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Toth EE, Ihász F, Ruíz-Barquín R, Szabo A. Physical Activity and Psychological Resilience in Older Adults: A Systematic Review of the Literature. J Aging Phys Act 2024; 32:276-286. [PMID: 37699587 DOI: 10.1123/japa.2022-0427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/25/2023] [Accepted: 06/21/2023] [Indexed: 09/14/2023]
Abstract
Older adults face numerous unfavorable functional changes caused by aging, but many exhibit resilience, which helps them cope with challenges. Physical activity is positively associated with resilience. Therefore, this systematic literature review aimed to uncover the relationships between physical activity and resilience in older adults. We have analyzed three freely and openly available databases: (a) PubMed/Medline, (b) ScienceDirect, and (c) Google Scholar, which yielded 20 eligible articles based on the inclusion and exclusion criteria. Most studies (14) were cross-sectional, three were longitudinal, and three others used mindfulness-based or endurance-enhancing physical activity interventions. Their results revealed increased resilience even after short-duration and low-frequency interventions. Cross-sectional research results also support the positive relationship between physical activity and resilience in older adults, suggesting that the relationship might depend on exercise volume. Still, further research is needed to design interventions, understand the mechanism(s) involved in altering resilience, and maximize physical activity's benefits in aging people.
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Affiliation(s)
- Eliza E Toth
- Doctoral School of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University Budapest, Budapest, Hungary
| | - Ferenc Ihász
- Faculty of Education and Psychology, Institute of Sport Science, ELTE Eötvös Loránd University, Szombathely, Hungary
| | - Roberto Ruíz-Barquín
- Facultad de Formación de Profesorado y Educación, Universidad Autónoma de Madrid, Madrid, Spain
| | - Attila Szabo
- Faculty of Education and Psychology, Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
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2
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Wong MYC, Ou KL, Man Leung K. Investigating and promoting health behaviors reactivity among Hong Kong older adults in the post-COVID-19 Era: An exploratory network analysis. PLoS One 2023; 18:e0293512. [PMID: 37917757 PMCID: PMC10621926 DOI: 10.1371/journal.pone.0293512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/14/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Physical distance has increased the risk of developing a variety of health problems, especially among older people. During the COVID-19 lockdown period, physical activity decreased, screen time increased, food consumption increased, as well as exposure to unhealthy behaviour, leading to poorer sleep quality and more negative emotions, which ultimately led to poorer physical health, mental health, and subjective vitality among older adults. Although there were numerous research studies on changes in health behaviours during COVID-19, only a few were targeted at older adults, and none were conducted in Asian countries. METHOD The current study is aiming to identify the changes in health behaviours, as well as their associations with older adults' mental health as a result of the COVID-19 pandemic among Hong Kong older adults, using exploratory network analysis. In this study, a random tele-survey was conducted among older adults. RESULTS A total of 664 participants have been involved in the telephone survey, with 213 males and 451 females, of which mean age was 74.37. The explored network showed strong centrality and edge stability, thus enabling to reveal an overview of the associations between health behaviours and mental well-being of older adults. The lavaan model has also demonstrated the casual paths within the explored network, which indicated the significant impact of sleeping quality, eating habits and social networking on resilience. CONCLUSION The outcomes of the study were able to identify the lifestyle changes of Hong Kong older adults due to COVID-19. Although the present study is not regarded as novel internationally, it may be representative of the Hong Kong community. In order to facilitate active aging during the pandemic, a user-friendly electronic platform for healthy living should include older adults in the future.
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Affiliation(s)
| | - Kai-ling Ou
- Hong Kong Baptist University, Hong Kong, China
| | - Ka Man Leung
- The Education University of Hong Kong, Hong Kong, China
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3
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Li MK, Patel BP, Chu L, Strom M, Hamilton JK. Investigating resilience and its association with stress, anthropometrics, and metabolic health in adolescents with obesity: a pilot study. PSYCHOL HEALTH MED 2023; 28:1997-2006. [PMID: 35373663 DOI: 10.1080/13548506.2022.2059094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
The increasing prevalence of children with obesity has contributed to a higher risk of developing cardiometabolic comorbidities. Adversity and chronic stress are negatively linked to cardiometabolic outcomes, and resilience is positively associated with improved outcomes. However, whether resilience is protective against metabolic disturbances preceding disease presentation is less understood. This study explored correlations between stress, anthropometrics, and metabolic parameters with resilience (total, individual, family, peers, school, community), and determined which resilience domains predict metabolically unhealthy obesity. Adolescents with obesity (n = 39; 12-18y) completed anthropometrics, an oral glucose tolerance test, the Adolescent Resilience Questionnaire, and Perceived Stress Scale. Lower stress (r = -0.70, p < 0.001), BMI (r = -0.42, p = 0.01), fat mass (ρ = -0.41, p = 0.01), and fat-free mass (ρ = -0.41, p = 0.01) were associated with greater resilience. Greater school resilience was associated with lower risk for having metabolically unhealthy obesity (odds ratio = 0.87, 95% Confidence Intervals, 0.78-0.98, p = 0.02). Our findings suggest that resilience is associated with lower adiposity, and that lower school resilience is an independent predictor of having metabolically unhealthy obesity. Further work exploring correlations between school resilience, perceived stress, and metabolic outcomes, would optimize programs for obesity-related chronic conditions.
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Affiliation(s)
- Ming K Li
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Barkha P Patel
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lisa Chu
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michele Strom
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jill K Hamilton
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
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4
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Seal E, Vu J, Winfield A, Fenesi B. Impact of COVID-19 on Physical Activity in Families Managing ADHD and the Cyclical Effect on Worsening Mental Health. Brain Sci 2023; 13:887. [PMID: 37371367 DOI: 10.3390/brainsci13060887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Physical activity supports symptom management in children with ADHD and reduces the mental health burden associated with caregiving for children with ADHD. Survey-based research shows that COVID-19 reduced physical activity among diverse populations. This study used a qualitative approach situated within a socioecological framework to (1) understand how COVID-19 impacted physical activity of children with ADHD and their caregivers, to (2) identify barriers to their physical activity, and to (3) identify potential areas of support. Thirty-three participants were interviewed between October 2020 and January 2021. Content analysis revealed that physical activity declined for children and caregivers; significant barriers were social isolation and rising intrapersonal difficulties such as diminishing self-efficacy and energy levels and increased mental health difficulties. Worsening mental health further alienated caregivers and children from physical activity, undermining its protective effects on ADHD symptom management and mental wellbeing. Participants identified needing community support programs that offer virtual, live physical activity classes as well as psycho-emotional support groups. There is vital need to support physical activity opportunities during high-stress situations in families managing ADHD to buffer against diminishing mental wellbeing. This will promote further physical activity engagement and allow families to reap the cognitive, psychological, and emotional benefits.
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Affiliation(s)
- Erica Seal
- Faculty of Education, Western University, London, ON N6G 1G7, Canada
| | - Julie Vu
- Department of Psychology, Faculty of Social Sciences, Western University, London, ON N6A 5C2, Canada
| | - Alexis Winfield
- Faculty of Education, Western University, London, ON N6G 1G7, Canada
| | - Barbara Fenesi
- Faculty of Education, Western University, London, ON N6G 1G7, Canada
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5
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Pahk K, Joung C, Kwon HW, Kim S. Chronic physical exercise alleviates stress-associated amygdala metabolic activity in obese women: A prospective serial 18F-FDG PET/CT study. Front Endocrinol (Lausanne) 2023; 13:1046838. [PMID: 36686422 PMCID: PMC9851606 DOI: 10.3389/fendo.2022.1046838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
Background Psychological stress is considered as a major risk factor for cardiovascular disease (CVD). Chronic exercise is known to reduce CVD risk partly through attenuating psychological stress. Obesity has been linked with increased levels of psychological stress. We aimed to prospectively evaluate whether physical exercise could alleviate stress-associated amygdala metabolic activity, assessed by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in women with obesity. Material and methods A total of 43 participants were enrolled in this study. Twenty-three obese women were participated in a physical exercise program 5 days per week for 3 months. The exercise program consisted of aerobic exercise and resistance training. Serial 18F-FDG PET/CT was taken before the start of physical exercise program (baseline) and after finishing the program (post-exercise). A total of 20 participants who underwent 18F-FDG PET/CT for general health check-up were enrolled as non-obese control group. Brain amygdala activity (AmygA) was calculated as maximum standardized uptake value (SUVmax) of amygdala normalized to mean SUV of temporal lobe. Results Chronic physical exercise significantly reduced AmygA and improved body adiposity and systemic inflammation. AmygA was highest in baseline, intermediate in post-exercise, and lowest in non-obese control group (0.76 ± 0.17, 0.61 ± 0.1, 0.52 ± 0.09, p < 0.001). Furthermore, physical exercise also abrogated the association of AmygA with systemic inflammation. Conclusions Chronic physical exercise reduced stress-associated amygdala metabolic activity and broke its association with systemic inflammation in obese women. This study could explain the putative mechanism underlying the health beneficial effect of exercise on CVD via attenuation of stress neurobiology.
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Affiliation(s)
- Kisoo Pahk
- Department of Nuclear Medicine, Korea University Ansan Hospital, Ansan, South Korea
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Chanmin Joung
- Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Hyun Woo Kwon
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Sungeun Kim
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, South Korea
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Sisto A, Barone M, Giuliani A, Quintiliani L, Bruni V, Tartaglini D, Persichetti P, Tambone V. The body perception, resilience, and distress symptoms in candidates for bariatric surgery and post bariatric surgery. EUROPEAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.1007/s00238-022-02026-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Low resilience in severe obesity: marker of adverse childhood experiences and current psychological disorders. Eat Weight Disord 2022; 27:3507-3519. [PMID: 36209466 DOI: 10.1007/s40519-022-01488-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/25/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Psychological disorders, early-age psychological traumas and eating disorders may contribute to the development of severe obesity in vulnerable individuals. Resilience may serve a protective role against binge eating disorder or depression. The current study aimed to investigate the relationship between adverse childhood experiences (ACE), resilience, and current psychological disorders. It also examined whether resilience plays a protective role in this pathway in a cohort of patients seeking bariatric surgery. METHODS Two hundred patients (153 women, 47 men) with severe obesity scheduled for bariatric surgery at the CHRU Nancy were included between September 2016 and April 2017. Participants completed the Resilience Scale for Adults (RSA) questionnaire and underwent a structured interview on ACE and current psychological disorders. RESULTS Mean total RSA score was 5.16 ± 0.87. The most frequent ACE were emotional neglect (90.5%) and emotional abuse (61%); 96% reported at least one ACE; 67% presented at least one current psychological disorder, the most frequent being anxiety (36%) and BED (35%). The number of psychological disorders, cumulative ACE and age explained 19.5% of the variance in total RSA score (p < 0.0001; adjusted R2 = 0.19). The association of cumulative ACE and number of psychological disorders was mediated by resilience. CONCLUSION Our findings suggest that resilience is a relevant component of the psychosocial phenotype of severe obesity in bariatric surgery candidates. Resilience seems to play a partly mediation role in the relationship between ACE and psychological disorders. Low resilience becomes a marker that underscores the necessity to examine in greater depth ACE and psychological disorders. LEVEL OF EVIDENCE Level III, cohort analytic study.
