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García-Gollarte F, Mora-Concepción A, Pinazo-Hernandis S, Segura-Ortí E, Amer-Cuenca JJ, Arguisuelas-Martínez MD, Lisón JF, Benavent-Caballer V. Effectiveness of a Supervised Group-Based Otago Exercise Program on Functional Performance in Frail Institutionalized Older Adults: A Multicenter Randomized Controlled Trial. J Geriatr Phys Ther 2023; 46:15-25. [PMID: 34417416 DOI: 10.1519/jpt.0000000000000326] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Because of its high prevalence and association with negative health-related outcomes, frailty is considered one of the most important issues associated with human aging and its mitigation is among the essential public health goals for the 21st century. However, very few studies have focused on institutionalized older adults, despite the knowledge that frailty can be reversible when identified and treated from its earliest stages. Therefore, the objective of this study was to evaluate the effects of a supervised group-based multicomponent exercise program intervention with or without oral nutritional supplementation on functional performance in frail institutionalized older adults. METHODS This was a multicenter randomized controlled trial study with a 6-month intervention period. A total of 111 frail institutionalized older adults (75 years or older) who met at least 3 of the 5 Fried frailty criteria were randomly allocated to the control group (CG; n = 34, mean age = 87.3 ± 5.3 years), a supervised group-based multicomponent Otago Exercise Program group (OEP; n = 39, mean age = 86 ± 5.9 years), or a supervised group-based multicomponent exercise program intervention with oral nutritional supplementation (OEP+N; n = 38, mean age = 84.9 ± 6 years). Measurements included the Timed Up and Go test (TUG), Berg Balance Scale (BBS), Short Physical Performance Battery, repeated chair stand test (STS-5), handgrip strength (HGS), 10-m walking test, and 6-minute walking test, both at baseline and after the 6-month intervention period. RESULTS AND DISCUSSION The between-group analysis by 2-way analysis of covariance showed significant improvement in the TUG [{OEP vs CG: -8.2 seconds, 95% CI [-13.3 to -2.9]; P < .001}; {OEP vs OEP+N: -7.3 seconds, 95% CI [-12.4 to -2.2]; P = .002}], BBS [{OEP vs CG; 8.2 points, 95% CI [5.2 to 11.2]; P < .001}; [{OEP+N vs CG: 4.6 points, 95% CI [1.6 to 7.6]; P < .001}; {OEP vs OEP+N: 3.5 points, 95% CI [0.6 to 6.5]; P = .011}], and HGS [{OEP vs CG: 3.4 kg, 95% CI [1.5 to 5.3]; P < .001}; {OEP+N vs CG: 3.6 kg, 95% CI [1.7 to 5.5]; P < .001}]. Additionally, the within-group analysis showed a significant improvement in the TUG (-6.9 seconds, 95% CI [-9.8 to -4.0]; P < .001) and BBS (4.3 points, 95% CI [2.6 to 5.9]; P < .001) in the OEP group. A significant decrease in the BBS and HGS was shown in the CG. CONCLUSIONS A 6-month supervised group-based multicomponent exercise intervention improved the levels of mobility, functional balance, and HGS in frail institutionalized older adults. Further research will be required to evaluate the nutritional supplementation effects on functional performance to better determine its clinical applicability for tackling frailty.
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Affiliation(s)
| | | | | | - Eva Segura-Ortí
- Department of Physical Therapy, University CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Juan José Amer-Cuenca
- Department of Physical Therapy, University CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | | | - Juan Francisco Lisón
- Department of Biomedical Sciences, University CEU Cardenal Herrera, CEU Universities, Valencia, Spain
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain
| | - Vicent Benavent-Caballer
- Department of Physical Therapy, University CEU Cardenal Herrera, CEU Universities, Valencia, Spain
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Keaton SA, Arnetz J, Jamil H, Dhalimi A, Stemmer PM, Ruden DM, Yamin J, Achtyes E, Smart L, Brundin L, Arnetz BB. IL-10: A possible immunobiological component of positive mental health in refugees. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 8:100097. [PMID: 35757662 PMCID: PMC9216633 DOI: 10.1016/j.cpnec.2021.100097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 01/23/2023] Open
Abstract
Objective As the number of refugees continues to rise, there is growing concern about the impact from trauma exposures on their mental health. However, there is a limited understanding of possible biological mechanisms contributing to the substantial inter-individual differences in trauma-related outcomes, especially as it relates to positive mental health. Only sparse work has focused on the biology of positive mental health, including energy and sleep, in trauma-exposed persons. In this study, we analyzed cytokines in blood from newly arrived refugees with differential trauma exposures in relationship to self-reported energy, as a key marker of positive mental health. Methods Within the first month of arrival in the USA, 64 refugees from Iraq and Syria were interviewed. Refugees completed the clinical DSM-IV PTSD-Checklist Civilian Version (PCL-C), the Beck Anxiety Inventory (BAI), and the Hospital Anxiety and Depression Scale (HADS). Ten psychiatrically healthy non-refugee persons were used as healthy controls to compare levels of cytokines. Blood samples were collected at the time of the interview and subsequently analyzed for IL-1β, IL-6, IL-8, IL-10, and TNF-α concentrations. Results Energy correlated positively with current concentration ability and sleep quality, and negatively with stress, PCL-C, BAI and HADS scores (Spearman correlations, all p<0.05). Refugees had lower levels of IL-10 compared to controls (p<0.05). IL-10 levels in refugees correlated with higher energy levels (p<0.01). Conclusions Results suggest that self-reported energy is a key component of positive mental health in newly arrived traumatized refugees. Additionally, the anti-inflammatory cytokine IL-10 could be a marker of, or causally associated with positive mental health. A better understanding of the balance between pro- and anti-inflammatory states in highly traumatized individuals has the potential to create more targeted and effective treatments with implications for long-term health outcomes.
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Affiliation(s)
- Sarah A. Keaton
- Department of Physiology, Michigan State University, East Lansing, MI, USA
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Judy Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Hikmet Jamil
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Abir Dhalimi
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Paul M. Stemmer
- Institute of Environmental Health Science, Wayne State University, Detroit, MI, USA
| | - Douglas M. Ruden
- Institute of Environmental Health Science, Wayne State University, Detroit, MI, USA
| | - Jolin Yamin
- Institute of Environmental Health Science, Wayne State University, Detroit, MI, USA
| | - Eric Achtyes
- Pine Rest Christian Mental Health, Grand Rapids, MI, USA
- Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - LeAnn Smart
- Pine Rest Christian Mental Health, Grand Rapids, MI, USA
| | - Lena Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
- Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Bengt B. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Inoue Y, Nakata A, Kurioka S, Nagata T, Mori K. [Association of self-rated health with inflammatory markers among nursing home employees]. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2021; 63:117-128. [PMID: 33087634 DOI: 10.1539/sangyoeisei.2020-020-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Although self-rated health (SRH), the self-evaluation of one's own health status, has been reported to be associated with the immune status, the relationship between three different SRH measures (global, self-comparative, and age-comparative) with inflammatory markers as well as the relative strength of these associations by age are not well understood. The current study investigated the associations between SRH measures and inflammatory markers among nursing home employees. METHODS A sample of 120 Japanese employees at a nursing home (90 women and 30 men), aged 21-68 years (mean, 40.9 years), underwent a blood test for the measurement of inflammatory markers (interferon-γ, interleukin [IL]-4, IL-6, and tumor necrosis factor [TNF]-α, white blood cell count) and SRH during the annual health checkup. Multiple regression analysis adjusted for covariates was performed to analyze the relationship between inflammatory markers and SRH measures stratified by age, that is, aged < 40 years (younger age group) and 40 years and over (older age group). RESULTS Among the participants aged 40 years and over, poor global SRH was significantly associated with an increase in IL-6, while poor age-comparative SRH was significantly associated with an increase in TNF-α among participants aged < 40 years in the fully adjusted model controlling for potential confounders. Age-comparative SRH was also significantly associated with an increase in IL-6 among all participants. Self-comparative SRH was not significantly associated with inflammatory markers. CONCLUSIONS Our results suggest that three SRH measures are not equivalently associated with inflammatory markers, especially when the analyses were performed separately for the younger and older populations. This implies that not only differences in forms of SRH but also in age modify the relationship between SRH and inflammatory markers.
