Child health and its effect on adult social capital accumulation

Although studies have demonstrated important effects of poor health in childhood on stocks of human and health capital, little research has tested economic theories to investigate the effect of child health on social capital in adulthood. Studies on the influence of child health on adult social capital are mixed and have not used sibling fixed effects models to account for unmeasured family and genetic characteristics, that are likely to be important. Using the Add-Health sample, health in childhood was assessed as self-rated health, the occurrence of a physical health condition or mental health condition, while social capital in adulthood was measured as volunteering, religious service attendance, team sports participation, number of friends, social isolation, and social support. We used sibling fixed effects models, which attenuated several associations to non-significance. In sibling fixed effects models there was significant positive effects of greater self-rated health on participation in team sports and social support, and negative effect of mental health in childhood on social isolation in adulthood. These results suggest that children with poor health require additional supports to build and maintain their stock of social capital and highlight further potential benefits to efforts that address poor child health.

Benefits of Meeting the Healthy People 2030 Youth Sports Participation Target

INTRODUCTION

Healthy People 2030, a U.S. government health initiative, has indicated that increasing youth sports participation to 63.3% is a priority in the U.S. This study quantified the health and economic value of achieving this target.

METHODS

An agent-based model developed in 2023 represents each person aged 6-17 years in the U.S. On each simulated day, agents can participate in sports that affect their metabolic and mental health in the model. Each agent can develop different physical and mental health outcomes, associated with direct and indirect costs.

RESULTS

Increasing the proportion of youth participating in sports from the most recent participation levels (50.7%) to the Healthy People 2030 target (63.3%) could reduce overweight/obesity prevalence by 3.37% (95% CI=3.35%, 3.39%), resulting in 1.71 million fewer cases of overweight/obesity (95% CI=1.64, 1.77 million). This could avert 352,000 (95% CI=336,200, 367,500) cases of weight-related diseases and gain 1.86 million (95% CI=1.86, 1.87 million) quality-adjusted life years, saving $22.55 billion (95% CI=$22.46, $22.63 billion) in direct medical costs and $25.43 billion (95% CI= $25.25, $25.61 billion) in productivity losses. This would also reduce depression/anxiety symptoms, saving $3.61 billion (95% CI=$3.58, $3.63 billion) in direct medical costs and $28.38 billion (95% CI=$28.20, $28.56 billion) in productivity losses.

CONCLUSIONS

This study shows that achieving the Healthy People 2030 objective could save third-party payers, businesses, and society billions of dollars for each cohort of persons aged 6-17 years, savings that would continue to repeat with each new cohort. This suggests that even if a substantial amount is invested toward this objective, such investments could pay for themselves.

Rest-activity rhythm disruption and metabolic health in schizophrenia: a cross-sectional actigraphy study of community-dwelling people living with schizophrenia and non-psychiatric comparison participants

STUDY OBJECTIVES

People living with schizophrenia (PLWS) have increased physical comorbidities and premature mortality which may be linked to dysregulated rest-activity rhythms (RARs). This study aimed to compare RARs between PLWS and non-psychiatric comparison participants (NCs); examine the relationships of RARs with age, sleep, metabolic and physical health outcomes; and, among PLWS, relationships of RARs with illness-related factors.

METHODS

The study sample included 26 PLWS and 36 NCs, assessed with wrist-worn actigraphy to compute RAR variables and general sleep variables. Participants completed assessments for clinical symptoms, physical health, sleep quality, medication use, and assays for fasting glycosylated hemoglobin (HbA1c) levels. We examined group differences in RAR and sleep variables, relationships of RAR variables with metabolic and physical health measures, and, among PLWS, relationships between RAR variables and illness-related measures.

RESULTS

PLWS had significantly shorter active periods, lower relative amplitude, and lower mean activity during their most active 10 hours compared to the NCs (Cohen's d=.79, .58, and .62; respectively). PLWS had poorer sleep quality, greater mean percent sleep, less wake after sleep onset, and higher total sleep time (TST) variability compared to NCs. PLWS had higher rates of antidepressant, anxiolytic, and antipsychotic medication use compared to NCs, which may have impacted sleep quality and objective sleep measures. Across both groups, more fragmented and variable RARs were associated with higher HbA1c levels (ηp2=0.10) and worse physical health (ηp2=0.21). Among PLWS, RARs were correlated with TST (rs=.789, p<0.01) and percent sleep (rs=.509, p<0.05), but not with age, sleep quality, or other illness-related factors.

CONCLUSIONS

RARs provide unique information about sleep and activity for PLWS and have the potential for targeted interventions to improve metabolic health and mortality.

Testing the Effectiveness of an Intervention to Improve Romanian Teachers' LGBT+-Related Attitudes, Cognitions, Behaviors, and Affect: Protocol for a Randomized Controlled Trial

BACKGROUND

Repeated stigmatization due to group membership constitutes a recurrent stressor with negative impact on physical and mental health (minority stress model). Among European countries, Romania ranks low on LGBT+ (lesbian, gay, bisexual, and transgender people. The "+" represents individuals whose identities do not fit typical binary notions of male and female [nonbinary]) inclusion, with 45% of Romanian LGBT+ respondents reporting discrimination in at least 1 area of life in the year preceding the survey. Importantly, while all LGBT+ people might experience minority stress, younger sexual minority individuals are more prone to the detrimental impacts of stigma on their mental and physical health. As such, interventions are necessary to improve the inclusion climate within schools, where young people spend most of their time. Until now, most interventions addressing this topic have been conducted on undergraduate students in Western countries, with no studies conducted in countries that have widespread anti-LGBT+ attitudes.