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Kholmatova K, Krettek A, Leon DA, Malyutina S, Cook S, Hopstock LA, Løvsletten O, Kudryavtsev AV. Obesity Prevalence and Associated Socio-Demographic Characteristics and Health Behaviors in Russia and Norway. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159428. [PMID: 35954782 PMCID: PMC9367755 DOI: 10.3390/ijerph19159428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 01/27/2023]
Abstract
Associations between obesity and socio-demographic and behavioral characteristics vary between populations. Exploring such differences should throw light on factors related to obesity. We examined associations between general obesity (GO, defined by body mass index) and abdominal obesity (AO, defined by waist-to-hip ratio) and sex, age, socio-economic characteristics (education, financial situation, marital status), smoking and alcohol consumption in women and men aged 40–69 years from the Know Your Heart study (KYH, Russia, N = 4121, 2015–2018) and the seventh Tromsø Study (Tromsø7, Norway, N = 17,646, 2015–2016). Age-standardized prevalence of GO and AO was higher in KYH compared to Tromsø7 women (36.7 vs. 22.0% and 44.2 vs. 18.4%, respectively) and similar among men (26.0 vs. 25.7% and 74.8 vs. 72.2%, respectively). The positive association of age with GO and AO was stronger in KYH vs. Tromsø7 women and for AO it was stronger in men in Tromsø7 vs. KYH. Associations between GO and socio-economic characteristics were similar in KYH and Tromsø7, except for a stronger association with living with spouse/partner in KYH men. Smoking had a positive association with AO in men in Tromsø7 and in women in both studies. Frequent drinking was negatively associated with GO and AO in Tromsø7 participants and positively associated with GO in KYH men. We found similar obesity prevalence in Russian and Norwegian men but higher obesity prevalence in Russian compared to Norwegian women. Other results suggest that the stronger association of obesity with age in Russian women is the major driver of the higher obesity prevalence among them compared to women in Norway.
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Affiliation(s)
- Kamila Kholmatova
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- International Research Competence Centre, Northern State Medical University, Troitsky Av., 51, 163069 Arkhangelsk, Russia
- Correspondence:
| | - Alexandra Krettek
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- Department of Public Health, School of Health Sciences, University of Skövde, 541 28 Skövde, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 405 30 Gothenburg, Sweden
| | - David A. Leon
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Academician M.A. Lavrentiev Av., 17, 630090 Novosibirsk, Russia;
- Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, Krasny Av., 52, 630090 Novosibirsk, Russia
| | - Sarah Cook
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
| | - Ola Løvsletten
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
| | - Alexander V. Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- International Research Competence Centre, Northern State Medical University, Troitsky Av., 51, 163069 Arkhangelsk, Russia
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Ghulam A, Bonaccio M, Costanzo S, Bracone F, Gianfagna F, de Gaetano G, Iacoviello L. Psychological Resilience, Cardiovascular Disease, and Metabolic Disturbances: A Systematic Review. Front Psychol 2022; 13:817298. [PMID: 35282220 PMCID: PMC8909142 DOI: 10.3389/fpsyg.2022.817298] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/24/2022] [Indexed: 12/20/2022] Open
Abstract
Background Positive psychosocial factors can play an important role in the development of cardiovascular disease (CVD). Among them, psychological resilience (PR) is defined as the capacity of responding positively to stressful events. Our aim was to assess whether PR is associated with CVD or metabolic disturbances through a systematic review. Methods We gathered articles from PubMed, Web of Science, PsycInfo, and Google Scholar up to October 28, 2021. We included articles that were in English, were observational, and had PR examined as exposure. The CVD outcomes were either clinical or metabolic outcomes (i.e., dyslipidemia, obesity, metabolic syndrome, hypertension, and diabetes). Results Our literature search identified 3,800 studies, of which 17 met the inclusion criteria. Of them, seven were longitudinal and 10 cross-sectional, and 13 were on adults and four on children. The exposure assessment was heterogeneous, i.e., 12 studies used different kinds of self-administered questionnaires and five used interviews with a psychologist. Regarding outcomes, five studies investigated CVD, seven obesity, one metabolic syndrome, two hypertension, four dyslipidemia, and four diabetes. In longitudinal studies, PR was found to have an inverse association with included outcomes in five studies from the Swedish military conscription cohort but had no association with CVD in a study on African-American women and was associated with slower progression of diabetes in a general population. The cross-sectional studies showed that the prevalence of disease was not associated with PR in many cases but the progression of disease was associated with PR. Conclusion PR seems to have a possibly favorable association with CVD and metabolic disturbances that differs according to the type of outcome and population. Our study limitations are given by the small number of studies available and the heterogeneity in PR measurement. Systematic Review Registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=237109], identifier [CRD42021237109].
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Affiliation(s)
- Anwal Ghulam
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) NEUROMED, Pozzilli, Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) NEUROMED, Pozzilli, Italy
| | - Francesca Bracone
- Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) NEUROMED, Pozzilli, Italy
| | - Francesco Gianfagna
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) NEUROMED, Pozzilli, Italy
| | - Licia Iacoviello
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy.,Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) NEUROMED, Pozzilli, Italy
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10
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Chong MFF, Lim HX, Wong BWX, Chi ZH, Inthujaa JK, Müller-Riemenschneider F, Cheon BK, Gorny AW, Chia KS. Transiting Out of Full-Time National Service: A Qualitative Study of Barriers and Motivators of Weight Change in Young Adult Men in Singapore. Am J Mens Health 2022; 16:15579883221074788. [PMID: 35272525 PMCID: PMC8921754 DOI: 10.1177/15579883221074788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Higher prevalence of obesity in men compared with women, particularly among those 18 to 40 years of age, has been observed in Singapore. We explored young men's perceptions of weight change after transiting out of National Service (NS) over a 12-month period and sought to understand the underlying drivers. In-depth interviews, guided by the Health Belief Model (HBM), were conducted with young men 12 months after they had completed full-time NS. Six constructs from the HBM, namely, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and perceived self-efficacy, were utilized to guide the analysis. Thematic analysis revealed that participants generally perceived a gain in body weight after the transition and attributed this to decreased exercise-related physical activity (PA) levels and increased consumption of unhealthy food. However, many did not display immediate concerns nor view leading a healthy lifestyle as priority, citing time constraints, inertia to comply, or lack of access to sports facilities and healthy food options as barriers. Healthy lifestyle behaviors, mainly PA, were mostly pursued for physical health and appearance. Motivators toward a healthy lifestyle tended to be internal factors such as self-motivation, personal preference, and habit, whereas external motivators included peer or familial influence and environmental factors. Our findings align with key concepts of the HBM and suggest a need to educate young men transiting out of NS on lifestyle, weight, and health, in particular addressing their misconceptions.
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Affiliation(s)
- Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Hui Xian Lim
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Beverly W X Wong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Zi Han Chi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - J K Inthujaa
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Bobby K Cheon
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.,School of Social Sciences, Nanyang Technological University, Singapore
| | - Alexander W Gorny
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Singapore Armed Forces, Singapore
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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11
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Ghulam A, Bonaccio M, Costanzo S, Gialluisi A, Santonastaso F, Di Castelnuovo A, Cerletti C, Donati MB, de Gaetano G, Gianfagna F, Iacoviello L. Association of Psychological Resilience with All-Cause and Cardiovascular Mortality in a General Population in Italy: Prospective Findings from the Moli-Sani Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:222. [PMID: 35010483 PMCID: PMC8750664 DOI: 10.3390/ijerph19010222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/19/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Psychological resilience (PR) is the capacity to adapt positively in face of adversity. Its role as an independent protective factor has been acknowledged in recent years. We aimed to test the association of PR with all-cause and cardiovascular disease (CVD) mortality in a general adult population. We performed longitudinal analyses on 10,406 CVD-free individuals from the Moli-Sani cohort (follow up = 11.2 year). PR was assessed by the 25-item Connor and Davidson resilience scale. PR factors were identified through polychoric factor analysis. Associations with mortality were tested using multivariable Cox regressions. Higher levels of PR were associated with reduced all-cause mortality in a model including sex and age (HR = 0.78; 95%CI 0.62-1.00). The association decreased after inclusion of socioeconomic, clinical, and behavioral factors into the model (HR = 0.80; 95%CI 0.62-1.03). No relation was observed with cardiovascular mortality in the fully adjusted model (HR = 0.89; 95%CI 0.56-1.39). An inverse association of Factor 1 (reflecting positive acceptance of change) with all-cause mortality (HR = 0.89; 95%CI 0.82-0.98; p value = 0.01) was found. However, at a borderline non-significant way, PR predicts all-cause mortality in a general population of Italian adults. This is supported by the findings demonstrating a significant association between the PR's domain reflecting a positive acceptance of change and all-cause mortality.
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Affiliation(s)
- Anwal Ghulam
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy; (A.G.); (F.S.); (F.G.); (L.I.)
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (S.C.); (A.G.); (C.C.); (M.B.D.); (G.d.G.)
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (S.C.); (A.G.); (C.C.); (M.B.D.); (G.d.G.)
| | - Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (S.C.); (A.G.); (C.C.); (M.B.D.); (G.d.G.)
| | - Federica Santonastaso
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy; (A.G.); (F.S.); (F.G.); (L.I.)
| | | | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (S.C.); (A.G.); (C.C.); (M.B.D.); (G.d.G.)
