Self-reported physical and mental health status and quality of life in adolescents: a latent variable mediation model

Depression Literacy and Depressive Symptoms: The Mediating Role of Self-Rated Mental Health Among Korean Americans

OBJECTIVE

Depression literacy (DL) is increasingly recognized as an important predictor of mental health outcomes, but there remains a noticeable lack of scientific inquiry focusing on Korean Americans in this area. In addition, women are known to be more susceptible to depression, potentially affecting their DL and depressive symptoms differently than men. This study aimed to explore two primary objectives: (1) the potential role of self-rated mental health (SRMH) in mediating the association between DL and depressive symptoms in this population, and (2) whether gender differences exist in the presence and magnitudes of these mediation effects.

METHOD

Data were drawn from a survey with 693 Korean Americans aged 18 and older residing in New York and New Jersey. The PROCESS macro was used to test the mediation effect of self-rated mental health on the relationship between depression literacy and depressive symptoms in men and women.

RESULTS

Self-rated mental health was found to mediate the relation between depression literacy and depressive symptoms in women but not in men.

CONCLUSIONS

Providing evidence-informed, culturally tailored and gender specific depression literacy education and programs for the KA communities may be an important strategy to reduce depressive symptoms in this group.

Self-rated mental health in the transition to adulthood predicts depressive symptoms in midlife

Self-rated mental health (SRMH), a single item asking individuals to evaluate their mental or emotional health, is included in some surveys as an indicator of risk for mental disorders and to monitor population health, yet little longitudinal research examines how well it predicts future outcomes. Following a life course perspective, the current longitudinal study of 502 Canadian high school seniors tracked into midlife examined to what extent SRMH at ages 20, 25, and 32 years predicted depressive symptoms at ages 43 and 50. Hierarchical linear regressions showed that lower SRMH at age 25 and at 32 years was a significant predictor of higher levels of depressive symptoms at ages 43 and 50, even when controlling for sex, participant education, marital/cohabitation status, self-rated physical health, and baseline depressive symptoms. The results provide evidence that SRMH assessed during the transition to adulthood may be useful as a broad and powerful measure of risk for mental health problems decades into the future.

Mental health problems among healthcare professionals following the workplace violence issue-mediating effect of risk perception

Although there have been numerous studies on mental wellbeing impairment or other negative consequences of Workplace Violence (WPV) against healthcare professionals, however, the effects of WPV are not limited to those who experience WPV in person, but those who exposed to WPV information indirectly. In the aftermath of "death of Dr. Yang Wen," a cross-sectional study was conducted to explore the psychological status of healthcare professionals. A total of 965 healthcare professionals from 32 provinces in China participated in our research. The prevalence rates of Post-Traumatic Stress Disorder (PTSD) symptoms, depression, anxiety among healthcare professional in the current study were 25.60, 46.01, and 27.88%, respectively. Moreover, our research suggested that the awareness of WPV-incident had a significant association with PTSD symptoms. In addition, risk perception was shown to mediate the effect of WPV awareness on PTSD symptoms. Furthermore, the present research also found a U-shaped relationship between issue salience and PTSD symptoms, and the relationship between issue salience and anxiety, indicating that higher awareness of WPV issue was negatively related to mental health status (including PTSD and anxiety) but only to the points at which there were no additional effects of more issue salience. This study highlighted that more protective measures for healthcare professionals need to be implemented in response to potential WPV events. More importantly, risk perception was found to mediate the effect of WPV issue salience on PTSD symptoms, it is critical to reduce the mental health burden through intervening in risk perception.

Measuring Mental Wellness of Adolescents: A Systematic Review of Instruments

Objective

Mental health is critical to the healthy development of adolescents. However, mental health encompasses more than the absence of mental illness; and should include indicators of mental wellness. A critical review of available mental wellness instruments for adolescents were conducted to identify operational definitions of mental wellness concepts for this population group.

Method

A systematic review of literature published between 2000 and 2020 was done to identify mental wellness instruments for adolescent populations. The review followed the PRISMA operational steps.

