Assessment of the Health Status of Women in Prison: A Comparison between Drug Users versus Non-users

This study aims to analyze the history of substances use, clinical diagnoses, contacts with healthcare, and health complaints. Also, it aims to compare the health status of substance users versus non-users. Health records of 93 detained women from a prison in northern Portugal, with a mean age of 38.02 years old, were reviewed and coded using both International Classification of Primary Care-2 and International Classification of Diseases-10th. Data revealed high percentages of detainees with a history of substance use and pre-existing clinical diagnosis. During the first month of imprisonment, on average, participants had complained to a health professional 14.63 times. Substance users were younger and presented more mental health problems and health complaints. Health policies and professional practices in prison must include immediate assessment of a woman's health concerns and foster the development of efficient protocols to address those problems, especially substance use disorder treatment.

Trust and Psychosomatic Complaints in Adolescence: Findings From a Swedish Cohort Study

Objectives: To examine the cross-sectional and longitudinal associations between generalised and institutional trust and psychosomatic complaints in mid and late adolescence. Methods: Data were derived from the Swedish cohort study Futura01, using survey information collected amongst 3,691 grade 9 students (∼15-16 years, t1) who were followed-up 2 years later (∼17-18 years, t2). Registry information on sociodemographic characteristics was linked to the data. Linear regression analyses were performed. The longitudinal analyses applied the first difference (FD) approach as well as the lagged dependent variable (LDV) approach. Covariates included gender, family type, parental education, parental country of birth, and upper secondary programme. Results: Higher levels of generalised and institutional trust were cross-sectionally associated with lower levels of psychosomatic complaints at both time points. The FD analyses showed that increases in generalised and in institutional trust between ages 15-16 and 17-18 years were associated with corresponding decreases in psychosomatic complaints. The LDV analyses demonstrated reciprocal temporal associations between trust and psychosomatic complaints. Conclusion: The findings indicate that trust is a social determinant of psychosomatic complaints in adolescents, but also that health may affect trust.

Trends in adolescent psychosomatic complaints: a quantile regression analysis of Swedish HBSC data 1985-2017

BACKGROUND AND AIMS

According to recent criticism, survey-based measures of adolescent psychosomatic complaints have poor content validity insofar as they conflate trivial with severe complaints. It is argued that this means that estimates of prevalence and trends in complaints may reflect trivial complaints that are not indicators of health problems. In this study, two observable implications of this criticism were investigated: (a) that self-reported psychosomatic complaints should have a bimodal distribution; and (b) that the increase in complaints over time should be of approximately equal size throughout the distribution of complaints.

METHODS

Three decades (1985/1986-2017/2018) of repeated cross-sectional data from the Swedish Health Behaviour in School-aged Children survey were used. Psychosomatic complaints were measured using the screening instrument Health Behaviour in School-aged Children symptom checklist. Histograms, bar charts and quantile regression models were used for the analysis.

RESULTS AND CONCLUSIONS

With regard to the first implication, the results showed that the distribution of complaints was not bimodal and that there were no clusters of respondents. This suggests that binary categorisations of students can be reductive and conceal important variations across students. With regard to the second implication, the results showed that the increase in complaints was greatest among students who report frequent and co-occurring complaints. This suggests that reports of increasing complaints in adolescents cannot be explained as being primarily due to a greater inclination to report trivial complaints. It is concluded that any conflation of trivial and more severe complaints in surveys of psychosomatic complaints is not reflected in population-based estimates.

Inequalities in health complaints: 20-year trends among adolescents in Scotland, 1998-2018

This study examined trends in inequalities in health complaints among early adolescents in Scotland from 1998 to 2018. We analysed data from the Health Behaviour in School-aged Children (HBSC) survey conducted in Scotland in 1998, 2002, 2006, 2010, 2014 and 2018. A self-report questionnaire was administered in schools to a nationally representative sample of 11-, 13-, and 15-year-olds (n = 29,250). Health complaints were measured using a scale comprising four psychological symptoms (feeling low, feeling nervous, irritability and sleep difficulties) and four somatic symptoms (headache, backache, stomachache and dizziness). Socio-economic status was measured using the Family Affluence Scale. Between 1998 and 2018, there were significant increases in the proportion of girls and boys reporting feeling low, feeling nervous, sleep difficulties and backache. Prevalence of the eight individual health complaints was higher among girls and adolescents from lower affluence families. Socio-economic inequalities increased over time, such that declines in mental health were greatest among low affluence adolescents. The data show worsening trends in health complaints among Scottish adolescents between 1998 and 2018, particularly for girls and adolescents from low affluence families. Increasing inequalities in mental health highlight the need to address the underlying social and structural determinants of adolescent mental health.

Health Complaints, Mental Status and Quality of Life among the Aquaculture Workers: A Cross-Sectional Study in Northern Region of Peninsular Malaysia

Aquaculture is seen as an essential food-producing sector for improving global food security and nutrition indices. This cross-sectional study examined the health complaints and mental health status of aquaculture workers, as well as their relationship with quality of life, with respect to the brackish water and freshwater aquaculture cultivation system in Penang, Malaysia. The workers’ health complaints were collected, and mental health status was evaluated as means of depression, anxiety, stress and self-esteem. Self-perceived quality of life was assessed using a structured questionnaire. This study involved the participation of 88 brackish water (84.6%) and 16 freshwater (15.4%) aquaculture workers. A total of 72.7% of the brackish water aquaculture workers were aged beyond 50 years old and had worked within five years (77.3%) in the aquaculture industry. Both brackish water and freshwater cultivation workers were confronted with fatigue, pain and insomnia. Up to 48%, 40.4%, 26% and 24% of them were facing depression, anxiety, stress and low self-esteem, respectively. A total of 3.4% of the brackish water aquaculture workers were having bad quality of life. The complaints of neck/shoulder/arm pain (F = 13.963; p < 0.001), back pain (F = 10.974; p < 0.01), hand/wrist pain (F = 8.041; p < 0.01), knee/hip pain (F = 12.910; p < 0.01) and insomnia (F = 10.936; p < 0.01) were correlated with bad quality of life among the workers. For mental health status, self-esteem (F = 4.157; p < 0.05) was found to be negatively correlated with quality of life scores. The results outlined the concerning level of health complaints and psychological distress among the aquaculture workers. The study emphasized the importance of developing an appropriate occupational health strategy in the aquaculture industry. Longitudinal investigations aimed to explore the effects of psychological distress on employment productivity among the high-risk workers are warranted.