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (S.C.); (A.G.); (C.C.); (M.B.D.); (G.d.G.)
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (S.C.); (A.G.); (C.C.); (M.B.D.); (G.d.G.)
| | - Francesco Gianfagna
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy; (A.G.); (F.S.); (F.G.); (L.I.)
- Mediterranea Cardiocentro, 80121 Napoli, Italy;
| | - Licia Iacoviello
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy; (A.G.); (F.S.); (F.G.); (L.I.)
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (S.C.); (A.G.); (C.C.); (M.B.D.); (G.d.G.)
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Nishimi K, Choi KW, Cerutti J, Powers A, Bradley B, Dunn EC. Measures of adult psychological resilience following early-life adversity: how congruent are different measures? Psychol Med 2021; 51:2637-2646. [PMID: 32406816 PMCID: PMC7863576 DOI: 10.1017/s0033291720001191] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychological resilience - positive psychological adaptation in the context of adversity - is defined and measured in multiple ways across disciplines. However, little is known about whether definitions capture the same underlying construct and/or share similar correlates. This study examined the congruence of different resilience measures and associations with sociodemographic factors and body mass index (BMI), a key health indicator. METHODS In a cross-sectional sample of 1429 African American adults exposed to child maltreatment, we derived four resilience measures: a self-report scale assessing resiliency (perceived trait resilience); a binary variable defining resilience as low depression and posttraumatic stress (absence of distress); a binary variable defining resilience as low distress and high positive affect (absence of distress plus positive functioning); and a continuous variable reflecting individuals' deviation from distress levels predicted by maltreatment severity (relative resilience). Associations between resilience measures, sociodemographic factors, and BMI were assessed using correlations and regressions. RESULTS Resilience measures were weakly-to-moderately correlated (0.27-0.69), though similarly patterned across sociodemographic factors. Women showed higher relative resilience, but lower perceived trait resilience than men. Only measures incorporating positive affect or resiliency perceptions were associated with BMI: individuals classified as resilient by absence of distress plus positive functioning had lower BMI than non-resilient (β = -2.10, p = 0.026), as did those with higher perceived trait resilience (β = -0.63, p = 0.046). CONCLUSION Relatively low congruence between resilience measures suggests studies will yield divergent findings about predictors, prevalence, and consequences of resilience. Efforts to clearly define resilience are needed to better understand resilience and inform intervention and prevention efforts.
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Affiliation(s)
- Kristen Nishimi
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Karmel W. Choi
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA
| | - Janine Cerutti
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Atlanta, GA
| | - Erin C. Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA
- Center on the Developing Child at Harvard University, Cambridge, MA
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Oyedapo HA, Ayeni O, Afolabi NB, Akinyemi OJ. Quantile regression methods for determination of factors associated with nutritional status of women of reproductive age in Nigeria. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e00988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ozdemir C, Akbas Gunes N. The effect of diet and regular exercise on psychological resilience in obese or overweight women. Int J Clin Pract 2021; 75:e14320. [PMID: 33960086 DOI: 10.1111/ijcp.14320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 05/03/2021] [Indexed: 12/17/2022] Open
Abstract
AIM This study aimed to investigate the effects of diet and regular exercise on resilience in obese or overweight women. METHODS The study was conducted with the 109 patients who applied to the obesity polyclinics. The patients were divided into three groups by their current disease conditions and willingness; those who were willing to both diet and exercise (diet + exercise group) (n: 35), those who were willing to only diet (diet group) (n: 37) and those who were not willing to recommended diet or exercise (control group) (n: 37). The "Connor-Davidson Resilience Scale" (CD-RISC) was applied to all the participants through face-to-face interviews. The CD-RISC scale was repeated 8 weeks after the first evaluation. RESULTS There was a significant difference between the total score and subscores of the scale in the intra-group comparison before and after the intervention (P < .05). When the groups were compared after the intervention, a significant difference was found between the diet group and the control group as well as the exercise +diet group and the control group (P < .05). CONCLUSION We found that diet and exercise practices increased psychological endurance in obese or overweight women. In addition, positive improvements were also detected in psychological resilience subgroups such as perseverance and personal competence, tolerance to negative events and spiritual disposition.
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Affiliation(s)
| | - Nurcan Akbas Gunes
- Department of Family Medicine, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
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15
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Vannini P, Gagliardi GP, Kuppe M, Dossett ML, Donovan NJ, Gatchel JR, Quiroz YT, Premnath PY, Amariglio R, Sperling RA, Marshall GA. Stress, resilience, and coping strategies in a sample of community-dwelling older adults during COVID-19. J Psychiatr Res 2021; 138:176-185. [PMID: 33862301 PMCID: PMC8369528 DOI: 10.1016/j.jpsychires.2021.03.050] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/11/2021] [Accepted: 03/26/2021] [Indexed: 11/28/2022]
Abstract
Assessing the impact of the COVID-19 pandemic on perceived stress in older adults is critical to understanding how to best support elderly individuals navigating stressful situations, with the aim to lessen the impact of stressors on their brain health. Here, we collected measures on perceived stress, resilience, and behavioral coping strategies, in the context of the COVID-19 pandemic, in a cross-sectional sample of 141 community dwelling older adults (mean age = 74.4 ± 8.4, 59% females) who were part of two longitudinal observational studies in Massachusetts, U.S. Our results indicate that participants demonstrated moderate levels of stress related to COVID-19 and showed relatively high levels of resilience. Higher resilience was associated with greater use of adaptive coping behaviors and less use of maladaptive coping behaviors. The use of maladaptive coping strategies was associated with more stress. Moreover, hierarchical regression analyses revealed that resilience was the strongest unique predictor of stress, thus, largely accounting for the observed coping-outcome associations. Individual differences in resilience levels moderated the effects of two coping strategies (planning and self-blame) on stress. Specifically, planning was associated with increased levels of stress for people with low resilience. In contrast, high personal resilience attenuated the negative effect of self-blame on their stress levels. Taken together, our findings suggest that resilience is critical for coping with stress during the COVID-19 pandemic. Future approaches for augmenting resilience could prove to be important potential interventions to help support older adults navigating stressful situations as well as lessen adverse effects on neurocognitive and mental health in the future.
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Affiliation(s)
- Patrizia Vannini
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Geoffroy P Gagliardi
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Madeline Kuppe
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Michelle L Dossett
- Division of General Internal Medicine, Geriatrics, and Bioethics, University of California Davis, Sacramento, CA, USA
| | - Nancy J Donovan
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Division of Geriatric Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jennifer R Gatchel
- Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Division of Geriatric Psychiatry, McLean Hospital, USA
| | - Yakeel T Quiroz
- Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | - Rebecca Amariglio
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Gad A Marshall
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Abstract
Adolescents with thalassemia often manifest with an increased risk of emotional and behavioral problems, as well as poor quality of life. However, some can be well-adapted and demonstrate evidence of resilience. This study aimed to explore resilience among those with thalassemia and determine the protective factors for their resilience. Sixty adolescents with thalassemia and 60 healthy adolescents as a comparison group participated in the study. Most adolescents with thalassemia demonstrated resilience. Eighty percent of them scored in the low-risk range of the SDQ total difficulties scale, and 91.7% scored in the low-risk range of the SDQ prosocial scale. The mean total difficulties scores of the thalassemia patients and the healthy controls were 11.38 and 11.27 respectively, whereas the mean prosocial scores were 7.28 and 6.65, without statistical significance. Despite the extensive demands of the illness, most adolescents with thalassemia appear to be adapted well, demonstrating evidence of resilience. Factors promoting resilience are lower BMI, less severe type of thalassemia, and younger age at the start of an iron chelator. Health care professionals who take care of adolescents with thalassemia should collaborate to improve their resilience.
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Affiliation(s)
- Pattaporn Kaewkong
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nonglak Boonchooduang
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pimlak Charoenkwan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Orawan Louthrenoo
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Hall A, Perez A, West X, Brown M, Kim E, Salih Z, Aronoff S. The Association of Adverse Childhood Experiences and Resilience With Health Outcomes in Adolescents: An Observational Study. Glob Pediatr Health 2021; 8:2333794X20982433. [PMID: 33614836 PMCID: PMC7868450 DOI: 10.1177/2333794x20982433] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/20/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022] Open
Abstract
The relationship between Adverse childhood experiences (ACEs), resilience, and health outcomes has not been as thoroughly studied in adolescents. Adolescents completed the ACEs Questionnaire and a validated resilience measure (Child Youth Resilience Measure, or CYRM). Poor health outcome was having 1 or more: obesity, hypertension, and/or depression. 34.5% of teens had a poor health outcome, 38.6% had ACE scores of 4 or more, and resilience ranged from 45 to 84 (mean = 74.6). By univariate and bivariate analysis, ACEs (OR = 1.11, 95% CI = 1.03-1.19, P = .0039; OR = 1.08, 95% CI = 1.0-1.16, P = .045) and resilience (OR = 0.95, 95% CI = 0.92-0.98, P = .0016; OR = 0.96, 95% CI = 0.93-0.99, P = .016) were significantly associated with poor health outcome. Resilience relationship subscale was significantly associated with reduced health risk (OR = 0.85, 95%CI = 0.75-0.95, P = .005). ACEs are associated with poor health outcomes in adolescents, resilience is inversely related, and the caregiver relationship may be the driving force.