OBJECTIVE

This paper describes the research protocol for a randomized controlled trial investigating whether LGBT+ stigma and bias among Romanian school teachers can be reduced using an internet-based intervention focusing on education and contact as primary training elements.

METHODS

A sample of 175 school teachers will be randomly assigned to either the control or experimental group. The experimental group participants will receive the intervention first and then complete the outcome measures, whereas the control group will complete the outcome measures first and then receive the intervention. The 1-hour multimedia intervention is developed for internet-based delivery under controlled conditions. It includes 2 interactive exercises, 2 recorded presentations, animations, and testimonies from LGBT+ individuals. Data for attitudinal, behavioral, cognitive, and affective measures will be collected during the same session (before or after the intervention, depending on the condition). We also plan to conduct a brief mixed methods follow-up study at 6 to 8 months post participation to investigate potential long-term effects of training. However, due to attrition and lack of experimental control (all participants will have completed the intervention, regardless of the condition), these data will be analyzed and reported separately using a mixed methods approach.

RESULTS

This paper details the protocol for the teacher intervention study. Data collection began in December 2022 and was completed by February 2023. Data analysis will be performed upon protocol acceptance. Follow-up measures will be completed in 2024. Results are expected to be submitted for publication following analysis in the spring of 2024.

CONCLUSIONS

The findings of this study will establish the effectiveness of an internet-based intervention intended to lessen anti-LGBT stigma and sentiment in a nation where these views have long been prevalent. If successful, the intervention could end up serving as a resource for Romanian teachers and guidance counselors in high schools.

TRIAL REGISTRATION

ISRCTN 84290049; https://doi.org/10.1186/ISRCTN84290049.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/54254.

Shaping research for people living with co-existing mental and physical health conditions: A research priority setting initiative from the United Kingdom

INTRODUCTION

Those with severe and enduring mental ill health are at greater risk of long-term physical health conditions and have a reduced life expectancy as a result. Multiple factors compound this health inequality, and the need for setting research priorities in this area is highlighted with physical and mental healthcare services being separate, and limited multimorbidity research.

METHODS

The aim of this exercise was to work in partnership with healthcare professionals and carers, family, friends and individuals with lived experience of both mental and physical health conditions, to set research priorities to help people with mental health conditions to look after their physical health. The exercise was guided by the James Lind Alliance approach. For this, a steering group was set up, two surveys were completed and a final priority workshop was conducted.

RESULTS

This priority setting exercise guided by people's needs and lived experience has produced a set of well-defined research topics. Initially, 555 research questions were suggested in the first survey, which were refined to 54 questions for the second survey. A priority setting workshop was then conducted to get the final 10 priorities.

CONCLUSIONS

Taking these topics forward to improve services and treatment for both mental and physical ill health may in turn improve physical health and lessen the reduced life expectancy of those living with mental ill health.

PATIENT OR PUBLIC CONTRIBUTION

This work was completed in collaboration with people who have lived experience of mental ill health and physical health conditions, as well as carers, family and friends. Their contribution has been significant for this work from piloting surveys, amending language used and educating the researchers and contributing to this paper. The initial work was completed with a steering group and continued with surveys and workshops.

Asian Hate, religion, and perceived changes in physical health: exploring the flip side of minority stress during the COVID-19 pandemic

OBJECTIVES

Prior research suggests that racism is associated with adverse mental health outcomes for Asians in the United States. Relatively less research has been conducted to examine the effects of racism on physical health, particularly the changes in physical health among Asians and Asian Americans. This study aims to fill in this gap in prior research.

DESIGN

Survey was conducted via Qualtrics in March 2023. A panel sample of 356 Asian and Asian American adults from across the US was collected. Ordinary Least Squares Regression was employed to examine the interrelationships among racism, religion, and perceived changes in physical health during the COVID-19 pandemic.

RESULTS

Contrary to conventional wisdom, more frequent experience with blatant racism was associated with a perceived improvement in physical health after controlling for subtle racism, anxiety, acculturation, and various sociodemographic variables. Interestingly, this robust relationship was more significant among Asians who attended religious services more frequently. Additional three-way interactions revealed that the interaction between blatant racism and religious service attendance on perceived changes in physical health was more significant for US-born Asians and Asians of Indian or Japanese ethnicity.

CONCLUSION

Racism exerts a significant influence on physical health outcomes among Asians and Asian Americans. However, this relationship was contingent upon the specific aspect of racism and intersected with religiosity, acculturation, and ethnic identity.

Longitudinal Effects of Elexacaftor/Tezacaftor/Ivacaftor: Multidimensional Assessment of Neuropsychological Side Effects and Physical and Mental Health Outcomes in Adolescents and Adults

BACKGROUND

Italy initiated elexacaftor/tezacaftor/ivacaftor (ETI) for people with cystic fibrosis (pwCF) in July 2021. It has led to dramatic improvements in lung function, BMI, sweat chloride, and respiratory symptoms. However, few data are available on side effects or effects on a broad range of outcomes.