School Satisfaction and Its Associations with Health and Behavioural Outcomes among 15-Years Old Adolescents

Background: Health and behavioural outcomes of adolescents have been shown to be related to school pressure, demands or unfavourable relationships with classmates or teachers. These associations may relate to school satisfaction, but evidence on this is lacking. Therefore, our aim is to explore the associations of school satisfaction with hopelessness, health complaints, fighting and truancy. Methods: Data come from the cross-sectional Health Behaviour in School-aged Children study collected in 2018 from Slovak 15-year-old adolescents (N = 816; 50.9% boys). School satisfaction was measured by school engagement and attitudes towards education, grouped as: satisfied (both positive), inconsistent (one positive, one negative) and indifferent (both negative). Hopelessness, health complaints, fighting and truancy were measured using self-report questionnaires. Logistic regression models were used to explore the associations of school satisfaction with hopelessness, health complaints, fighting and truancy separately. Results: Indifferent adolescents were more likely to feel hopeless, to frequently experience two or more health complaints, to be involved in a fight and to skip school (odds ratios/95%-confidence interval: 2.57/1.49-4.45; 2.51/1.48-4.25; 1.92/1.02-3.60; and 2.34/1.25-4.40, respectively) than satisfied adolescents. Inconsistent adolescents were more likely to frequently experience two or more health complaints than satisfied adolescents (1.72/1.05-5.79). Conclusions: School satisfaction affects adolescents' health and social behaviour and may threaten their healthy development.

Single-Item Happiness Measure Features Adequate Validity Among Adolescents

Background

Happiness is becoming increasingly relevant in recent research, including adolescents. Many studies are using the single-item measure for adolescent happiness, however, its validity is not well known. We aimed to examine the validity of this measure among adolescents in three countries from distinct European regions - Eastern (Lithuania), Southern (Portugal), and Western (Scotland).

Materials and Methods

The analysis included data from Health Behaviour in School-aged Children (HBSC) study from three countries and three last surveys (2009/10, 2013/14, and 2017/18). The total sample comprised 47,439 schoolchildren. For validity, the indicators reflecting subjective health, life satisfaction, quality of life, well-being, social support, health complaints, bullying, and self-directed violence were assessed. The calculations were conducted in the total sample and by gender, age, survey year, and country.

Results

The different indicators of concurrent and convergent validity revealed consistent correlations with happiness, with better well-being, health, and subjective perceptions being related to higher happiness. Meanwhile, health complaints, bullying behaviors, and self-directed violence were related to lower happiness. The subgroup differences were consistent across gender, age groups, countries, and survey rounds. The extent of differences was more expressed among girls.

Conclusion

The single item for adolescent happiness measurement features a consistent pattern of validity concerning indicators of concurrent and convergent validity. Higher self-reported happiness is associated with better mental and physical health and well-being, and less expressed negative factors (complaints, bullying, and self-directed violence). In addition, among girls the correlations tend to be stronger than boys.

The Health Cost of Organizational Citizenship Behavior: Does Health-Promoting Leadership Matter?

Previous research has mainly focused on the positive effects of organizational citizenship behavior (OCB). This study questions the positive impact of OCB, arguing that there is a health cost of OCB. Based on the conservation of resource theory, this study expects that OCB triggers citizenship fatigue, which, in turn, negatively affects employees' health and results in health complaints. This study also seeks to find a moderator (health-promoting leadership) that could mitigate the negative effects of citizenship fatigue (caused by engaging in OCB) on health complaints. To test our predictions, we collected three-wave data from 207 leader-subordinate dyads. The results of regression analyses show that OCB is positively related to employees' health complaints, which is mediated by citizenship fatigue. Health-promoting leadership weakens the positive relationship between citizenship fatigue and health complaints, thus negatively moderating the indirect relationship between OCB and health complaints via citizenship fatigue. This study provides theoretical and practical implications for future research directions.

Antecedents and outcomes of daily anticipated stress and stress forecasting errors

Stressors can have negative effects on well-being, but little is known about how an individual's inability to precisely forecast upcoming stress could be a risk factor for well-being. Antecedents and outcomes of two stress forecasting variables, anticipated stress level and underestimation errors in stress forecasting (operationalized by the residual change scores obtained by regressing the evening experienced stress on the morning anticipated stress), were investigated. In a daily diary study of 110 undergraduate students over a workweek, poor sleep quality and negative affect reported in the morning predicted a higher anticipated stress of the upcoming day. Poor sleep quality was found to be related to less underestimation errors (i.e., more overestimation). Mispredicting the daily stress level was found to predict greater health complaints and negative affect by the end of the day. Those high on trait resilience were found to make fewer underestimation errors on average. Worse emotional outcomes were associated with underestimation errors during stress forecasting than with overestimation errors. This study demonstrates that examining an individual's experience in forecasting upcoming stressors is an important area for future research in determining points of intervention to promote adaptive management of daily demands.

The Way of Distance Teaching Is Related to Adolescent Students' Health and Loneliness during the School Closure in Finland

The COVID-19 pandemic enforced countries to close schools and rapidly transfer to distance teaching without preparation. Little is known about how different distance teaching practices influenced students’ wellbeing. We studied this during the period of school closures in Finland. Wellbeing was measured by health complaints and perceived loneliness, and distance learning was measured in terms of structure and dialogue of teaching, functioning of internet and digital equipment, difficulty of given tasks, and support for studies. All lower secondary schools were invited, and 29,898 students from 340 schools (grades 7–9) participated. A digital survey was distributed through schools just when these were reopened in May 2020. The main results were that the distance learning practices were related to adolescent health complaints and loneliness, so that less structure and dialogue in teaching, more problems with digital devices and internet, more difficult tasks and less support for studies were associated with higher health complaints and loneliness. From the point of view of students’ wellbeing, it matters how the distance learning is organised, how digital communication works, and if enough support for studies is available. These results of our research on distance learning practices during the present pandemic may guide schools in future crises and pandemic situations when distance learning is needed.

Sense of Unity and Self-Reported Health Among 15-year-Olds: Findings From the Swedish 2017/18 Health Behavior in School-Aged Children Study

Objectives: Sense of unity refers to the positive feeling of being part of a larger social structure. This study aimed to investigate to what extent adolescents report sense of unity and if this differs across groups, and to assess the associations between sense of unity and self-reported health while taking into account sociodemographic characteristics and tangible social relationships. Methods: Data were obtained from the 2017/18 Swedish Health Behavior in School-aged Children study, using information collected among 15-year-old students (n = 1,392). Linear and binary logistic regression analyses were performed. Results: The participants reported overall high levels of sense of unity. Sense of unity did not differ by gender, but adolescents without an immigrant background and those with higher family affluence reported higher levels. Sense of unity was inversely associated with psychological complaints, somatic complaints, and less than good self-rated health, even when adjusting for sociodemographic characteristics and family, classmate, and teacher relationships. Conclusion: This study suggests that sense of unity may be an important social determinant for adolescent health. More research is needed on the origins and implications of sense of unity.

Favorable Working Conditions Related to Health Behavior Among Nurses and Care Assistants in Sweden-A Population-Based Cohort Study

Objective: To analyze the associations between favorable physical and psychosocial work factors and health behavior among healthcare employees (nurses and care assistants) with health complaints.