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Affiliation(s)
- Ashleigh Hall
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Alberly Perez
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Xandria West
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Maryilyn Brown
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Ella Kim
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Zainab Salih
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Stephen Aronoff
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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Levels and Factors Associated with Resilience in Italian Healthcare Professionals during the COVID-19 Pandemic: A Web-Based Survey. Behav Sci (Basel) 2020; 10:bs10120183. [PMID: 33260390 PMCID: PMC7760580 DOI: 10.3390/bs10120183] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 01/10/2023] Open
Abstract
Background: Resilience is defined as the capacity to cope successfully with change or adversity. The aims of our study were to investigate levels of resilience in Italian healthcare professionals (HCPs) during the Coronavirus disease 2019 (COVID-19) pandemic and to identify potential predictors of resilience. Methods: We performed a web-based survey of HCPs (n = 1009) working in Italian hospitals during the COVID-19 pandemic. The survey contained a 14-item resilience scale (RS14) and questionnaires to evaluate depression and anxiety symptoms. Non-HCP individuals (n = 375) from the general population were used for comparison. Results: HCPs showed significantly lower resilience compared to the control group (p = 0.001). No significant differences were observed after stratification for geographical area, work setting, role, or suspected/confirmed diagnosis of COVID-19. In a linear regression analysis, RS14 was inversely correlated with depression (R2 = 0.227, p < 0.001) and anxiety (R2 = 0.117, p < 0.001) and directly correlated with age (R2 = 0.012, p < 0.001) but not with body mass index (BMI, R2 = 0.002, p = 0.213). In male HCPs, higher depression score (odds ratio (OR) 1.147, p < 0.001) or BMI (OR 1.136, p = 0.011) significantly predicted having low resilience. In female HCPs, higher depression score (OR 1.111, p < 0.0001) and working in a COVID-19 free setting (OR 2.308, p = 0.002) significantly predicted having low resilience. HCPs satisfied with personal protective equipment had higher levels of resilience (p < 0.010). Conclusions: Our findings suggest that resilience was lower in Italian HCPs than in the general population after the first COVID-19 wave. Specific factors can be identified, and targeted interventions may have an important role to foster resilience of HCPs.
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Demographic and Socioeconomic Determinants of Body Mass Index in People of Working Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218168. [PMID: 33167352 PMCID: PMC7663841 DOI: 10.3390/ijerph17218168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 12/13/2022]
Abstract
Obesity is currently the most common metabolic disease, causing numerous health problems and, if untreated, leading to premature mortality. Obesity is a significant issue among people of working age since their ability to work depends directly on their health condition and psychomotor fitness. Demographic and socioeconomic factors have a significant impact on the body weight of people of working age. The aim of this study is to identify relationships between the body mass index and selected demographic and socioeconomic variables in working-age residents of the city of Wrocław, Poland. The study involved 4315 respondents (2206 women and 2109 men) aged 18–64 years from Wrocław. The sample selection was random and purposive, using multilevel stratification. The applied research tool was the authors’ own cross-sectional diagnostic questionnaire of socioeconomic status. Based on the collected data, the respondents’ body weight was categorized according to WHO criteria. The majority of respondents (60%) had a normal body weight, while 40% were categorized as overweight or obese. The difference was statistically significant (p < 0.001). Sex, age, occupational status, marital status, number of people in the household, having a steady source of income, disposable (net) income, and savings were significantly correlated (p < 0.001) with respondents’ body mass index. Public health programs aimed at promoting healthy lifestyle behaviors should be addressed primarily to groups at the highest risk of overweight and obesity.
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Ciaffi J, Brusi V, Lisi L, Mancarella L, D'Onghia M, Quaranta E, Bruni A, Spinella A, Giuggioli D, Landini MP, Ferri C, Meliconi R, Ursini F. Living with arthritis: a "training camp" for coping with stressful events? A survey on resilience of arthritis patients following the COVID-19 pandemic. Clin Rheumatol 2020; 39:3163-3170. [PMID: 32979101 PMCID: PMC7519383 DOI: 10.1007/s10067-020-05411-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/20/2020] [Accepted: 09/16/2020] [Indexed: 11/29/2022]
Abstract
Resilience is defined as “the capacity of individuals to cope successfully with significant change or adversity”. The challenge posed by the COVID-19 pandemic may potentially represent an overwhelmingly stressful event for patients with chronic diseases. Aim of our study was to investigate the levels of resilience in individuals with inflammatory arthritis living in Emilia Romagna, the third hardest-hit Italian region during the ongoing COVID-19 pandemic. To this purpose, we developed a survey consisting of four different sections assessing demographic characteristics, the 14-item resilience scale (RS14) and questionnaires evaluating depression and anxiety. Consecutive patients with inflammatory arthritis were recruited over a short time frame immediately after the end of national lockdown and compared with control individuals from the general population. One hundred twenty-two patients and 173 controls were included. Levels of resilience, as measured by RS14 score, were significantly higher in patients with inflammatory arthritis (82.6 ± 14.0 vs 79.0 ± 12.8, p = 0.018). After stratification for gender, the difference in RS14 score was maintained in women (p = 0.045), but not in men (p = 0.252). High resilience, defined as having a RS14 score > 90, was significantly more prevalent in patients than in controls (30% vs 16%, p = 0.009). In arthritis patients, no significant differences in RS14 were observed after stratification for specific diagnosis, age, or disease duration and activity. Our findings suggest that patients with inflammatory arthritis may be more resilient than the general population towards unexpected stressful events such as the ongoing COVID-19 pandemic.Key Points • Living with inflammatory arthritis may foster resilience. • After COVID-19, patients with inflammatory arthritis were more resilient than the general population. |
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Affiliation(s)
- Jacopo Ciaffi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Veronica Brusi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Lucia Lisi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luana Mancarella
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Martina D'Onghia
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Elisabetta Quaranta
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Antonella Bruni
- Neuropsychiatric Rehabilitation, Villa Patrizia Hospital, Piossasco, Turin, Italy
| | - Amelia Spinella
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Dilia Giuggioli
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Clodoveo Ferri
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Meliconi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Francesco Ursini
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Chung GKK, Chung RYN, Chan DCC, Lai FTT, Wong H, Lau MKW, Wong SYS, Yeoh EK. The independent role of deprivation in abdominal obesity beyond income poverty. A population-based household survey in Chinese adults. J Public Health (Oxf) 2020; 41:476-486. [PMID: 30215743 DOI: 10.1093/pubmed/fdy161] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/13/2018] [Accepted: 08/27/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Individual-level deprivation takes into account the non-monetary aspects of poverty that neither income poverty nor socio-economic factors could fully capture; however, it has rarely been considered in existing studies on social inequality in obesity. Therefore, we examined the associations of deprivation, beyond income poverty, with both general and abdominal obesity. METHODS A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed via face-to-face household interviews between 2014 and 2015. Deprivation was assessed by a Deprivation Index specific to the Hong Kong population. General obesity was defined as body mass index (BMI) ≥ 25 kg/m2, while abdominal obesity was defined as waist circumference (WC) ≥ 90 cm/80 cm for male/female. Multivariable binary logistic regressions were performed. RESULTS Deprivation was independently associated with abdominal obesity (odds ratios (OR) = 1.68; 95% confidence intervals (CI): 1.27-2.22); however, no significant association was found with general obesity (OR=1.03; CI: 0.77-1.38). After additional adjustment for BMI, deprivation remained strongly associated with abdominal obesity (OR=2.00; CI: 1.41-2.83); and after further adjustment for WC, deprivation had a marginal inverse association with general obesity (OR=0.72; CI: 0.51-1.01). CONCLUSIONS Deprivation is an important risk factor of abdominal obesity and plays a critical role in capturing the preferential abdominal fat deposition beyond income poverty.
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Affiliation(s)
- Gary Ka-Ki Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Roger Yat-Nork Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Dicken Cheong-Chun Chan
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Francisco Tsz-Tsun Lai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Hung Wong
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - Maggie Ka-Wai Lau
- Asia-Pacific Institute of Ageing Studies, Lingnan University, Hong Kong
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Changes in Cognitive Function and in the Levels of Glycosylated Haemoglobin (HbA1c) in Older Women with Type 2 Diabetes Mellitus Subjected to a Cardiorespiratory Exercise Programme. SUSTAINABILITY 2020. [DOI: 10.3390/su12125038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ageing and diabetes are recognised as important risk factors for the development of cognitive deterioration. The aim was to analyse the effects of a walking-based training programme on cognitive deterioration and glycosylated haemoglobin (HbA1c) in older women with type 2 diabetes. This was a six-month experimental and longitudinal study with an experimental group (EG) (n = 57) and a control group (CG) (n = 52). All participants were diabetic with hypoglycaemic treatment. EG carried out a walking-based training program. After the training, we evaluated the diabetic state (HbA1c), cognitive functioning with the Mini-Mental State Examination (MMSE), cardiorespiratory fitness (VO2max) and body mass index (BMI). Results: EG obtained better results than CG in all the analysed variables. EG showed a significant improvement in the levels of HbA1c (−4.5%; p < 0.001), VO2max (+5.9%; p < 0.001) and BMI (−5.4%; p < 0.001); it also obtained increases in the scores of cognitive functioning, which were statistically significant in all dimensions, except for calculation (p = 0.384) and language (p = 0.168). Conclusion: The aerobic treatment produced significant improvements in the diabetic state and cognitive functioning in older women with type 2 diabetes.
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Lehrer HM, Steinhardt MA, Dubois SK, Laudenslager ML. Perceived stress, psychological resilience, hair cortisol concentration, and metabolic syndrome severity: A moderated mediation model. Psychoneuroendocrinology 2020; 113:104510. [PMID: 31911349 PMCID: PMC7769194 DOI: 10.1016/j.psyneuen.2019.104510] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 09/22/2019] [Accepted: 11/07/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Psychological resilience is considered to protect against detrimental effects of perceived stress on cardiovascular and metabolic health, but few studies have tested biological mechanisms underlying these relationships. PURPOSE This study examined whether psychological resilience moderated the indirect association of perceived stress with Metabolic Syndrome (MetS) severity via hair cortisol concentration (HCC), a retrospective index of hypothalamic pituitary adrenal (HPA) axis activity. METHOD Participants included 228 adults (73 White, 86 Hispanic, 69 African American; mean age 45.29 years; 68% females). Participants completed questionnaires assessing perceived stress (Perceived Stress Scale) and resilience (Brief Resilience Scale). The first 3 cm of scalp-near hair were analyzed for cortisol concentration using enzyme-linked immunoassay analysis. Cardiometabolic risk factors including blood glucose, lipids, blood pressure, and waist circumference were assessed, from which a sex- and race/ethnicity-specific continuous MetS severity score was calculated. A moderated mediation model was tested using path analysis. RESULTS Psychological resilience moderated the association of perceived stress with HCC (R2 change for interaction = 0.014, p = 0.043), such that the association of perceived stress and HCC decreased as resilience scores increased. Resilience also moderated the indirect association of perceived stress with MetS severity via HCC (b = -0.039, 95% CI [-0.001; -0.100]), such that HCC mediated the association of greater perceived stress with greater MetS severity only for individuals reporting Brief Resilience Scale scores 3 or below (range: 1.17-5.00). Psychological resilience was also associated with lower MetS severity (β = -0.227, p = 0.014) independent of perceived stress and HCC. CONCLUSION Findings suggest that psychological resilience may serve as both a stress buffer and as a direct determinant of cardiometabolic health. These results extend literature on psychological resilience to measures of retrospective HPA axis function and MetS severity in a diverse sample.