RESEARCH QUESTION

How does ETI affect mental health, cognitive processing, neuropsychological side effects, GI symptoms, and health-related quality of life over time?

STUDY DESIGN AND METHODS

This was a prospective, "real-world" longitudinal study. Participants were recruited consecutively and evaluated at initiation (T0) and after 1 month, 3 months, and 6 months of starting treatment. Assessments included depression (nine-item Patient Health Questionnaire), anxiety (seven-item Generalized Anxiety Disorder), cognition (Symbol Digit Modalities Test), GI Symptom Tracker, and health-related quality of life (Cystic Fibrosis Questionnaire-Revised). Based on literature, an ad hoc questionnaire was developed to assess side effects: insomnia, headache, memory problems, "brain fog," and concentration problems. Following descriptive analyses, longitudinal data were analyzed by using mixed models for repeated measures, controlling for age and sex when appropriate.

RESULTS

Ninety-two consecutive pwCF (female/male, 46/46; mean age, 25.4 years) participated. FEV1 increased initially and then remained stable. BMI also increased significantly from T0 to 6 months (P < .01). Depression improved from T0 to 1 month (P < .001); however, no changes in anxiety were found. Cognitive processing improved from T0 to subsequent assessments. Positive changes were reported on the GI Symptom Tracker for stools and adherence challenges, although no changes were found for abdominal pain and digestion. Side effects occurred in 10% to 29%, with no reduction over time; insomnia increased significantly across time. Female participants reported more side effects than male participants (ie, insomnia, headache, concentration problems, brain fog).

INTERPRETATION

This prospective study evaluated the effects of ETI using multiple measures. Significant improvements were found in many domains; however, side effects were reported by a substantial proportion of pwCF, with no improvements over time. Female participants reported more side effects than male participants. pwCF should be followed up systematically to assess the frequency of side effects after starting this new modulator.

The views and perceptions of training in physical health care amongst mental health nurses, managers of mental health nurses and trainers: A systematically constructed narrative synthesis

People with serious mental illness have higher morbidity and mortality rates compared with the general population. Mental health nurses are in an optimal position to address physical healthcare needs and inequalities experienced by this group. Research evidence suggests that mental health nurses may lack appropriate skills and confidence. The training needs of mental health nurses in physical health care of patients with serious mental illness and the perceived effectiveness of training that is provided to mental health nurses are explored in this review. A narrative synthesis approach (PROSPERO protocol registration ID=CRD42021230923) involved searching five electronic databases (PsycInfo, Cinahl, Embase, Medline and Web of Science) from 1990 to 2021. Study quality was assessed, and analysis and synthesis were initially deductively guided by a theoretical framework of training effectiveness prior to inductive data analysis. Eleven studies met the inclusion criteria. For studies examining perceived effectiveness of training, four themes were derived from the theoretical framework (individual trainee characteristics, work environment, learning outcomes, transfer of training to job) and further theme (service user factor) generated inductively. For studies examining training needs, three themes were derived inductively (knowledge and skills requirements, modality of training, service and healthcare factors). The study highlights the need for ongoing learning to improve practice. It also provides another perspective in terms of understanding the influence of service user factors (motivation and mental state) in designing and implementing of future training in mental health settings.

Self-Reported Mood and Lifestyle-Related Physical Activity of Young Adults With Major Depressive Disorder

We investigated whether mood and lifestyle-related indicators of physical health are differentially expressed according to self-reported levels of depressive symptoms among young adults with a current episode of major depression. In a cross-sectional study, we recruited 94 young adults (females = 67, 71.3%; males = 27, 28.7%; aged 18-35 years) with a current episode of major depression. We assessed their mood with the Profile of Mood States (POMS), and Beck Anxiety Inventory-(BAI), sleep with the Pittsburgh Sleep Quality Index (PSQI), physical activity with the Simple Physical Activity Questionnaire (SIMPAQ), and their cardiorespiratory fitness. Participants' depression levels were classified as follows using established cut-points: (a) Mild Depressive Symptoms (MIDS, BDI-II 14-19 points, n = 17), (b) Moderate Depressive Symptoms (MODS, BDI-II 20-28 points, n = 37) or (c) Severe Depressive Symptoms (SEDS, BDI-II 29-63 points, n = 40). As expected, we found that young adults with SEDS, when compared to those with MODS and MIDS, showed higher depressive mood on the POMS, and they exhibited greater anxiety symptoms, lower reported 'vigor' on physical activity measures, worse sleep quality as expressed by their global score sleep; daytime dysfunction; and sleep disturbance, and they showed lower cardiorespiratory fitness. Those with moderate depressive symptoms only differed from those with mild symptoms with respect to hostility, fatigue and mood disturbance. Although there was a gradient whereby worse mental and physical health indicators were more closely related to the SEDS depression categorization, while healthier indicators were associated with the MIDS category, some parameters were not different between the MDD severity groups, particularly when comparing MIDS and MODS. Clinicians treating patients with MDD should consider these factors when designing lifestyle-based interventions.

Work status among middle-aged and older individuals in China: the effects on physical and mental health

Objective

China's middle-aged and older population is a rich source of human capital. Therefore, considering the health of this group is important when creating and using human resources.