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Affiliation(s)
- Yukiko Inoue
- Graduate School of Medicine, International University of Health and Welfare.,Institutional Research Center, University of Occupational and Environmental Health, Japan
| | - Akinori Nakata
- Graduate School of Medicine, International University of Health and Welfare
| | | | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
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Arnetz BB, Templin TN, Jen KLC, Sudan S, Arnetz JE. Lifestyle and psychosocial factors associated with maintenance of normal body mass index in college students: a cross sectional study. BMC Res Notes 2020; 13:516. [PMID: 33168065 PMCID: PMC7653865 DOI: 10.1186/s13104-020-05362-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The purpose of this study was to identify lifestyle and psychosocial factors associated with maintenance of normal body mass index (BMI, 18.5-24.9 kg/m2). Undergraduate students (n = 2781; 7.1% response rate) at a Big Ten university responded to a survey in 2018. BMI was calculated from the reported weight and height at the time of the survey and upon entering the university. Logistic regression analyses examined lifestyle and psychosocial health factors associated with maintenance of normal BMI by academic year. RESULTS Current BMI was within normal range for 68.8% of freshmen and 60.6% of seniors. Never consuming fast food was a significant predictor for maintaining normal BMI in sophomores (OR 3.78; 95% CI 1.61, 8.88; p < 0.01) and juniors (OR 7.82; 95% CI 2.14, 28.65; p < 0.01). In seniors, better psychosocial health (OR 1.40; 95% CI 1.12, 1.76; p < 0.01) was the only significant predictor for maintaining one's normal freshman BMI category. Among those within the normal BMI range upon entering the university, psychosocial health (OR 1.31; 95% CI 1.10, 1.55; p < 0.01) was the only predictor of retaining one's absolute BMI within ± 3% as a senior. Prospective studies are needed to better understand the interaction between environment, behavior, and psychological health involved in retaining normal weight.
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Affiliation(s)
- Bengt B Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, 15 Michigan Street NE, Grand Rapids, MI, 49503, USA.
| | | | - K-L Catherine Jen
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI, USA
| | - Sukhesh Sudan
- Department of Family Medicine, College of Human Medicine, Michigan State University, 15 Michigan Street NE, Grand Rapids, MI, 49503, USA
| | - Judith E Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, 15 Michigan Street NE, Grand Rapids, MI, 49503, USA
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Miura K, Takamori A, Hamazaki K, Tsuchida A, Tanaka T, Origasa H, Inadera H. Dietary patterns during pregnancy and health-related quality of life: The Japan Environment and Children's Study. PLoS One 2020; 15:e0236330. [PMID: 32717744 PMCID: PMC7384865 DOI: 10.1371/journal.pone.0236330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 07/03/2020] [Indexed: 11/26/2022] Open
Abstract
Background Limited research exists on how dietary pattern (DP) influences pregnant women’s health-related quality of life (HRQOL). This study aimed to identify DPs in a cohort of 92,448 pregnant Japanese women using fixed data from the Japan Environment and Children’s Study (JECS) to investigate the associations of DP with HRQOL. Methods During the first trimester, DPs were assessed using the Food Frequency Questionnaire (FFQ), and HRQOL was assessed using the 8-Item Short-Form Health Survey (SF-8). DPs such as Western, Japanese and Unbalanced DP were identified through principal component analysis (PCA). Multivariable logistic model analysis was used to assess the associations between DP and HRQOL as good or poor. Results We found a significant association between poor mental HRQOL in the univariate analysis for the Western DP (p = 0.014). However, this association was not significant in the multivariate analysis adjusted for basic confounders (p = 0.078). Western DP was not highly associated with poor physical HRQOL (from low-medium to high levels of intake; adjusted odds ratio [OR] 0.87–0.88, all p≤0.001, when comparing highest to lowest intake levels). A high intake of the Japanese DP was significantly associated with poor mental HRQOL and physical HRQOL (adjusted OR 1.20, p<0.0001 and adjusted OR 1.12, p = 0.005, respectively). A medium-high intake of the Unbalanced DP was not highly associated with poor physical HRQOL (adjusted OR 0.93, p = 0.048) but with poor mental HRQOL (adjusted OR 1.29, p<0.0001). Conclusion This is the first known prospective study to establish an association between DP and HRQOL in pregnant women. We hope that our findings will help in the field of nutritional science.
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Affiliation(s)
- Kayoko Miura
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- * E-mail:
| | - Ayako Takamori
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Kei Hamazaki
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Akiko Tsuchida
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Tomomi Tanaka
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hideki Origasa
- Department of Biostatistics and Clinical Epidemiology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
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Galland-Decker C, Marques-Vidal P, Vollenweider P. Prevalence and factors associated with fatigue in the Lausanne middle-aged population: a population-based, cross-sectional survey. BMJ Open 2019; 9:e027070. [PMID: 31446404 PMCID: PMC6720133 DOI: 10.1136/bmjopen-2018-027070] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To assess the prevalence and factors associated with fatigue in the general population. DESIGN Population-based, cross-sectional survey performed between May 2014 and April 2017. SETTING General population of the city of Lausanne, Switzerland. PARTICIPANTS 2848 participants (53.2% women, age range 45-86 years). PRIMARY OUTCOME MEASURE Prevalence of fatigue the previous week, defined as a score of ≥4 using the Fatigue Severity Scale. RESULTS The prevalence of fatigue was 21.9% (95% CI 20.4% to 23.4%) in the total sample. On bivariate analysis, participants with fatigue were younger, had a higher body mass index, a lower handgrip strength and lower ferritin levels. Participants with fatigue were more frequently women, had a lower educational level, presented more frequently with clinical insomnia, diabetes, anaemia, depression and low thyroid stimulating hormone (TSH) values, had a higher consumption of antihistamines, antidepressants and hypnotics, and rated more frequently their health as bad or very bad. Multivariable analysis showed that obesity (OR 1.40 (95% CI 1.03 to 1.91)), insomnia categories (p value for trend <0.001), depression (OR 3.26 (95% CI 2.38 to 4.46)), anaemia (OR 1.70 (95% CI 1.00 to 2.89)) and low self-rated health status (p value for trend <0.001) were positively associated with fatigue, while older age (p value for trend 0.002) was negatively associated with fatigue. Conversely, no association was found for diabetes, TSH levels, antihistamines or hypnotics. CONCLUSION In a population-based sample aged 45-86, fatigue was present in one out of five subjects. Regarding clinical factors, sleep disturbances such as insomnia and sleep apnoea should be assessed first, followed by depression. Regarding biological factors, anaemia should be ruled out, while screening for hypothyroidism is not recommended as a first step. Sleep complaints and fatigue in older subjects are not due to ageing and should prompt identification of the underlying cause.
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Affiliation(s)
- Coralie Galland-Decker
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Abstract
OBJECTIVE Despite its simplicity, single-item measures of self-rated health have been associated with mortality independent of objective health conditions. However, little is known about the mechanisms potentially responsible for such associations. This study tested the association between self-rated heath and inflammatory markers as biological pathways, and whether sleep quality and/or depression statistically mediated such links. METHOD Eighty-six heterosexual married couples completed a standard measure of self-rated health, the Center of Epidemiological Studies-Depression Scale, and the Pittsburgh Sleep Quality Index. Participants also had blood drawn for determination of plasma levels of interleukin 6 and high-sensitivity C-reactive protein. The Monte Carlo method was used to construct confidence intervals for mediation analyses. RESULTS Results indicated that poor self-rated health was associated with higher CRP levels (B = .31, SE = .14, p = .028). Importantly, the Monte Carlo mediational analyses showed that these results were statistically mediated by sleep quality (aXb = 0.10, 95% confidence interval = 0.003 to 0.217) but not depressive symptoms (aXb = 0.03, 95% confidence interval = -0.03 to 0.10). CONCLUSIONS These results highlight the biological and behavioral mechanisms potentially linking self-rated health to longer-term health outcomes. Such work can inform basic theory in the area as well as intervention approaches that target such pathways.
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Arnetz BB, Arnetz J, Harkema JR, Morishita M, Slonager K, Sudan S, Jamil H. Neighborhood air pollution and household environmental health as it relates to respiratory health and healthcare utilization among elderly persons with asthma. J Asthma 2019; 57:28-39. [PMID: 30810414 DOI: 10.1080/02770903.2018.1545856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: The study investigated the associations between fine particulate matter (PM2.5; <2.5 μm in diameter), indoor environment, pulmonary function, and healthcare utilization in a vulnerable group of elderly persons with asthma. We hypothesized that environmental conditions were associated with adverse pulmonary health outcomes. Methods: The study involved elderly (n = 76; mean age 64.6 years; 48 women) vulnerable persons in Detroit, Michigan, USA, with physician-diagnosed asthma. Exposure variables included measured outdoor PM2.5, self-rated outdoor and household environmental pollutants. Outcome variables were self-rated and measured pulmonary function, and asthma-related healthcare utilization. Results: Mean ambient PM2.5 concentrations during the study was 14.14 ± (S.D. 6.36) µg/m3 during the summer and 14.20 (6.33) during the winter (p = 0.95). In multiple regression analyses, adjusting for age and gender, mean 6-month concentration of PM2.5 was related to shortness of breath (SHOB; standardized β = 0.26, p = 0.02) and inversely with self-rated respiratory health (SRRH; β = 0.28, p = 0.02). However, PM2.5 did not predict lung function (FEV1% predicted and FEV1/FVC). However, PM2.5 was related to use of asthma controller drugs (β = 0.38, p = 0.001). Participants' air pollution ratings predicted total healthcare utilization (β = 0.33, p = 0.01). Conclusions: In elderly persons with asthma, living near heavy industry and busy highways, objective and perceived environmental pollution relate to participants' respiratory health and healthcare utilization. Importantly, air pollution might increase use of asthma controller drugs containing corticosteroids with implication for elderly persons' risk to develop osteoporosis and cardiovascular disease.