Results

We identified 2,543 articles from the search strategy and screened titles and abstracts for eligibility. After appraisal, 97 studies were included in the qualitative synthesis; of which, 79 mental wellness instruments were identified. Most studies did not provide a definition for mental wellness. We identified thirteen mental wellness concepts from 97 studies, namely: life satisfaction, mental wellbeing [general], resilience, self-efficacy, self- esteem, connectedness, coping, self-control, mindfulness/spiritual, hope, sense of coherence, happiness, and life purpose.

Conclusion

The review reflected previous research identifying a lack of consensus around the definitions of mental health, mental wellness, and mental wellbeing. This has implications for developing instruments for adolescents that adequately measure these constructs. Most of the instruments identified in the review were predominantly English and from developed countries. This indicates a need for instrument that are explicitly conceptualised and operationalised for adolescents in all their varied contexts.

Migraine Attacks and Relevant Trigger Factors in Undergraduate Nursing Students in Hong Kong: A Cross-Sectional Study

Objective

This study aimed to examine the prevalence and features of migraine and explore the possible migraine triggers in a sample of university nursing students in Hong Kong.

Methods

A cross-sectional study using self-administered questionnaires was conducted in the Hong Kong Polytechnic University in 2016. The questionnaire included ID Migraine™ for migraine screening and items measuring the frequency, duration, severity, associated symptoms, and trigger factors of migraine. Years 2–5 undergraduate nursing students from the university completed the questionnaires. Binary logistic regression was conducted to examine the migraine-associated factors.

Results

A total of 702 nursing students, including 168 males and 534 females, were successfully screened. Their mean age was 20.8 ± 1.4 years. The overall prevalence of migraine reached 11.8%. Over half (67.5%) of the students with migraine experienced attacks at least once per month. Each attack had a median duration of 3 h (interquartile range: 1–4 h) and the mean pain intensity score of 6.4 ± 1.6. Students with a family history of migraine (adjusted odds ratio [OR]: 1.89; 95% confidence interval [CI]: 1.10, 3.25; p < 0.05) and poor general health status (Adjusted OR: 3.41, 95% CI: 1.05, 11.09; p < 0.05) were more likely to suffer from migraine than those without. The three most common migraine triggers were the lack of sleep (94.0%), change in sleep schedule (83.1%), and noise (81.9%). Female students were more likely to experience fatigue-triggered migraine than male students (85.9% vs 63.2%, p < 0.05).

Conclusion

Migraine prevalence was relatively high among undergraduate nursing students in Hong Kong. Sleep problem was the most frequent trigger factor. The students’ awareness of migraine attacks should be increased, and migraine management must be improved by avoiding common trigger factors in this population.

Investigating Effects of COVID-19 Pandemic on the Mental Health of Nursing Students During Remote Learning: An Experience from Dong A University, Vietnam

Introduction

There was a radically changed in nursing education during the nationwide lockdown due to the COVID-19 outbreaks. The transition to remote learning stressed nursing students in many countries, particularly in Vietnam. However, there is still lacking a novel study to describe the mental characteristics of nursing students in detail.

Objectives

To assess the mental health of nursing students, including stress, anxiety, and depression, and to identify the related factors to their mental health during the online study period because of the COVID-19 pandemic.

Methods

A cross-sectional survey was conducted on 540 nursing students at Dong A university using a socio-demographic questionnaire, the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21). Data were analyzed by descriptive statistics and tests, including Mann-Whitney, Kruskal-Wallis, and Spearman's correlation to identify the related factors.

Results

In total 540 participants, nursing students reported stress (N  =  120, 22.2%), anxiety (n  =  195, 36.1%), and depression symptoms (n  =  135, 23.1%). There was a significant relationship between age, work status, married status, number of children, stress, anxiety, and depression (P < 0.01). In addition, our study showed a negative correlation between frequency of physical activity, perceived health and stress (r  =  -0.117; p < 0.01, r  =  -0.127, p < 0.01), anxiety (r  =  -0.133; p < 0.01, r  =  -0.112, p < 0.01), depression (r  =  -0.134; p < 0.01, r  =  -0.135, p < 0.01). A significant relationship was observed between e-learning space and Internet status with mental health (p < 0.05). Especially, there was no association between average online learning time, academic workload, stress, anxiety, and depression (p > 0.05). However, the authors found a positive association between perceived level of stress related to evaluative activities and stress, anxiety, depression (r  =  0.120, p < 0.01; r  =  0.089, p < 0.05; r  =  0.088, p < 0.05).

