Latent classes of sleep problems and subjective cognitive decline among middle-aged and older adults in the United States.

Objective: Previous studies have linked sleep problems to subjective cognitive decline (SCD) using a variable-centered approach (e.g., adding sleep symptoms to form a score); however, sleep problems may cluster differently between individuals.

Material Need Insecurities among People on Hemodialysis: Burden, Sociodemographic Risk Factors, and Associations with Substance Use.

Key Points: Food insecurity and housing instability may affect dialysis outcomes through health behaviors like treatment adherence and their effect on access to transplantation or home dialysis therapies. People on hemodialysis who were younger, with less educational attainment, with lower incomes, or experiencing financial strain were more likely to experience material need insecurities. Participant race was not associated with material need insecurities, although residential segregation moderated associations between age, sex, and food insecurity.

Measuring social norms and attitudes about age-disparate transactional sex: Psychometric testing of the NAATSS.

Background: Transactional sex between girls under 18 years-old and adult men at least ten years older, known as age-disparate transactional sex (ADTS), is an established risk factor for HIV, STI and early pregnancy among girls and women. Social norms or beliefs about what others expect from you and what others do can sustain behaviours such as ADTS even when individuals may be personally against them. In order to evaluate interventions to change social norms, validated instruments for measuring change in personal beliefs and social norms regarding ADTS are needed.

The relationship between older adults' technology use, in-person engagement, and pandemic-related mental health.

Objective: The objectives of this study are to 1) describe changes in in-person communication/activity and changes in older adult technology use during the COVID-19 pandemic and 2) examine whether less in-person communication/activity mediates the relationship between pandemic-related mental health and technology use.

Method: Linear regressions (stratified by age and financial strain) and structural equation modeling were employed using a nationally representative, cross-sectional survey of 3,188 older adults from the 2020 National Health and Aging Trends Study's COVID-19 Questionairre.

Results: Older adults engaged in more technology-based activity (b = 0.

Exterior housing conditions are associated with objective measures of poor sleep among low-income older adults with disabilities.

Objective: To examine the association of housing and neighborhood conditions with sleep among disadvantaged older adults.

Methods: We used data from 136 low-income, predominantly Black older adults with disabilities. Predictors were indices of: interior housing conditions (eg, pests, tripping hazards); exterior housing conditions (eg, broken windows); and neighborhood disorder (eg, litter, vacant buildings).

Objectively measured sleep and physical function: Associations in low-income older adults with disabilities.

Objective: Late-life sleep health has been tied to physical function, but little is known about these associations among socially disadvantaged populations.

Design: We determined cross-sectional associations of sleep with physical function in low-income, predominantly Black older adults with disabilities.

Participants: One hundred thirty-six older adults (mean age 76.

A Comparison of Safety, Health, and Well-Being Risk Factors Across Five Occupational Samples.

The aim of this study was to present safety, health and well-being profiles of workers within five occupations: call center work ( = 139), corrections ( = 85), construction ( = 348), homecare ( = 149), and parks and recreation ( = 178). Baseline data from the Data Repository of Oregon's Healthy Workforce Center were used. Measures were compared with clinical healthcare guidelines and national norms.

Longitudinal Impact of the myPlan App on Health and Safety Among College Women Experiencing Partner Violence.

The objective of this study was to examine differences in change over time in health and safety outcomes among female college students randomized to myPlan, a tailored safety planning app, or usual web-based safety planning resources. Three hundred forty-six women (175 intervention, 171 control) from 41 colleges/universities in Oregon and Maryland completed surveys at baseline, 6- and 12-months from July 2015 to October 2017. Generalized estimating equations were used to test group differences across time.

Correlates of reproductive coercion among college women in abusive relationships: baseline data from the college safety study.

The purpose of this study was to examine correlates of reproductive coercion (RC) among a sample of college women in abusive relationships. 354 college students reporting a recent history of intimate partner violence (IPV). This study examines baseline data from a randomized controlled trial testing effectiveness of an interactive safety decision aid (myPlan).

Distinct clusters of older adults with common neuropsychological symptoms: Findings from the National Health and Aging Trends Study.