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Affiliation(s)
- Bengt B Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Judy Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jack R Harkema
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Masako Morishita
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - Kathleen Slonager
- Asthma and Allergy Foundation of America, Michigan Chapter, Franklin, MI, USA
| | - Sukhesh Sudan
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - Hikmet Jamil
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
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Can physical activity compensate for low socioeconomic status with regard to poor self-rated health and low quality-of-life? Health Qual Life Outcomes 2019; 17:33. [PMID: 30736815 PMCID: PMC6368755 DOI: 10.1186/s12955-019-1102-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 01/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background Both high socioeconomic status (SES) and high physical activity (PA) are associated with better self-rated health (SRH) and higher quality-of-life (QoL). Aim To investigate whether high levels of PA may compensate for the association between low SES and subjective health outcomes in terms of poorer SRH and lower QoL. Method Data from a cross-sectional, population-based study (n = 5326) was utilized. Multiple logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between indicators of SES (economic situation and educational level), SRH and QoL, as well as between the combination of SES and PA in relation to SRH and QoL. Result Participants with high PA and economic problems had approximately the same OR for good SRH as those with low PA and without economic problems (OR 1.75 [95% CI 1.20–2.54] and 1.81 [1.25–2.63] respectively). Participants with high PA and low education had higher odds for good SRH (OR 3.34 [2.96–5.34] compared to those with low PA and high education (OR 1.46 [0.89–2.39]).Those with high PA and economic problems had an OR of 2.09 [1.42–3.08], for high QoL, while the corresponding OR for those with low PA and without economic problems was 4.38 [2.89–6.63]. Conclusion Physically active people with low SES, had the same or even better odds to report good SRH compared to those with low PA and high SES. For QoL the result was not as consistent. The findings highlight the potential for promotion of PA to reduce SES-based inequalities in SRH. Electronic supplementary material The online version of this article (10.1186/s12955-019-1102-4) contains supplementary material, which is available to authorized users.
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Tamura T, Naito M, Maruyama K, Tsukamoto M, Sasakabe T, Okada R, Kawai S, Hishida A, Wakai K. The association between self-rated health and high-sensitivity C-reactive protein level: a cross-sectional and 5-year longitudinal study. BMC Public Health 2018; 18:1380. [PMID: 30558565 PMCID: PMC6297960 DOI: 10.1186/s12889-018-6251-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 11/22/2018] [Indexed: 11/25/2022] Open
Abstract
Background Although self-rated health (SRH) independently predicts mortality, the biological background of this association remains unexplained. This study aimed to examine the association between SRH and serum high-sensitivity C-reactive protein (hsCRP) level. Methods Subjects were 899 participants aged 35–69 years (237 men and 662 women) in the Daiko Study, part of the Japan Multi-Institutional Collaborative Cohort Study. They were enrolled from 2008 to 2010. Of the subjects, 666 participated in a second survey 5 years later. Lifestyle factors and SRH were assessed using a self-administered questionnaire. Serum hsCRP level was measured using a latex-enhanced immunonephelometric assay. The association between SRH and serum hsCRP level was evaluated using a general linear model with covariates. We further longitudinally investigated whether higher serum hsCRP level at baseline predicts poor SRH after 5 years using an unconditional logistic regression model. Results A higher serum hsCRP level was significantly associated with poor SRH at baseline after adjusting for covariates (p for trend = 0.023). The age- and sex-adjusted odds ratio and 95% confidence interval (CI) for poor SRH after 5 years was 1.45 (95% CI: 0.76–2.78) for the highest tertile compared with the lowest tertile of serum hsCRP level at baseline with a significant linear trend (p for trend = 0.033), although the risk increase disappeared after adjustment for other covariates. Conclusions The present study demonstrated that poor SRH is cross-sectionally associated with higher serum hsCRP level. However, the longitudinal data did not support the relationship between serum hsCRP level at baseline and future SRH. Further longitudinal studies that include data on mortality and multiple inflammatory markers are warranted to elucidate the possible role of low-grade inflammation in the association between SRH and mortality risk.
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Affiliation(s)
- Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Mariko Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenta Maruyama
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Mineko Tsukamoto
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Tae Sasakabe
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Sayo Kawai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.,Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Medication nonadherence, multitablet regimens, and food insecurity are key experiences in the pathway to incomplete HIV suppression. AIDS 2018; 32:1323-1332. [PMID: 29683846 DOI: 10.1097/qad.0000000000001822] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify potential pathways by which a variety of factors act to lead to unsuppressed viral load. DESIGN A prospective cohort of HIV-HCV co-infected adults receiving care from 18 HIV clinics across Canada was followed every 6 months between November 2012 and October 2015. Participants with at least two visits while receiving combined antiretroviral treatment (cART) were included. METHODS A path analysis was conducted on the basis of ordered sequences of multivariate logistic regressions using generalized estimating equations. The first regression model used incomplete viral suppression (viral load >50 copies/ml) as the outcome of interest and all other variables (i.e. nonadherence, food insecurity, treatment attributes, and other sociodemographic, behavioural, and clinical factors) as potential predictors. Any variable determined to be a statistically significant predictor of incomplete viral suppression was then used as the next outcome of interest in the subsequent regression, until all predictors of each selected outcome were purely explanatory variables. RESULTS A total of 566 participants had at least two visits. Drivers of incomplete viral suppression included injection drug use, age 45 years or less, living alone, poor health status, longer duration of HIV infection and baseline CD4 cell count less than 200 cells/μl. Nonadherence, food insecurity, and the use of multitablet regimens mediated the effects of these factors on incomplete viral suppression. CONCLUSION Our results suggest that nonadherence, multitablet regimens, and food insecurity are key points in the pathway to incomplete HIV suppression. These are potentially amenable intervention targets that would not be revealed using traditional regression analyses.
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Labrague LJ, McEnroe-Petitte DM, Leocadio MC, Van Bogaert P, Cummings GG. Stress and ways of coping among nurse managers: An integrative review. J Clin Nurs 2018; 27:1346-1359. [PMID: 29148110 DOI: 10.1111/jocn.14165] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To appraise and synthesise empirical studies examining sources of occupational stress and ways of coping utilised by nurse managers when dealing with stress. BACKGROUND The Nurse Manager's role is challenging yet draining and stressful and has adverse consequences on an individual's overall health and well-being, patients' outcomes and organisational productivity. Considerable research has been carried out; however, an updated and broader perspective on this critical organisational issue has not been performed. DESIGN An integrative review. METHODS Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO and MEDLINE) were searched to identify relevant articles. Search terms and MeSH terms included: "charge nurse," "coping," "coping strategy," "coping style," "psychological adaptation," "psychological stress," "stressors," "nurse manager" and "unit manager." Twenty-two articles were included in this review. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. RESULTS Four themes were identified: moderate stress levels, common sources of stress, ways of coping and the impact of nurses' characteristics on stress. CONCLUSIONS Nurse managers experienced moderate levels of stress mainly from heavy workloads, lack of resources and financial responsibilities. Enhancing social support and promoting job control were seen as important in reducing work stress and its related consequences. Additional studies using a more rigorous method and a larger sample size preferably in multicultural settings would shed more light on this topic. RELEVANCE TO CLINICAL PRACTICE Hospital and nurse administrators play an important role in promoting supportive structures for daily professional practice for nurse managers through staffing, organisational resources, support services, leadership and stress management training.
