Financial stress and depression in adults:A systematic review

Financial stress has been proposed as an economic determinant of depression. However, there is little systematic analysis of different dimensions of financial stress and their association with depression. This paper reports a systematic review of 40 observational studies quantifying the relationship between various measures of financial stress and depression outcomes in adults. Most of the reviewed studies show that financial stress is positively associated with depression. A positive association between financial stress and depression is found in both high-income and low-and middle-income countries, but is generally stronger among populations with low income or wealth. In addition to the “social causation” pathway, other pathways such as “psychological stress” and “social selection” can also explain the effects of financial stress on depression. More longitudinal research would be useful to investigate the causal relationship and mechanisms linking different dimensions of financial stress and depression. Furthermore, exploration of effects in subgroups could help target interventions to break the cycle of financial stress and depression

The cost of primary care consultations associated with long COVID in non-hospitalised adults:a retrospective cohort study using UK primary care data

Abstract Background The economic impact of managing long COVID in primary care is unknown. We estimated the costs of primary care consultations associated with long COVID and explored the relationship between risk factors and costs. Methods Data were obtained on non-hospitalised adults from the Clinical Practice Research Datalink Aurum primary care database. We used propensity score matching with an incremental cost method to estimate additional primary care consultation costs associated with long COVID (12 weeks after COVID-19) at an individual and UK national level. We applied multivariable regression models to estimate the association between risk factors and consultations costs beyond 12 weeks from acute COVID-19. Results Based on an analysis of 472,173 patients with COVID-19 and 472,173 unexposed individuals, the annual incremental cost of primary care consultations associated with long COVID was £2.44 per patient and £23,382,452 at the national level. Among patients with COVID-19, a long COVID diagnosis and reporting of longer-term symptoms were associated with a 43% and 44% increase in primary care consultation costs respectively, compared to patients without long COVID symptoms. Older age, female sex, obesity, being from a white ethnic group, comorbidities and prior consultation frequency were all associated with increased primary care consultation costs. Conclusions The costs of primary care consultations associated with long COVID in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with long COVID, those with long COVID symptoms, older adults, females, and those with obesity and comorbidities

Financial literacy and mental health

Being one of the essential skills in the 21st Century, financial literacy is important in its own right and for individuals’ life-long financial well-being. Financial literacy has been associated with a series of positive financial outcomes in previous literature. However, we still know little about how financial literacy is related to individuals’ mental well-being. This thesis aims to investigate the relationships between financial literacy, financial well-being and mental well-being among adults. To realise this, three empirical studies are conducted. The first empirical study examines the relationship between financial literacy and depressive symptoms, providing the first empirical evidence of the relationship between the two concepts in a middle-income setting: China. The second empirical study provides the first longitudinal investigation on the relationship between financial literacy and depression and its underlying economic pathways, using data from a nationally representative dataset: the Health and Retirement Study (HRS) based on the U.S.. The third empirical study investigates the moderating role of financial literacy in the association between financial shocks and depression aiming to further enclose the relationship between financial literacy and mental well-being. The findings highlight both positive and negative effects of financial literacy on mental well-being. On one hand, financial literacy is significantly associated with fewer depressive symptoms and financial literacy may positively impact individuals’ mental well-being either directly or indirectly operated through its influence on household finances such as income and wealth. On the other hand, when individuals experience financial shocks, financial literacy can magnify the negative effect of experiencing financial shocks on mental well-being. The findings suggest that investing in acquiring or sustaining financial literacy may have the potential to protect against depression and thus promote positive mental health in adults by assuring better financial well-being. However, the observed negative psychological effect of higher financial literacy suggests that the role of financial literacy on mental health is complex. Future research is needed to further understandings of the causal impact of enhancing financial literacy on mental well-being and of its complex and multifaceted underly mechanisms

Home Non-Invasive Ventilation in COPD: A Global Systematic Review.

Background Uncertainty remains around the benefit of home non-invasive ventilation (NIV) for stable chronic obstructive pulmonary disease (COPD) patients and those with a recent exacerbation (post-hospital). The aim of this systematic review was to: (1) update the evidence base with studies published in any language, including Chinese language studies not indexed in standard medical databases, and (2) explore the impact of additional studies on the evidence base. Methods Standard systematic review methodology was used for identifying and appraising studies. Randomized controlled trials (RCTs) and non-randomized studies reporting mortality, hospitalizations, exacerbations, quality of life, adverse events, or adherence were included. Random effects meta-analysis was undertaken for mortality and hospitalizations, with studies sub-grouped by population and study design. Sensitivity analysis was performed to explore the effect of including studies from Western and non-Western countries. Results A total of 103 studies were included, substantially more than in previous reviews. There was no significant effect on mortality for the stable population. There was a benefit from NIV for the post-hospital population based on non-randomized studies, or RCTs from non-Western countries. There was a small but significant reduction in hospital admissions (1-2/year) with NIV across all sub-groups, and a variable reduction in duration of stay with greater reductions in studies from China. Conclusions The evidence base on home NIV is considerably larger than previously presented. While NIV may reduce hospital admissions and improve quality of life, there is still little evidence of a reduction in mortality, regardless of country. Individual participant data analysis may clarify which patients would benefit most from NIV

G-rich Oligonucleotides Inhibit HIF-1α and HIF-2α and Block Tumor Growth

Hypoxia-inducible factor-1 (HIF-1) plays crucial roles in tumor promotion by upregulating its target genes, which are involved in energy metabolism, angiogenesis, cell survival, invasion, metastasis, and drug resistance. The HIF-1α subunit, which is regulated by O2-dependent hydroxylation, ubiquitination, and degradation, has been identified as an important molecular target for cancer therapy. We have rationally designed G-rich oligodeoxynucleotides (ODNs) as inhibitors of HIF-1α for human cancer therapy. The lead compounds, JG243 and JG244, which form an intramolecular parallel G-quartet structure, selectively target HIF-1α and decreased levels of both HIF-1α and HIF-2α (IC50 < 2 µmol/l) and also inhibited the expression of HIF-1-regulated proteins [vascular endothelial growth factor (VEGF), Bcl-2, and Bcl-XL], but did not disrupt the expression of p300, Stat3, or p53. JG-ODNs induced proteasomal degradation of HIF-1α and HIF-2α that was dependent on the hydroxylase activity of prolyl-4-hydroxylase-2. JG243 and JG244 dramatically suppressed the growth of prostate, breast, and pancreatic tumor xenografts. Western blots from tumor tissues showed that JG-ODNs significantly decreased HIF-1α and HIF-2α levels and blocked the expression of VEGF. The JG-ODNs are novel anticancer agents that suppress tumor growth by inhibiting HIF-1