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Affiliation(s)
- H. Matthew Lehrer
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Mary A. Steinhardt
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Susan K. Dubois
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA,Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Martin A, Eglit GML, Maldonado Y, Daly R, Liu J, Tu X, Jeste DV. Attitude Toward Own Aging Among Older Adults: Implications for Cancer Prevention. THE GERONTOLOGIST 2020; 59:S38-S49. [PMID: 31100140 DOI: 10.1093/geront/gnz039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Negative age stereotypes can become internalized and contribute to lower levels of physical and mental well-being in older adults, including those with serious illnesses. The main objective of this study was to examine the relationships of attitude toward own aging (ATOA) with health outcomes after controlling for resilience among older cancer survivors and comparison subjects without cancer, aged 50 years or older. METHODS We examined data in 1,140 adults from the Successful Aging Evaluation (SAGE) study, a structured multi-cohort investigation of community-based adults selected using random digit dialing. There were 219 participants with cancer (excluding skin cancer) and 912 without cancer. ATOA was assessed with the Philadelphia Geriatric Morale Scale, and its relationship with measures of physical, cognitive, and mental health, as well as resilience was evaluated. RESULTS Individuals with cancer reported slightly more pessimistic ATOA than individuals without cancer. ATOA correlated with physical and mental health in individuals with and without cancer. Hierarchical linear multiple regression revealed that ATOA contributed significantly to the prediction of physical and mental health after controlling for socio-demographic variables and resilience. DISCUSSION AND IMPLICATIONS Higher levels of positive ATOA appear to be a protective factor for health in older adults, including those with cancer. Interventions that provide education about positive aspects of aging, modify negative automatic thoughts, and promote optimism may be useful for increasing ATOA and thereby improving physical and mental health in older adults, especially those with cancer.
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Affiliation(s)
- A'verria Martin
- Department of Psychiatry, University of California San Diego.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego
| | - Graham M L Eglit
- Department of Psychiatry, University of California San Diego.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego
| | - Yadira Maldonado
- Department of Psychiatry, University of California San Diego.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego
| | - Rebecca Daly
- Department of Psychiatry, University of California San Diego.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego
| | - Jinyuan Liu
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego.,Department of Family Medicine and Public Health, University of California San Diego
| | - Xin Tu
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego.,Department of Family Medicine and Public Health, University of California San Diego
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego.,Department of Neurosciences, University of California San Diego
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Jefferies P, Ungar M, Aubertin P, Kriellaars D. Physical Literacy and Resilience in Children and Youth. Front Public Health 2019; 7:346. [PMID: 31803709 PMCID: PMC6877541 DOI: 10.3389/fpubh.2019.00346] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 11/01/2019] [Indexed: 12/19/2022] Open
Abstract
Background: There is growing interest in the relationship between physical and psychosocial factors related to resilience to better understand the antecedents of health and successful adaptation to challenges in and out of school, and across the lifespan. To further this understanding, a trans-disciplinary approach was used to investigate the association between the multidimensional constructs of physical literacy and resilience in children at a key stage in their development. Methods: Cross-sectional data were collected from 227 school children aged 9-12 years old from five schools in Winnipeg, Manitoba, Canada. Resilience was measured using the Child and Youth Resilience Measure, and physical literacy through the Physical Literacy Assessment for Youth tools. Data were provided by self-report, surrogate assessors of the child (physical education teachers and parents), and trained assessors for movement skills. These data were analyzed using correlation and logistic regression. Results: Resilience was significantly correlated with numerous indicators of physical literacy, including movement capacity, confidence, and competence, environmental engagement, and overall perceptions of physical literacy. Regressions indicated that resilience could be predicted by movement confidence and competence, environmental engagement, and overall physical literacy. Conclusions: The findings of this study, using a constellation of sources, provide foundational evidence for the link between resilience and physical literacy among children, encouraging the importance of physical literacy development in schools. Longitudinal studies are required to further examine this relationship and how these previously unrelated fields may work together for a richer understanding of the interplay between the physical and psychological determinants of well-being.
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Affiliation(s)
- Philip Jefferies
- Resilience Research Centre, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Michael Ungar
- Resilience Research Centre, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Patrice Aubertin
- Center for Research Innovation and Transfer in Circus Arts, National Circus School, Montreal, QC, Canada
| | - Dean Kriellaars
- Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Jones NL, Burger J, Hall A, Reeves KA. The Intersection of Urban and Global Health. Pediatr Clin North Am 2019; 66:561-573. [PMID: 31036235 DOI: 10.1016/j.pcl.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Providers from high-income countries are often drawn to practicing medicine in settings identified as having greater need, whether that be in a low- or middle-income country or within an underserved area within their own high-income country. Despite sharing the goal of fostering health equity, global health and urban health are often considered in dichotomous ways. This article points a lens at the intersection of these 2 fields, highlighting what they can learn from each other.
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Affiliation(s)
- Nora L Jones
- Center for Bioethics, Urban Health, and Policy, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, Suite 324, Philadelphia, PA 19140, USA.
| | - Julia Burger
- Department of Pediatrics, Lewis Katz School of Medicine at Temple University, 3223 North Broad Street, 1st Floor, Old Dental School, Philadelphia, PA 19140, USA
| | - Ashleigh Hall
- Department of Pediatrics, Lewis Katz School of Medicine at Temple University, 3223 North Broad Street, 1st Floor, Old Dental School, Philadelphia, PA 19140, USA
| | - Kathleen A Reeves
- Center for Bioethics, Urban Health, and Policy, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, Suite 324, Philadelphia, PA 19140, USA
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Dar T, Radfar A, Abohashem S, Pitman RK, Tawakol A, Osborne MT. Psychosocial Stress and Cardiovascular Disease. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2019; 21:23. [PMID: 31028483 DOI: 10.1007/s11936-019-0724-5] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW This manuscript reviews the epidemiological data linking psychosocial stress to cardiovascular disease (CVD), describes recent advances in understanding the biological pathway between them, discusses potential therapies against stress-related CVD, and identifies future research directions. RECENT FINDINGS Metabolic activity of the amygdala (a neural center that is critically involved in the response to stress) can be measured on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) yielding a neurobiological signal that independently predicts subsequent CVD events. Furthermore, a serial pathway from ↑amygdalar activity → ↑hematopoietic tissue activity → ↑arterial inflammation → ↑CVD events has been elucidated, providing new insights into the mechanism linking stress to CVD. Psychosocial stress and stress conditions are independently associated with CVD in a manner that depends on the degree and duration of stress as well as the individual response to a stressor. Nevertheless, the fundamental biology remains incompletely defined, and stress is often confounded by adverse health behaviors. Thus, most clinical guidelines do not yet recognize psychosocial stress as an independent CVD risk factor or advocate for its treatment in CVD prevention. Clarification of this neurobiological pathway provides a better understanding of the underlying pathophysiology and suggests opportunities to develop novel preventive strategies and therapies.
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Affiliation(s)
- Tawseef Dar
- Cardiac MR-PET-CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, USA
| | - Azar Radfar
- Cardiac MR-PET-CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, USA
| | - Shady Abohashem
- Cardiac MR-PET-CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, USA
| | - Roger K Pitman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ahmed Tawakol
- Cardiac MR-PET-CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, USA
| | - Michael T Osborne
- Cardiac MR-PET-CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. .,Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, USA. .,Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA, 02114-2750, USA.
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Spinosa J, Christiansen P, Dickson JM, Lorenzetti V, Hardman CA. From Socioeconomic Disadvantage to Obesity: The Mediating Role of Psychological Distress and Emotional Eating. Obesity (Silver Spring) 2019; 27:559-564. [PMID: 30821100 PMCID: PMC6593860 DOI: 10.1002/oby.22402] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/10/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Lower socioeconomic status is robustly associated with obesity; however, the underpinning psychological mechanisms remain unclear. The current study sought to determine whether the relationship between lower socioeconomic status and obesity is explained by psychological distress and subsequent emotional eating as a coping strategy. It also examined whether psychological resilience plays a protective role in this pathway. METHODS Participants (N = 150) from a range of socioeconomic backgrounds completed questionnaire measures of psychological distress, emotional eating, and resilience. They reported their income and education level as an indicator of socioeconomic status and their height and weight in order to calculate BMI. RESULTS There was a significant indirect effect of socioeconomic status on BMI via psychological distress and emotional eating; specifically, lower socioeconomic status was associated with higher distress, higher distress was associated with higher emotional eating, and higher emotional eating was associated with higher BMI (b [SE] = -0.02 [0.01]; 95% CI: -0.04 to -0.01). However, resilience was not a significant moderator of this association. CONCLUSIONS Psychological distress and subsequent emotional eating represent a serial pathway that links lower socioeconomic status with obesity. Targeting these maladaptive coping behaviors may be one strategy to reduce obesity in low-income populations.
