Associations Between Oral Health Status, Perceived Stress, and Neuropsychiatric Symptoms Among Community Individuals With Alzheimer's Disease: A Mediation Analysis

Community individuals with Alzheimer's disease (AD) experience oral disease alongside neuropsychiatric symptoms (NPS) with disease progression. Despite growing evidence for the link between oral health and cognitive status, few studies have investigated the associations between oral health and NPS, especially based on individuals' experience of AD. The primary aim of this study was to examine (a) the difference in oral health-related stressors among individuals with AD, mild cognitive impairment (MCI), and subjective cognitive decline (SCD); and (b) the associations of these stressors with NPS under the framework of the stress process model (SPM). A cross-sectional study was conducted among individuals diagnosed with AD (n = 35), MCI (n = 36) or SCD (n = 35), matched for age, sex education, and body mass index (BMI). Multiple regression and mediation model analyses were performed to explore predictors and their relationships with NPS based on the SPM. Data collection comprised four sections: (a) individual context; (b) oral health-related stressors, including dental caries, periodontal status, oral hygiene, the geriatric oral health assessment index (GOHAI), oral salivary microbiota, pro-inflammatory cytokines, and oral health behavior; (c) subjective stressors (i.e., perceived stress [PS]); and (d) NPS. Decayed, missing, and filled teeth (DMFT), missing teeth (MT), loss of attachment (LoA), plaque index (PLI), PS, oral health behavior, GOHAI, pro-inflammatory cytokines, and salivary bacterial composition were significantly different among the three groups; these parameters were poorer in the AD group than SCD and/or MCI group. LoA, PLI, PS, and pain or discomfort in the GOHAI were directly associated with NPS. PLI, LoA, and psychosocial function in the GOHAI indirectly affected NPS, and this relationship was mediated by PS. Individuals with AD reported greater oral health-related stressors. This study identifies direct and indirect associations linking oral health-related stressors and PS with NPS in individuals with AD. Our findings suggest that targeted dental care and oral-related stressor control may be valuable for managing NPS.

Smokers' Engagement Behavior on Facebook regarding to Smoking Cessation Verbalization and Facebook Reaction Usage: Content Analysis (Preprint)

BACKGROUND The Transtheoretical Model recommends "processes of change", while the Motivational Interviewing approach offers “motivational language” as indicators of health behavior change. The relationship between these indicators and the usage of Facebook reaction buttons is little known. However, this relationship may highlight how to evaluate one of the most popular engagement indicators (Facebook reactions) in online health behavior change interventions. OBJECTIVE The study aim was to understand the relationship between processes of change, motivational language, Facebook users’ gender, and the Facebook reaction buttons. METHODS A total of 821 comments were analyzed in the current study (N=821), which came from different Facebook users, and responded to image-based, smoking cessation support contents. The processes of change (experiential and behavioral processes) and the motivational language (change talk and sustain talk) in the investigated comments were identified. The presence, the number, and the proportion of these linguistic categories were compared with the Facebook users’ gender and the usage of reaction buttons. RESULTS The Facebook users who used the “Haha” reaction button wrote significantly higher proportion of sustain talk than those who used the “Like” or “Love” reaction (P=.011). No significant difference in the number or proportion of linguistic categories was found between those who used the "Like" reaction button, and those who did not use reaction buttons. The Facebook users who combined the comment and “Love” reaction wrote significantly more change talk than those who used the “Haha” and “Like” reactions, or those who did not utilize these buttons (P<.001). Significant female dominance was observed in the presence, the number, and the proportion of experiential processes and change talk (P<.05). In addition, significant male predominance was found in the presence, the number, and the proportion of sustain talk (P<.05). CONCLUSIONS The "Haha" reaction may be a negative engagement indicator, the "Like" reaction may be a neutral engagement indicator, and the "Love" reaction may be a positive engagement indicator in terms of the smoking cessation during Facebook-based interventions. Furthermore, female engagement may be characterized by utilizing the terms of experiential processes and change talk, while the usage of sustain talk can be typical for male engagement. We recommend the evaluation of processes of change and motivational utterances in participants' comments during online public health interventions.

