Treatment of Older Adult Patients with Glioblastoma: Moving towards the Inclusion of a Comprehensive Geriatric Assessment for Guiding Management

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, and over half of patients with newly diagnosed GBM are over the age of 65. Management of glioblastoma in older patients includes maximal safe resection followed by either radiation, chemotherapy, or combined modality treatment. Despite recent advances in the treatment of older patients with GBM, survival is still only approximately 9 months compared to approximately 15 months for the general adult population, suggesting that further research is required to optimize management in the older population. The Comprehensive Geriatric Assessment (CGA) has been shown to have a prognostic and predictive role in the management of older patients with other cancers, and domains of the CGA have demonstrated an association with outcomes in GBM in retrospective studies. Furthermore, the CGA and other geriatric assessment tools are now starting to be prospectively investigated in older GBM populations. This review aims to outline current treatment strategies for older patients with GBM, explore the rationale for inclusion of geriatric assessment in GBM management, and highlight recent data investigating its implementation into practice.

Association of Psychological Resilience with All-Cause and Cardiovascular Mortality in a General Population in Italy: Prospective Findings from the Moli-Sani Study

Psychological resilience (PR) is the capacity to adapt positively in face of adversity. Its role as an independent protective factor has been acknowledged in recent years. We aimed to test the association of PR with all-cause and cardiovascular disease (CVD) mortality in a general adult population. We performed longitudinal analyses on 10,406 CVD-free individuals from the Moli-Sani cohort (follow up = 11.2 year). PR was assessed by the 25-item Connor and Davidson resilience scale. PR factors were identified through polychoric factor analysis. Associations with mortality were tested using multivariable Cox regressions. Higher levels of PR were associated with reduced all-cause mortality in a model including sex and age (HR = 0.78; 95%CI 0.62–1.00). The association decreased after inclusion of socioeconomic, clinical, and behavioral factors into the model (HR = 0.80; 95%CI 0.62–1.03). No relation was observed with cardiovascular mortality in the fully adjusted model (HR = 0.89; 95%CI 0.56–1.39). An inverse association of Factor 1 (reflecting positive acceptance of change) with all-cause mortality (HR = 0.89; 95%CI 0.82–0.98; p value = 0.01) was found. However, at a borderline non-significant way, PR predicts all-cause mortality in a general population of Italian adults. This is supported by the findings demonstrating a significant association between the PR’s domain reflecting a positive acceptance of change and all-cause mortality.

A Critical Analysis on the Social Determinants of Health in Disabled Population

This paper addresses the social determinants of health affecting the disabled population. It is considered that the prevalence of disability among the general adult population is significant. Furthermore, this paper presents a comprehensive analysis to identify the key social determinants which are highly applicable to health inequities and inequalities. Correspondingly, recommendations are critically proposed and laid out to address the issues impacting the given population. The health interventions and stakeholders involved are also critically examined to provide a broader perspective on the issue.

Association between pesticide exposure and sleep health among a representative sample of US adults: evidence from NHANES 2009–2014

Background Data suggest that pesticides interact with the melatonin receptor, which may influence sleep. However, the link between pesticides and sleep remains unexplored among the general adult population. This study evaluated unstratified and sex-stratified associations between urinary pesticide exposure (N = 4,478) and self-reported acute household pesticide exposure (N = 14,956), with sleep health outcomes within a nationally representative sample of US adults. Methods Data from the National Health and Nutrition Examination Surveys (NHANES) 2009–2014 were combined for analysis of aim 1 and aim 2. Urinary pesticide metabolite concentrations served as biomarkers of pesticide exposure. Acute household pesticide exposure (if any chemical products were used in the home in the past seven days to control pests) was self-reported (yes/no). Insufficient sleep duration (< 7 h/night) and trouble sleeping (yes/no) were self-reported. Log-binomial regression models that accounted for complex survey weights and adjusted for confounders were used to compute prevalence ratios and 95% CI. Results Log urinary 3-phenoxybenzoic acid (3-PBA) was related to a higher probability of insufficient sleep [1.09 (95% CI: 1.00, 1.20), p = 0.04] and trouble sleeping [1.14 (95% CI: 1.02, 1.27), p = 0.02] among males. Self-reported acute household pesticide exposure was associated with a higher probability of insufficient sleep duration [1.16 (95% CI: 1.02, 1.32), p = 0.03] and trouble sleeping [1.20 (95% CI: 1.01, 1.44), p = 0.04] in the unstratified sample. Sex-stratified findings showed that associations between acute household pesticide exposure and trouble sleeping only persisted among males [1.69 (95% CI: 1.27, 2.24), p < .001]. Conclusions In summary, acute pesticide exposure may be detrimental to adult sleep health, particularly among US males.