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Affiliation(s)
- Jade Spinosa
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolUK
- Clinical Psychology DepartmentSt. Helens HospitalSt. HelensUK
| | - Paul Christiansen
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolUK
| | - Joanne M. Dickson
- Psychology DepartmentEdith Cowan UniversityJoondalup, Western AustraliaAustralia
| | - Valentina Lorenzetti
- School of Behavioural and Health SciencesAustralian Catholic UniversityMelbourne, VictoriaAustralia
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Ishai A, Osborne MT, Tung B, Wang Y, Hammad B, Patrich T, Oberfeld B, Fayad ZA, Giles JT, Lo J, Shin LM, Grinspoon SK, Koenen KC, Pitman RK, Tawakol A. Amygdalar Metabolic Activity Independently Associates With Progression of Visceral Adiposity. J Clin Endocrinol Metab 2019; 104:1029-1038. [PMID: 30383236 PMCID: PMC6375724 DOI: 10.1210/jc.2018-01456] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/26/2018] [Indexed: 12/14/2022]
Abstract
CONTEXT Epidemiologic data link psychological stress to adiposity. The underlying mechanisms remain uncertain. OBJECTIVES To test whether (i) higher activity of the amygdala, a neural center involved in the response to stress, associates with greater visceral adipose tissue (VAT) volumes and (ii) this association is mediated by increased bone marrow activity. SETTING Massachusetts General Hospital, Boston, Massachusetts. PATIENTS Two hundred forty-six patients without active oncologic, cardiovascular, or inflammatory disease who underwent clinical 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging were studied. VAT imaging was repeated ∼1 year later in 68 subjects. DESIGN Metabolic activity of the amygdala (AmygA), hematopoietic tissue activity, and adiposity volumes were measured with validated methods. MAIN OUTCOME MEASURE The relationship between AmygA and baseline and follow-up VAT. RESULTS AmygA associated with baseline body mass index (standardized β = 0.15; P = 0.01), VAT (0.19; P = 0.002), and VAT/subcutaneous adipose tissue ratio (0.20; P = 0.002), all remaining significant after adjustment for age and sex. AmygA also associated with bone marrow activity (0.15; P = 0.01), which in turn associated with VAT (0.34; P < 0.001). Furthermore, path analysis showed that 48% of the relationship between AmygA and baseline VAT was mediated by increased bone marrow activity (P = 0.007). Moreover, AmygA associated with achieved VAT after 1 year (P = 0.02) after adjusting for age, sex, and baseline VAT. CONCLUSIONS These results suggest a neurobiological pathway involving the amygdala and bone marrow linking psychosocial stress to adiposity in humans. Future studies should test whether targeting this mechanism attenuates adiposity and its complications.
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Affiliation(s)
| | - Michael T Osborne
- Cardiac MR-PET-CT Program, Boston, Massachusetts
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Brian Tung
- Cardiac MR-PET-CT Program, Boston, Massachusetts
| | - Ying Wang
- Cardiac MR-PET-CT Program, Boston, Massachusetts
| | - Basma Hammad
- Cardiac MR-PET-CT Program, Boston, Massachusetts
| | | | | | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jon T Giles
- Department of Rheumatology, Columbia University, New York, New York
| | - Janet Lo
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Program in Nutritional Metabolism, Massachusetts General Hospital, Boston, Massachusetts
| | - Lisa M Shin
- Department of Psychology, Tufts University, Medford, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Steven K Grinspoon
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Program in Nutritional Metabolism, Massachusetts General Hospital, Boston, Massachusetts
| | - Karestan C Koenen
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts
| | - Roger K Pitman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ahmed Tawakol
- Cardiac MR-PET-CT Program, Boston, Massachusetts
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Correspondence and Reprint Requests: Ahmed Tawakol, MD, Cardiology Division, Massachusetts General Hospital, 55 Fruit Street, Yawkey 5-050, Boston, Massachusetts 02114-2750. E-mail:
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Development of the Gothenburg Well-Being Scale in Late Adolescence: The Grow Up 1990 Gothenburg Study. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41543-019-00016-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Demographic and Social-Cognitive Factors Associated with Weight Loss in Overweight, Pre-diabetic Participants of the PREVIEW Study. Int J Behav Med 2019; 25:682-692. [PMID: 30128932 PMCID: PMC6244565 DOI: 10.1007/s12529-018-9744-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Purpose Weight loss has been demonstrated to be a successful strategy in diabetes prevention. Although weight loss is greatly influenced by dietary behaviors, social-cognitive factors play an important role in behavioral determination. This study aimed to identify demographic and social-cognitive factors (intention, self-efficacy, outcome expectancies, social support, and motivation with regard to dietary behavior and goal adjustment) associated with weight loss in overweight and obese participants from the PREVIEW study who had pre-diabetes. Method Prospective correlational data from 1973 adult participants were analyzed. The participants completed psychological questionnaires that assessed social-cognitive variables with regard to dietary behavior. Stepwise multiple regression analyses were performed to identify baseline demographic and social-cognitive factors associated with weight loss. Results Overall, being male, having a higher baseline BMI, having a higher income, perceiving fewer disadvantages of a healthy diet (outcome expectancies), experiencing less discouragement for healthy eating by family and friends (social support), and lower education were independently linked to greater weight loss. When evaluating females and males separately, education was no longer associated with weight loss. Conclusion The results indicate that a supportive environment in which family members and friends avoid discouraging healthy eating, with the application of a strategy that uses specific behavior change techniques to emphasize the benefits of outcomes, i.e., the benefits of a healthy diet, may support weight loss efforts. Weight loss programs should therefore always address the social environment of persons who try to lose body weight because family members and friends can be important supporters in reaching a weight loss goal.
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Opichka K, Smith C, Levine AS. Problematic Eating Behaviors Are More Prevalent in African American Women Who Are Overweight or Obese Than African American Women Who Are Lean or Normal Weight. FAMILY & COMMUNITY HEALTH 2019; 42:81-89. [PMID: 30768472 DOI: 10.1097/fch.0000000000000222] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Problematic eating behaviors such as overeating and loss of control over consumption can lead to obesity. Problematic eating behaviors among women of differing body mass indexes were explored through focus group methodology, the Palatable Eating Motives Scale (PEMS), and a taste test in a sample of low-income African American women (n = 45). Women who were overweight or obese (W-O/O) reported more problematic eating behaviors including eating in the absence of hunger, frequent overeating, and increased food thoughts than women who were lean or normal weight (W-L/N). The W-O/O appear to possess more problematic eating behaviors than W-L/N.
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Affiliation(s)
- Katelyn Opichka
- Department of Food Science and Nutrition, University of Minnesota, St Paul
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Chung RY, Lai FT, Chung GK, Yip BH, Wong SY, Yeoh EK. Socioeconomic disparity in mortality risks widened across generations during rapid economic development in Hong Kong: an age-period-cohort analysis from 1976 to 2010. Ann Epidemiol 2018; 28:743-752.e4. [DOI: 10.1016/j.annepidem.2018.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 05/15/2018] [Accepted: 06/03/2018] [Indexed: 10/14/2022]
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Surkan PJ, Sakyi KS, Hu A, Olinto MT, Gonçalves H, Horta BL, Gigante DP. Impact of stressful life events on central adiposity in the Pelotas Birth Cohort. Rev Saude Publica 2018; 52:61. [PMID: 29791680 PMCID: PMC5958973 DOI: 10.11606/s1518-8787.2018052000161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 05/08/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE: To investigate how stressful life events and social support relate to central adiposity in Southern Brazil. METHODS: Data included information from 802 participants in the 1982 Pelotas Birth Cohort that was collect in 2004-2005 and 2006. Stratifying by sex, we studied self-reported stressful life events during the year before 2004-2005 in relation to change in waist circumference between 2004-2005 and 2006 and waist-to-hip ratio in 2006, using both bivariate and multivariate linear regression models. RESULTS: In adjusted models, the experience of stressful life events during the year before 2004-2005 predicted a change in waist circumference in 2006 in men and a change in both waist-to-hip ratio in 2006 and waist circumference between 2004-2005 and 2006 in women. Men who experienced two or more stressful events had on average a one centimeter increase in their waist circumference between 2004-2005 and 2006 (β = 0.97, 95%CI 0.02-1.92), compared to those reporting no stressful events. For women, those who had one and those who had two or more stressful life events had over a 1 cm increase in their waist circumference from 2004-2005 to 2006 (β = 1.37, 95%CI 0.17-2.54; β = 1.26, 95%CI 0.11-2.40, respectively), compared to those who did not experience any stressful event. For both sexes, social support level was not significantly related to either waist-to-hip ratio or change in waist circumference, and it did not modify the association between stress and central adiposity. CONCLUSIONS: The experience of more than one stressful life event was associated with distinct indicators of central adiposity for men versus women.
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Affiliation(s)
- Pamela J Surkan
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Kwame S Sakyi
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Alice Hu
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Maria T Olinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil
| | - Helen Gonçalves
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Denise P Gigante
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
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Bonaccio M, Di Castelnuovo A, Costanzo S, Pounis G, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Mediterranean-type diet is associated with higher psychological resilience in a general adult population: findings from the Moli-sani study. Eur J Clin Nutr 2017; 72:154-160. [PMID: 28952609 DOI: 10.1038/ejcn.2017.150] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/04/2017] [Accepted: 08/08/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVE Psychological resilience is a measure of stress coping ability and has been associated with favourable health outcomes. While evidence on the relationship of dietary habits with a number of psychosocial conditions is available, there is lack of studies on their association with psychological resilience in a general adult population. SUBJECTS/METHODS Cross-sectional analysis on 10 812 subjects recruited within the cohort of the Moli-sani study (2005-2010). Psychological resilience was measured by the 25-item Connor-Davidson Psychological Resilience Scale. Food intake was recorded by the EPIC food frequency questionnaire and adherence to Mediterranean diet was appraised by both a Greek Mediterranean diet score and an Italian Mediterranean Index. Empirically derived dietary patterns were obtained by principal factor analysis. Multivariable linear regression analysis (95%CI) was used to test the association between dietary scores and psychological resilience. RESULTS Higher adherence to Mediterranean-type diets or consumption of a vegetable-based dietary pattern (obtained from principal factor analysis) were positively associated with psychological resilience (β=0.43; 95%CI: 0.19-0.66, β=0.92; 0.69-1.16, and β=1.18; 0.93-1.44, for Greek Mediterranean diet score, Italian Mediterranean Index and the 'Olive oil and vegetables pattern', respectively). Dietary polyphenol or antioxidant intakes and greater variety in fruit and vegetable consumption were also positively associated with psychological resilience, while the associations with Western-like diets were weak. CONCLUSIONS In conclusion, Mediterranean diet, vegetable-based dietary patterns and better diet quality were all positively associated with higher psychological resilience, whereas Western-type diets were not.
