Adverse childhood experiences (ACEs) and later-life depression: perceived social support as a potential protective factor.

OBJECTIVE: To investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these. METHOD: We analysed baseline data from the Mitchelstown (Ireland) 2010-2011 cohort of 2047 men and women aged 50-69 years. Self-reported measures included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale) and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by ACE scores and ACE subtypes abuse, neglect and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors. We tested whether the estimated associations varied across levels of PSS (poor, moderate and strong). RESULTS: 23.7% of participants reported at least one ACE (95% CI 21.9% to 25.6%). ACE exposures (overall, subtype or ACE scores) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. Exposure to any ACE (vs none) was associated with almost three times the odds of depressive symptoms (adjusted OR 2.85; 95% CI 1.64 to 4.95) among individuals reporting poor PSS, while among those reporting moderate and strong PSS, the adjusted ORs were 2.21 (95% CI 1.52 to 3.22) and 1.39 (95% CI 0.85 to 2.29), respectively. This pattern of results was similar when exposures were based on ACE subtype and ACE scores, though the interaction was clearly strongest among those reporting abuse. CONCLUSIONS: ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms, particularly among those with poor PSS. Interventions that enhance social support, or possibly perceptions of social support, may help reduce the burden of depression in older populations with ACE exposure, particularly in those reporting abuse

Challenges in modelling the random structure correctly in growth mixture models and the impact this has on model mixtures

Lifecourse trajectories of clinical or anthropological attributes are useful for identifying how our early-life experiences influence later-life morbidity and mortality. Researchers often use growth mixture models (GMMs) to estimate such phenomena. It is common to place constrains on the random part of the GMM to improve parsimony or to aid convergence, but this can lead to an autoregressive structure that distorts the nature of the mixtures and subsequent model interpretation. This is especially true if changes in the outcome within individuals are gradual compared with the magnitude of differences between individuals. This is not widely appreciated, nor is its impact well understood. Using repeat measures of body mass index (BMI) for 1528 US adolescents, we estimated GMMs that required variance-covariance constraints to attain convergence. We contrasted constrained models with and without an autocorrelation structure to assess the impact this had on the ideal number of latent classes, their size and composition. We also contrasted model options using simulations. When the GMM variance-covariance structure was constrained, a within-class autocorrelation structure emerged. When not modelled explicitly, this led to poorer model fit and models that differed substantially in the ideal number of latent classes, as well as class size and composition. Failure to carefully consider the random structure of data within a GMM framework may lead to erroneous model inferences, especially for outcomes with greater within-person than between-person homogeneity, such as BMI. It is crucial to reflect on the underlying data generation processes when building such models

Positive lifestyle changes around the time of pregnancy:a cross-sectional study

OBJECTIVES: To examine the prevalence of positive lifestyle behaviours before and during pregnancy in Ireland. DESIGN: Cross-sectional study. SETTING: Population-based study in Ireland. PARTICIPANTS: A total of 718 women of predominantly Caucasian origin from the Pregnancy Risk Assessment Monitoring System (PRAMS), Ireland, were included. PRIMARY AND SECONDARY OUTCOME MEASURES Positive lifestyle behaviour changes before and during pregnancy in Ireland on alcohol consumption, smoking, folate use and nutrition. RESULTS: Of 1212 women surveyed, 718 (59%) responded. 26% were adherent to all three recommendations on alcohol consumption, smoking and folate use before pregnancy. This increased to 39% for the same three behaviours during pregnancy, with greater increases in adherence observed among women with the lowest adherence before pregnancy. Age, education and ethnicity gaps in adherence before pregnancy appeared to narrow during pregnancy. Adherence to all seven food pyramid guidelines was less than 1% overall, and less than 1% of participants met all four micronutrient guidelines on vitamin D, folate, calcium and iron intake around the time of pregnancy. CONCLUSIONS: Low levels of healthy lifestyle behaviours before pregnancy and low levels of positive lifestyle behaviours during pregnancy demonstrate an urgent need for increased clinical and public health efforts to target deleterious health behaviours before, during and after pregnancy