This study aims to identify distinct clusters of community-dwelling older adults (N = 7580) based on characteristics of common neuropsychological symptoms and examine how these clusters differ in socio-demographics and health-related attributes. Four clusters were identified: 1-No Symptoms (41%), 2-Pain Only (32%), 3-Pain+Moderate+Insomnia+Mild Depression+Mild Anxiety (17%), and 4-Pain+Mild insomnia+Moderate Depression+Moderate Anxiety (10%). Compared to clusters 1 and 2, individuals in clusters 3 and 4 tended to be older, Hispanic or non-Hispanic Black, female, obese, have high school education or less, not live with anyone, and rate their health fair or poor.

Using natural language processing of clinical text to enhance identification of opioid-related overdoses in electronic health records data.

Purpose: To enhance automated methods for accurately identifying opioid-related overdoses and classifying types of overdose using electronic health record (EHR) databases.

Methods: We developed a natural language processing (NLP) software application to code clinical text documentation of overdose, including identification of intention for self-harm, substances involved, substance abuse, and error in medication usage. Using datasets balanced with cases of suspected overdose and records of individuals at elevated risk for overdose, we developed and validated the application using Kaiser Permanente Northwest data, then tested portability of the application using Kaiser Permanente Washington data.

Patterns and Usefulness of Safety Behaviors Among Community-Based Women Survivors of Intimate Partner Violence.

Women who experience intimate partner violence (IPV) use a variety of safety strategies to reduce the frequency and severity of violence, including both informal and formal help-seeking. The purpose of this study was to identifying patterns of engagement in safety behaviors by U.S.

Identifying and classifying opioid-related overdoses: A validation study.

Purpose: The study aims to develop and validate algorithms to identify and classify opioid overdoses using claims and other coded data, and clinical text extracted from electronic health records using natural language processing (NLP).

Methods: Primary data were derived from Kaiser Permanente Northwest (2008-2014), an integrated health care system (~n > 475 000 unique individuals per year). Data included International Classification of Diseases, Ninth Revision (ICD-9) codes for nonfatal diagnoses, International Classification of Diseases, Tenth Revision (ICD-10) codes for fatal events, clinical notes, and prescription medication records.

Fall Ascertainment and Development of a Risk Prediction Model Using Electronic Medical Records.

Objectives: To examine the use of electronic medical record (EMR) data to ascertain falls and develop a fall risk prediction model in an older population.

Design: Retrospective longitudinal study using 10 years of EMR data (2004-2014). A series of 3-year cohorts included members continuously enrolled for a minimum of 3 years, requiring 2 years pre-fall (no previous record of a fall) and a 1-year fall risk period.

How Equity-Oriented Health Care Affects Health: Key Mechanisms and Implications for Primary Health Care Practice and Policy.

Unlabelled: Policy Points A consensus regarding the need to orient health systems to address inequities is emerging, with much of this discussion targeting population health interventions and indicators. We know less about applying these approaches to primary health care. This study empirically demonstrates that providing more equity-oriented health care (EOHC) in primary health care, including trauma- and violence-informed, culturally safe, and contextually tailored care, predicts improved health outcomes across time for people living in marginalizing conditions.

Lifetime prevalence, correlates and health consequences of gender-based violence victimisation and perpetration among men and women in Somalia.

Background: Humanitarian emergencies increase the risk of gender-based violence (GBV). We estimated the prevalence of GBV victimisation and perpetration among women and men in urban settings across Somalia, which has faced decades of war and natural disasters that have resulted in massive population displacements.

Methods: A population-based survey was conducted in 14 urban areas across Somalia between December 2014 and November 2015.

Experiences of Racism and Preterm Birth: Findings from a Pregnancy Risk Assessment Monitoring System, 2004 through 2012.

Background: Racial disparities in birth outcomes represent a significant public health concern in the United States. Factors associated with racism have been posited as a mechanism underlying these disparities. Yet, findings from previous studies are mixed and based on small, geographically limited samples.