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Affiliation(s)
- M Bonaccio
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy
| | - A Di Castelnuovo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy
| | - S Costanzo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy
| | - G Pounis
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy
| | - M Persichillo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy
| | - C Cerletti
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy
| | - M B Donati
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy
| | - G de Gaetano
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy
| | - L Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, Pozzilli, Italy.,Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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Solano JPC, Bracher ESB, Faisal-Cury A, Ashmawi HA, Carmona MJC, Lotufo Neto F, Vieira JE. Factor structure and psychometric properties of the Dispositional Resilience Scale among Brazilian adult patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:1014-1020. [DOI: 10.1590/0004-282x20160148] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 07/27/2016] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective Verifying the psychometrics of a Brazilian version of the Dispositional Resilience Scale (DRS-15). Methods Cross-cultural adaptation was done interviewing 65 adult patients. Validation was evaluated by application of the Lipp Brazilian Stress Symptoms Inventory (ISSL), Self-Report Questionnaire (SRQ), and other measures to 575 participants from the psychiatric ambulatories (for borderline personality, anxiety or post-traumatic stress disorders) and non-psychiatric ambulatories (chronic pain, pre-anesthetic consultation and companions for the latter). Temporal stability was verified with 123 participants. Results Exploratory factor analysis yielded a three-factor solution. Psychometrics were acceptable (alpha coefficient, 0.71; intraclass correlation coefficient, 0.81). Correlations with the ISSL, SRQ and other measures were noted except for factor 3. In the psychiatric sample, hardiness scores of borderline patients were lower than those of patients with anxiety disorders. Conclusion This version of the DRS-15 exhibited good reliability in a sample of Brazilian patients; validity was confirmed in two of the scale factors.
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The impact of weight loss and low BMI on mortality of nursing home residents – Results from the nutritionDay in nursing homes. Clin Nutr 2016; 35:900-6. [DOI: 10.1016/j.clnu.2015.06.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/01/2015] [Accepted: 06/13/2015] [Indexed: 01/01/2023]
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Juvanhol LL, Lana RM, Cabrelli R, Bastos LS, Nobre AA, Rotenberg L, Griep RH. Factors associated with overweight: are the conclusions influenced by choice of the regression method? BMC Public Health 2016; 16:642. [PMID: 27461119 PMCID: PMC4962412 DOI: 10.1186/s12889-016-3340-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 07/22/2016] [Indexed: 11/10/2022] Open
Abstract
Background Different analytical techniques have been used to study the determinants of overweight. However, certain commonly used techniques may be limited by the continuous nature and skewed distribution of body mass index (BMI) data. In this article, different regression models are compared to identify the best approach for analysing predictors of BMI. Methods Data collected on 2270 nurses at 18 public hospitals in Rio de Janeiro, RJ (2010–2011) were analysed (80.6 % of the respondents). The explanatory variables considered were age, marital status, race/colour, mother’s schooling, domestic overload, years worked at night, consumption of fried food, physical inactivity, self-rated health and BMI at age 20 years. In addition to gamma regression, regarded as the reference method for selecting the set of explanatory variables described here, other modelling strategies – including linear, quantile (for the 0.25, 0.50 and 0.75 quantiles), binary and multinomial logistic regression – were compared in terms of final results and measures of fit. Results The variables age, marital status, race/colour, domestic overload, self-rated health, physical inactivity and BMI at age 20 years were significantly associated with BMI, independently of the method used. In the same way, consumption of fried food was significant in all the models, but a dose–response pattern was identified only in the gamma and normal models and the quantile model for the 0.75 quantile. Years worked at night was also associated with BMI in these three models only. The variable mother’s schooling returned significant results only for the category 12 or more years of schooling, except for overweight in the multinomial model and for the 0.50 quantile in the quantile model, in which the two categories were not significant. The results of the quantile regression showed that, generally, the effects of the variables investigated were greater in the upper quantiles of the BMI distribution. Of the models using BMI in its continuous form, the gamma model showed best fit, followed by the quantile models (0.25 and 0.5 quantiles). Conclusions The different strategies used produced similar results for the factors associated with BMI, but differed in the magnitude of the associations and goodness of fit. We recommend using the different approaches in combination, because they furnish complementary information on the problem studied. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3340-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Raquel Martins Lana
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Renata Cabrelli
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Aline Araújo Nobre
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Lúcia Rotenberg
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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MacLeod S, Musich S, Hawkins K, Alsgaard K, Wicker ER. The impact of resilience among older adults. Geriatr Nurs 2016; 37:266-72. [PMID: 27055911 DOI: 10.1016/j.gerinurse.2016.02.014] [Citation(s) in RCA: 262] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/05/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
Abstract
The purpose of this literature review was to provide an overview of resilience for the purpose of informing potential intervention designs that may benefit older adults. While numerous reviews have focused on various specific aspects of resilience, none have provided the necessary information required to design an effective resilience intervention. Research examining resilience suggests that older adults are capable of high resilience despite socioeconomic backgrounds, personal experiences, and declining health. Thus opportunities to inform interventions in this area exist. Research studies have identified the common mental, social, and physical characteristics associated with resilience. High resilience has also been significantly associated with positive outcomes, including successful aging, lower depression, and longevity. Interventions to enhance resilience within this population are warranted, but little evidence of success exists. Thus this review provides an overview of resilience that may aid in the design of resilience interventions for the often underserved population of older adults.
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Affiliation(s)
- Stephanie MacLeod
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305 Ann Arbor, MI 48108, USA.
| | - Shirley Musich
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305 Ann Arbor, MI 48108, USA
| | - Kevin Hawkins
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305 Ann Arbor, MI 48108, USA
| | - Kathleen Alsgaard
- UnitedHealthcare Medicare & Retirement, P.O. Box 9472 Minneapolis, MN 55440-9472, USA
| | - Ellen R Wicker
- AARP Services, Inc., 650 F. Street, NW, Washington, D.C. 20004, USA
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Campos-Matos I, Russo G, Perelman J. Connecting the dots on health inequalities--a systematic review on the social determinants of health in Portugal. Int J Equity Health 2016; 15:26. [PMID: 26879973 PMCID: PMC4754837 DOI: 10.1186/s12939-016-0314-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/01/2016] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Health inequalities are recognised as a public health issue worldwide, but only a few countries have developed national strategies to monitor and reduce them. Despite its considerable health inequalities, Portugal seems to lack a systematic strategy to tackle them, possibly due to the absence of organised evidence on the issue. We performed a systematic review that aimed to describe the available evidence on social inequalities in health in Portugal, in order to contribute towards a comprehensive and focused strategy to tackle them. METHODS We followed the PRISMA guidelines and searched Scopus, Web of Science and PubMed for studies that looked at the association between a measure of socioeconomic status and a health outcome in the Portuguese resident population since the year 2000. We excluded health behaviours and healthcare use from our search. We performed a qualitative description of the results. RESULTS Seventy-one publications were selected, all reporting observational analyses, most of them using cross-sectional data. These publications showed strong evidence for health inequalities related to education and gender, chiefly for obesity, self-rated health and mental health. CONCLUSIONS Analysis of the eligible publications showed that current research does not seem to have consistently covered the link between health and key Portuguese social problems. A strategy focusing on the monitoring of most prevalent diseases, most determining socioeconomic factors and vulnerable populations would be crucial to guide academic research in a country in which health inequalities are so ubiquitous and deeply rooted. REGISTRATION This systematic review is not registered.
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Affiliation(s)
- Inês Campos-Matos
- Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal.
- Centro de Investigação em Saúde Pública, Lisbon, Portugal.
| | - Giuliano Russo
- Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Lisbon, Portugal
| | - Julian Perelman
- Centro de Investigação em Saúde Pública, Lisbon, Portugal
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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General and abdominal adiposity in a representative sample of Portuguese adults: dependency of measures and socio-demographic factors’ influence. Br J Nutr 2015; 115:185-92. [DOI: 10.1017/s0007114515004055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AbstractThe aims of this study were: (i) to estimate the dependency between BMI and waist:height ratio (WHtR) as measures of general and abdominal adiposity, and (ii) to evaluate the influence of socio-demographic factors on both measures and on their dependency in risk classification. Data from a cross-sectional study conducted in 2009 among a representative sample of 3529 Portuguese adults were used. Height, weight and waist were measured and socio-demographic data (sex, age, education level, occupational status, marital status, region of residence) were obtained. Using logistic regression, crude and adjusted OR for high general (BMI≥25·0 kg/m2) and abdominal (WHtR≥0·5) adiposity, and for incompatible classification between them, were calculated. Above half (50·8 %) of the respondents had high BMI and 42·1 % had high WHtR, and the rates were higher in men than in women. There was an inverse association between education level and both adiposity measures. The lowest prevalence of high general and abdominal adiposity was observed in students and singles, whereas the highest was found in retired, widowed and respondents from Azores, Madeira and Alentejo. Nearly a quarter of respondents (24·0 %) were incompatibly classified by BMI and WHtR, with higher prevalence in men than in women and in low- than in high-educated people. Future surveys should focus on developing at least sex-specific cut-offs for both measures. Implementation of effective strategies for preventing and reducing high adiposity levels in Portugal should be directed primarily to men, older, low-educated individuals, as well as those living in the islands and poor regions of the country.
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Sex commonalities and differences in the relationship between resilient personality and the intrinsic connectivity of the salience and default mode networks. Biol Psychol 2015; 112:107-15. [PMID: 26440126 DOI: 10.1016/j.biopsycho.2015.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 09/02/2015] [Accepted: 09/25/2015] [Indexed: 01/19/2023]
Abstract
Increased resilience is associated with better health outcomes and reduced morbidity in response to injury and homeostatic perturbations. Proper functioning of the salience network (SN) and modulation of the default mode network (DMN) by SN may play a role in adaptively responding to stress. Here, we demonstrate that resilient personality in healthy subjects is associated with SN and DMN connectivity patterns and that these patterns are influenced by sex. While connectivity of SN with several brain regions including right anterior insula was significantly associated with resilient personality in both men and women, results suggest that increased functional integration of anterior DMN preferentially benefits women while increased functional integration of posterior DMN preferentially benefits men in terms of resilience. These findings may relate to previous demonstrations that men and women engage different information processing and behavioral strategies to achieve resilience and highlight the importance of considering sex in resilience research.