Conclusion

Nursing students suffered stress, anxiety, and depression during online learning due to the COVID-19 pandemic in the presence of some related factors. Therefore, this study may increase more attention of universities, families, and governments to reduce the stress of nursing students during distance education.

Adolescents' Mental Health at School: The Mediating Role of Life Satisfaction

In this study, we further developed prior research on risk and protective factors in adolescents' mental health. More specifically, we used structural equation modelling to assess whether relationships at school with teachers and peers, and life satisfaction predicted mental health in a large sample of adolescents, while also testing for age and gender invariance. The sample comprised 3,895 adolescents (M age = 16.7, SD = 1.5, 41.3% girls), who completed self-report instruments assessing their perceived life satisfaction, student-teacher relationship, school connectedness and mental health. Overall, the results suggested that life satisfaction acted as a mediator between adolescents' positive school relations and their mental health. Outcomes were invariant across genders, while quality of school relations and mental health declined with age. Limitations of the study and futures lines in mental health research among adolescents are briefly discussed.

Lifestyle mediates the relationship between self-esteem and health-related quality of life in Chilean schoolchildren

A healthy lifestyle, including food habits, physical activity (PA) and screen time (ST), is an important factor for well-being. The main purpose of this study was to analyze the association between lifestyle (i.e., PA, ST and food habits), self-esteem and health-related quality of life (HRQoL). A second objective was to determine the association between self-esteem with HRQoL, considering the mediating effect of lifestyle. A descriptive and cross-sectional study was performed, involving both girls (n = 282, 11.86 ± 0.82 years) and boys (n = 352, 12.02 ± 0.87 years). Lifestyle, self-esteem, HRQoL and anthropometrics parameters were evaluated. The study reported that self-esteem (β; 0.04, P = 0.49) and PA (β; 1.15, P < 0.001) had positive association with HRQoL. By contrast,ST was linked in an inverse way to HRQoL (β; -1.82,, P < 0.001). According to the second objective, self-esteem had a significant association with HRQoL (total effect = 0.48, p < 0.01), and ST mediated this association negatively, instead, PA and food habits positively mediated this association. In conclusion, self-esteem presented association with HRQoL and lifestyle mediates this relationship positively (PA, MD adherence) and negatively (ST). Therefore, promoting healthy lifestyle among children should be a target of community- and school-based interventions to promote well-being.

Immigrant acculturation and wellbeing across generations and settlement contexts in Canada

When immigrants settle into their new societies, variations in their wellbeing are commonly found, due to a number of factors: their generation; their specific settlement context; and their acculturation strategies. With respect to settlement context, the policy of multiculturalism in Canada and of interculturalism in Quebec, provide different contexts for immigrant acculturation and wellbeing. Acculturation strategies are assessed with measures of sense of belonging to Canada and to the province of residence: Canada and Province (strong sense of belonging to both); either Canada only or province only (strong belonging to one or to the other); and neither (strong to neither). Wellbeing is assessed by scales of Life Satisfaction and Mental Health. This study examines whether these context differences may be associated with variations in the acculturation strategies and wellbeing among immigrants and later generations. Samples of adult immigrants and subsequent generations were drawn from those who live in Québec and in the rest of Canada. The distribution of the four profiles among immigrants did not differ between Québec and the rest of Canada. However, among later generations, the 'Canada only' profile is lower, while the 'province only' is higher, in Québec than in the rest of Canada. These findings suggest a drawing away from identifying with Canada, and an increase in identifying with Québec, in later generations in Québec. This pattern is consistent with the goals of the different incorporation policies in Québec and the rest of Canada. Wellbeing was generally higher in the group with high sense of belonging to both Canada and Québec, and Mental Health was higher in Québec than in the Rest of Canada in all three generations. Implications of these findings for acculturation and settlement policy are discussed.