Methods: The study was based on seven iterations (2001–2013) of a biennial Swedish work environment survey linked with data from public registers. In all, 7,180 healthcare employees, aged 16–64 years, who had reported health complaints, were included. Health behavior was operationalized through four combinations of sickness absence (SA) and sickness presence (SP): ‘good health behavior' (Low SP/Low SA), ‘recovery behavior' (Low SP/High SA), ‘risk behavior' (High SP/Low SA), and ‘poor health behavior' (High SP/High SA). Odds ratios (OR) were calculated by multinomial logistic regression with 95% confidence intervals (CI).

Results: After adjusting for socio-demographic factors, those who rarely worked in strenuous postures had an increased probability of having ‘good health behavior' (OR range: nurses 1.72–2.02; care assistants 1.46–1.75). Those who rarely experienced high job demands had increased odds for having ‘good health behavior' (OR: nurses 1.81; OR range: care assistants 1.67–2.13), while having good job control was found to be related to ‘good health behavior' only among care assistants (OR range 1.30–1.68). In the full model, after also considering differences in health, none of the work environment indicators affected ‘good health behavior' among nursing professionals. Among care assistants, rarely having heavy physical work and having low psychosocial demands remained significantly associated with ‘good health behavior' (OR range: 1.24–1.58) and ‘recovery behavior' (OR range: 1.33–1.70). No associations were found between favorable work environment factors and ‘risk behavior' among the two groups of employees. However, positive assessments of the work situation were associated with ‘good health behavior,' even after controlling for all confounders for both groups (OR range: 1.43–2.69).

Conclusions: ‘Good health behavior' and ‘recovery behavior' among care assistants were associated with favorable physical and psychosocial working conditions even when health was considered. This implies that reduced sickness presence and sickness absence among care assistants can be achieved through improved physical and psychosocial working conditions.

Sadness and Other Health Complaints among Swedish Adolescents: A Cross-Sectional Study

Health complaints are increasing among adolescents and are recognized as a global public health issue. Health complaints are an indicator for subjective ill-being, but little is known about the relationship between sadness and other health complaints. The aim of this study was to investigate sadness and other health complaints among Swedish adolescents. A survey with a cross-sectional design was completed by adolescents (n = 1489, 15-17 years old) in the south of Sweden. A logistic regression analysis was used to analyze the relationship between sadness and other health complaints. The result show that sadness and other health complaints were common among adolescents, and sadness was related to health complaints (headache (OR: 1.58), sleeping difficulties (OR: 2.00), reduced appetite (OR: 1.43), tension (OR: 2.44), and concentration difficulties (OR: 2.75)). When adolescents express sadness or other health complaints it is important to reflect on what these complaints are an expression of, and take into account the body as physical and psychological intertwined. This might entail person-centered support that hopefully leads to an improvement in adolescents' well-being. Future research that profoundly highlights adolescents' existential health is needed.

The Coronavirus Pandemic and the Occurrence of Psychosomatic Symptoms: Are They Related?

Most studies on the coronavirus pandemic focus on clinical aspects of the COVID-19 disease. However, less attention is paid to other health aspects of the pandemic. The aim of this study was to assess the relationship between the coronavirus pandemic (risk of infection by virus together with associated measures taken to combat it), and the occurrence of a wide range of psychosomatic symptoms and to explore if there is any factor that plays a role in this association. We collected data from a sample of Czech adults (n = 1431) and measured the occurrence of nine health complaints, respondents’ experience during the pandemic and sociodemographic characteristics. The results showed associations between the coronavirus pandemic and increased psychosomatic symptoms and negative emotions. We further found higher risks of increased health complaints in younger people and women. It is also possible that there is higher risk of increased health complaints for respondents with secondary school education, students, and highly spiritual people, but this relationship has to be further investigated. In contrast, respondents with their highest achieved education level being secondary school graduation had a lower risk of increased frequency of stomach-ache. We also found that more negative emotions could increase the frequency of health complaints. Our findings suggest that the coronavirus pandemic and associated government measures could have a significant influence on the prevalence of health complaints and emotional state.

Sexual jokes at school and psychological complaints: Student- and class-level associations

Background: Students who are subjected to sexual harassment at school report lower psychological well-being than those who are not exposed. Yet, it is possible that the occurrence of sexual harassment in the school class is also stressful for those who are not directly targeted, with potential negative effects on well-being for all students. Aim: The aim was to examine whether exposure to sexual jokes at the student level and at the class level was associated with students’ psychological complaints, and if these associations differed by gender. Method: Data from the Swedish Health Behaviour in School-aged Children (HBSC) of 2017/18 was used, with information from students aged 11, 13 and 15 years (N=3720 distributed across 209 classes). Psychological health complaints were constructed as an index based on four items. Exposure to sexual jokes at the student level was measured by one item, and at the class level as the class proportion of students exposed to sexual jokes, in per cent. Two-level linear regression analyses were performed.Results: Students who had been exposed to sexual jokes at school reported higher levels of psychological complaints, especially boys. Furthermore, the class proportion of students who had been exposed to sexual jokes was also associated with psychological complaints, even when adjusting for student-level exposure to sexual jokes, gender, grade and class size. Conclusions: Sexual jokes seem to be harmful for those who are directly exposed, but may also affect indirectly exposed students negatively. Thus, a school climate free from sexual jokes may profit all students.

Clinical Characteristics of Patients Seeking Treatment for Common Mental Disorders Presenting With Workplace Bullying Experiences

BACKGROUND

Targets of workplace bullying tend to develop severe mental health complaints, having increased risk of sick leave and expulsion from the workplace. Hence, these individuals are likely to be overrepresented among patients seeking treatment for common mental disorders (CMD). This study investigated the prevalence of exposure to workplace bullying in a patient group seeking treatment for CMD. Further we explored if exposed and non-exposed patients differed on clinical and work-related characteristics.

METHODS

The sample comprised of 675 patients from an outpatient clinic in Norway and consisted of 70% women and had a mean age of 39 (SD = 10.5) years. The study had a cross-sectional design and differences between the patient groups were analysed using chi-square, Mann-Whitney U-tests and independent sample t-tests.

RESULTS

The prevalence of exposure to bullying was 25.8%. The patients exposed to bullying reported significantly more major depressive disorders (MDDs) measured with the MINI psychiatric interview, higher levels of depressive symptoms, anxiety symptoms, subjective health complaints, alcohol use, and lower resilience as measured with questionnaires. Twice as many were on full-time sick leave, reported lower work ability, lower return to work self-efficacy, and lower job satisfaction. A majority preferred another job than the one they have today over returning to their current employment.

CONCLUSION

Victims of workplace bullying are a vulnerable group at risk of expulsion from working life, being overrepresented among patients seeking mental health treatment for CMD. One in four patients represented with such experience have higher levels of psychological symptoms and are more often diagnosed with depression as compared to other patients. Thus, this is a problem that should be addressed in clinical settings. If not addressed there is an increased risk of sick leave and permanent exclusion from working life.