The effect of SENATOR (Software ENgine for the Assessment and optimisation of drug and non-drug Therapy in Older peRsons) on incident adverse drug reactions (ADRs) in an older hospital cohort - Trial Protocol

Background: The aim of this trial is to evaluate the effect of SENATOR software on incident, adverse drug reactions (ADRs) in older, multimorbid, hospitalized patients. The SENATOR software produces a report designed to optimize older patients' current prescriptions by applying the published STOPP and START criteria, highlighting drug-drug and drug-disease interactions and providing non-pharmacological recommendations aimed at reducing the risk of incident delirium. Methods: We will conduct a multinational, pragmatic, parallel arm Prospective Randomized Open-label, Blinded Endpoint (PROBE) controlled trial. Patients with acute illnesses are screened for recruitment within 48 h of arrival to hospital and enrolled if they meet the relevant entry criteria. Participants' medical history, current prescriptions, select laboratory tests, electrocardiogram, cognitive status and functional status are collected and entered into a dedicated trial database. Patients are individually randomized with equal allocation ratio. Randomization is stratified by site and medical versus surgical admission, and uses random block sizes. Patients randomized to either arm receive standard routine pharmaceutical clinical care as it exists in each site. Additionally, in the intervention arm an individualized SENATOR-generated medication advice report based on the participant's clinical and medication data is placed in their medical record and a senior medical staff member is requested to review it and adopt any of its recommendations that they judge appropriate. The trial's primary outcome is the proportion of patients experiencing at least one adjudicated probable or certain, non-trivial ADR, during the index hospitalization, assessed at 14 days post-randomization or at index hospital discharge if it occurs earlier. Potential ADRs are identified retrospectively by the site researchers who complete a Potential Endpoint Form (one per type of event) that is adjudicated by a blinded, expert committee. All occurrences of 12 pre-specified events, which represent the majority of ADRs, are reported to the committee along with other suspected ADRs. Participants are followed up 12 (+/- 4) weeks post-index hospital discharge to assess medication quality and healthcare utilization. This is the first clinical trial to examine the effectiveness of a software intervention on incident ADRs and associated healthcare costs during hospitalization in older people with multi-morbidity and polypharmacy

Statistical review of Hydroxychloroquine in patients with COVID-19 : an open-label, randomized, controlled trial

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PERANAN PEMERINTAH DESA DALAM PEMBERDAYAAN MASYARAKAT ADAT DI KAMPUNG CIKONDANG DESA LAMAJANG KECAMATAN PANGALENGAN KABUPATEN BANDUNG

Penelitian ini berjudul “Peranan Pemerintah Desa dalam Pemberdayaan Masyarakat Adat di Kampung Cikondang Desa Lamajang Kecamatan Pangalengan Kabupaten Bandung”. Fenomena masalah penelitian yaitu banyak masyarakat keluarga kurang sejahtera, pengelolaan wisata kebudayaan belum berkembang, kurangnya keterbukaan pembuatan kebijakan, kurangnya anggaran dan fasilitas pendukung, serta jarangnya pelatihan. Penelitian bertujuan mendeskripsikan dan menganalisis bagaimana peranan Pemerintah Desa dalam pemberdayaan masyarakat adat di Kampung Cikondang Desa Lamajang, faktor penghambat dan upaya yang telah dilakukan. Pada penelitian ini menggunakan teori peranan dari Okke Rosmaladewi dalam Saufiah R, Arpandi, Saidah H (2024) “sebagai Regulator, Dinamisator, dan Fasilitator”, dengan pendekatan kualitatif deskriptif. Teknik pengumpulan data yaitu studi pustaka dan studi lapangan (observasi, wawancara dan dokumentasi). Teknik Analisis data yaitu reduksi data, penyajian data, dan pengambilan kesimpulan. Informan penelitian yaitu Kepala Desa, Sekretaris Desa, Ketua LPMD, RT03/RW03, RW03, Ketua Adat, dan masyarakat adat. Hasil Penelitian menunjukkan bahwa peranan Pemerintah Desa dalam pemberdayaan masyarakat adat di Kampung Cikondang Desa Lamajang sudah cukup optimal meliputi Dimensi Regulator sebagai pembuat kebijakan, meningkatkan produktivitas, dan mengatasi permasalahan. Dinamisator cukup optimal meliputi peningkatan kompetensi dan pemberdayaan berbasis partisipatif, belum optimal dalam mempercepat perubahan Desa. Fasilitator cukup optimal dalam penyediaan sarana prasarana dan pendidikan pelatihan, belum optimal dalam penyuluhan pendampingan, serta pemberian pelatihan teknis. &nbsp