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Rostalski T, Muehlan H, Schmidt S. Momentary Affect and the Optimism-Health Relationship. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2018. [DOI: 10.1027/2512-8442/a000003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The aim of this intensive longitudinal study was to examine the moderating effect of affect on the optimism-health relationship and to separately consider valence and arousal, the basic dimensions of affect. For 14 days 45 students answered three times a day a questionnaire regarding affect and health status. Valence interacts with optimism in the prediction of health and tense arousal moderates the pessimism-health relationship. Findings provide support for the relevance of a two-factor model of dispositional optimism and the importance of separate consideration of the basic affect dimensions in the understanding of the processes between optimism and health.
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Affiliation(s)
- Tim Rostalski
- Department Health & Prevention, Institute of Psychology, Ernst-Moritz-Arndt-University, Greifswald, Germany
| | - Holger Muehlan
- Department Health & Prevention, Institute of Psychology, Ernst-Moritz-Arndt-University, Greifswald, Germany
| | - Silke Schmidt
- Department Health & Prevention, Institute of Psychology, Ernst-Moritz-Arndt-University, Greifswald, Germany
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Ramji R, Arnetz BB, Nilsson M, Wiklund Y, Jamil H, Maziak W, Arnetz J. Waterpipe use in adolescents in Northern Sweden: Association with mental well-being and risk and health behaviours. Scand J Public Health 2017; 46:867-876. [PMID: 29226800 DOI: 10.1177/1403494817746534] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS There is a lack of studies examining the association between waterpipe smoking and mental well-being among adolescents. This study sought to determine whether waterpipe smoking is associated with mental well-being and other risk and health behaviours in adolescents. METHODS A questionnaire was distributed to 1006 adolescents in grades 9-12 (with a response rate of >95%), containing questions on measures of stress, mental energy and sleep. In addition, the questionnaire assessed risk and health behaviours, including use of a waterpipe, cigarettes, e-cigarettes, snus, alcohol, narcotics, gambling and exercise. Logistic regression was used to assess factors associated with waterpipe use. RESULTS Thirty-seven per cent ( n=371) of the participants had used a waterpipe at some point. Waterpipe use was associated with lower mental energy (odds ratio [OR] = 0.90, 95% confidence interval [CI] 0.81-0.99), higher stress (OR = 1.10, 95% CI 1.02-1.20) and use of cigarettes (OR = 3.82, 95% CI 2.33-6.03), e-cigarettes (OR = 3.26, 95% CI 2.12-4.99), snus (OR = 2.29, 95% CI 2.12-4.99), alcohol (OR = 1.92, 95% CI 1.07-3.44) and narcotics (OR = 3.64, 95% CI 1.75-7.58). Waterpipe use was not significantly associated with gambling, exercise or sleep quality. CONCLUSIONS Waterpipe use in adolescents is associated with worse mental well-being, as well as use of other nicotine products, alcohol and narcotics. Prospective studies are needed to delineate causal and temporal relationships further between waterpipe use and mental well-being and its relationship to other risky behaviours in order to design effective prevention programs.
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Affiliation(s)
- Rathi Ramji
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Bengt B Arnetz
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden.,2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
| | - Maria Nilsson
- 2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,4 Västerbotten County Council, Sweden
| | | | - Hikmet Jamil
- 3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
| | - Wasim Maziak
- 5 Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Judy Arnetz
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden.,2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
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Rådmark L, Magnusson Hanson LL, Bojner Horwitz E, Osika W. Prevalence of mind and body exercises (MBE) in relation to demographics, self-rated health, and purchases of prescribed psychotropic drugs and analgesics. PLoS One 2017; 12:e0184635. [PMID: 28915274 PMCID: PMC5600368 DOI: 10.1371/journal.pone.0184635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 08/28/2017] [Indexed: 11/20/2022] Open
Abstract
This study aims to identify any differences regarding gender, age, socioeconomic status (SES), self-rated health, perceived stress and the purchase of prescribed drugs among people who practice mind and body exercises (MBE) extensively compared to people who do not. METHODS The study includes 3,913 men and 4,803 women aged 20-72 who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH). The respondents were divided into three groups depending on frequency of MBE practice (never/seldom/often). Measures regarding MBE practice, health behaviors, self-rated health, and illnesses were drawn from the SLOSH questionnaire, while more objective measures of socioeconomic status and education were derived from registry data. In addition, data on purchases of prescription drugs for all respondents were included in the study. These data were obtained from the Swedish Prescribed Drug Register, which contains information about prescription drugs dispensed at Swedish pharmacies. Separate analyses were performed for mental MBE (mindfulness, meditation, relaxation techniques) and physical MBE (yoga, Tai Chi, Qi Gong), respectively. RESULTS A high intensity MBE practice is cross-sectionally related to poor self-assessed health (sleeping problems, pain, depressive symptoms, mental disorders), high levels of stress, and high levels of purchases of psychotropic drugs and analgesics. These cross-sectional relationships are generally stronger for mental MBE than for bodily-directed MBE. More women than men are practicing MBE on a regular basis, and physically active people participate to a greater extent in MBE compared with the physically inactive. CONCLUSION Overall, the study shows that frequent participation in mind and body exercises is associated with high levels of purchases of psychotropic drugs and analgesics as well as with poor self-assessed health and high levels of stress. However, since this is a cross-sectional study, it is impossible to establish cause and effect, and to further investigate the associations found; longitudinal studies that can account for temporality between covariates and MBE use are needed.
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Affiliation(s)
- Lina Rådmark
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | | - Eva Bojner Horwitz
- Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health, Uppsala University, Uppsala, Sweden
| | - Walter Osika
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Social Sustainability, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stress Clinic, Stockholm, Sweden
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Active Traveling and Its Associations with Self-Rated Health, BMI and Physical Activity: A Comparative Study in the Adult Swedish Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050455. [PMID: 27136570 PMCID: PMC4881080 DOI: 10.3390/ijerph13050455] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/04/2016] [Accepted: 04/23/2016] [Indexed: 01/09/2023]
Abstract
Active traveling to a daily occupation means that an individual uses an active way of traveling between two destinations. Active travel to work or other daily occupations offers a convenient way to increase physical activity levels which is known to have positive effects on several health outcomes. Frequently used concepts in city planning and regional planning today are to create environments for active commuting and active living. Even then, little research has focused on traveling modes and subjective health outcomes such as self-rated health (SRH). This study aimed to explore and investigate associations between travel mode and health-related outcomes, such as self-rated health (SRH), body mass index (BMI) and overall physical activity, in an adult population in Sweden. A cross-sectional study was conducted in a randomly selected population-based sample (n = 1786, age 45-75 years); the respondents completed a questionnaire about their regular travel mode, demographics, lifestyle, BMI and SRH. Chi-square tests and logistic regressions found that inactive traveling was associated with poor SRH, a greater risk of obesity or being overweight and overall physical inactivity. In addition, lifestyle factors, such as choice of food and smoking habits, were associated with SRH, BMI and overall physical activity.
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Al-Modallal H. Effect of intimate partner violence on health of women of Palestinian origin. Int Nurs Rev 2016; 63:259-66. [DOI: 10.1111/inr.12239] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hanan Al-Modallal
- Department of Community and Mental Health Nursing; Hashemite University College of Nursing; Zarqa Jordan
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Ren F, Wang G, Phull G, Zhang J. Taxometric analysis of the Children's Sleep Habits Questionnaire. Sleep Biol Rhythms 2015. [DOI: 10.1111/sbr.12113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Fen Ren
- Key Laboratory of Mental Health; Institute of Psychology; Chinese Academy of Sciences; Beijing China
- University of Chinese Academy of Sciences; Beijing China
| | - Guanghai Wang
- School of Psychology and Cognitive Science; East China Normal University; Shanghai China
| | - Gurpreet Phull
- Division of Pulmonary and Sleep Medicine; Children's National Health System; Washington DC Washington USA
| | - Jianxin Zhang
- Key Laboratory of Mental Health; Institute of Psychology; Chinese Academy of Sciences; Beijing China
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Berglund E, Lytsy P, Westerling R. The influence of locus of control on self-rated health in context of chronic disease: a structural equation modeling approach in a cross sectional study. BMC Public Health 2014; 14:492. [PMID: 24885619 PMCID: PMC4070405 DOI: 10.1186/1471-2458-14-492] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 05/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-rated health is a robust predictor of several health outcomes, such as functional ability, health care utilization, morbidity and mortality. The purpose of this study is to investigate and explore how health locus of control and disease burden relate to self-rated health among patients at risk for cardiovascular disease. METHODS In 2009, 414 Swedish patients who were using statins completed a questionnaire about their health, diseases and their views on the three-dimensional health locus of control scale. The scale determines which category of health locus of control - internal, chance or powerful others - a patient most identifies with. The data was analyzed using logistic regression and a structural equation modeling approach. RESULTS The analyses showed positive associations between internal health locus of control and self-rated health, and a negative association between health locus of control in chance and powerful others and self-rated health. High internal health locus of control was negatively associated with the cumulative burden of diseases, while health locus of control in chance and powerful others were positively associated with burden of diseases. In addition, age and education level had indirect associations with self-rated health through health locus of control. CONCLUSIONS This study suggests that self-rated health is positively correlated with internal locus of control and negatively associated with high locus of control in chance and powerful others in patients at high risk for cardiovascular disease. Furthermore, disease burden seems to be negatively associated with self-rated health.