Methods

Using data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 baseline survey of 19,000 adults ages 45 years and older, this study was an objective investigation of the effects of work on the physical and mental health of middle-aged and older adults. We conducted several types of analyses using details of participants' lifestyles and demographic characteristics (living environment, education, financial level, and access to medical services) with work (i.e., employment or volunteer work) as a primary input component of health production to examine their effects on the health status of middle-aged and older individuals.

Results

Six primary outcomes were identified: (1) Employment positively affects both the physical and mental health of middle-aged and older people; (2) Employment can influence the physical and mental health of middle-aged and older people through income, cognitive level, and social support networks; (3) Compared to non-self-employment, self-employment dramatically worsens physical health but has no apparent detrimental effects on mental health. Compared to non-agricultural employment, agricultural labor affects both physical and mental health. (4) Employment has more positive physical and mental health effects in Individuals with higher rather than lower levels of education. (5) Employment opportunities in the eastern region are more likely to promote better physical health than those in the central and western regions of China, although the effects on mental health are negative. (6) When considering groups at different ages of the lifespan, the 60-65-year-old group, who are just entering retirement probably benefit more from continuing work.

Conclusion

We provide some recommendations to encourage middle-aged and older people to work and utilize their experience, which will enhance their physical and mental well-being and help them in realize their own value and social integration.

Navigating AI transitions: how coaching leadership buffers against job stress and protects employee physical health

The dynamic interplay between Artificial Intelligence (AI) adoption in modern organizations and its implications for employee well-being presents a paramount area of academic exploration. Within the context of rapid technological advancements, AI's promise to revolutionize operational efficiency juxtaposes challenges relating to job stress and employee health. This study explores the nuanced effects of Artificial Intelligence (AI) adoption on employee physical health within organizational settings, investigating the potential mediating role of job stress and the moderating influence of coaching leadership. Drawing from the conservation of resource theory, the research hypothesized that AI adoption would negatively impact employee physical health both directly and indirectly through increased job stress. Critically, our conceptual model underscores the mediating role of job stress between AI adoption and physical health. Further, introducing a novel dimension to this discourse, we postulate the moderating influence of coaching leadership. To empirically test the hypotheses, we gathered survey data from 375 South Korean workers with a three-wave time-lagged research design. Our results demonstrated that all the hypotheses were supported. The results have significant implications for organizational strategies concerning AI implementation and leadership development.

Influence of organisational climate on public service employee physical health

Background

The working conditions in the South African public service, notably its challenging environment, pose significant threats to the physical health of employees. Calls exist in understanding how this can be addressed.

Aim

The study investigated the predictors of physical health, accounting for the role of organisational climate and decent work.

Setting

The study was conducted in Bisho in the Eastern Cape province of South Africa.

Methods

An instrument was administered through a survey using a sample of 289 respondents. Descriptive and inferential statistics were used to test the hypothesised relationships.

Results

No significant direct effect existed to show that the sounder an organisational climate, the better the physical health of employees will be (β = -0.014, t = -0.199, p = 0.843, 95% confidence interval [CI] [-0.153 to 0.125]). However, statistically significant evidence existed to show that the more focus on promoting decent work, the better the physical health of employees will be (β = 0.463, p = < 0.001, 95% CI [0.258 to 0.668]). Finally, decent work has a full mediating effect on the relationship between organisational climate and employee physical health (β = 0.105, 95% CI [0.054 to 0.167]).

Conclusion

Public service organisations need to pay attention to the role of its climate and decent working conditions in promoting employee physical health.

Contribution

Interventions are needed centered on improving decent work and the organisational climate as identified predictors of employee physical health.

Experiences of physical healthcare services in Māori and non-Māori with mental health and substance use conditions

OBJECTIVES

Inequities in physical health outcomes exist for people with mental health and substance use conditions and for Indigenous populations (Māori in Aotearoa New Zealand). These inequities may be partly explained by poorer quality of physical healthcare services, including discrimination at systemic and individual levels. This study investigated the experiences of people with mental health and substance use conditions accessing physical healthcare and differences in service quality for non-Māori relative to Māori.

METHODS

A cross-sectional online survey of people with mental health and substance use conditions in New Zealand asked about four aspects of service quality in four healthcare settings: general practice, emergency department, hospital and pharmacy. The quality domains were: treated with respect; listened to; treated unfairly due to mental health and substance use conditions; mental health and substance use condition diagnoses distracting clinicians from physical healthcare (diagnostic and treatment overshadowing).

RESULTS

Across the four health services, pharmacy was rated highest for all quality measures and emergency department lowest. Participants rated general practice services highly for being treated with respect and listened to but reported relatively high levels of overshadowing in general practice, emergency department and hospital services. Experiences of unfair treatment were more common in emergency department and hospital than general practice and pharmacy. Compared to Māori, non-Māori reported higher levels of being treated with respect and listened to in most services and were more likely to report 'never' experiencing unfair treatment and overshadowing for all health services.

CONCLUSION

Interventions to address discrimination and poor-quality health services to people with mental health and substance use conditions should be tailored to the physical healthcare setting. More needs to be done to address institutional racism in systems that privilege non-Māori.

The silent epidemic of loneliness: identifying the antecedents of loneliness using a lagged exposure-wide approach

BACKGROUND

A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness.

METHODS

We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t0;2006/2008 to t1;2010/2012) were associated with subsequent loneliness 4 years later (t2;2014/2016).

RESULTS

Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness.

CONCLUSIONS

Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.