Effects of primary care clinician beliefs and perceived organizational facilitators on the delivery of preventive care to individuals with mental illnesses.

Background: Although many studies have documented patient-, clinician-, and organizational barriers/facilitators of primary care among people with mental illnesses, few have examined whether these factors predict actual rates of preventive service use. We assessed whether clinician behaviors, beliefs, characteristics, and clinician-reported organizational characteristics, predicted delivery of preventive services in this population.

Methods: Primary care clinicians (n = 247) at Kaiser Permanente Northwest (KPNW) or community health centers and safety-net clinics (CHCs), in six states, completed clinician surveys in 2014.

Colorectal Cancer Screening Completion Among Individuals With and Without Mental Illnesses: A Comparison of 2 Screening Methods.

Purpose: Cancer mortality is worse among people with psychiatric disorders. The purpose of this study was to compare facilitators and rates of colorectal cancer (CRC) screening between people with and without mental illnesses.

Design: We conducted a secondary analysis using data from a general population cohort study (N = 92 445) that assessed effects of 2 types of CRC screening test kits-guaiac fecal occult blood testing (gFOBT) and fecal immunochemical testing (FIT)-on CRC screening completion.

Preventive Service Use Among People With and Without Serious Mental Illnesses.

Introduction: People with serious mental illnesses experience excess morbidity and premature mortality resulting from preventable conditions. The goal was to examine disparities in preventive care that might account for poor health outcomes.

Methods: In this retrospective cohort study, adults (N=803,276) served by Kaiser Permanente Northwest and federally qualified health centers/safety-net community health clinics were categorized into five groups: schizophrenia spectrum disorders, bipolar disorders/affective psychoses, anxiety disorders, nonpsychotic unipolar depression, and reference groups with no evidence of these specific mental illnesses.

Association between self-reported sexually transmitted infection treatment and mental health symptoms in conflict-affected eastern Democratic Republic of the Congo.

Although poor mental health has been associated with sexual risk behavior, few studies have examined the association between mental health and sexually transmitted infections (STIs) in conflict-affected settings. With elevated symptoms of poor mental health in conflict-affected settings, it is important to consider if and how mental health may be a risk factor for STIs in these settings. We used cross-sectional logistic regression to examine the association between symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) with having been treated for an STI in rural South Kivu, Democratic Republic of the Congo.

Methodologic considerations of household-level methicillin-resistant Staphylococcus aureus decolonization among persons living with HIV.

Background: People living with HIV (PLWH) have a higher prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization and likelihood of recurrent infection than the general population. Simultaneously treating MRSA-colonized household members may improve success with MRSA decolonization strategies. This article describes a pilot trial testing household-level MRSA decolonization and documents methodologic and pragmatic challenges of this approach.

Randomised controlled trial of a livestock productive asset transfer programme to improve economic and health outcomes and reduce intimate partner violence in a postconflict setting.

Background: Diverse economic empowerment programmes (eg, microcredit, village-led savings and loan, cash and productive asset transfers) for the poor have demonstrated mixed results as vehicles for improved economic stability, health and women's empowerment. However, limited rigorous evaluations exist on the impact of financial and non-financial outcomes of these programmes, especially in conflict-affected areas.

Methods: The team evaluated the effectiveness of an innovative livestock productive asset transfer intervention-Pigs for Peace (PFP)-on economic, health and women's empowerment outcomes with participants in households in 10 villages in Eastern Democratic Republic of Congo.

Preventing risky behaviours among young adolescents in eastern Democratic Republic of Congo: A qualitative study.

This qualitative study explores and describes adolescent risk behaviours, specifically consumption of alcohol and use of violence; the perceived consequences of these behaviours on future well-being and relationships; and collaboratively identifies the essential components of a prevention intervention for risk behaviours (alcohol use, violence) among young adolescents while strengthening the protective individual and relationship factors in post-conflict Democratic Republic of Congo. One-on-one in-depth interviews were conducted with 28 male and female youth, 20 parents/guardians and 20 stakeholders in three rural villages of South Kivu Province. Trained interviewers conducted interviews and participated in daily debriefing.