Construct and Psychometric Properties of a New Version Quality of Life Scale Based on Choice Theory

BACKGROUND

Choice theory, as a psychopathological model, postulated five basics, genetically and universally, needs. Accordingly, the rate of everybody happiness and quality of life is depended on the number of his needs fulfilling. Although some scales have been constructed to assess basic needs, they have proposed unity of needs for all human.

AIM

The present study was designed to construct a new scale, considering individualisation needs for each person; quality of life scale based on choice theory (QOLSCT).

METHODS

Using cluster sampling, six hundred (49% female and 51% male) postgraduate students were selected. One hundred fifty participants also filled SF-36 and GHQ, and 80 participants refilled QOLSCT with four weeks' interval again.

RESULTS

Cronbach's alpha, split-half and test re-test (one month) reliability scores were 0.78, 0.75, and 0.92 successively. The correlation between items and total scores range from 0.36 to 0.72, all with P values ≥ 0.0001. Confirmatory factor analysis showed satisfactory values of goodness-of-fit indices, RMSEA, CFI, NFI and GFI were, 0.05, 0.99, 0.99 and 0.99 respectively. Convergent and divergent validity also showed significant correlations.

CONCLUSION

The result of the present study showed that the new version of quality of life scale based on choice theory could be confirmed. The good level of reliability, fairly goodness of fit indexes, and very good convergent validity support this idea.

Predictors of positive mental health among refugees: Results from Canada's General Social Survey

Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.

Girls' quality of life prior to detention in relation to psychiatric disorders, trauma exposure and socioeconomic status

PURPOSE

Practice and research on detained girls has mainly been problem oriented, overlooking these minors' own perspective on and satisfaction with life. The aim of this study was to examine how girls evaluate multiple domains of quality of life (QoL) and how each domain is affected by psychiatric (co)morbidity, trauma, and socioeconomic status (SES).

METHODS

An abbreviated version of the World Health Organization (WHO) QoL Instrument was used to assess the girls' (N = 121; M(age) = 16.28) QoL prior to detention. This self-report questionnaire consists of two benchmark items referring to their overall QoL and health, and 24 remaining items measuring their QoL regarding four domains (physical health, psychological health, social relationships, and environment). The Diagnostic Interview Schedule for Children-IV was used to assess the past-year prevalence of psychiatric disorders and life-time trauma exposure.

RESULTS

Detained girls perceived their QoL almost as good as the 12- to 20-year-olds from the WHO's international field trial on all but one domain (i.e., psychological health). They were most satisfied with their social relationships and least satisfied with their psychological health. Psychiatric disorders, trauma, and low SES were distinctively and negatively related to various domains of QoL. The girls' psychological health was most adversely affected by psychosocial and socioeconomic problems, while these variables had an almost negligible impact on their satisfaction with their social relationships.

CONCLUSIONS

The particularity of each domain of QoL supports a multidimensional conceptualization of QoL. Regarding treatment, psychological health appears as a domain of major concern, while social relationships might serve as a source of resilience.

Single item measures of self-rated mental health: a scoping review

BACKGROUND

A single-item measure of self-rated mental health (SRMH) is being used increasingly in health research and population health surveys. The item asks respondents to rate their mental health on a five-point scale from excellent to poor. This scoping study presents the first known review of the SRMH literature.

METHODS

Electronic databases of Medline, CINAHL, PsycINFO, EMBASE and Cochrane Reviews were searched using keywords. The databases were also searched using the titles of surveys known to include the SRMH single item. The search was supplemented by manually searching the bibliographic sections of the included studies. Two independent reviewers coded articles for inclusion or exclusion based on whether articles included SRMH. Each study was coded by theme and data were extracted about study design, sample, variables, and results.

RESULTS

Fifty-seven studies included SRMH. SRMH correlated moderately with the following mental health scales: Kessler Psychological Distress Scale, Patient Health Questionnaire, mental health subscales of the Short-Form Health Status Survey, Behaviour and Symptom Identification Scale, and World Mental Health Clinical Diagnostic Interview Schedule. However, responses to this item may differ across racial and ethnic groups. Poor SRMH was associated with poor self-rated health, physical health problems, increased health service utilization and less likelihood of being satisfied with mental health services. Poor or fair SRMH was also associated with social determinants of health, such as low socioeconomic position, weak social connections and neighbourhood stressors. Synthesis of this literature provides important information about the relationships SRMH has with other variables.