Correlates of Social Participation of Adults with Intellectual and Developmental Disabilities

Social participation has been linked to healthy aging, yet little is known about social participation during extended periods of time for adults with intellectual and developmental disabilities. The social participation of 777 adults with intellectual and developmental disabilities (aged 18-77 years), during a 4-year period, was examined. Sociodemographic, physical, and behavioral health-related correlates of engagement in social participation were investigated. Findings indicated that the majority of adults with intellectual and developmental disabilities engaged in at least a moderate level of social participation during the 4-years. Employment status, physical health, and Special Olympics participation were associated with a higher level of social participation. Findings have implications for supports and services seeking to promote social participation opportunities for adults with intellectual and developmental disabilities.

Are Changes in Somatic Health Reflected Differently in Updated Self-Ratings by Big-Five Personality Traits?

Objectives: This longitudinal study tests whether the Big-Five personality traits influence the changes individuals make in self-rated health (SRH) as they adjust their initial level to account for information on concurrent changes in disease burden, activities of daily living (ADLs), and pain. Methods: A bi-variate Latent Growth Curve model was fitted to data to estimate longitudinal associations between SRH and each health measure across up-to-five repeated observations, collected from the year 2006 to 2018 from 13,096 participants in the Health and Retirement Study. Results: Negative longitudinal associations between SRH and all three health reports were significantly stronger for those who are more conscientious. No significant moderation was found for the other four personality traits. Discussion: Compared to the less conscientious, highly conscientious people may assign greater importance to specific health reports when rating and revising their assessments of SRH. This moderating effect was previously tested but not supported.

A US national update of health condition prevalence among privately-insured autistic adults

Aim: Previous research using state or regional samples has shown that autistic adults have a higher prevalence of health conditions in comparison to the general population. Methods: To build upon this important previous research, we conducted a cross-sectional retrospective study of 2019-2020 healthcare claims to determine the prevalence of conditions in a US national sample of privately insured autistic adults (n = 30,258) and an age- and sex-matched population comparison (n = 60,516) group of adults without autism diagnoses. Results: Like previous studies, we found that autistic adults had significantly greater odds of most mental and physical health conditions. However, our prevalence estimates differed from previous studies for several mental and physical health conditions. For example, our sample of autistic adults had higher prevalence of anxiety disorders (55%) and attention deficit hyperactivity disorders (34%), but lower prevalence of asthma (9%) and sleep disorders (3%) than previous studies. Discussion & conclusion: Our use of a large US national sample, more recent healthcare claims data, and different methods for identifying health conditions may have contributed to these differences. Our findings alert healthcare providers and policymakers to the health conditions most common among the growing population of autistic adults. We hope these findings lead to improved screening and management of these conditions, inform initiatives to improve access to healthcare, and guide future funding.

The Occurrence of Anxiety, Depression, and Distress among Professionals Working in Emergency Care

Maintaining mental health is essential for professions with higher stress levels and challenging environments, including emergency specializations. In this study, the occurrence of distress, anxiety, and depression among a group of ambulance and hospital emergency care professionals was assessed (n = 202). A cross-sectional, quantitative, descriptive online survey was conducted, including the internationally validated Beck depression inventory (BDI), the perceived stress scale (PSS-14), and the State-Trait Anxiety Inventory (STAI). Statistical analyses involved descriptive statistics, the χ2-test, Mann-Whitney U test, Kruskal-Wallis test, Dunn-Bonferroni test, logistic regression (LR), Cramer coefficient (Cramer's V), Kolmogorov-Smirnov test, and Spearman's rank correlation coefficient (rs). Based on the results, female professionals are more likely to have depressive symptoms (OR = 2.6, 95% CI = 1.3-5.1), perceived stress (OR = 1.2, 95% CI = 1.2-4.1), and anxiety (OR = 2.1, 95% CI = 1.0-4.1) than male professionals. Perceived stress levels decreased proportionally with increasing years spent working in healthcare (OR = 7.4, 95% CI = 7.1-8.3). Extended work shifts of 12 or 24 h increase the risk of perceived stress and anxiety in emergency care workers (p = 0.02). Customized stress management interventions are needed to mitigate the amplified mental strain associated with gender, working years, and longer shifts in the emergency care sector to sustain their mental health and well-being.

Loneliness in Pregnancy and Parenthood: Impacts, Outcomes, and Costs

Background: Becoming a parent has been highlighted as a period associated with increased risks for loneliness, with around one-third of parents reporting feeling lonely often or always. However, as most understanding of loneliness is based on elderly or student cohorts, further insights into the costs of parental loneliness is needed. Method: We conducted a literature review of impacts of loneliness in pregnancy and parenthood and present a synthesis of the health, social, societal, and economic costs. We draw on evidence about impacts and costs of loneliness in other cohorts to help provide a wider context to understand the impacts and costs and how parental loneliness differs from other populations. Results: Similar to literature with elderly cohorts, parental loneliness has impacts on health and wellbeing, such as depression in new parents and increased general practitioner (GP) visits in pregnancy. But also has intergenerational impacts via its association with poor mental health and social competence and increased respiratory tract infections in the child. Physical health impacts widely associated with loneliness in other cohorts have yet to be examined in parents. Loneliness in parents is likely to result in social withdrawal further isolating parents and wider societal and economic costs relating to absence from employment and informal caring roles. Conclusion: Parental loneliness has the potential for negative and pervasive impacts. As parental loneliness has wide ranging and intergenerational impacts it is important that a multi-sectoral perspective is used when examining its costs.

