nimizing the impact of gait-related oscillations to the head, as evidenced by reduced mediolateral attenuation in older fallers.There is strong evidence linking relationships and emotions to physical health outcomes. What is critically missing is a more comprehensive understanding of how these important psychosocial factors influence disease over the lifespan. In this narrative review, existing lifespan models of social support and emotion regulation are reviewed and integrated into a general conceptual framework in the health domain. This integrated model takes into account bidirectional links between relationships and emotions, as well as health behaviors, biological pathways, and health. Evidence is consistent with the utility of an integrative model attempting to understand its links to health-relevant pathways and outcomes in older adults. Future work that examines multiple pathways using prospective designs will be necessary for this work to reach its full potential, including intervention and policy opportunities.Frailty is an important consequence of ageing, whereby frail patients are more likely to face adverse outcomes, such as disability and death. Risk of frailty increases in people with poor biological health, and has been shown in many ethnicities and countries. In economically developed countries, 10% of older adults are living with frailty. Ethnic minorities in the West face significant health inequalities. However, little is known about frailty prevalence and the nature of frailty in different ethnic groups. This has implications for healthcare planning and delivery, especially screening and the development of interventions. Global frailty prevalence is variable low- to middle-income countries demonstrate higher rates of frailty than high-income countries, but available evidence is low. Little is known about the characteristics of these differences. However, female sex, lower economic status, lower education levels, and multimorbidity are identified risk factors. Ethnic minority migrants in economically developed countries demonstrate higher rates of frailty than white indigenous older people and are more likely to be frail when younger. Similar patterns are also seen in indigenous ethnic minority marginalised groups in economically developed countries such as the US, Australia and New Zealand, who have a higher prevalence of frailty than the majority white population. Tirzepatide peptide Frailty trajectories between ethnic minority migrants and white indigenous groups in high-income countries converge in the ‘oldest old’ age group, with little or no difference in prevalence. Frailty risk can be attenuated in migrants with improvements in integration, citizenship status, and access to healthcare. Ethnicity may play some role in frailty pathways, but, so far, the evidence suggests frailty is a manifestation of lifetime environmental exposure to adversity and risk accumulation.

To explore the attitudes, confidence and social norm of Dutch occupational physicians (OPs) regarding menopause in a work context.

A nationwide cross-sectional exploratory design. An invitation to participate in an online survey was sent to all OPs registered at the Dutch occupational physicians’ society (n = 1663). This survey collected data about attitudes, confidence, social norm and current practice of OPs regarding menopause and work. Descriptive statistics and post hoc logistic multivariate analyses were used to evaluate the data.

Attitudes, confidence and social norms in relation to menopause and work.

Data from 267 OPs were analysed. Most OPs do recognize a role for menopause in presenteeism and sickness absence. However, 48% stated that women with bothersome menopausal symptoms are ‘not sick’ and ‘just experiencing symptoms of a normal physiological process’. Over 56% of OPs find it difficult to assess the relationship between menopausal symptoms and work ability, and 63% to report menopause as a diagnosis in the context of a sick leave certification. Over 56% of OPs acknowledge that talking about menopause in the workplace is a taboo. A positive attitude towards menopause (OR 1.11, 95% CI 1.02-1.20) and greater confidence (OR 1.22, 95% CI 1.14-1.31) were associated with significantly higher levels of diagnosing menopause in sick leave certification.

Dutch OPs generally have a positive attitude towards menopause, but perceive a lack of knowledge and a taboo culture around menopause in a work context. They indicate a need for education and a guideline on menopause and work.

Dutch OPs generally have a positive attitude towards menopause, but perceive a lack of knowledge and a taboo culture around menopause in a work context. They indicate a need for education and a guideline on menopause and work.

Various combinations of estrogens and progestogens are available for menopausal hormone therapy that differ in their efficacy and safety profile. We evaluated the efficacy and long-term safety of low-dose estradiol (0.5 mg) / dydrogesterone (2.5 mg) in subgroups of postmenopausal women with vasomotor symptoms.

Efficacy analysis was performed on data from 2 previously published studies for subgroups defined by age, duration of menopause, and body mass index at baseline. The primary efficacy variable was the number of moderate to severe hot flushes from baseline to week 13. Long-term safety was evaluated in relation to age and duration of menopause. Safety variables included adverse events to week 52 and change from baseline to endpoint in laboratory and vital sign values.

The treatment difference seen in the overall population in favour of low-dose estradiol/dydrogesterone was also observed in the subgroups of patients aged 45 to < 55 years (p < 0.01) and ≥55 years (p < 0.05), with menopause duration of >12 months to <60 months (p < 0.05) and ≥ 60 months (p < 0.005), and with a BMI at baseline of <25 kg/m

(p < 0.05) and 25 to <30 kg/m

(p < 0.01). Low-dose estradilol/dydrogesterone was well tolerated across the different subgroups. The incidence of breast-related adverse events was very low. No breast malignancy was reported. Only one adverse endometrial outcome of simple hyperplasia was observed.

The results of our analyses confirmed the consistent treatment effect on vasomotor symptoms and the favourable safety profile of 0.5 mg 17β estradiol and 2.5 mg dydrogesterone in different patient subgroups.

The results of our analyses confirmed the consistent treatment effect on vasomotor symptoms and the favourable safety profile of 0.5 mg 17β estradiol and 2.5 mg dydrogesterone in different patient subgroups.