Difference in predictors and barriers to arts and cultural engagement with age in the United States: A cross-sectional analysis using the Health and Retirement Study

INTRODUCTION: Arts and cultural engagement are associated with a range of mental and physical health benefits, including promoting heathy aging and lower incidence of age-related disabilities such as slower cognitive decline and slower progression of frailty. This suggests arts engagement constitutes health-promoting behaviour in older age. However, there are no large-scale studies examining how the predictors of arts engagement vary with age. METHODS: Data from the Health and Retirement Study (2014) were used to identify sociodemographic, life satisfaction, social, and arts appreciation predictors of (1) frequency of arts engagement, (2) cultural attendance, (3) difficulty participating in the arts, and (4) being an interested non-attendee of cultural events. Logistic regression models were stratified by age groups [50-59, 60-69, ≥70] for the frequency of arts participation outcome and [50-69 vs ≥70] all other outcomes. RESULTS: Findings indicated a number of age-related predictors of frequent arts engagement, including gender, educational attainment, wealth, dissatisfaction with aging, and instrumental activities of daily living (iADL). For cultural event attendance, lower interest in the arts predicted lack of engagement across age groups, whereas higher educational attainment and more frequent religious service attendance became predictors in older age groups (≥ 70). Adults in both age groups were less likely to report difficulties engaging in the arts if they had lower neighbourhood safety, whilst poor self-rated health and low arts appreciation also predicted reduced likelihood of this outcome, but only in the younger (50-69) age group. Adults in the older (≥ 70) age group were more likely to be interested non-attendees of cultural events if they had higher educational attainment and less likely if they lived in neighbourhoods with low levels of safety. CONCLUSIONS: Our results suggest that certain factors become stronger predictors of arts and cultural engagement and barriers to engagement as people age. Further, there appear to be socioeconomic inequalities in engagement that may increase in older ages, with arts activities overall more accessible as individuals age compared to cultural engagement due to additional financial barriers and transportation barriers. Ensuring that these activities are accessible to people of all ages will allow older adults to benefit from the range of health outcomes gained from arts and cultural engagement

HUBUNGAN ANTARA CURAH HUJAN, SUHU UDARA DAN KELEMBABAN DENGAN KEJADIAN DEMAM BERDARAH DENGUE DI KOTA MANADO TAHUN 2015-2020

Kasus demam berdarah dengue (DBD) masih tinggi di Manado. Kondisi lingkungan diduga berpengaruh pada angka kejadian DBD tersebut. Tujuan penelitian ini yaitu untuk mengetahui hubungan curah hujan, suhu udara, dan kelembaban dengan kejadian Demam Berdarah Dengue di Kota Manado tahun 2015-2020. Penelitian ini adalah studi korelasional menggunakan data kejadian DBD, curah hujan, suhu udara dan kelembaban di Manado dari Januari 2015 – Desember 2020. Hubungan faktor-faktor lingkungan ini dengan angka kejadian DBD dianalisis menggunakan grafik dan analisis korelasi Spearman. Hasil analisis menunjukkan adanya hubungan antara curah hujan (rho = 0,32; p = 0,006) dan suhu udara (rho = -0,41; p < 0,001) dengan angka kejadian DBD. Namun demikian, hubungan kelembaban dengan kejadian DBD tidak signifikan (rho = 0,12; p = 0,299). Penduduk Manado di daerah dengan curah hujan relatif tinggi dan suhu udara cenderung lebih rendah dari wilayah lain di Manado perlu meningkatkan kewaspadaan terhadap perjangkitan DBD. Penelitian ini memperlihatkan adanya hubungan antara faktor-faktor lingkungan tersebut dengan kejadian DBD di Manado. Kata Kunci: Kejadian DBD, Curah Hujan, Suhu Udara, Kelembaban ABSTRACTThe prevalence of dengue hemorrhagic fever (DHF) remains high in Manado. It has been suggested that certain environmental factors play a role in the number of cases. The objective of this study was to evaluate the relationship of precipitation, ambient temperature, and humidity with the prevalence of DHF in Manado. This was a correlational study using the data on rainfall rate, ambient temperature, and humidity in Manado recorded between January 2015 and December 2020 by the local department of meteorology and geophysics, as well as the information about DHF number of cases at the same period as published by the Health Department of Manado. The relationship between these environmental factors and DHF prevalence was analyzed using graphs and Spearman correlation. The results of the analysis showed a significant relationship between precipitation (rho = 0.32; p = 0.006) and air temperature (rho = -0.41; p < 0.001) with the prevalence of DHF. However, there was no significant relationship found between humidity and DHF prevalence (rho = 0.12; p = 0.299). Manado residents in areas with relatively high rainfall and air temperatures tend to be lower than other areas in Manado need to increase vigilance against DHF infection. This study shows a link between these environmental factors and the incidence of DHF in Manado. Keyword: DHF Prevalence, Precipitation, Ambient Temperature, Humidit

A life less lonely: the state of the art in interventions to reduce loneliness in people with mental health problems