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Affiliation(s)
- Erik Berglund
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden.
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Cao X, Jiang X, Li X, Hui Lo MCJ, Li R. Family functioning and its predictors among disaster bereaved individuals in China: eighteen months after the Wenchuan Earthquake. PLoS One 2013; 8:e60738. [PMID: 23573280 PMCID: PMC3616101 DOI: 10.1371/journal.pone.0060738] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Accepted: 03/02/2013] [Indexed: 02/05/2023] Open
Abstract
Background The 2008 Wenchuan earthquake in China resulted in great loss of life and property, and previous studies have focused on psychopathological symptoms in survivors after disasters. This study examined perceived family functioning and its predictors in disaster bereaved individuals eighteen months after the 2008 Wenchuan earthquake. Methodology/Findings This was a cross-sectional study of a convenience sample of 264 bereaved individuals. The instruments used in the study included Family APGAR Index, Family Adaptability and Cohesion Evaluation Scale??, Emotional and Social Loneliness Scale, and a range of items eliciting demographic characteristics and disaster-related variables. The results indicated that the rates of moderate family dysfunction and severe family dysfunction in bereaved individuals were 37.1% and 12.9%, respectively. Less financial loss during the earthquake was a significant predictor for positive family function. Better self-rated health status after the earthquake was significantly related to positive family function, cohesion, and adaptability. Scores on family cohesion and adaptability in bereaved individuals from extended or nuclear families were significantly higher than those from single-parent families. The ability to give birth to another baby of bereaved parents was a significant predictor for positive family function and cohesion. Poorer family function, cohesion and adaptability were significantly related to greater loneliness. Conclusions/Significance This study found a high prevalence of family dysfunction in bereaved individuals eighteen months after the 2008 Wenchuan earthquake. Strategies can be designed to facilitate post-disaster recovery, particularly for the bereaved at high risk for family dysfunction. The study provides useful information for post-disaster rebuilding and relief work.
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Affiliation(s)
- Xiaoyi Cao
- Department of Nursing, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Xiaolian Jiang
- Department of Nursing, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- * E-mail:
| | - Xiaolin Li
- Department of Nursing, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Man-chun Jenny Hui Lo
- School of Social Science, Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - Rong Li
- Department of Nursing, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
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Edries N, Jelsma J, Maart S. The impact of an employee wellness programme in clothing/textile manufacturing companies: a randomised controlled trial. BMC Public Health 2013; 13:25. [PMID: 23311458 PMCID: PMC3574831 DOI: 10.1186/1471-2458-13-25] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 01/06/2013] [Indexed: 11/21/2022] Open
Abstract
Background The prevalence of health risk behaviours is growing amongst South African employees. Health risk behaviours have been identified as a major contributor to reduced health related quality of life (HRQoL) and the increased prevalence of non-communicable diseases. Worksite wellness programmes promise to promote behaviour changes amongst employees and to improve their HRQoL. The aim of this study was to evaluate the short-term effects of an employee wellness programme on HRQoL, health behaviour change, body mass index (BMI) and absenteeism amongst clothing and textile manufacturing employees. Methods The study used a randomised control trial design. The sample consisted of 80 subjects from three clothing manufacturing companies in Cape Town, South Africa. The experimental group was subjected to a wellness programme based on the principles of cognitive behaviour therapy (CBT) as well as weekly supervised exercise classes over six weeks. The control group received a once-off health promotion talk and various educational pamphlets, with no further intervention. Measurements were recorded at baseline and at six weeks post-intervention. Outcome measures included the EQ-5D, Stanford Exercise Behaviours Scale, body mass index and absenteeism. Data was analysed with the Statistica-8 software program. Non-parametric tests were used to evaluate the differences in the medians between the two groups and to determine the level of significance. The Sign test was used to determine the within group changes. The Mann–Whitney U test was used to determine the difference between the two groups. Results At six weeks post intervention the experimental group (39 subjects) demonstrated improvement in almost every parameter. In contrast, apart from an overall decrease in time off work and a reduction in BMI for all study participants, there was no significant change noted in the behaviour of the control group (41 subjects). Seventy percent of the experimental group had improved HRQoL EQ-5D VAS scores post intervention, indicating improved perceived HRQoL. In comparison, only 58% of the control group had improved HRQoL EQ-5D VAS scores post intervention. There was no significant difference between the two groups at baseline or at six weeks post intervention. Conclusion An employee wellness programme based on the principles of CBT combined with weekly aerobic exercise class was beneficial in improving the perceived HRQoL and changing health-related behaviours of clothing manufacturing employees. However, it cannot be concluded that the EWP was more effective than the once off health promotion talk as no significant changes were noted between the two groups at 6-weeks post intervention.This trial has been registered with ClinicalTrials.gov (trial registration number NCT01625039).
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Affiliation(s)
- Naila Edries
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Anzio Road, Cape, South Africa.
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Canlon B, Theorell T, Hasson D. Associations between stress and hearing problems in humans. Hear Res 2013; 295:9-15. [DOI: 10.1016/j.heares.2012.08.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 08/24/2012] [Accepted: 08/27/2012] [Indexed: 12/20/2022]
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Gender differences in predictors of self-rated health in Armenia: a population-based study of an economy in transition. Int J Equity Health 2012; 11:67. [PMID: 23151068 PMCID: PMC3544611 DOI: 10.1186/1475-9276-11-67] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 11/11/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Self-rated health is a widely used health outcome measure that strongly correlates with physical and mental health status and predicts mortality. This study identified the set of predictors of fair/poor self-rated health in adult female and male populations of Armenia during a period of long-lasting socio-economic transition to a market economy. METHODS Differences in self-rated health were analyzed along three dimensions: socioeconomic, behavioral/attitudinal, and psychosocial. The study utilized data from a 2006 nationwide household health survey that used a multi-stage probability proportional to size cluster sampling with a combination of interviewer-administered and self-administered surveys. Both female and male representatives of a household aged 18 and over completed the self-administered survey. Multivariate odds ratios (OR) for fair/poor self-rated health were calculated for different sets of variables and logistic regression models fitted separately for women and men to identify the determinants of fair/poor self-rated health. RESULTS Overall, 2310 women and 462 men participated in the survey. The rate of fair/poor self-rated health was 61.8% among women and 59.7% among men. For women, the set of independent predictors of fair/poor self-rated health included age, unemployment, poverty, low affordability of healthcare, depression, and weak social support. For men, the set included age, lower education, depression, weak social support, and drinking alcohol less than once a week. For both genders, depression and weak social support demonstrated the strongest independent association with fair/poor self-rated health. CONCLUSIONS The prevalence of fair/poor self-rated health was similar among men and women in this study, but the sets of independent predictors of perceived health differed somewhat, possibly, reflecting lifestyle differences between men and women in Armenia. Nevertheless, psychosocial variables were the strongest predictors of fair/poor self-rated health for both genders, indicating the importance of improving the country's psychosocial environment through social reforms and poverty reduction.
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Abstract
OBJECTIVE To determine whether obstructive sleep apnea mediates the relationship between posttraumatic stress disorder (PTSD) and psychosomatic and somatic disorders and its implications for self-rated health (SRH) among Iraqi immigrants in the United States. METHODS A random sample of immigrants who had left Iraq before the 1991 Gulf War (n = 145) or after (n = 205) and are residing in metropolitan Detroit responded to a structured interview covering questions on sociodemographics, premigration trauma, SRH, physician-diagnosed and -treated obstructive sleep apnea, somatic disorders, and psychosomatic disorders. Structural equation modeling was used to evaluate the relationship between premigration trauma scores and health, as well as to explore mediating pathways between PTSD, obstructive sleep apnea, and health. RESULTS The prevalence of obstructive sleep apnea among post-Gulf Warimmigrants (30.2%) was significantly higher than among pre-Gulf War immigrants (0.7%; p < .001). Premigration trauma scores were positively associated with depression and PTSD. Structural equation modeling supported a model in which obstructive sleep apnea mediated the relationship between PTSD and psychosomatic and somatic disorders. Premigration trauma also related directly to SRH. CONCLUSIONS Part of the PTSD-associated adverse health effects observed in Iraqi immigrants is mediated by obstructive sleep apnea. Because sleep apnea in the current study is based on medical history and current treatment, there is a need for future confirmatory polysomnographic studies.