Comparison of hesitancy between COVID-19 and seasonal influenza vaccinations within the general Hungarian population: a cross-sectional study

Background The willingness to get COVID-19 or seasonal influenza vaccines has not yet been thoroughly investigated together, thus, this study aims to explore this notion within the general adult population. Methods The responses of 840 Hungarian participants were analysed who took part in a nationwide computer-assisted telephone interviewing. During the survey questions concerning various demographic characteristics, perceived financial status, and willingness to get the two types of vaccines were asked. Descriptive statistics, comparative statistics and word co-occurrence network analysis were conducted. Results 48.2% of participants were willing to get a COVID-19 vaccine, while this ratio for the seasonal influenza was only 25.7%. The difference was significant. Regardless of how the participants were grouped, based on demographic data or perceived financial status, the significant difference always persisted. Being older than 59 years significantly increased the willingness to get both vaccines when compared to the middle-aged groups, but not when compared to the younger ones. Having higher education significantly elevated the acceptance of COVID-19 vaccination in comparison to secondary education. The willingness of getting any type of COVID-19 vaccine correlated with the willingness to get both influenza and COVID-19. Finally, those who were willing to get either vaccine coupled similar words together to describe their thoughts about a COVID-19 vaccination. Conclusion The overall results show a clear preference for a COVID-19 vaccine and there are several similarities between the nature of willingness to get either type of vaccine.

The acceptability of COVID-19 vaccination during spring crisis in Myanmar

Background: During the spring crisis, the coup and COVID-19 have led to a weakening vaccination program and Myanmar’s coronavirus prevention measures have been collapsed. The objective of this study was to determine the COVID-19 vaccine acceptance and assess its associated factors among the general adult population in Myanmar.Methods: A cross-sectional, web-based survey was conducted with a total of 301 participants. The association between vaccine acceptability and its determinants was assessed by binary logistic regression analysis.Results: The majority (90.4%) responded that they would like to accept vaccination if it is successfully developed and approved for listing in the future. Among the respondents, two-fifths (40.5%) had already received 1st dose of the COVID-19 vaccine, and 86.4% of the respondents thought that doctor’s recommendation is a crucial factor in vaccination decision-making, while 70.4% responded that vaccine price is an essential factor. If the younger age of participants who possessed lower monthly household income and agreed that the doctor’s recommendation is an important factor in vaccine decision making, the probability of accepting vaccine was more chance than those of older age participants.Conclusions: The study highlighted that majority of the respondents wanted to accept the vaccine although they were concerned about the side effects and political unrest. It is the recommended to develop a strategy successfully to strengthen vaccine convenience.

Representativeness of individual-level data in COVID-19 phone surveys: Findings from Sub-Saharan Africa