Factors Associated With Health Complaints Among Leather Tannery Workers in Bangladesh

Background: Few studies have reported associations between occupational exposure to tannery chemicals with breathing difficulty and skin diseases and none have been conducted in Bangladesh. The aim of this study was to investigate the associations of health complaints with types of work and length of employment among tannery workers in Bangladesh, where occupational health and safety regulations are less restricted compared with the developed world. Methods: One hundred sixty-seven (n = 167) workers from 10 tanneries were interviewed using a questionnaire adapted from the European Community Respiratory Health Survey (ECRHS) and the Tasmanian Longitudinal Health Study (TAHS) to collect information on occupational exposures and health outcomes. Workers' length of employment was examined, as well as their areas of work including beamhouse, wet finishing, dry finishing, and miscellaneous. Univariate and multivariate logistic regressions were performed to investigate potential associations while controlling for confounders. Results: Length of employment was positively associated with breathing difficulty (odds ratio [OR]: 1.32, 95% confidence interval [CI]:1.07-1.64). Workers involved in the wet finishing (OR: 11.75, 95% CI: 2.12-65.10) and dry finishing (OR: 13.38, 95% CI: 1.00-181.70) had higher odds of breathing difficulty; while, working in the beamhouse was associated with an increased risk of developing skin diseases (OR: 4.36, 95% CI: 1.10-17.32). Conclusion/Application to Practice: Length of employment and types of work were associated with increased risk of health complaints, including breathing difficulty and skin disease among tannery workers. Stronger regulations with regular enforcement, regular health surveillance, and worker and employer education are necessary for reducing these exposures and improving the health outcomes of the tannery workers.

Spirituality, Religious Attendance and Health Complaints in Czech Adolescents

Research in some religious countries shows that religiosity and spirituality positively affect adolescent health. We studied whether religiosity and spirituality also have positive associations with adolescent health in a secular country. We tested the associations between religious attendance and spirituality and self-reported health and health complaints using a representative sample of Czech adolescents (n = 4182, 14.4 ± 1.1 years, 48.6% boys) from the 2014 health behavior in school-aged children (HBSC) study. We used religious attendance, the adjusted shortened version of the spiritual well-being scale (SWBS), and its two components—religious well-being (RWB) and existential well-being (EWB)—as independent variables and the eight item “HBSC symptom checklist” and self-reported overall health as dependent variables. A higher level of spirituality was associated with lower chances of health complaints and self-reported health, ranging from a 9% to 30% decrease in odd ratios (OR). Religious attendance was not associated with any of the observed variables. The EWB showed a negative association with all of the observed variables, with associations ranging from a 19% to 47% decrease. The RWB was associated with a higher risk of nervousness (OR = 1.12), while other associations were not significant. Non-spiritual but attending respondents were more likely to report a higher occurrence of stomachache (OR = 2.20) and had significantly worse overall health (OR = 2.38). In a largely secular country, we found that spirituality and the EWB (unlike religious attendance and the RWB) could have a significant influence on adolescent health.

Work-Related Stress Among Chefs: A Predictive Model of Health Complaints

Aim: We studied occupational stress and its effects on health in a sample of Italian chefs using a structural equation modeling (SEM) analytical approach.

Methods: In an online study, 710 chefs were recruited through the Italian Chefs Federation. They answered several questionnaires to evaluate whether the risk of occupational stress (measured with the Karasek's Job Content Questionnaire and Siegrist's Effort-Reward Imbalance) correlates with the quality of life and the prevalence of health complaints. We also sought to evaluate whether individual characteristics (age, sex or body mass index) or work-related factors (i.e., chef categories, job duration, and length of working day) might be considered as stress risk factors.

Results: Forty-seven percent of the chefs [88% male, mean age: 44.4 ± 6.3 years; body mass index (kg/m²): 28.5 ± 1.2; job duration: 24.9 ± 4.1 years; working hours per week: 66.4 ± 28.9] reported, at least, two or more health complaints (i.e., gastrointestinal, blood pressure, and musculoskeletal problems). SEM analyses demonstrated that occupational job duration and the length of working week in chefs are significantly associated with a lower quality of life and an increasing prevalence of health complaints. This relationship is mediated by the presence of high level of occupational stress, which was revealed with a prevalence ranging from 13.8 to 24.9%. Age, sex, and unhealthy lifestyles do not affect this pattern of findings.

Conclusion: Job duration and the length of working day can be considered as stress predictors in chef-related daily activity, which increase the likelihood of illness.

Complex families and health complaints among adolescents: A population-based cross-sectional study

Aims: The structure of adolescents' families has become more complex over the last decades in several western countries. In parallel, health complaints among adolescents appear to have risen in the Nordic countries. This study aimed to examine the association between family structure and health complaints among Norwegian adolescents while capturing biological, half-, and stepsiblings (sibship-type) in the families. Methods: Data stem from the youth@hordaland study, an epidemiological study of adolescents aged 16-19 years (N = 10,257; participation rate = 53%) conducted in 2012. This study is based on a subsample of 8808 adolescents who lived with parent(s). The adolescents provided detailed information on sociodemographics, family structure, sibship-type, and common health complaints among youth (headache, dizziness, and abdominal, neck, back, and shoulder pain). Results: Adolescents in nuclear families and joint physical custody (JPC) reported significantly lower levels of health complaints compared to peers in single- or stepparent families. Independent of family structure, biological siblings were associated with lower levels of health complaints, while stepsiblings were associated with higher levels of health complaints, but only among girls. These findings were robust to adjustments of sociodemographic variables. Conclusions: Health complaints are frequent but unequally distributed across family structures. Adolescents in nuclear families and JPC report lower levels of health complaints compared to peers in single- or stepparent families. Considering siblings appears to be relevant, as biological- and stepsiblings were related to adolescents' symptoms, independent of family structure. In combination, knowledge about family structure and sibship-type may aid the identification of adolescents at risk of experiencing health complaints.

Detailed injury epidemiology in contemporary dance: a 1-year prospective study of 134 students

Aim

We investigated the extent and characteristics of injuries in contemporary dance students.

Methods

During one academic year, 134 students of Bachelor dance and Bachelor dance teacher from Codarts University of the Arts (Rotterdam, the Netherlands) were prospectively monitored monthly, using the Performing Artist and Athlete Health Monitor which includes the Oslo Sports Trauma Research Centre Questionnaire on Health Problems.

Results

130 students were included in the analyses. The response rate of monthly completed questionnaires was 80%. During the academic year, 97% of students reported at least one injury, mental complaint or other health problem. The 1-year injury incidence proportion was 81%. Of these injured students, 58% were substantially injured (ie, problems leading to moderate or severe reductions in training volume or performance or complete inability to participate in activities). The monthly injury proportion (all injuries) ranged from 23% to 43% and for substantial injuries from 6% to 17%. The injury incidence rate per 1000 hours dance exposure was 1.9 (95% CI 1.7 to 2.2). Ankle/foot (30%), lower back (17%) and knee (15%) were the most common sites of injury.

Conclusion

Contemporary dance students are at high risk for injuries. Injury prevention programmes among contemporary dance students should focus on the ankle/foot, lower back and knee.