Relationships between employment status with self-perceived mental and physical health in Canada

Background

The annual cost of mental illnesses in Canada is estimated to be $50 billion. Research from other countries have suggested that employment status is associated with mental and physical health. Within the Canadian context, there is a dearth of research on the relationship between employment and mental health.

Objective

To explore the relationships between age, gender, income, and employment status on mental and physical health.

Methods

The 2021 Canadian Digital Health Survey dataset was used for this study. Data records, which included responses for the questions on age, gender, income, employment status, mental, and physical health, were used in the analysis. Ordinal logistics regression was applied to investigate the associations that may exist between mental and physical health with the various sociodemographic factors. Descriptive statistics were also provided for the data.

Results

The total sample size included in the analysis was 10,630. When compared to respondents who had full-time employment, those who were unemployed were more likely to have lower self-perceived mental health (OR: 1.91; 95% CI: 1.55-2.34). Retired respondents were less likely to have worse mental health than respondents who were employed full-time (OR: 0.78; 95% CI: 0.68-0.90). Self-perceived physical health was more likely to be lower for those who were unemployed (OR: 1.74; 95% CI: 1.41-2.14) or retired (OR: 1.28; 95% CI: 1.12-1.48) when compared to respondents employed full-time. The likelihood of worsening mental and physical health was also found to be associated with age, gender, and income.

Conclusion

Our findings support the evidence that different factors contribute to worsening mental and physical health. Full-time employment may confer some protective effects or attributes leading to an increased likelihood of having improved mental health compared to those who are unemployed. Understanding the complex relationships on how various factors impact mental health will help better inform policymakers, clinicians, and other stakeholders on how to allocate its limited resources.

Disorder and rehabilitation: The paradox of digital games and vulnerabilities

BACKGROUND

The impact of digital gaming on human health, both mental and physical, can be both positive and negative. However, excessive gaming can lead to gaming disorders, which are a cause for concern. With the pandemic, online classes became more common, leading to an increase in gaming-related disorders and even suicides. While the combination of education and fun in online gaming can be beneficial, it can also be a risk for gaming disorders and suicide. This study aimed to explore this paradox and provide safety measures to prevent gaming disorders.

MATERIALS AND METHODS

A qualitative research methodology with exploratory and discourse analysis was used in the study. Several real-life incidents related to the research were gathered from newspaper research articles, media, and existing theses. The researchers used textual interpretation in secondary sources to identify the paradox of digital games and vulnerabilities.

RESULTS

This research article focuses on the various benefits and harmful effects of digital games on individuals' mental and physical health. The research findings were presented based on true events that occurred in and around India. The results of the current study specified that gaming disorders were pushing individuals toward mental disorders and suicide. It is crucial to implement preventive measures to address this issue.

CONCLUSION

According to the study, people who suffer from excessive gaming disorders may experience anxiety, depression, and even suicidal thoughts, which can have negative effects on society. To address this issue, it is helpful to monitor and control individuals' digital game usage and provide informative sessions on how to use digital games properly. While it may not be possible to completely ban the use of digital games, certain restrictions can be put in place. Educating individuals on both the benefits and drawbacks of digital gaming and the rapid technological advancements is essential. Through proper education, it is possible to reduce the number of suicides among gamers and individuals.

Reflections on resilience

Resilience research has long sought to understand how factors at the child, family, school, community, and societal levels shape adaptation in the face of adversities such as poverty and war. In this article we reflect on three themes that may prove to be useful for future resilience research. First is the idea that mental and physical health can sometimes diverge, even in response to the same social process. A better understanding of explanations for this divergence will have both theoretical and public health implications when it comes to efforts to promote resilience. Second is that more recent models of stress suggest that stress can accelerate aging. Thus, we suggest that research on resilience may need to also consider how resilience strategies may need to be developed in an accelerated fashion to be effective. Third, we suggest that if psychological resilience interventions can be conducted in conjunction with efforts to enact system-level changes targeted at adversities, this may synergize the impact that any single intervention can have, creating a more coordinated and effective set of approaches for promoting resilience in young people who confront adversity in life.

Video consultation and treatment in the community smoking cessation therapy success rates in patients with mental illness: a randomized controlled trial

PURPOSE

Smoking is the single factor with the highest impact on reducing life expectancy of patients with mental illness. Patients experience difficulty in participating in smoking cessation programs but are concerned about the impact of tobacco on their health and finances. Smoking cessation advice via videoconferencing might be an alternative to an ordinary in-person consultation.

MATERIAL AND METHOD

Randomized controlled trial with follow-up at 6 months. We included patients with diagnoses of schizophrenia and affective disorder from psychiatric outpatient clinics. Intervention 1 involved daily video consultations; intervention 2 was treatment as usual.

RESULTS

Seventy patients were included. For both/all groups/interventions, rates of smoking cessation were 45% and predictors for a 50% reduction in smoking were antipsychotic medication load [odds ratio (OR) 0.54; p = 0.045] and number of nicotine patches (OR 1.02; p = 0.06). Predictors for a reduction in the number of cigarettes to < 10 were antipsychotic medication load (OR 0.52; p = 0.04), number of nicotine patches (OR 1.01; p = 0.02) and number of cigarettes at baseline [OR 0.95 (p = 0.09); adjusted OR 0.94 (p = 0.02)]. Patients prevented weight gain during the cessation period.