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Verropoulou G. Determinants of change in self-rated health among older adults in Europe: a longitudinal perspective based on SHARE data. Eur J Ageing 2012; 9:305-318. [PMID: 28804430 DOI: 10.1007/s10433-012-0238-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The present study aims at detecting factors which may predict a decline or an improvement in self-rated health (SRH) of older adults (persons aged 50 or higher) among socio-demographic characteristics, physical and mental health indicators and risky health behaviours. In the analysis, multinomial logistic regression models are applied to data from waves 1 and 2 of the Survey of Health Ageing and Retirement in Europe (carried out about 3 years apart); persons who report a decline or an improvement in SRH at wave 2 are compared to those who report no change while controlling for SRH at baseline and country of residence. The analysis was carried out for the whole sample and two subgroups, persons aged 50-64 and 65 or higher. The results indicate that female sex and higher educational attainment have a strong protective effect against decline in SRH. Worse health at baseline is an important predictor of subsequent decline but changes occurring between the waves have a more pronounced effect, implying that SRH is influenced more by recent developments. The findings also indicate that improvement in SRH is a more complex concept than decline and is strongly affected by factors other than health. Among behavioural risk factors, low levels of physical activity and a decrease in the levels of activity between the waves are significantly related to decline while frequent drinking seems associated with improvement. Differentiations by age are modest and probably suggest that advancing age is related to a milder view of one's health.
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Affiliation(s)
- Georgia Verropoulou
- Department of Statistics & Insurance Science, University of Piraeus, 80, Karaoli & Dimitriou Str, 185 34 Piraeus, Athens, Greece
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Malagón-Aguilera MC, Fuentes-Pumarola C, Suñer-Soler R, Bonmatí-Tomàs A, Fernández-Peña R, Bosch-Farré C. El sentido de coherencia en el colectivo enfermero. ENFERMERIA CLINICA 2012; 22:214-8. [PMID: 22840432 DOI: 10.1016/j.enfcli.2012.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 04/26/2012] [Accepted: 06/22/2012] [Indexed: 11/16/2022]
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Lindholm H, Sinisalo J, Ahlberg J, Hirvonen A, Hublin C, Partinen M, Savolainen A. Attenuation of vagal recovery during sleep and reduction of cortisol/melatonin ratio in late afternoon associate with prolonged daytime sleepiness among media workers with irregular shift work. Am J Ind Med 2012; 55:643-9. [PMID: 22473600 DOI: 10.1002/ajim.22042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Media work is characterized by information flow, deadlines, and 24/7 alertness. Good recovery prevents stress-related disorders. METHODS The standardized questionnaire included items about health, health habits, sleep, work conditions, and work stress. Recordings of 24-hr heart rate variability (HRV) and four salivary samples for cortisol and melatonin levels were analyzed from 70 randomly selected workers with irregular shift work, and 70 workers with normal daytime work. RESULTS Irregular shift work increased the risk of insufficient recovery when compared to normal daytime work (OR 2.0; P < 0.05). In the group of workers with insufficient subjective recovery, HRV was attenuated (P < 0.05) during the early hours of night, and cortisol/melatonin ratio was decreased (P < 0.05) in the afternoon. CONCLUSIONS Physiological changes underlying subjective feelings of insufficient recovery are measurable. Attenuated HRV during sleep reflects prolonged sympathetic drive and/or impaired parasympathetic recovery. Interactions between cortisol and melatonin hormones might be involved in the development of chronic exhaustion.
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Affiliation(s)
- Harri Lindholm
- Finnish Institute of Occupational Health, Centre of Excellence of Health and Work Ability, Helsinki, Finland.
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Silva LS, Barreto SM. Stressful working conditions and poor self-rated health among financial services employees. Rev Saude Publica 2012; 46:407-16. [PMID: 22450562 DOI: 10.1590/s0034-89102012005000023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Accepted: 01/12/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the association between exposure to adverse psychosocial working conditions and poor self-rated health among bank employees. METHODS A cross-sectional study including a sample of 2,054 employees of a government bank was conducted in 2008. Self-rated health was assessed by a single question: "In general, would you say your health is (...)." Exposure to adverse psychosocial working conditions was evaluated by the effort-reward imbalance model and the demand-control model. Information on other independent variables was obtained through a self-administered semi-structured questionnaire. A multiple logistic regression analysis was performed and odds ratio calculated to assess independent associations between adverse psychosocial working conditions and poor self-rated health. RESULTS The overall prevalence of poor self-rated health was 9%, with no significant gender difference. Exposure to high demand and low control environment at work was associated with poor self-rated health. Employees with high effort-reward imbalance and overcommitment also reported poor self-rated health, with a dose-response relationship. Social support at work was inversely related to poor self-rated health, with a dose-response relationship. CONCLUSIONS Exposure to adverse psychosocial work factors assessed based on the effort-reward imbalance model and the demand-control model is independently associated with poor self-rated health among the workers studied.
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Affiliation(s)
- Luiz Sérgio Silva
- Depto Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
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Powell-Young YM. Household income and spiritual well-being but not body mass index as determinants of poor self-rated health among African American adolescents. Res Nurs Health 2012; 35:219-30. [PMID: 22456912 DOI: 10.1002/nur.21473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2012] [Indexed: 11/09/2022]
Abstract
Very little is known about predictors of subjective health status among African American adolescents. This study was designed to determine whether selected anthropometric, psychological, lifestyle behavioral, and structural variables predicted poor self-rated general health in a cross-sectional nonclinical sample of 310 female African American adolescents, 14-18 years old. The odds of reporting poor self-rated health were 2-3 times greater for African American teens from lower socioeconomic households when compared to teens residing in higher socioeconomic households and for those reporting infrequent participation in activities that promote spiritual well-being compared to those who participate more frequently in activities that enhance spiritual health. Findings indicate that socioeconomic level and engagement in behaviors that enhance healthy spirituality appear to be the most salient predictors of self-rated health. In addition to biodiversity considerations that influence perceptions of health status, culturally focused interventions should integrate variables shown to influence self-rated health among African American teens. These inclusions may inform a more integrated understanding of health, health outcomes, and health disparities in this vulnerable population.
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Xu Z, Su H, Zou Y, Chen J, Wu J, Chang W. Sleep quality of Chinese adolescents: distribution and its associated factors. J Paediatr Child Health 2012; 48:138-45. [PMID: 21470332 DOI: 10.1111/j.1440-1754.2011.02065.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To investigate the sleep quality status and its associated factors (including psychological and physiological as well as social demographic factors) among Chinese mainland adolescents. METHODS Ten schools, including junior schools, senior schools and universities of Hefei (the capital of Anhui Province in China), were randomly selected. By using the Pittsburgh Sleep Quality Index, Self-Rated Health Measurement Scale Version 1.0, University of California, Los Angeles, Loneliness Scale, Beck Depression Inventory, Self-rating Anxiety Scale and a demographic survey, a cross-sectional study was implemented to 5226 students of the selected schools to investigate the adolescents' sleep quality, self-rated health, psychological status and demographic variables. RESULTS There were significant sleep quality differences between different groups of grade level, residence, family type, self-report personality, self-report examination scores, self-rated health, depression, loneliness and anxiety according to the results of the univariate analysis (P < 0.01 or <0.05). The multivariate analysis indicated that high grade level (OR = 1.490, 95%CI = 1.350-1.645), living in rural areas (OR = 0.874, 95%CI = 0.799-0.956), poor self-rated health (OR = 0.934, 95%CI = 0.926-0.942), high degree of depression (OR = 1.867, 95%CI = 1.514-2.302) and anxiety (OR = 1.976, 95%CI = 1.647-2.372) may be the influencing factors of poor sleep. CONCLUSIONS The poor sleep quality of many adolescents may be attributed to various causes, especially psychological reasons.