Emotional Exhaustion and Health Complaints as Indicators of Occupational Diseases Among Civil Servants in Spain

Occupations focused on helping others, guaranteeing people’s security, and defending societal values can be stressful and risky for the workers involved. Emotional exhaustion and health complaints usually emerge as indicators of the stress suffered by these workers in undertaking their roles. This research aims to explore the effects of psychological contract breach on both emotional exhaustion and health complaints among three kinds of Spanish workers, namely firefighters (n = 80), professional soldiers (n = 77), and prison officers (n = 107). The predictor variables include job tenure and psychological contract breach. Criterion variables are employees’ emotional exhaustion and health complaints. Our findings showed that job tenure and contract breaches significantly explain both emotional exhaustion and health complaints. Despite these general findings, some differences emerge as a function of the organizations. Significance levels were higher for prison officers than for firemen and Spanish soldiers. Results are discussed, suggesting conceptual integration and direction for future risk prevention in this kind of public organization.

Spirituality but not Religiosity Is Associated with Better Health and Higher Life Satisfaction among Adolescents

Careful conceptualization and differentiation of both spirituality and religiosity is a necessary precondition for understanding the potential role they play in health, whether physical or mental. The aim of this study was to explore the associations of spirituality with self-rated health, health complaints, and life satisfaction of adolescents with the moderating role of religiosity. Data from the Health Behaviour in School-aged Children study conducted in 2014 in Slovakia were used. The final sample consisted of 658 adolescents (mean age = 15.37; 50.6% boys). Data regarding spirituality, religiosity, self-rated health, health complaints, and life satisfaction were obtained. Binary logistic models revealed spirituality to be associated with self-rated health, health complaints, and life satisfaction. A moderating role of religiosity was not confirmed. The presented findings indicate the need to distinguish between the concepts of religiosity and spirituality in connection with subjective health and life satisfaction.

The Romanian Adaptation of the Survey Work-Home Interaction, NijmeGen

To date, there are no scales measuring work-home interaction which are adapted for the Eastern European population. Owing to the significantly different sociocultural contexts and geopolitical history between Western and Eastern populations, despite the massive contemporary East-West migration, a more culturally appropriate scale is needed to ensure valid and reliable measurement of the construct. This article presents the adaptation of the Survey Work-Home Interaction-NijmeGen (SWING) for the Romanian population. The results show that SWING can successfully measure work-home interaction for this population. Gender equivalence is also discussed.

Adverse Health Complaints of Adults Exposed to Benzene After a Flaring Disaster at the BP Refinery Facility in Texas City, Texas

OBJECTIVE

The objective of this study was to assess the adverse health symptoms experienced by adult subjects who were exposed to benzene after a flaring disaster at the BP refinery in Texas City, Texas.

METHODS

A total of 2162 adults aged 18 years or older and exposed to benzene were included. Using the patients' medical charts, we collected and analyzed data on health complaints as well as the patients' serum levels of beta-2-microglobulin and urinary excretion of phenol.

RESULTS

A total of 11,368 health symptom complaints were reported in 2162 adults exposed to benzene. Neurological symptoms occurred most frequently (174%), followed upper respiratory symptoms (115%), cough (31%), painful joints (30%), cardiac symptoms (28%), dermatological symptoms (28%), gastrointestinal symptoms (27%), diarrhea (25%), vision symptoms (21%), and nausea/vomiting (19%). Logistic regression analysis indicated that urinary symptoms (R2=0.65) and painful joints (R2=0.44) were positively associated with increasing age in benzene-exposed subjects.

CONCLUSION

Adult subjects exposed to benzene experience a range of adverse health symptoms and an altered profile of urinary phenol, thus indicating they are at high risk of developing serious future health complications. (Disaster Med Public Health Preparedness. 2018;12:232-240).

Health complaints in late adolescence; Frequency, factor structure and the association with socio-economic status

AIMS

Little is known about social disparities in health in late adolescence. Among boys and girls aged 17-19, we aimed to (1) describe frequency of health complaints, (2) investigate the factor structure of health complaints and (3) examine the association between health complaints and socio-economic status (SES).

METHODS

Data from the large population-based youth@hordaland survey ( n=10,253) were used. Health complaints were assessed by five items from the Health Behaviour in School-Aged Children Symptoms Checklist, SES by parental education and perceived family economy. Associations between health complaints and SES were investigated using analysis of variance, and the factor structure of health complaints using confirmatory factor analyses.

RESULTS

At least one weekly complaint was reported by 47% of girls and 21% of boys. The items showed a good fit to a simple one-factor model when back pain and neck/shoulder pain were allowed to correlate. Health complaints were more frequent among adolescents reporting poor perceived family economy and lower parental education.

CONCLUSIONS

Our results suggest that health complaints are common in adolescence and might, as in adults, be part of everyday life. Health complaints are more frequent among adolescents from families with lower SES.

Working suspended in a harness rig: A comparative study of musculoskeletal health complaints in rope access technicians and controls

BACKGROUND

Rope access technique is an alternative method for gaining access to challenging work locations. There is limited knowledge about possible adverse effects of this technique on the workers' health.

OBJECTIVE

To compare the frequency of bodily regions with pain in rope access technicians with craft workers and the working population in general.

METHODS

The one-month prevalence of pain in the head, neck, distal upper extremities, lower back and lower extremities was recorded in rope access technicians (n = 95), "craft workers" (n = 289) and "all occupations" (n = 1563).

RESULTS

An increased prevalence of pain in the neck, distal upper extremities and lower extremities was found for the rope access technicians compared with all occupations (p-values <0.01). Compared with the craft workers, relatively more rope access technicians reported pain in the lower extremity region (p <0.01) while the groups were similar for the other body regions.

CONCLUSIONS

The prevalence of pain in the lower extremities was higher in rope access technicians compared with craft workers, while no differences were found for other body regions. The increased prevalence of pain in the neck and distal upper extremities in the technicians compared with all occupations may therefore be related to the work tasks and not the access technique.

Psychosocial work environment in school and students' somatic health complaints: An analysis of buffering resources

AIM

This study explores the association between the psychosocial work environment in school and students' somatic health complaints. With its point of departure from the Demand-Control-Support (DCS) model, the aim was to examine how aspects of decision control and social support can moderate stress-related health implications of high psychological demands.

METHODS

Data come from two cross-sectional waves of the Swedish version of Health Behaviour in School-aged Children (HBSC 2005/2006 and 2009/2010), which consists of a total of 9427 11-, 13- and 15-year-old students. A two-level random intercept model was applied, with school class as the level 2 unit.

RESULTS

Findings showed significant associations between school demands and somatic health complaints for all studied age groups, with a slight increase in strength with age. Decision control as well as social support from teachers, parents and peers consistently predicted a favorable association with health. An age pattern emerged in the analyses of stress-moderating resources. For 11 year olds parental support was the only resource that displayed a significant interaction with demands in relation to somatic health complaints, whereas for 13 year olds, decision control and support from teachers and parents all demonstrated moderating effects on student health. For 15 year olds, however, it was peer support that acted as a buffering resource in the studied relationship.