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Cioli VM, Gagliardi G, Pescatori M. Psychological stress in patients with anal fistula. Int J Colorectal Dis 2015; 30:1123-9. [PMID: 25976930 DOI: 10.1007/s00384-015-2245-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2015] [Indexed: 02/04/2023]
Abstract
AIM Psychological stress is known to affect the immunologic system and the inflammatory response. The aim of this study was to assess the presence of psychological stress, anxiety, and depression in patients with anal fistula. METHODS Consecutive patients with anal fistula, hemorrhoids, and normal volunteers were studied prospectively. Stressful life events were recorded and subjects were asked to complete the state-trait anxiety inventory (STAI), a depression scale, and three different reactive graphic tests (RGT). RESULTS Seventy-eight fistula patients, 73 patients with grade III-IV hemorrhoids, and 37 normal volunteers were enrolled. Of the fistula patients, 65 (83 %) reported one or more stressful events in the year prior to diagnosis, compared to 16 (22 %) of the hemorrhoid patients (P = 0.001). There were no significant differences in the percentage of subjects with abnormal trait anxiety (i.e., proneness for anxiety) and depression scores between fistula patients, hemorrhoid patients, and controls. Fistula patients had significantly higher (i.e., better) scores compared to hemorrhoid patients in two of three RGT and significantly lower (i.e., worse) scores in all three RGT compared to healthy volunteers. Of 37 patients followed up for a median of 28 months (range 19-41 months) after surgery, 8 (21.6 %) had persistent or recurrent sepsis. There was no significant difference in depression, STAI, and RGT scores between patients with sepsis and patients whose fistula healed. CONCLUSION Our results suggest that an altered emotional state plays an important role in the pathogenesis of anal fistula and underline the importance of psychological screening in patients with anorectal disorders.
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Affiliation(s)
- V M Cioli
- Coloproctology Unit, Parioli Clinic, Rome, Italy
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Mogre V, Nyaba R, Aleyira S, Sam NB. Demographic, dietary and physical activity predictors of general and abdominal obesity among university students: a cross-sectional study. SPRINGERPLUS 2015; 4:226. [PMID: 26140255 PMCID: PMC4480231 DOI: 10.1186/s40064-015-0999-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 04/24/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND Obesity has become a disease of global public health concern in both developing and developed countries. We investigated the influence of socio-demographic, dietary habits and physical activity levels on general and abdominal obesity among a sample of university students in Ghana. METHODS This cross-sectional study was carried out among a sample of 552 students attending the University for Development Studies, School of Medicine and Health Sciences, Tamale, Ghana. Demographic characteristics were assessed using questionnaire. Dietary habits were measured by means of food frequency questionnaires. Anthropometric measurements were done using appropriate methods. Physical activity levels were measured using the World Health Organization (WHO) global physical activity questionnaire. Spearman's nonparametric correlation coefficient and multinomial logistic regression analysis were used to investigate the determinants of general and abdominal obesity. RESULTS The prevalence of general overweight/obesity (25.8 % vs. 5.9 %) and abdominal obesity (40.9 % vs. 0.8 %) was higher in female students than in male students. General overweight/obesity was less likely in students who engaged in vigorous physical activity (Adjusted Odds Ratio (AOR) = 0.3, 95 % CI = 0.1 - 0.7, p = 0.004), but more likely in students who consumed fruits and vegetables > 3 days per week (AOR = 2.6, 95 % CI = 1.2 - 5.4, p = 0.015). Abdominal obesity was also less likely in male students (AOR = 0.0, 95 % CI = 0.0 - 0.5, p = 0.017) but more likely in students who consumed roots and tubers > 3 times per week (AOR = 8.0, 95 % CI = 2.2 - 10.1, p = 0.017) and in those who consumed alcoholic and non-alcoholic beverages > 3 times per week (AOR = 8.2, 95 % CI = 2.2 - 31.1, p = 0.002). CONCLUSION Demographic factors, dietary habits and physical activity levels were found to be associated to general overweight/obesity and abdominal obesity. General overweight/obesity was associated to the consumption of fruits and vegetables > 3 times a week. The consumption of roots and tubers > 3 times per week and alcoholic and non-alcohol beverages > 3 times a week was associated to abdominal obesity. Engagement in vigorous physical activity and being male were negatively associated to general overweight/obesity and abdominal obesity respectively. Promotion of active lifestyles in young adults should be encouraged.
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Affiliation(s)
- Victor Mogre
- />Department of Human Biology, School of Medicine and Health Sciences, University for Development Studies, P.O. Box TL 1883, Tamale, Ghana
| | - Rauf Nyaba
- />Department of Allied Health Sciences, School of Medicine and Health Sciences, University for Development Studies, P.O. Box TL 1883, Tamale, Ghana
| | - Samuel Aleyira
- />Department of Allied Health Sciences, School of Medicine and Health Sciences, University for Development Studies, P.O. Box TL 1883, Tamale, Ghana
| | - Napoleon B. Sam
- />Academic Affairs Unit, University for Development Studies, P.O. Box 1350, Tamale, Ghana
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Egan M, Burke E, Meskell P, MacNeela P, Dowling M. Quality of life and resilience related to chemotherapy-induced peripheral neuropathy in patients post treatment with platinums and taxanes. J Res Nurs 2015. [DOI: 10.1177/1744987115574296] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to ascertain patients' quality of life and resilience related to chemotherapy-induced peripheral neuropathy (CIPN) after treatment with platinum- and taxane-based chemotherapy drugs. A self-administered questionnaire combining the EORTC QLQ-C30 (version 3), the EORTC QLQ-CIPN20 and the resilience scale RS-14TM was posted to a non-probability sample of 100 patients who had recently completed treatment with a platinum- or taxane-based drug. In total, 86 completed questionnaires were returned (86% response rate). Participants rated their overall quality of life and overall health over the previous week. The combined global health status score was 70, indicating that participants had a relatively high health status. Similar to the scores on the EORTC QLQ-30, scores for the EORTC QLQ-CIPN20 showed that the majority of participants indicated experiencing very little impact (not at all, a little) on sensory, motor and autonomic scales. However, motor scale items were generally rated lower than items concerning sensory functioning. The study results are an encouraging indication of minimal impact on quality of life when treatment with taxanes and platinums ended. The results also indicate that resilience scores among the participants were moderately high.
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Affiliation(s)
- Mary Egan
- Advanced Nurse Practitioner, Portiuncula Hospital, Ballinasloe, Co. Galway, Ireland
| | - Eimear Burke
- University Teacher, School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Pauline Meskell
- Lecturer, School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Pádraig MacNeela
- Lecturer, School of Psychology, National University of Ireland, Galway, Ireland
| | - Maura Dowling
- Lecturer and programme director, School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
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Oliveira AJ, Rostila M, Saarela J, Lopes CS. The influence of bereavement on body mass index: results from a national Swedish survey. PLoS One 2014; 9:e95201. [PMID: 24759975 PMCID: PMC3997390 DOI: 10.1371/journal.pone.0095201] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 03/24/2014] [Indexed: 11/23/2022] Open
Abstract
Background Previous findings suggest that the loss of a family member is associated with health and mortality. The purpose of this study was to investigate the association between bereavement experiences and BMI, and whether there are socio-demographic differences in this association. Objective To investigate the association between bereavement experiences and BMI, and whether there are socio-demographic differences in this association. Methods We used cross-sectional data with retrospective questions from the Swedish Level of Living Survey (LNU) of 2000, including 5,142 individuals. The bereavement experiences examined in the study include the loss of a sibling, a parent or a spouse, and time since the death of a parent. BMI (kg/m2) was calculated using self-reported measurements of weight and height. The association between bereavement and BMI was evaluated through linear regressions. Results After controlling for possible confounders, most of the models detected an association between bereavement and BMI. The fully-adjusted model showed that loss of parents was associated with a 0.45 increase in BMI (SE = 0.20). The effect also seemed to be dependent on time since the loss and social class position. Conclusions The present study is the first to examine associations between different types of familial losses and BMI. We find an association between the death of a family member and BMI, but it appears to be related to time since the death, type of bereavement experience and social class.
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Affiliation(s)
- Aldair J. Oliveira
- Laboratory of Social Dimensions Applied to Physical Activity and Sport (LABSAFE), Department of Physical Education and Sports, Rural Federal University of Rio de Janeiro, Seropédica, Brazil
- * E-mail:
| | - Mikael Rostila
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Jan Saarela
- University of Helsinki, Helsinki, Finland and Åbo Akademi University, Vasa, Finland
| | - Claudia S. Lopes
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
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de Hollander EL, Picavet HSJ, Milder IE, Verschuren WMM, Bemelmans WJE, de Groot LCPGM. The impact of long-term body mass index patterns on health-related quality of life: the Doetinchem Cohort Study. Am J Epidemiol 2013; 178:804-12. [PMID: 23820786 DOI: 10.1093/aje/kwt053] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Overweight is associated with a reduced health-related quality of life (QOL), but less is known about the impact of long-term body mass index (BMI, calculated as weight (kg)/height (m)(2)) patterns on QOL in adults. In the Dutch Doetinchem Cohort Study (1989-2009) that included 1,677 men and 1,731 women aged 20-66 years, 6 BMI patterns were defined by using 4 measurements over a 15-year period: 1) persistent healthy weight (18.5-24.9, reference pattern); 2) persistent overweight (25.0-29.9); 3) persistent obesity (≥30.0); 4) developing overweight; 5) developing obesity; and 6) switching between BMI categories. For each BMI pattern, adjusted QOL (measured on a 0-100 scale) was estimated at the end of this period. The lowest QOL was observed for persistent obesity of all BMI patterns. It was 5.0 points (P = 0.02) lower for 1 mental dimension in men and 6.2-11.6 points (P < 0.05) lower for 5 (mainly physical) dimensions in women. Developing overweight or obesity scored 1.8-6.3 points (P < 0.05) lower on 2-5 (mainly physical) dimensions. Persistent overweight hardly differed from a persistent healthy weight. In women, switching between BMI categories resulted in a lower QOL on the mental dimensions. Studying long-term BMI patterns over a 15-year period showed that persistent obesity, developing overweight, and developing obesity resulted in a lower QOL-particularly on the physical dimensions-compared with a persistent healthy weight.
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Affiliation(s)
- Ellen L de Hollander
- Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
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