I'm wearing a mask, but are they?: Perceptions of Self-Other Differences in COVID-19 Health Behaviors

As information about COVID-19 safety behavior changed, people had to judge how likely others were to protect themselves through mask-wearing and vaccination seeking. In a large, campus-wide survey, we assessed whether University of Kansas students viewed others' protective behaviors as different from their own, how much students assumed others would share their beliefs and behaviors, and which individual differences were associated with those estimations. Participants in our survey (N = 1,704; 81.04% white, 64.08% female) evaluated how likely they and others were to wear masks on the University of Kansas campus, wear masks off-campus, and seek a vaccine. They also completed measures of political preference, numeracy, and preferences for risk in various contexts. We found that participants estimated that others would be less likely to engage in health safety behaviors than themselves, but that their estimations of others were widely shared. In addition, of all the individual differences we assessed, political preference displayed the most consistent associations across health behaviors. Not only was false uniqueness ubiquitous across different forms of COVID-19 safety behavior, it was indeed false - estimates of others' health behavior were lower than their actual rates. Understanding this relationship could allow for more accurate norm-setting and normalization of mask-wearing and vaccination.

Structural Equation Model for Evaluating Factors Affecting Health-related Quality of Life in Adolescents With Moyamoya Disease: Based on Salutogenesis Theory

BackgroundMoyamoya disease is a cerebrovascular disorder and a significant chronic health concern requiring regular monitoring to control the disease and its related complications.ObjectiveTo develop a structural model based on the salutogenesis theory, and to identify how social support, sense of coherence, and stress contribute to health behaviors, subjective health status, and quality of life in adolescents with moyamoya disease.MethodsWe examined a hypothetical model by integrating the concepts of a structural health-related quality-of-life model based on the salutogenesis theory among 239 adolescents with moyamoya disease in Korea. Data on health-related quality of life of adolescents with moyamoya disease were collected using the following scales: social support rating scale, sense of coherence scale, stress scale, health behavior scale, subjective health status scale, and quality-of-life scale. A structural equation model was used to analyze the data.ResultsThe final model demonstrated goodness-of-fit. A sense of coherence directly influenced quality of life (β = 0.504, p < 0.01) and indirectly influenced quality of life (β = 0.299, p < 0.05) through health behavior. Stress (β = -0.414, p < 0.001) and health behavior (β = -0.085, p < 0.01) directly influenced quality of life. Social support directly influenced health behavior (β = 0.321, p < 0.01) and subjective health status (β = 0.112, p < 0.01).DiscussionSince moyamoya disease, a chronic disease, is progressive, it is very important to identify factors for health promotion.This study found that sense of coherence and social support were significant factors contributing to lower stress, improved health, and quality of life in adolescents with moyamoya disease. This paper is intended to help health experts to develop an intervention strategy based on theory as an approach for chronic disease management.

Drivers of Pigeon Pea Consumption Among School-Aged Children in Central Tanzania

Background: Protein energy malnutrition (PEM) and iron deficiencies (ID) are of major public health concern in Tanzania including among school-aged children. PEM and ID in early childhood have serious, long-term consequences because they impede motor, sensory, social and emotional development, growth retardation, poor cognitive development, learning disability of children, lowered resistance to infectious diseases, and reduced physical work capacity. The objective of this study was to elucidate the drivers of pigeon pea consumption among school-aged children in Dodoma district, Central Tanzania. Understanding these drivers would be useful in promoting pigeon pea consumption among school-aged children as one of the strategies to increase dietary protein and iron intake.Methods: This study was a cross-sectional study in which data were collected using a questionnaire based on a combination of the Theory of Planned Behavior and Health Belief Model. The data were collected from caregivers (n = 138) in four villages in Kongwa district, Dodoma region, Central Tanzania. We used correlations and multiple regressions to assess associations between constructs and identify predictive constructs. Mann–Whitney U tests were used for score comparisons with a significant p-value set at &lt;0.10.Results: Health value was significantly correlated with health behavior identity (rs = 0.63, p &lt; 0.001) and also significantly predicted health behavior identity (rs = 0.49, p = 0.001). The constructs cues to action and control belief were significantly associated with intention (β = −0.41, p = 0.059 and β = 0.06, p = 0.019 respectively). Finally, we observed that intention was a significant predictor of behavior (β = 1.38, p = 0.001). We also observed a significant negative interaction between perceived barriers and intention to consume pigeon pea (β = −0.04, p = 0.006), indicating that perceived barriers limit intention to consume pigeon pea.Conclusion and Implication: Our findings indicate that when the caregiver places increased importance on preventing her school-aged child from being iron or protein deficient or indeed anemic (health value), it results in a positive evaluation of the effectiveness of giving pigeon pea to address these nutrient deficiencies. Programs and efforts aimed at promoting pigeon pea consumption should focus on educating caregivers on iron and protein deficiency and the role that pigeon pea could play in addressing these. However, perceived barriers such as pest infestation during storage need to be addressed to increase pigeon pea consumption. The involvement of post-harvest management specialists is therefore crucial. Along with this, increasing productivity and crop management is also crucial to ensure year-round affordable supply of pigeon pea.