CONCLUSIONS

The psychosocial work environment is an important predictor of students' health complaints. Overall, social support was a better stress-moderating resource than decision control, but some "buffers" were more important at certain ages than others.

Illness Symptoms Experienced by Children Exposed to Benzene After a Flaring Incident at the BP Refinery Facility in Texas City

Objective To evaluate the illness symptoms experienced by children who were exposed to benzene following a flaring incident at the BP refinery in Texas City, Texas. Methods A total of 641 children, aged <17 years, exposed to benzene were included. Using medical charts, data on the children's illness symptoms as well as the serum levels of β-2-microglobulin and the amount of urinary excretion of phenol were reviewed and analyzed. Results A total of 1790 illness symptoms were reported in 641 children exposed to benzene. Upper respiratory symptoms were the most (67%) frequently reported, followed by neurological symptoms (57%), diarrhea (25%), and cough (24%). Logistic regression analysis indicated that neurological symptoms (R(2) = 0.75), chest pain (R(2) = 0.64), joint pain (R(2) = 0.57), and vision difficulty (R(2) = 0.54) were positively associated with increasing age. β-2-Microglobulin levels were significantly higher in children <5 years compared with those >5 year (P = .04). Conversely, urinary phenol levels were significantly lower in children <5 years compared with those >5 years (P = .00). Conclusion Together, these findings reveal that children exposed to benzene experience a range of illness symptoms and an altered profile of urinary phenol indicating their vulnerability to potentially increased health complications.

Resource Loss and Gain, Life Satisfaction, and Health Among Retirees in Spain

OBJECTIVE

This article focuses on retirement transition from the Conservation of Resources (COR) perspective to better understand how aged participants' perceptions of retirement losses and gains significantly explain retirement well-being. In this article, the mediation of social support in the losses-well-being relationship is explored.

METHOD

The study was conducted with a two-wave longitudinal design. Participants at T1 were aged Spanish workers (>64 years) and at T2 were retirees, with a final sample of 275, who had retired during the previous 6 months.

RESULTS

Findings supported the assertion that losses better explain well-being than gains. In addition, specific losses revealed a higher explaining power of life satisfaction and health complaints depending on their content. Social support mediated between perceived losses and well-being.

DISCUSSION

This study suggests that both perceived losses and gains associated with retirement and social support during retirement should be taken into account when addressing postretirement well-being.

Parental educational level and psychological positive health and health complaints in Spanish children and adolescents

BACKGROUND

Interest on the impact of socioeconomic differences on youth's health is growing. The aim of the present study was to examine the association of parental educational level with psychological positive health and health complaints in Spanish children and adolescents.

METHODS

Parental educational level, psychological positive health indicators (perceived health status, life satisfaction, quality of family relationships, quality of peer relationships and academic performance) and health complaint index (headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, feeling dizzy) were self-reported using the Health Behavior in School-aged Children questionnaire in 685 (366 boys and 319 girls) children and adolescents.

RESULTS

Children reporting parents with non-university studies (father, mother or both) had significantly higher odd ratio of having lower academic performance, lower life satisfaction, perceiving their health status as otherwise (vs. excellent) and having health complaints sometime than their counterparts reporting parents with university studies (father, mother or both).

CONCLUSION

Current results provide evidence that children having parents with a university degree (father, mother or both) are more likely to have higher psychological positive health and lower health complaints than children reporting parents with non-university studies. This is particularly important for the welfare policy that must pay attention for implementing programs for helping population to access to university studies by their impact on youth health.

Effort-reward imbalance and organisational injustice among aged nurses: a moderated mediation model

AIM

To test the effort-reward imbalance model among older nurses, expanding it to include the moderation of overcommitment and age in the stress-health complaints relationship, mediated by organisational injustice.

BACKGROUND

The theoretical framework included the effort-reward imbalance, the uncertainty management and the socio-emotional selectivity models.

METHOD

Employing a two-wave design, the participants were 255 nurses aged 45 years and over, recruited from four large hospitals in Spain (Madrid and Basque Country).

RESULTS

The direct effect of imbalance on health complaints was supported: it was significant when overcommitment was low but not when it was high. Organisational injustice mediated the influence of effort-reward imbalance on health complaints. The conditional effect of the mediation of organisational injustice was significant in three of the overcommitment/age conditions but it weakened, becoming non-significant, when the level of overcommitment was low and age was high.

CONCLUSIONS

The study tested the model in nursing populations and expanded it to the settings of occupational health and safety at work.

IMPLICATIONS FOR NURSING MANAGEMENT

The results of this study highlight the importance of effort-reward imbalance and organisational justice for creating healthy work environments.

Is Healthier Nutrition Behaviour Associated with Better Self-Reported Health and Less Health Complaints? Evidence from Turku, Finland

We examined nutrition behaviour, self-reported health and 20 health complaints of undergraduates in Finland. Students at the University of Turku in Finland participated in a cross-sectional online survey (N = 1189). For nutrition behaviour, we computed two composite food intake pattern scores (sweets, cakes and snacks; and fruits and vegetables), a dietary guideline adherence index and the subjective importance of healthy eating. Multinomial logistic regression assessed the association of students' nutrition behaviour with three levels of self-reported health, controlling for many potential confounders (age, sex, living with partner, economic situation, moderate physical activity, Faculty and BMI). Factor analysis of the 20 health complaints revealed three components (psychological, pains/aches and circulatory/breathing symptoms). Multiple linear regression tested the association of students' eating habits with the three components of health complaints, controlling for the same confounders. Fruits and raw and cooked vegetable consumption, dietary guideline adherence index and subjective importance of healthy eating were highest among students with excellent/very good self-reported health, exhibiting a decreasing trend for those individuals with poor/fair self-reported health. High levels of psychological symptoms were associated with decreased consumption of fruits and vegetables, less dietary guideline adherence and less subjective importance of healthy eating. Pain/aches symptoms were associated with a higher consumption of sweets, cookies and snacks and a lower adherence to dietary guidelines. More healthy nutrition behaviour was consistently associated with better self-reported health and less health complaints. Of the four nutrition behaviour indicators we employed, the dietary guideline adherence index was the best indicator and exhibited the most consistent associations with self-reported health and health complaints.

A prospective population-based study of health complaints in adolescence and use of social welfare benefits in young adulthood

BACKGROUND

There is a lack of knowledge on how health problems in adolescence are connected to work marginalization in adulthood. The aim of this study was to study work marginalization in young adulthood, measured by use of long-term social welfare benefits, and its associations with self-reported health complaints, total symptom burden and self-rated general health at ages 15-16.

METHODS

We linked data from a youth health survey conducted during 1999-2004 to data from Norwegian registries that followed each participant through February 2010. Cox regression analysis was used to compute hazard ratios (HRs) for the use of long-term social welfare benefits in young adulthood, based on health measures in 15-16 year-olds.