PURPOSE: There is growing evidence of significant harmful effects of loneliness. Relatively little work has focused on how best to reduce loneliness in people with mental health problems. We aim to present an overview of the current state of the art in loneliness interventions in people with mental health problems, identify relevant challenges, and highlight priorities for future research and implementation. METHODS: A scoping review of the published and grey literature was conducted, as well as discussions with relevant experts, to propose a broad classification system for types of interventions targeting loneliness. RESULTS: We categorised interventions as ‘direct’, targeting loneliness and related concepts in social relationships, and ‘indirect’ broader approaches to well-being that may impact on loneliness. We describe four broad groups of direct interventions: changing cognitions; social skills training and psychoeducation; supported socialisation or having a ‘socially-focused supporter’; and ‘wider community approaches’. The most promising emerging evidence appears to be in ‘changing cognitions’, but, as yet, no approaches have a robust evidence base. Challenges include who is best placed to offer the intervention, how to test such complex interventions, and the stigma surrounding loneliness. CONCLUSIONS: Development of clearly defined loneliness interventions, high-quality trials of effectiveness, and identifying which approaches work best for whom is required. Promising future approaches may include wider community initiatives and social prescribing. It is important to place loneliness and social relationships high on the wider public mental health and research agenda

Determination of the Acceleration Region Size in a Loop-structured Solar Flare

In order to study the acceleration and propagation of bremsstrahlung-producing electrons in solar flares, we analyze the evolution of the flare loop size with respect to energy at a variety of times. A GOES M3.7 loop-structured flare starting around 23:55 on 2002 April 14 is studied in detail using \textit{Ramaty High Energy Solar Spectroscopic Imager} (\textit{RHESSI}) observations. We construct photon and mean-electron-flux maps in 2-keV energy bins by processing observationally-deduced photon and electron visibilities, respectively, through several image-processing methods: a visibility-based forward-fit (FWD) algorithm, a maximum entropy (MEM) procedure and the uv-smooth (UVS) approach. We estimate the sizes of elongated flares (i.e., the length and width of flaring loops) by calculating the second normalized moments of the intensity in any given map. Employing a collisional model with an extended acceleration region, we fit the loop lengths as a function of energy in both the photon and electron domains. The resulting fitting parameters allow us to estimate the extent of the acceleration region which is between $\sim 13 \rm{arcsec}$ and $\sim 19 \rm{arcsec}$. Both forward-fit and uv-smooth algorithms provide substantially similar results with a systematically better fit in the electron domain.The consistency of the estimates from these methods provides strong support that the model can reliably determine geometric parameters of the acceleration region. The acceleration region is estimated to be a substantial fraction ($\sim 1/2$) of the loop extent, indicating that this dense flaring loop incorporates both acceleration and transport of electrons, with concurrent thick-target bremsstrahlung emission.Comment: 8 pages, 5 figures, accepted to Astronomy and Astrophysics journa

Genetic diversity in Cypripedium calceolus (Orchidaceae) with a focus on north-western Europe, as revealed by plastid DNA length polymorphisms

Background and Aims Cypripedium calceolus, although widespread in Eurasia, is rare in many countries in which it occurs. Population genetics studies with nuclear DNA markers on this species have been hampered by its large nuclear genome size. Plastid DNA markers are used here to gain an understanding of variation within and between populations and of biogeographical patterns. Methods Thirteen length-variable regions (microsatellites and insertions/deletions) were identified in non-coding plastid DNA. These and a previously identified complex microsatellite in the trnL-trnF intergenic spacer were used to identify plastid DNA haplotypes for European samples, with sampling focused on England, Denmark and Sweden. Key Results The 13 additional length-variable regions identified were two homopolymer (polyA) repeats in the rps16 intron and a homopolymer (polyA) repeat and ten indels in the accD-psa1 intergenic spacer. In accD-psa1, most of these were in an extremely AT-rich region, and it was not possible to design primers in the flanking regions; therefore, the whole intergenic spacer was sequenced. Together, these new regions and the trnL-trnF complex microsatellite allowed 23 haplotypes to be characterized. Many were found in only one or a few samples (probably due to low sampling density), but some commoner haplotypes were widespread. Most of the genetic variation was found within rather than between populations (83 vs. 18%, respectively). Two haplotypes occurred from the Spanish Pyrenees to Sweden. Conclusions Plastid DNA data can be used to gain an understanding of patterns of genetic variation and seed-mediated gene flow in orchids. Although these data are less information-rich than those for nuclear DNA, they present a useful option for studying species with large genomes. Here they support the hypothesis of long-distance seed dispersal often proposed for orchid

Hospital Resource Utilization and Treatment Cost of Skeletal-Related Events in Patients with Metastatic Breast or Prostate Cancer: Estimation for the Portuguese National Health System

BACKGROUND: Skeletal-related events (SREs) occur frequently in patients with bone metastases as a result of breast (BC) and prostate (PC) cancers. They increase both morbidity and mortality and lead to extensive health-care resource utilization. METHODS: Health care resource utilization by BC/PC patients with at least one SRE during the preceding 12 months was assessed through retrospective chart review. SRE-treatment costs were estimated using the Portuguese Ministry of Health cost database and analyzed using generalized linear models. RESULTS: This study included 152 patients from nine hospitals. The mean (SD) annual SRE-treatment cost per patient was €5963 (€3646) and €5711 (€4347), for BC (n=121) and PC (n=31) patients, respectively. Mean cost per single episode ranged between €1485 (radiotherapy) and €13,203 (spinal cord compression). Early onset of bone metastasis (P = 0.03) and diagnosis of bone metastases at or after the occurrence of the first SRE (P < 0.001) were associated with higher SRE-treatment costs. CONCLUSION: These results reveal the high hospital SRE-treatment costs, highlighting the need for early diagnosis and treatment, and identify key factors determining the economic value of therapies for patients with skeletal metastases