results were found in stratified models, although no sex difference was observed in Australia or UK (P>0.05), and age was associated with campaign awareness in UK (P<0.001). Common key words in all countries included sugar/sugary drinks, fruits and vegetables, and physical activity. The top five campaigns recalled were Chécate, mídete, muévete (Mexico), PrevenIMSS (Mexico), Change4Life (UK), LiveLighter® (Australia), and Actívate, Vive Mejor (Mexico). Conclusions: In Mexico, UK and Australia, comprehensive campaigns to promote healthy lifestyles appear to have achieved broad, population-level reach.

AWARENESS ON PENSION PLANS-A STUDY OF INVESTORS’ IN BENGALURU CITY

Individuals make inconsistent, irrational financial decisions mainly due to disproportionate time preferences. Bias and procrastination prevail. Along with a default option, there is a need for a customized plan with individuals' socio-cultural and economic status. Low participation rates are mainly due to a lack of awareness of pension literacy and behavioral aspects. Individuals have failed to create a corpus to protect themselves for retirement as there is a lack of awareness to suitability of a plan to one’s situation, failure to measure income adequacy at retirement, not able to identify the link between contributions made and pension drawdown, etc. Age and gender differences prevail strongly. Defined contribution plans are likely to dominate in global pension model in the years to come. Individuals are ready to own their risk but have little control and knowledge to cover themselves. Frequent timely and prompt advice or counseling from investment advisors will enable participants to understand the need, identify suitable options and schemes, and provide themselves with sustainable long-term savings. This should convert willingness to participate to real participation. Keywords: Financial literacy, Pension knowledge, Defined contribution pension plans (DCP), irrational decision making, demographics.

How Much Should the Poor Save for Retirement? Data and Simulations on Retirement Income Adequacy among Low-earning Households

A number of US states have introduced automatic enrollment retirement accounts as a means to raise retirement savings for lower-income households. The presumption is that such households, whose rates of formal retirement saving are low, would benefit from higher saving and higher incomes in retirement. Nevertheless, there has been little explicit analysis of how much lower-income households should save in excess of their social security contributions. There is also little evidence that many current lower-income retirees are unable to maintain their pre-retirement standards of living. To study this issue, this chapter builds a simple model of retirement saving, allowing for the inclusion of social security benefits, different standards of retirement income adequacy, and different assumptions regarding pre- and post-retirement investment returns. Interestingly, low-income retirees express less satisfaction with the adequacy of their retirement incomes than other retirees, but their self-assessed retirement income adequacy has actually increased in recent years. The chapter also shows that, for very low earners, little savings are necessary on top of social security payments.