CONCLUSION

The smoking cessation rate was high. One of the reasons for the high cessation rate was that the intervention was carried out by highly experienced and professionally qualified staff. In addition, we used free nicotine patches to increase the patients' motivation to quit smoking. It is very important that we introduce these results into our clinical work with the patients.

The impact of the cost-of-living crisis on population health in the UK: rapid evidence review

BACKGROUND

In the UK, unique and unforeseen factors, including COVID-19, Brexit, and Ukraine-Russia war, have resulted in an unprecedented cost of living crisis, creating a second health emergency. We present, one of the first rapid reviews with the aim of examining the impact of this current crisis, at a population level. We reviewed published literature, as well as grey literature, examining a broad range of physical and mental impacts on health in the short, mid, and long term, identifying those most at risk, impacts on system partners, including emergency services and the third sector, as well as mitigation strategies.

METHODS

We conducted a rapid review by searching PubMed, Embase, MEDLINE, and HMIC (2020 to 2023). We searched for grey literature on Google and hand-searched the reports of relevant public health organisations. We included interventional and observational studies that reported outcomes of interventions aimed at mitigating against the impacts of cost of living at a population level.

RESULTS

We found that the strongest evidence was for the impact of cold and mouldy homes on respiratory-related infections and respiratory conditions. Those at an increased risk were young children (0-4 years), the elderly (aged 75 and over), as well as those already vulnerable, including those with long-term multimorbidity. Further short-term impacts include an increased risk of physical pain including musculoskeletal and chest pain, and increased risk of enteric infections and malnutrition. In the mid-term, we could see increases in hypertension, transient ischaemic attacks, and myocardial infarctions, and respiratory illnesses. In the long term we could see an increase in mortality and morbidity rates from respiratory and cardiovascular disease, as well as increase rates of suicide and self-harm and infectious disease outcomes. Changes in behaviour are likely particularly around changes in food buying patterns and the ability to heat a home. System partners are also impacted, with voluntary sectors seeing fewer volunteers, an increase in petty crime and theft, alternative heating appliances causing fires, and an increase in burns and burn-related admissions. To mitigate against these impacts, support should be provided, to the most vulnerable, to help increase disposable income, reduce energy bills, and encourage home improvements linked with energy efficiency. Stronger links to bridge voluntary, community, charity and faith groups are needed to help provide additional aid and support.

CONCLUSION

Although the CoL crisis affects the entire population, the impacts are exacerbated in those that are most vulnerable, particularly young children, single parents, multigenerational families. More can be done at a community and societal level to support the most vulnerable, and those living with long-term multimorbidity. This review consolidates the current evidence on the impacts of the cost of living crisis and may enable decision makers to target limited resources more effectively.

Somatization Patterns and Minority Stress Among LGBTQ+ Individuals in Hungary

This research aims to explore the relationship between somatization and minority stress in the LGBTQ+ community in Hungary, building on the biopsychosocial model, addressing the unique health challenges of the community and expanding the currently limited literature on the subject. The study involved adult, LGBTQ+, Hungarian individuals, and it assessed somatic symptom severity using the Patient Health Questionnaire-15. Ordinal logistic regressions were carried out, using multiple covariates and factors. Our findings shows that women reported higher somatic symptoms and stress levels, however, these effects are moderate among those living in the capital. The influence of residence type on the individual's psychosomatic health was proven to depend on their sexual orientations and gender identities. Additionally, older respondents, regardless of their gender or sexual orientation, seem to experience less somatic symptoms and stress. The gender respondents identify with, their type of residency, and age have been demonstrated as the most significant factors influencing somatic symptoms and perceived stress. As one of the pioneering studies on psychosomatic symptoms in sexual and gender minorities in Hungary, this research underscores the imperative to academically and practically address the health concerns of the LGBTQ+ community.

Digital Health Literacy of the Population in Germany and Its Association With Physical Health, Mental Health, Life Satisfaction, and Health Behaviors: Nationally Representative Survey Study

BACKGROUND

Digital health literacy, also known as eHealth literacy, describes the ability to seek, find, understand, and apply health information from the internet to address health problems. The World Health Organization calls for actions to improve digital health literacy. To develop target group-specific digital health literacy interventions, it is necessary to know the digital health literacy of the general population and relevant subgroups.

OBJECTIVE

This study aims to representatively assess the digital health literacy of the population in Germany and relevant subgroups. The results are meant to facilitate the development of target group-specific digital health literacy interventions. Additionally, this study further explores the associations between digital health literacy and physical health, mental health, life satisfaction, and diverse health behaviors.

METHODS

Study participants were drawn from a representative panel of the German-speaking population with internet access. To further increase the representativeness of the sample, survey weights were calculated using an iterative proportional fitting procedure. Participants answered a series of questionnaires regarding their digital health literacy, physical health, mental health, life satisfaction, and diverse health behaviors. Two-sided independent sample t tests were conducted to determine the significant differences between societal subgroups. Pearson correlation coefficients were calculated to explore the correlates of digital health literacy.