CONCLUSIONS

SRMH is associated with multi-item measures of mental health, self-rated health, health problems, service utilization, and service satisfaction. Given these relationships and its use in epidemiologic surveys, SRMH should continue to be assessed as a population health measure. More studies need to examine relationships between SRMH and clinical mental illnesses. Longitudinal analyses should look at whether SRMH is predictive of future mental health problems.

The role of quality of care and attitude towards disability in the relationship between severity of disability and quality of life: findings from a cross-sectional survey among people with physical disability in China

Background

People with physical disability (PWPD) is the largest subgroup of people with disability (PWD) in China, but few studies have been conducted among this vulnerable population. The objective of this study was to investigate the level of quality of life (QoL), self-perceived quality of care and support (QOCS), severity of disability and personal attitude towards disability among people with physical disability in China, as well as to identify how QoL can be affected by severity of disability through QOCS and personal attitude towards disability among PWPD.

Methods

A cross-sectional study was conducted among 1,853 PWPD in Guangzhou, China. Data were collected on participants’ QoL, QOCS, personal attitude towards disability and severity of disability. Structural equation modeling was used to examine the effects of the other variables on QoL.

Results

Even with a mild disability (mean score:1.72), relatively low levels of QoL (mean score: 2.65- 3.22) and QOCS (mean score: 2.95 to 3.28), as well as unfavorable personal attitude towards disability (mean score: 2.75 to 3.36) were identified among PWPD. According to SEM, we found that the influence of severity of physical disability on QoL is not only exerted directly, but is also indirectly through QOCS and their personal attitudes towards disability, with QOCS playing a more important mediating role than PWPD’s attitudes towards their own disability.

Conclusions

Unfavorable health status was identified among PWPD in China. Focusing on improvement of assistance and care services has the potential to substantially improve PWPD’s QoL. Further research should focus on understanding the needs and their current state of health care of PWPD in China thus being able to develop better interventions for them.

Bilingualism: A Pearl to Overcome Certain Perils of Cochlear Implants

Cochlear implants (CI) have demonstrated success in improving young deaf children's speech and low-level speech awareness across a range of auditory functions, but this success is highly variable, and how this success correlates to high-level language development is even more variable. Prevalence on the success rate of CI as an outcome for language development is difficult to obtain because studies vary widely in methodology and variables of interest, and because not all cochlear implant technology (which continues to evolve) is the same. Still, even if the notion of treatment failure is limited narrowly to those who gain no auditory benefit from CI in that they cannot discriminate among ambient noises, the reported treatment failure rate is high enough to call into question the current lack of consideration of alternative approaches to ensure young deaf children's language development. Recent research has highlighted the risks of delaying language input during critical periods of brain development with concomitant consequences for cognitive and social skills. As a result, we propose that before, during, and after implantation deaf children learn a sign language along with a spoken language to ensure their maximal language development and optimal long-term developmental outcomes.

Urban environment and children's active lifestyle: softGIS revealing children's behavioral patterns and meaningful places

PURPOSE

To determine the relationship between (1) urban structure characteristics, (2) children's environmental experiences and active behavioral patterns, and (3) perceived health and body mass index (BMI).

DESIGN

Cross-sectional study.

SETTING

City of Turku, western coast of Finland, 175,000 inhabitants. Average residential density of the studied settings was 17 housing units per hectare, proportion of green structure 43%, and proportion of population under 15 years old 17%.

SUBJECTS

One thousand eight hundred thirty seven fifth (10-12 years old) and seventh (13-15 years old) graders from 54 schools in Turku.

MEASURES

Self-reported behavioral patterns (activity of school travel mode, territorial range, mobility licenses, and distance to meaningful places) and environmental experiences (localized meaningful places, likability index, environmental fears) were gathered on the basis of locality with an Internet-based softGIS method. Self-reported BMI, perceived health, and daily symptoms were also queried. Geographic information system-based measures of urban structure (residential density, proportion of green structure, proportion of children), calculated within a 500-m buffer of each respondent's home, were used as independent variables.

ANALYSIS

Mainly logistic regression analysis.