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Affiliation(s)
- Zhiwei Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China
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Eklund M, Erlandsson LK. Return to Work Outcomes of the Redesigning Daily Occupations (ReDO) Program for Women with Stress-Related Disorders—A Comparative Study. Women Health 2011; 51:676-92. [DOI: 10.1080/03630242.2011.618215] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Johansson G, Sandahl C, Hasson D. Role stress among first-line nurse managers and registered nurses - a comparative study. J Nurs Manag 2011; 21:449-58. [PMID: 23409760 DOI: 10.1111/j.1365-2834.2011.01311.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies show that first-line nurse managers (F-LNMs) experience high psychological job demands and inadequate managerial guidance. The purpose of this study was to investigate whether F-LNMs have higher stress levels and show more signs of stress-related ill health than registered nurses (RNs). AIM The aim of this study was to examine possible differences in self-rated health between F-LNMs and RNs on various psychosocial factors (e.g. job demand, job control and managerial support). METHODS Data were collected at a university hospital in Sweden. Sixty-four F-LNMs and 908 RNs filled in a web-based questionnaire. RESULTS Both F-LNMs and RNs reported having good health. Approximately 10-15% of the F-LNMs and RNs showed signs of being at risk for stress-related ill health. Statistically significant differences (Mann-Whitney U-test) were found in the distribution between the F-LNMs and the RNs on three indices of job control, job demand and managerial support. CONCLUSION Our findings suggest that F-LNMs were able to cope with high-demand job situations because of relatively high control over work. IMPLICATION FOR NURSING MANAGEMENT The implication for nursing management shows the needs for a work environment for both F-LNMs and RNs that includes high job control and good managerial support.
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Affiliation(s)
- Gunilla Johansson
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
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Darviri C, Artemiadis AK, Tigani X, Alexopoulos EC. Lifestyle and self-rated health: a cross-sectional study of 3,601 citizens of Athens, Greece. BMC Public Health 2011; 11:619. [PMID: 21816035 PMCID: PMC3161893 DOI: 10.1186/1471-2458-11-619] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Accepted: 08/04/2011] [Indexed: 11/21/2022] Open
Abstract
Background Self-rated health (SRH) is a popular health measure determined by multiple factors. International literature is increasingly focusing on health-related behaviors such as smoking, dietary habits, physical activity, even religiosity. However, population-based studies taking into account multiple putative determinants of SRH in Greece are scarce. The aim of this study was to clarify possible determinants of SRH with an emphasis on the relationship between SRH and lifestyle variables in a large sample of urban citizens. Methods In this one-year cross-sectional study, a stratified random sample of 3,601 urban citizens was selected. Data were collected using an interview-based questionnaire about various demographic, socioeconomic, disease- and lifestyle related factors such as smoking, physical activity, dietary habits, sleep quality and religiosity. Multivariate logistic regression was used separately in three age groups [15-29 (N = 1,360), 30-49 (N = 1,122) and 50+ (N = 1,119) years old] in order to identify putative lifestyle and other determinants of SRH. Results Reporting of good SRH decreased with age (97.1%, 91.4% and 74.8%, respectively). Overall, possible confounders of the lifestyle-SRH relationship among age groups were sex, education, hospitalization during the last year, daily physical symptoms and disease status. Poor SRH was associated with less physical activity in the 15-29 years old (OR 2.22, 95%CI 1.14-4.33), with past or heavy smoking, along with no sleep satisfaction in the 30-49 years old (OR 3.23, 95%CI 1.35-7.74, OR 2.56, 95%CI 1.29-5.05, OR 1.79, 95%CI 1.1-2.92, respectively) and with obesity and no sleep satisfaction in the 50+ years old individuals (OR 1.83, 95%CI 1.19-2.81, OR 2.54, 95%CI 1.83-3.54). Sleep dissatisfaction of the 50+ years old was the only variable associated with poor SRH at the 0.001 p level of significance (OR 2.45, 99%CI 1.59 to 3.76). Subgroup analyses of the 15-19 years old individuals also revealed sleep dissatisfaction as the only significant variable correlated with SRH. Conclusions Slight differences in lifestyle determinants of SRH were identified among age groups. Sleep quality emerged as an important determinant of SRH in the majority of participants.
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Affiliation(s)
- Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Str,, 4, Postal code: GR-115-27, Athens, Greece
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Xu Z, Su H, Zou Y, Chen J, Wu J, Chang W. Self-rated health of Chinese adolescents: distribution and its associated factors. Scand J Caring Sci 2011; 25:780-6. [DOI: 10.1111/j.1471-6712.2011.00893.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Neuner B, Busch MA, Singer S, Moons P, Wellmann J, Bauer U, Nowak-Göttl U, Hense HW. Sense of coherence as a predictor of quality of life in adolescents with congenital heart defects: a register-based 1-year follow-up study. J Dev Behav Pediatr 2011; 32:316-27. [PMID: 21325966 DOI: 10.1097/dbp.0b013e31821102ee] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Sense of coherence (SOC) is a resource for health and quality of life (QoL) in adults. The aim of this investigation was to prospectively evaluate the association between SOC and QoL in adolescents with congenital heart defects (CHDs). METHODS This is an observational study among 770 adolescents aged 14 to 17 years from a national CHD register. SOC was measured at baseline with the SOC-L9 questionnaire. QoL was measured at baseline and at a follow-up 12 months later. For this, we used the KINDL-R (revidierter KINDer Lebensqualitätsfragebogen) questionnaire to evaluate overall well-being and 6 subscales (physical well-being, psychological well-being, self-esteem, family-related well-being, friend-related well-being, and school-related well-being). The association between SOC and QoL both in terms of overall well-being and the KINDL-R subscales was evaluated in multilevel linear models. Fully adjusted models accounted for age, gender, behavioral factors, and medical and socioeconomic status. RESULTS Overall well-being, self-esteem, and school-related well-being were significantly higher at follow-up than at baseline. SOC (median: 50 [range: 16-63] points) was positively associated with overall well-being and all KINDL-R subscales at baseline. In overall well-being and the KINDL-R subscales (except in psychological well-being), significant negative interaction terms were observed for SOC at baseline and time to follow-up. However, the associations between SOC at baseline and overall well-being and all KINDL-R subscales at follow-up remained significant even in fully adjusted models. CONCLUSION SOC is an independent predictor of QoL in adolescents with CHD. In psychological well-being, this prediction remains stable, whereas in total well-being and all other QoL subdimensions, its strength as such wanes over the course of a year but does not entirely dissipate. Further studies should evaluate whether interventions designed to increase SOC in children with CHD would also improve their QoL.
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Affiliation(s)
- Bruno Neuner
- From the *Clinical Epidemiology Section, Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; †Department of Epidemiology, Robert Koch Institute, Berlin, Germany; ‡Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany; §Centre for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium; ∥Competence Network for Congenital Heart Defects, National CHD Register, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany; ¶Pediatric Haematology/Oncology, University of Münster, Münster, Germany
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Maghout Juratli S, Janisse J, Schwartz K, Arnetz BB. Demographic and lifestyle factors associated with perceived stress in the primary care setting: a MetroNet study. Fam Pract 2011; 28:156-62. [PMID: 21068192 DOI: 10.1093/fampra/cmq091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Stress and stress-related disorders are common in primary care. The stress-related needs for patients are often unmet partially due to the time and resource constraints inherent to many primary care settings. We examined the relative significance of key demographic and lifestyle factors related to stress among primary care patients. This information is unknown and needed to strategize these increasingly limited resources. METHODS We distributed surveys to 100 consecutive adult patients in each of four family medicine centres in metropolitan Detroit between 2006 and 2007. Hierarchical multivariable regression analyses were used to assess the relative significance of the demographic and lifestyle factors related to stress. RESULTS Of the 400 distributed surveys, 315 (78.7%) answered a minimum of 70% of the questions and were included in the analysis. The lifestyle factors [exercise, body mass index (BMI), sleep, social support, recovery or self-care skills (such as the ability to rest, relax and recuperate)] explained 39% (P < 0.001) of the variance in stress compared to 10% (P < 0.001) by the demographic factors (age, gender, race, employment, education and marital status). Stress was inversely related to sleep (P < 0.001), recovery (P < 0.001) and social support (P = 0.02) and positively to education (P < 0.001). CONCLUSIONS The modifiable lifestyle factors explained significantly more of perceived stress among primary care patients than the demographic factors. Sleep and recovery had the biggest inverse relationship with stress, which suggests that they should be the primary target for assessment and intervention in patients who report stress or stress-related disorders.
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Affiliation(s)
- Sham Maghout Juratli
- Wayne State University, Department of Family Medicine and Public Health Sciences, Detroit, MI 48201, USA.