PENGARUH KEPEMIMPINAN CAMAT TERHADAP EFEKTIVITAS PEMBERDAYAAN USAHA MIKRO KECIL DAN MENENGAH DI KECAMATAN PADALARANG KABUPATEN BANDUNG BARAT

Penelitian ini bertujuan untuk mengetahui sejauh mana pengaruh kepemimpinan camat terhadap efektivitas pemberdayaan Usaha Mikro, Kecil, dan Menengah (UMKM) di Kecamatan Padalarang, Kabupaten Bandung Barat. Latar belakang penelitian ini adalah masih belum optimalnya pelaksanaan program pemberdayaan UMKM di tingkat kecamatan, yang ditandai dengan rendahnya pemanfaatan fasilitas, terbatasnya promosi, serta minimnya pelatihan keterampilan bagi pelaku usaha. Penelitian ini menggunakan pendekatan kuantitatif deskriptif dengan jumlah populasi sebanyak 5.753 pelaku UMKM, dan sampel yang digunakan sebanyak 100 responden. Teknik pengumpulan data dilakukan melalui studi pustaka dan studi lapangan, seperti angket dan observasi langsung. Hasil penelitian menunjukkan bahwa kepemimpinan camat tergolong cukup baik dengan nilai rata-rata 1,95, dan efektivitas pemberdayaan UMKM juga berada pada kategori cukup baik dengan nilai rata-rata 1,98. Analisis statistik menghasilkan koefisien determinasi sebesar 94,09%, yang berarti terdapat pengaruh yang sangat kuat antara kepemimpinan camat dan efektivitas pemberdayaan UMKM. Temuan ini memperkuat pentingnya peran kepemimpinan lokal dalam menggerakkan sektor UMKM sebagai bagian dari pembangunan ekonomi daerah

Pengaruh Penggunaan Model Pembelajaran Kooperati Terhadap Hasil Belajar Siswa Kelas X Administrasi Perkantoran SMKN 1 Mandalle Kabupaten Pangkep

Penelitian ini bertujuan untuk mengetahui pengaruh media pembelajaran terhadap hasil belajar siswa kelas X Administrasi Perkantoran SMKN 1 Mandalle Kabupaten Pangkep. Penelitian ini menggunakan penelitian Kuantitatif dengan dengan populasi adalah seluruh siswa kelas X Administrasi Perkantoran yang berjumlah 43 siswa. Pengumpulan data dilakukan dengan cara menggunakan observasi, kuesioner (angket), wawancara, dan dokumentasi. Teknik analisis data yang digunakan adalah analisis statistic deskriptif dan analisis statistic inferensial. Hasil penelitian ini menunjukan bahwa model pembelajaran Kooperatif di SMKN 1 Mandalle tergolong kategori cukup baik, yang meliputi pencapaian hasil belajar, penerimaan terhadap keragaman, pengembangan ketrampilan sosial. Hasil belajar siswa kelas X Administrasi Perkantoran SMKN 1 Mandalle Kabupaten Pangkep tergolong dalam kategori cukup baik ditinjau dari nilai rapor siswa. Selanjutnya terdapat pengaruh model pembelajaran kooperatif pada mata pelajaran mengaplikasikan ketrampilan dasar komunikasi 2 terhadap hasil belajar siswa kelas X Administrasi perkantoran SMKN 1 Mandalle Kabupaten Pangkep. Tingkat pengaruh model pembelajaran kooperatif pada mata pelajaran mengaplikasikan ketrampilan dasar komunikasi 2 terhadap hasil belajar siswa kelas X Administrasi Perkantoran SMKN 1 Mandalle Kabupaten Pangkep tergolong sedang. Hal ini berarti siswa antara lain ditentukan oleh penggunaan model pembelajaran kooperatif dan sebaliknya dipengaruhi oleh faktor lainnya