RESULTS

During the follow-up, 17% of the study population received some sort of long-term social welfare benefit. In the baseline survey, 95% of the adolescents reported one or more health complaints. The mean number of health complaints was 4.8. Girls reported a significantly higher mean number of complaints (5.7) than did boys (3.8) (p < 0.001). Several individual health complaints were associated with an increased use of long-term social welfare benefits. We found an increasing relative hazard of social welfare usage, depending on the number of complaints reported at baseline. Ill self-perceived general health was found to be strongly associated with the use of benefits during the follow-up: In girls, we found HRs of 1.41 (CI 1.21-1.65), 2.76 (2.29-3.31) and 2.77 (1.51-5.07) for those with good, not so good and bad health, respectively; compared to very good health. The corresponding numbers in boys were 1.41 (1.25-1.59), 1.93 (1.60-2.32) and 1.31 (0.72-2.38), respectively.

CONCLUSIONS

Several health measures in adolescents were found to be associated with future work marginalization in young adulthood. The associations remained significant, even after correcting for such strong predictors as the parents' education and family economy. Total symptom burden and self-perceived general health can add additional knowledge onto how adolescent health is related to work marginalization, in a longitudinal perspective.

Effort-reward imbalance in the school setting: associations with somatic pain and self-rated health

AIMS

According to the workplace theory of effort-reward imbalance (ERI), individuals who perceive a lack of reciprocity between their effort spent at work and the rewards received in turn are at an increased risk of stress-related ill-health. It is also assumed that being overcommitted to work is linked to an increased risk of stress-related ill-health. This study applies the effort-reward imbalance model to the school setting. It aims to analyse the associations that effort-reward imbalance and overcommitment share with somatic pain and self-rated health among adolescents.

METHODS

Data are from the School Stress and Support Study (TriSSS), involving students in grades 8 and 9 (ages 14-16 years) in two schools in Stockholm, Sweden, during 2010 (n=403). Information on effort-reward imbalance and health outcomes was gathered from self-report questionnaires. An adjusted short version of ERI was used. Factor analysis showed that extrinsic effort, reward and overcommitment constitute three distinct dimensions. The designed measures demonstrated sound psychometric properties both for the full sample and for subgroups. Ordered logistic regressions were conducted.

RESULTS

The analyses showed that low reward and higher overcommitment were associated with greater somatic pain and poorer self-rated health. Furthermore, effort-reward imbalance was linked with an elevated risk of somatic pain and poorer self-rated health.

CONCLUSIONS

Students are more likely to experience stress-related ill-health when they perceive an imbalance between their effort and rewards. In addition, high overcommitment is associated with an increased risk of ill-health among students.

Loneliness and health care consumption among older people

Few studies have investigated loneliness in relation to health care consumption among frail older people. The aim of this study was to examine loneliness, health-related quality of life (HRQoL), and health complaints in relation to health care consumption of in- and outpatient care among frail older people living at home. The study, with a cross-sectional design, comprised a sample of 153 respondents aged from 65 years (mean age 81.5 years) or older, who lived at home and were frail. Data was collected utilising structured interviews in the respondent's home assessing demographic data, loneliness, HRQoL and health complaints. Patient administrative registers were used to collect data on health care consumption. Loneliness was the dependent variable in the majority of the analyses and dichotomised. For group comparisons Student's t-test, Mann-Whitney U-test and Chi-square test were used. The results showed that 60% of the respondents had experienced loneliness during the previous year, at least occasionally. The study identified that lonely respondents had a lower HRQoL (p = 0.022), with a higher total number of reported health complaints (p = 0.001), and used more outpatient services including more acute visits at the emergency department, compared to not lonely respondents (p = 0.026). Multiple linear regression analysis showed that a depressed mood was independently associated to total use of outpatient care (B = 7.4, p < 0.001). Therefore, it might not be loneliness, per se, that is the reason for seeking health care. However, reasons for using health care services are difficult to determine due to the complex situation for the frail older person. To avoid emergency department visits and to benefit the well-being of the frail older person, interventions targeting the complex health situation, including loneliness, are suggested.

Joint physical custody, turning to parents for emotional support, and subjective health: A study of adolescents in Stockholm, Sweden

AIMS

Among children with separated parents, the arrangement of joint physical custody, i.e. children living equally much in both parents' homes, has increased substantially during the last decades in Sweden. To date, empirical research on the living conditions of this group is limited. This study analyses family type differences in turning to parents for emotional support and in subjective health among adolescents. The focus of the study is adolescents in joint physical custody, who are compared with those living with two original parents in the same household; those living (only) in a single-parent household; and those living (only) in a reconstituted family.

METHODS

The data come from the Stockholm School Survey of 2004, a total population survey of students in grade 9 (15-16 years) in Stockholm (n=8,840). Ordinary least squares (OLS) regressions were conducted.

RESULTS

Turning to both parents about problems is most commonly reported by adolescents in intact families, followed by those in joint physical custody. Adolescents in non-traditional family types report worse subjective health than adolescents in intact families, but the difference is smaller for those in joint physical custody than for those living with a single parent. The slightly poorer health of adolescents in joint physical custody than those in intact families is not explained by their lower use of parents as a source of emotional support.

CONCLUSIONS

The study suggests that joint physical custody is associated with a higher inclination to use parents as a source of emotional support and better subjective health than other post-divorce family types.

Lower cumulative stress is associated with better health for physically active adults in the community

Both cumulative adversity, an individual's lifetime exposure to stressors, and insufficient exercise are associated with poor health outcomes. The purpose of this study was to ascertain whether exercise buffers the association of cumulative adverse life events (CALE) with health in a community-wide sample of healthy adults (ages 18-50 years; women: n = 219, 29.5 ± 9.2 years; men: n = 176, 29.4 ± 8.7 years, mean ± standard deviation). Participants underwent the Cumulative Adversity Interview, which divides life events into three subsets: major life events (MLE), recent life events (RLE) and traumatic experiences (TLE). These individuals also completed the Cornell Medical Index and a short assessment for moderate or greater intensity exercise behavior, modified from the Nurses' Health Study. Results indicated that higher CALE was associated with greater total health problems (r = 0.431, p < 0.001). Interactions between stress and exercise were not apparent for RLE and TLE. However, at low levels of MLE, greater exercise was related to fewer total, physical, cardiovascular and psychological health problems (p value <0.05). Conversely, at high levels of MLE, the benefits of exercise appear to be absent. Three-way interactions were observed between sex, exercise and stress. Increased levels of exercise were related to better physical health in men, at all levels of CALE. Only women who reported both low levels of CALE and high levels of exercise had more favorable physical health outcomes. A similar pattern of results emerged for RLE. Together, these data suggest that increased exercise is related to better health, but these effects may vary by cumulative stress exposure and sex.

Peer acceptance in the school class and subjective health complaints: a multilevel approach

BACKGROUND

Feeling accepted by peers is important for young people's health but few studies have examined the overall degree of acceptance in school and its health consequences. The purpose of the study was to investigate whether health complaints among Swedish students can be attributed to the acceptance climate in their school class even when the health effects of their own (individual) acceptance score have been taken into account.