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Investigating the associations between work hours, sleep status, and self-reported health among full-time employees. Int J Public Health 2011; 57:403-11. [DOI: 10.1007/s00038-011-0242-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 01/27/2011] [Accepted: 02/14/2011] [Indexed: 10/18/2022] Open
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Hasson D, Theorell T, Wallén MB, Leineweber C, Canlon B. Stress and prevalence of hearing problems in the Swedish working population. BMC Public Health 2011; 11:130. [PMID: 21345187 PMCID: PMC3056746 DOI: 10.1186/1471-2458-11-130] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 02/23/2011] [Indexed: 01/15/2023] Open
Abstract
Background Current human and experimental studies are indicating an association between stress and hearing problems; however potential risk factors have not been established. Hearing problems are projected to become among the top ten disabilities according to the WHO in the near future. Therefore a better understanding of the relationships between stress and hearing is warranted. Here we describe the prevalence of two common hearing problems, i.e. hearing complaints and tinnitus, in relation to different work-and health-related stressors. Methods A total of 18,734 individuals were invited to participate in the study, out of which 9,756 (52%) enrolled. Results The results demonstrate a clear and mostly linear relationship between higher prevalence of hearing problems (tinnitus or hearing loss or both) and different stressors, e.g. occupational, poorer self-rated health, long-term illness, poorer sleep quality, and higher burnout scores. Conclusions The present study unambiguously demonstrates associations between hearing problems and various stressors that have not been previously described for the auditory system. These findings will open new avenues for future investigations.
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Affiliation(s)
- Dan Hasson
- Karolinska Institutet, Department of Physiology and Pharmacology, Stockholm, Sweden.
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Nakata A, Takahashi M, Otsuka Y, Swanson NG. Is self-rated health associated with blood immune markers in healthy individuals? Int J Behav Med 2010; 17:234-42. [PMID: 20512441 DOI: 10.1007/s12529-010-9102-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although self-rated health (SRH) has been established as a robust predictor of morbidity and mortality, the immunological mechanisms underpinning this relationship are poorly understood. PURPOSE This study examined the association of SRH with humoral and cellular immune markers in healthy individuals who reported no physical illnesses. METHOD A total of 116 healthy Japanese white-collar employees (79 women and 37 men) at a pharmaceutical company, aged 23-62 (mean 32) years, underwent a blood draw for the measurement of circulating immune (T, B, and natural killer) cells, inflammatory cytokines (interleukin-6 and tumor necrosis factor-alpha), and plasma immunoglobulin G (IgG) and completed a health survey including SRH. The question regarding SRH ranged from "very good" (coded 1) to "very poor" (coded 5). Hierarchical multiple regression analysis was carried out to calculate the relationship between SRH and immune markers. RESULTS In this sample, poor SRH was positively correlated with B (CD19(+)) cell numbers (beta = 0.260, p < 0.05) and IgG levels (beta = 0.335, p < 0.01) even after adjusting for depressive symptoms, age, education, marital status, smoking, alcohol consumption, physical activity, body mass index, sex, and sex x SRH interaction. The interaction between SRH and sex on the immune markers was not significant. CONCLUSION Although the connection between SRH and immune markers was not strong in this context, the results suggest that poor SRH may be associated with reduced humoral immune system capacity to respond to new/latent challenges. The results provide some support for the immunological basis of SRH in healthier individuals.
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Affiliation(s)
- Akinori Nakata
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, MS-C24, Cincinnati, OH 45226, USA.
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Hasson D, Von Thiele Schwarz U, Lindfors P. Self-rated Health and Allostatic Load in Women Working in Two Occupational Sectors. J Health Psychol 2009; 14:568-77. [DOI: 10.1177/1359105309103576] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study set out to investigate how biological dysregulation, in terms of allostatic load (AL), relates to self-rated health (SRH) in women. Data on SRH and 12 biomarkers used to assess AL were available for 241 employees from the health care sector and 98 employees from the IT/media sector. In line with the hypothesis, results showed that a poor SRH, along with occupational sector, age and education, were significantly associated with a high AL, particularly for those working within the health care sector. This association between a poor SRH and AL, suggests a link between SRH and biological dysregulation.
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Affiliation(s)
- Dan Hasson
- Karolinska Institutet, Stockholm, Sweden
| | | | - Petra Lindfors
- Stockholm University/Karolinska Institutet, Stockholm, Sweden,
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Impact of a web-based stress management and health promotion program on neck-shoulder-back pain in knowledge workers? 12 month prospective controlled follow-up. J Occup Environ Med 2009; 50:667-76. [PMID: 18545094 DOI: 10.1097/jom.0b013e3181757a0c] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the influence of a web-based stress management program on neck-shoulder-back pain and perceived pain-relatedness to stress in a prospective and controlled study. METHODS Study points were baseline, after 6 months intervention and at 12 months follow-up on 226 news media employees in two study groups and one control group. RESULTS Between groups no significant differences were found at any study point. Within groups, the study group with less intensive program improved in pain-relatedness to stress at follow-up. Between baseline and after intervention, the group with more intensive program showed decreased low back pain, and the control group showed less pain-relatedness to stress. Within group differences varied according to pain localization and were inconsistent. CONCLUSION Present web-based stress management program did not influence neck-shoulder-back pain or perceived pain-relatedness to stress in stress-intensive occupations.
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Siahpush M, Spittal M, Singh GK. Happiness and life satisfaction prospectively predict self-rated health, physical health, and the presence of limiting, long-term health conditions. Am J Health Promot 2008; 23:18-26. [PMID: 18785370 DOI: 10.4278/ajhp.061023137] [Citation(s) in RCA: 151] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the effect of happiness and life satisfaction on health. DESIGN Longitudinal data from waves 1 and 3, conducted in 2001 and 2004, respectively, of the Household Income and Labour Dynamics in Australia survey. SETTING Australia. SUBJECTS A total of 9981 respondents aged 18 years and older. MEASURES Outcomes were self-reported health; the absence of long-term, limiting health conditions; and physical health. Happiness was assessed with the following question: "During the past 4 weeks, have you been a happy person"? Life satisfaction was determined with the following question: "All things considered, how satisfied are you with your life"? ANALYSIS We used multiple regression analysis to estimate odds ratios (ORs), beta coefficients (beta), and 95% confidence intervals (CIs) for the associations between baseline happiness or life satisfaction and health at wave 3. RESULTS Baseline happiness and life satisfaction both were positively associated at wave 3 with excellent, very good, or good health (OR = 1.50, CI = 1.33-1.70, p < .0001; and OR = 1.62, CI = 1.27-2.08, p < .0001, respectively); with the absence of long-term, limiting health conditions (OR = 1.53, CI = 1.35-1.75, p < .0001; and OR = 1.51, CI = 1.25-1.82, p < .0001, respectively); and with higher physical health levels (beta = .99, CI = .60-1.39, p < .0001; and beta = .99, CI = .20-1.78, p < .0145, respectively). CONCLUSION This study showed that happier people and those who were more satisfied with their lives at baseline reported better health (self-rated health; absence of limiting, long-term conditions; and physical health) at the 2-year follow-up when adjusted for baseline health and other relevant covariates.
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Affiliation(s)
- Mohammad Siahpush
- Department of Health Promotion, Social and Behavioral Health Sciences, College of Public Health, University of Nebraska Medical Center, 986075 Nebraska Medical Center, Omaha, NE 68198-6075, USA.
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Ho SY, Mak KK, Thomas GN, Schooling M, Fielding R, Janus ED, Lam TH. The relation of chronic cardiovascular diseases and diabetes mellitus to perceived health, and the moderating effects of sex and age. Soc Sci Med 2007; 65:1386-96. [PMID: 17597275 DOI: 10.1016/j.socscimed.2007.05.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Indexed: 01/04/2023]
Abstract
This study investigates the relation of five chronic cardiovascular diseases and diabetes mellitus (DM) to perceived health, and the moderating effects of sex and age. In a community-based cross-sectional telephone survey in Hong Kong, 7730 Chinese aged 25-74 were interviewed in 1994-1996. The odds ratio for poor perceived health associated with each condition was calculated adjusting for age, sex and education. Subjects free from the six conditions were treated as the comparison group. Hypertension, angina, DM, coronary heart disease (CHD) and stroke were significantly associated with poor perceived health. The odds ratio of poor perceived health was significantly greater in men than in women for having more than one condition among DM, CHD and stroke (p=0.02), and insignificantly greater for stroke, CHD and angina. The odds ratios were significantly greater in the young (25-39) versus the old (60-74) for DM (p=0.008) in men and women combined, and for having either DM, CHD or stroke in men (p=0.02). These findings suggest that the relation of DM, CHD and stroke with poor perceived health tends to be stronger in men and younger adults. These findings have implications for health care workers and home carers who need to appreciate that the same condition may have a different perceived impact on persons of different sex and age, and be sensitive to their varying needs.
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Affiliation(s)
- Sai Yin Ho
- University of Hong Kong, Hong Kong, China.
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Kaiser PO, Mattsson B, Marklund S, Wimo A. Sense of coherence and vocational rehabilitation of persons with chronic musculoskeletal disorders–gender aspects. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.jmhg.2006.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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