RESULTS

After controlling for gender, age, and neighborhood socioeconomic status (proportion of academically educated), residential density was significantly associated with active travel mode to school and short distances to the meaningful places of children. The proportions of green structure and children had an association with nonactive transport, long distance to meaningful places, and small territorial range. We also found significant associations between active school travel mode and reduced risk of being overweight when controlled for gender and age but not when the proportion of academically educated was also controlled. The negative association between likability index and daily symptoms and positive association with perceived health remained significant after controlling for all three background variables. The only urban structure variable directly associated with good perceived health was the proportion of green structure around the child's home.

CONCLUSION

Moderate urban density seems to have child-friendly characteristics such as an ability to promote active school journeys and to guarantee a short distance to meaningful places. The studied Finnish children expressed very few environmental fears, and the possibilities for them to independently use the opportunities of the urban environment were very high. The limitation of the study was that the socioeconomic background variables were extracted from register-based geographic grid data rather than from respondents. More refined measures of urban structure are also needed in future studies.

Efficacy-mediated effects of spirituality and physical activity on quality of life: a path analysis

BACKGROUND

Physical activity has been established as an important determinant of quality of life, particularly among older adults. Previous research has suggested that physical activity's influence on quality of life perceptions is mediated by changes in self-efficacy and health status. In the same vein, spirituality may be a salient quality of life determinant for many individuals.

METHODS

In the current study, we used path analysis to test a model in which physical activity, spirituality, and social support were hypothesized to influence global quality of life in paths mediated by self-efficacy and health status. Cross-sectional data were collected from a sample of 215 adults (male, n = 51; female, n = 164) over the age of 50 (M age = 66.55 years).

RESULTS

The analysis resulted in a model that provided acceptable fit to the data (χ2 = 33.10, df = 16, p < .01; RMSEA = .07; SRMR = .05; CFI = .94).

CONCLUSIONS

These results support previous findings of an efficacy-mediated relationship between physical activity and quality of life, with the exception that self-efficacy in the current study was moderately associated with physical health status (.38) but not mental health status. Our results further suggest that spirituality may influence health and well-being via a similar, efficacy-mediated path, with strongest effects on mental health status. These results suggest that those who are more spiritual and physically active report greater quality of life, and the effects of these factors on quality of life may be partially mediated by perceptions of self-efficacy.

Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks

Background

Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks.

Methods

A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group - employed women with paid work, and, 2. home-based social network group - women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class.

Results

There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥4 [OR 1.73 (95% CI: 1.23-2.42)].

Conclusions

Pregnant and post-partum Brazilian women in paid employment outside the home and having social supports had better OHRQoL than those with home-based social networks.

Does the association between depressive symptomatology and physical activity depend on body image perception? A survey of students from seven universities in the UK

This cross-sectional study assessed the association between depression and PA in university students of both genders and the role of body image perception as a potential effect modifier. Undergraduate students (N = 3706) from seven universities in the UK completed a self-administered questionnaire that assessed sociodemographic information; a range of health, health behaviour and health awareness related factors; the modified version of Beck’s Depression Inventory (M-BDI); educational achievement, and different levels of physical activity (PA), such as moderate PA (at least 5 days per week moderate exercise of at least 30 minutes), and vigorous PA (at least 3 days per week vigorous exercise of at least 20 minutes). Only 12.4% of the sample achieved the international recommended level for moderate PA, and 33.1% achieved the recommendations for vigorous PA. Both moderate and vigorous PA were inversely related to the M-BDI score. Physically active students, regardless of the type of PA, were significantly more likely to perceive their health as good, to have higher health awareness, to perform strengthening exercises, and to be males. The stratified analyses indicated that the association between depression and PA differed by body image. In students perceiving their body image as ‘just right’, moderate (>4th percentile) and high (>5th percentile) M-BDI scores were inversely related to vigorous PA. However, in students who perceived their body image as ‘overweight’, the inverse association was only significant in those with high M-BDI scores. We conclude that the positive effect of PA on depression could be down modulated by the negative impact of a ‘distorted’ body image on depression. The practical implications of these findings are that PA programmes targeting persons with depressive symptoms should include effective components to enhance body image perception.