METHODS

The data used were from the Health Behaviour in School-aged Children (HBSC) study for the years 2001 to 2002, 2005 to 2006, and 2009 to 2010, consisting of 13,902 5th-, 7th-, and 9th-grade Swedish students nested into 742 school classes. The statistical analyses were performed by means of linear regression multilevel analysis.

RESULTS

The results indicated that the variation in subjective health complaints could be ascribed partly to the school-class level (boys: 5.0%; girls: 13.5%). Peer acceptance at the individual level demonstrated a clear association with health: the lower the acceptance, the higher the complaint scores. For girls, but not for boys, the overall degree of peer acceptance in the school class demonstrated a contextual effect on health, net of acceptance at the student level. Interaction analyses also revealed an increasingly favorable health among poorly accepted girls as the acceptance climate in the school class declined.

CONCLUSIONS

A lower overall degree of peer acceptance in the school class is associated with poorer health among girls. However, girls who themselves feel poorly accepted are not as negatively affected health-wise by a poor acceptance climate, as are well-accepted girls.

Distal and proximal factors of health behaviors and their associations with health in children and adolescents

OBJECTIVE

The aim of the present paper was to analyze factors affecting distal and proximal health behavior within a biopsychosocial model for examining their interactions and associations with respect to health.

METHODS

Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years (SD = 4.01). Socio-demographic data, psychosocial factors and health behavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination.

RESULTS

Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown.

CONCLUSIONS

Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected health behaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness.

Correlation between physical activity and sedentary behavior with healthy and unhealthy behaviors in Italy and Tuscan region: a cross sectional study

INTRODUCTION

Regular physical activity (PA) has associated with various positive health aspects such as a decreased risk of chronic or generic illnesses, furthermore, a sedentary lifestyle has been associated with health problems such as obesity. To examine the relationship between patterns of PA, screen-based media use (SBM) and social health indicators within a specific demographic group and highlight the regional vs. national differences in these relationships.

METHODS

The data is drawn from the Health Behaviour in School-Aged Children (HBSC) database, a national cross-sectional survey in a representative sample (N = 3920) of students aged 11-13-15 years and compared to those of the Tuscan region (N = 3381). Variables considered other than PA and SBM use includes positive health indicators such as physical health status, quality of family and peer relationships, fruit consumption, breakfast consumption as well as negative health indicators, such as health complaints, smoking and alcohol use.

RESULTS

Some positive health indicators showed a positive correlation with PA. Students adopting healthy behaviours often met the Physical Activity Guide Line (PAGL). On the contrary, negative health indicators were associated with PAGL in a negative way. In general SBM was positively related to several of the negative health indicators and vice versa. SBM was related in a positive fashion to tobacco use that represents a protective factor.

DISCUSSION

The results show that met PAGL is associated with positive health indicators and that high levels of SBM use is associated with negative health indicators. The study also emphasizes the relationship between PA, SBM use and socialfactors. Increasing PA and decreasing SBM use should be an aim in general health behaviour promotion.

Experience of health complaints and help seeking behavior in employees screened for depressive complaints and risk of future sickness absence

INTRODUCTION

The aim of this study was to examine the associations between on the one hand depressive complaints and risk of future sickness absence and on the other hand experience of health complaints and help seeking behavior in the working population.

METHODS

Cross-sectional data were used from employees working in the banking sector (n = 8,498). The screening instrument included measures to examine the risk of future sickness absence, depressive complaints and help seeking behavior.

RESULTS

Of employees reporting health complaints, approximately 80% had already sought help for these complaints. Experience of health complaints and subsequent help seeking behavior differed between employees with mild to severe depressive complaints and employees at risk of future sickness absence. Experience of health complaints was highest in employees identified with both concepts (69%) compared with employees identified at risk of future sickness absence only (48%) and with mild to severe depressive complaints only (57%). In those employees identified with one or both concepts and who had not sought help already, intention to seek help was about 50%.

CONCLUSIONS

From a screening perspective, employees who do not experience health complaints or who do not have the intention to seek help may refuse participation in early intervention. This might be a bottleneck in the implementation of preventive interventions in the occupational health setting.

Patterns of adolescent physical activity, screen-based media use, and positive and negative health indicators in the U.S. and Canada

PURPOSE

To examine: (1) how adolescent physical activity (PA) and screen-based media use (SBM) relate to physical and social health indicators, and (2) crossnational differences in these relationships.

METHODS

Essentially identical questions and methodologies were used in the Health Behavior in School-Aged Children cross-sectional surveys of nationally representative samples of American (N = 14,818) and Canadian (N = 7266) students in grades 6 to 10. Items included questions about frequency of PA, SBM, positive health indicators (health status, self-image, quality of life, and quality of family and peer relationships), and negative health indicators (health complaints, physical aggression, smoking, drinking, and marijuana use).

RESULTS

In regression analyses controlling for age and gender, positive health indicators were uniformly positively related to PA while two negative health indicators were negatively related to PA. However, PA was positively related to physical aggression. The pattern for SBM was generally the opposite; SBM was negatively related to most positive health indices and positively related to several of the negative health indicators. The notable exception was that SBM was positively related to the quality of peer relationships. Although there were crossnational differences in the strength of some relationships, these patterns were essentially replicated in both countries.

CONCLUSIONS

Surveys of nationally representative samples of youth in two countries provide evidence of positive physical and social concomitants of PA and negative concomitants of SBM. These findings suggest potential positive consequences of increasing PA and decreasing SBM in adolescents and provide further justification for such efforts.

Excessive working hours and health complaints among hospital physicians: a study based on a national sample of hospital physicians in Germany

OBJECTIVES

To determine correlations between excessively long working hours and subjectively experienced somatic health complaints among hospital physicians.

METHODS

Quantitative data were collected as part of the survey "Working life, Lifestyle and Health of Hospital Physicians in Germany 2006" using self-reporting questionnaires. The individually experienced health was assessed on the basis of Zerssen's list of somatic complaints. The indicator of excessively long working hours was defined as 10 or more working hours per working day and 6 or more on-call shifts a month among full-time employees. The net sample consisted of 3295 randomly selected physicians from 515 hospitals.

RESULTS

The response rate was 58% (n=1917). Physicians with excessively long working hours (19%) had significantly higher sum score of health complaints (p=0.0001) and significantly increased mental and physical fatigue symptoms (feeling faint, languor, uneasiness, heavy legs, excessive need for sleep, trembling; p=0.0001 to 0.047), mood changes (irritability, brooding; p=0.008 to 0.014), gastrointestinal (nausea, loss of weight; p=0.0001 to 0.014) and heart disorders (lumpy sensation in the throat, chest pain; p=0.0001 to 0.042). When the sum score of health complaints was controlled for selected confounders, being female (B=-3.44, p=0.0001) and having excessively long working hours (B=2.76, p=0.0001) were significantly correlated with health complaints. In a separate gender analysis, being exposed to excessively long working hours remained a significant predictor for health complaints among both females (B=3.78, p=0.001) and males (B=2.28, p=0.004).

CONCLUSIONS

Excessively long working hours are associated with an increased risk of health complaints. Reducing working hours may be the first step to improving physicians' health.