Academia mental health & well-being最新文献

Background: Cognitive screening tools such as the Montreal Cognitive Assessment (MoCA) are widely used to detect cognitive impairments. However, their accuracy in low- and middle-income countries (LMICs) may be affected by variations in educational levels. This study examined the impact of educational attainment on MoCA performance in older Ugandan adults, considering sex- and age-related differences.

Methods: A cross-sectional study was conducted in Wakiso District, Uganda, involving adults aged ≥ 65 years. Their MoCA scores were analyzed in relation to their educational attainment, sex, and age. Multiple linear regression models were used to determine the independent effect of education on cognitive performance after adjusting for age and sex. Sensitivity analyses were conducted using multiple imputations for missing data.

Results: Higher educational attainment was significantly associated with a better MoCA performance (β = 1.73, 95% CI: 1.22-2.24, p < 0.001). Age was negatively associated with MoCA scores (β = -0.13, 95% CI: -0.19 to -0.07, p < 0.001), whereas male sex was positively associated (β = 1.89, 95% CI: 0.56-3.22, p = 0.005). The interaction terms (education × sex and education × age) were not significant, indicating that the effect of education was consistent across demographic subgroups. The final regression model explained 42.7% of the variance in the MoCA scores (adjusted R² = 0.43, p < 0.001). The sensitivity analysis confirmed the robustness of the findings.

Conclusions: Educational attainment impacts MoCA performance in older Ugandans, highlighting the need for region-specific norms and culturally adapted cognitive screening in LMICs.

This study expands upon syndemics, structural vulnerability, and health care utilization frameworks by examining individual and social factors influencing help-seeking, care barriers, and treatment satisfaction among sexual minority women (SMW; e.g., bisexual, lesbian) aged 50+ from Wave 3 of a community-based longitudinal study, the Chicago Health and Life Experiences of Women Study. Wave 3 data were collected in 2010-2012 (May 2010 to August 2012). Bivariate analyses were conducted to examine associations among help-seeking behaviors, self-rated physical and mental health, relationship status, and social support. We used multivariate logistic regression models to examine (1) associations between sociodemographic characteristics and help-seeking, (2) associations between help-seeking and treatment satisfaction variables and sociodemographic characteristics, (3) self-rated physical health and self-rated mental health as predictors of help-seeking and treatment satisfaction, and (4) interpersonal factors as predictors of help-seeking and treatment satisfaction. Participants (N = 196) were, on average, 58.15 years of age (SD = 6.61). Physical health and issues related to depression, anxiety, memory, and eating are synergistic among older SMW. Those with insufficient household incomes and identifying as bisexual, Black, or younger were more likely to seek help. Black and Latinx SMW reported fewer help-seeking barriers than White SMW. Self-rated poorer mental health was associated with greater difficulty accessing services; sociodemographic variables weakened this association. Poorer mental health and lower social support were associated with treatment dissatisfaction. Results highlight the relevance of structural vulnerabilities and social determinants of health among older SMW, emphasizing the need for integrated, culturally competent care models that enhance access and improve treatment satisfaction.

HappiGenius is a mindfulness-based social-emotional learning (SEL) program developed and initially deployed in the context of COVID-19. Novel features of the HappiGenius program include the use of behavioral practice and activities to enhance traditional classroom-based learning, the capability to teach in a remote setting, and a focus on internalizing behaviors in addition to traditionally targeted externalizing behaviors. A pilot study of four third-grade classrooms completed in the previous academic year showed promising results for improvements in students' experience of positive affect, self-compassion, total difficulties, and prosocial behaviors. This quasi-experimental case-control study was conducted in 14 third-grade classrooms across four schools in a midsize Midwestern US city. We hypothesized that HappiGenius would lead to improvements in positive affect, self-compassion, and mindfulness, in addition to other social behaviors measured by quantitative standardized scales. We used qualitative methodology to determine whether HappiGenius was feasible and acceptable to teachers for use in the classroom. While there was no statistically significant change in positive affect, self-compassion, or mindfulness, there was meaningful improvement in student internalizing problems and peer problems. Analysis of qualitative data showed the importance of timing during the year to maximize classroom benefits like establishing behavioral expectations early and reducing problem behaviors. The study represents a step in the direction of evaluating the implementation and outcomes of a new social-emotional learning program developed with deliberate attention to internalizing problems alongside traditionally studied externalizing problems.

In developing countries like Uganda, people with dementia are cared for by non-medically trained family members with minimal support from the formal healthcare system. The quality of care in this setting is largely unknown but significantly affects the well-being of those with dementia. A tool designed to measure the quality of informal care for old frail adults with or without dementia was translated into Luganda. A committee of experts reviewed and finalized the translation, which was pilot-tested and then used to measure the quality of dementia self-care. We consecutively enrolled 105 caregivers of elderly people with dementia; the median age was 35 years (Interquartile Range 26-47 years), and 67% were females, taking care of a grandparent (44%) or a parent (34%). We used confirmatory factor analysis to assess for structural validity and computed correlation coefficients and Cronbach's alpha to assess for discriminant validity and internal reliability, respectively. The three-factor model applied to the 20 items, adequately fit the data (Comparative Fit Index = 0.88, Tucker-Lewis Index = 0.87, Root Mean Square Error of Approximation = 0.08; 90% Confidence Interval (0.06-0.09), Standardized Root Mean Square Residual = 0.089). There was good discriminant validity, and correlation coefficients between dimensions/scales and the Dementia Knowledge Assessment Scale scores were low. There was good internal reliability with all items Cronbach's alpha ranging from 0.69 to 0.89. Our findings demonstrated that this culturally adapted, shorter measurement tool is valid and reliable. The tool can be used by researchers, health workers, and agencies to assess the quality of self-care for elderly people with dementia in Uganda.

This study aims to address Alzheimer's disease and related dementias (ADRD) in low- and middle-income countries (LMICs). It involves adaptation of the World Health Organization's iSUPPORT (WHO-iSUPPORT) psychosocial intervention for Uganda, assessing its feasibility and acceptability, and its effects on caregivers' psychological distress, quality of life (QoL), and depression levels. The adapted iSUPPORT (UGA-iSUPPORT) program was translated into Luganda, a local language, validated by experts, divided into four modules, and later piloted for four weeks in Wakiso, Uganda. The caregivers were randomly assigned to receive weekly UGA-iSUPPORT sessions or modified standard care via weekly phone consultations. Baseline and endpoint changes were assessed using the Kessler Psychological Distress Scale (K-10), the Centre for Epidemiological Studies Depression Scale (CES-D), and the Measure of Quality of Life for Dementia Caregivers (C-DEMQOL). The intervention group (n = 33, 87.9% females, mean age 32.5 years) showed significant improvements in psychological distress (decreased from 29.2 to 23.7, p = 0.001), depression (from 33.4 to 25.6, p = 0.001), and QoL (from 81.1 to 89.4, p = 0.001). The control group (n = 32, 50% female, mean age 36.7 years) did not experience similar enhancements. The high retention rate (97%) and positive feedback from the participants underscored the program's feasibility and acceptability. UGA-iSUPPORT effectively boosted the mental health and well-being of dementia caregivers in LMICs. This study highlights the necessity of enduring and expandable interventions within healthcare systems. Further studies are warranted to examine these interventions' prolonged impacts.