The COVID-19 pandemic has created urgent demand for timely data, leading to a surge in mobile phone surveys for tracking the impacts of and responses to the pandemic. Using data from national phone surveys implemented in Ethiopia, Malawi, Nigeria and Uganda during the pandemic and the pre-COVID-19 national face-to-face surveys that served as the sampling frames for the phone surveys, this paper documents selection the biases in individual-level analyses based on phone survey data. In most cases, individual-level data are available only for phone survey respondents, who we find are more likely to be household heads or their spouses and non-farm enterprise owners, and on average, are older and better educated vis-a-vis the general adult population. These differences are the result of uneven access to mobile phones in the population and the way that phone survey respondents are selected. To improve the representativeness of individual-level analysis using phone survey data, we recalibrate the phone survey sampling weights based on propensity score adjustments that are derived from a model of an individual’s likelihood of being interviewed as a function of individual- and household-level attributes. We find that reweighting improves the representativeness of the estimates for phone survey respondents, moving them closer to those of the general adult population. This holds for both women and men and for a range of demographic, education, and labor market outcomes. However, reweighting increases the variance of the estimates and, in most cases, fails to overcome selection biases. This indicates limitations to deriving representative individual-level estimates from phone survey data. Obtaining reliable data on men and women through future phone surveys will require random selection of adult interviewees within sampled households.

Knowledge, awareness and practice of vitamin D among population of Qassim Region, Saudi Arabia before and during COVID-19 pandemic

One billion people globally have been affected by vitamin D deficiency and its associated diseases; therefore, the present study was aimed to estimate the knowledge, awareness and practices of vitamin D in the Qassim region of the adult population before and during the COVID-19 pandemic. A cross-sectional survey was conducted among 195 of the general adult population in the Qassim region, Saudi Arabia from 15th September 2020 to 25th October 2020. The results revealed that a high percentage of participants are cognizant of vitamin D (93.8%). Also, it appears that there was no association between knowledge and awareness of vitamin D and age, gender, education or social status. Around 82.6% of the participants know the sources of vitamin D and the majority of participants enjoy sun exposure (79%), where the most time exposed to the sun is early in the morning and after 3 pm, reported to at 43.6% and 52.3%, respectively. In addition, about 35% of participants increased their knowledge of vitamin D after the emergence of COVID-19. A high percentage of participants thought that vitamin D raising the body immunity against viral infection or improve immunity, in general, was at 67.7%, that thought that vitamin D prevents or increase resistance to COVID-19. From the foregoing results, it could be concluded that a high level of knowledge and awareness about vitamin D in adults living in the Qassim region and increased knowledge after the emergence of COVID-19 is the most important result of the current study.

Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis

Background Older adults (aged 65 years and above) constitute the fastest growing population cohort in the western world. There is increasing evidence that the burden of infections disproportionately affects older adults, and hence this vulnerable population is frequently exposed to antimicrobials. There is currently no systematic review summarising the evidence for organ injury risk among older adults following antimicrobial exposure. This systematic review and meta-analysis examined the relationship between antimicrobial exposure and organ injury in older adults. Methodology We searched for original research articles in PubMed, Embase.com, Web of Science core collection, Web of Science BIOSIS citation index, Scopus, Cochrane Central Register of Controlled Trials, ProQuest, and PsycINFO databases, using key words in titles and abstracts, and using MeSH terms. We searched for all available articles up to 31 May 2021. After removing duplicates, articles were screened for inclusion into or exclusion from the study by two reviewers. The Newcastle-Ottawa scale was used to assess the risk of bias for cohort and case-control studies. We explored the heterogeneity of the included studies using the Q test and I2 test and the publication bias using the funnel plot and Egger’s test. The meta-analyses were performed using the OpenMetaAnalyst software. Results The overall absolute risks of acute kidney injury among older adults prescribed aminoglycosides, glycopeptides, and macrolides were 15.1% (95% CI: 12.8–17.3), 19.1% (95% CI: 15.4–22.7), and 0.3% (95% CI: 0.3–0.3), respectively. Only 3 studies reported antimicrobial associated drug-induced liver injury. Studies reporting on the association of organ injury and antimicrobial exposure by age or duration of treatment were too few to meta-analyse. The funnel plot and Egger’s tests did not indicate evidence of publication bias. Conclusion Older adults have a significantly higher risk of sustaining acute kidney injury when compared to the general adult population. Older adults prescribed aminoglycosides have a similar risk of acute kidney injury to the general adult population.