PENGARUH PELAKSANAAN PROGRAM LITERASI DINAS PERPUSTAKAAN DAN ARSIP TERHADAP EFEKTIVITAS PEMBANGUNAN BUDAYA LITERASI DI KECAMATAN RANCABALI KABUPATEN BANDUNG

Indeks Pembangunan Literasi Masyarakat (IPLM) Kabupaten Bandung mengalami penurunan signifikan sebesar 28,3% di tahun 2023. Penelitian ini bertujuan untuk mengetahui pengaruh pelaksanaan program literasi Dinas Perpustakaan dan Arsip terhadap efektivitas pembangunan budaya literasi di Kecamatan Rancabali, Kabupaten Bandung. Penelitian ini dilakukan di Dinas Perpustakaan dan Arsip Kabupaten Bandung dan di Kecamatan Rancabali Kabupaten Bandung. Metode penelitian yang digunakan adalah kuantitatif eksplanatif dengan pengumpulan data utama melalui kuesioner, serta wawancara, dan observasi sebagai data pendukung. Penelitian ini melibatkan 100 responden masyarakat Rancabali. Data dianalisis menggunakan SPSS versi 29. Hasil penelitian menunjukkan bahwa pelaksanaan program literasi dikategorikan cukup baik meskipun masih terdapat kelemahan dalam konsistensi jadwal dan dalam hal evaluasi yang masih satu arah. Efektivitas pembangunan budaya literasi di Kecamatan Rancabali juga tergolong cukup baik, namun dukungan literasi di lingkungan masyarakat masih rendah. Terdapat pengaruh positif dan signifikan antara pelaksanaan program literasi dengan efektivitas pembangunan budaya literasi, dibuktikan dengan nilai thitung (5,744) > ttabel (1,661) dan signifikansi 0,01 < 0,05. Koefisien determinasi sebesar 0,252 mengindikasikan kontribusi program literasi terhadap efektivitas pembangunan budaya literasi sebesar 25,2%, dengan tingkat korelasi sedang (r = 0,502)

Environmental and developmental determinants of obesity in Cebu, Philippines

Obesity is now recognized as a serious challenge to global public health. Obesity is often viewed as a problem that results from a deficiency in a person's character; that obesity is the consequence of gluttony and sloth. However, obesity is impacted by a variety of factors that are largely exogenous to human choices. We investigated both how shared environment and individual level socio-economic status influence obesity risk, as well as how prenatal characteristics can increase human susceptibility to the obesogenic effects of modern environments before we are even born. Analyses were conducted using data from the Cebu Longitudinal Health and Nutrition Survey, a community based study of a one year birth cohort (1983) followed up until young adulthood (2005). Using the spatial scan statistic we found that measures of overweight and obesity were spatially clustered in the study area Metro Cebu. The locations of these clusters coincided with the urban core of Cebu, but also extended into peri-urban and rural areas as well. Clustering in the males was largely explained by the spatial distribution of individual level socio-economic status. We then used multivariable linear models to explore the joint impact of community level urbanicity and multiple indicators of individual level socio-economic status on multiple measures of overweight and obesity. We found that socioeconomic status was positively associated with obesity in males but not females. Lastly, we tested the mismatch hypothesis, which generally posits that maternal constraint of fetal growth can lead to developmental changes in utero that increase an individual's susceptibility to obesogenic environments. More specifically, we found that that the positive association between socio-economic status and central adiposity in male study participants was amplified in firstborns. This research helps fill an important gap in understanding how socio-environmental conditions can influence obesity in a lower-income, rapidly developing context. We also provide one of the earliest explicit tests of the mismatch hypothesis with respect to birth order. The public health consequences of these associations could become critical as obesogenic environments become more common, and the proportion of lower order pregnancies among humans increases