RESULTS

Digital health literacy is unevenly distributed within German society. The results of this study suggest that people with a low level of formal education and people with a low social status would benefit from digital health literacy interventions that address their competencies in the domains of information seeking and information appraisal. Furthermore, the results suggest that older people would likely benefit from digital health literacy interventions that address their competencies in the domains of information seeking and also information appraisal. Regarding sex, this study suggests that men might benefit from digital health literacy interventions that specifically address their competencies in the domain of information seeking. Furthermore, digital health literacy is weakly positively correlated with physical health, mental health, life satisfaction, exercise routines, fruit consumption, and vegetable consumption.

CONCLUSIONS

Overall, the results of this study demonstrate that digital health literacy is associated with diverse health outcomes and behaviors. Furthermore, the results provide a starting point for the development of target group-specific digital health literacy interventions.

Barriers to using physical exercise as an intervention within inpatient mental health settings: A systematic review

Service providers find it difficult to implement Physical Exercise (PE) strategies in routine care within inpatient mental health settings even though they perceive it to be an effective therapy, with a robust evidence base. Identifying barriers that exist can assist with the development of future interventions and support PE services being introduced into mental health inpatient settings. The aim of this systematic review was to synthesise the evidence on the barriers or perceived barriers that exist amongst service users and providers when incorporating PE as an intervention within inpatient mental health settings. Using a narrative synthesis approach, four main themes were identified: (i) Barriers relating to service users' mental and physical health, (ii) Factors relating to service providers, (iii) Environmental factors and (iv) Cultural factors. Both service users and providers need more knowledge on implementing PE in inpatient mental health settings. Tailored programmes for service users are warranted, with specialist roles for staff developed.

Integrated physical and mental management for China's elderly: insights from Long-gang District, Shenzhen

China is in a period of rapid population aging. The total population of the elderly aged 60 and above in mainland China was 264 million in 2020, and is the country with the largest elderly population in the world, which is home to 1/5 of the world's older people. The urgency of actively coping with the aging population has never been greater, and China has raised it to the height of national strategy. To this end, China has issued several plans and projects on aging work. Many of them include multiple overlapping components. The management of physical illness and mental illness in the elderly is over-differentiated and segmented. However, it is common for older adults with complex health problems. The body and mind are inherently integrated and interact with each other, and should not be separated. There is an urgent need for integrated healthcare services for the physical and mental health of the elderly population. The national basic public health services play an important role in early detection and awareness of health problems for the elderly in community health services. This paper introduces the elderly health management services, one of the national basic public health projects, and the psychological care project for the elderly in Shenzhen, Guangdong Province, China. Taking Long-gang District's exploration of the joint management of physical and mental health of the elderly as an example, this review discusses the difficulties of the elderly health work, and the feasibility of integrating the elderly mental health and physical health in medical care. We outlook to build an integrated platform for physical and mental health of the elderly in China. Focus on the needs of older population, strengthen community health services, build a integrative team, fully publicize and improve health literacy of the elderly, link up and down and work together, improve coordination between providers of medical care and social services. It is of great significance to construct a strong public health system for the elderly and promote the realization of the grand goal of Healthy China.

Assessing the Role of Sports Participation on Depression, Suicide Ideation, and Suicide Behaviors Among Adolescents Before and During COVID-19

PURPOSE

To assess the association between sports participation, depression, suicide ideation, and suicide behaviors in a nationally representative sample of US adolescents before COVID-19 and during COVID-19.

METHODS

Data from the 2019 Youth Risk Behavior Survey (n = 13,526) and the 2021 Adolescent Behaviors and Experiences Survey (n = 7677) were used to analyze the association between past-year depression/suicide ideation/suicide behaviors and past-year sports participation.

RESULTS

The analysis found that 57.4% of adolescents indicated participating in at least 1 sport in 2019; this dropped to 47.7% in 2021. Furthermore, 36.7% of adolescents indicated feeling sad or hopeless almost every day for 2 weeks or more in a row in 2019; this increased to 44.2% in 2021. The percentage of adolescents who indicated considering suicide, making a suicide plan, attempting suicide, and attempted suicide that lead to an injury was similar during 2019 and 2021. Multivariable analysis found that participation in 2 or more sports in 2019 was associated with lower odds of each of the outcomes for depression, suicide ideation, and suicide behaviors, whereas in 2021, participation in 2 or more sports was only associated with lower odds of indicating being sad or hopeless (an indicator for depression) for a 2-week period (adjusted odds ratios = 0.70; 95% confidence interval, 0.58-0.85).

CONCLUSIONS

Participation in 2 or more sports lowered the risk of feeling sad or hopeless, suicide ideation, and suicide behaviors in 2019, but this effect was absent in 2021. Given the presence of multiple stressors during the COVID-19 pandemic, sports participation alone may not offer sufficient protective effects against suicide behaviors as it did pre pandemic.

Environmental pollution and health in Chilean older adults: Impact on quality of life and functional autonomy

Background and Aims

Due to increased urbanization and industry, environmental pollution is a serious public health concern. Globally, the quality of life is particularly lowered by exposure to high amounts of particulate matter (PM). Chile has five industrial zones with high pollution levels, called "sacrifice zones." However, the effect of polluted air on the quality of life and functional autonomy (FA) of older people living in industrial zones with high pollution levels is unknown. Therefore, this study aimed to determine the quality of life and FA differences between Chilean older women (OW) living in areas with lower and higher PM levels.

Materials and Methods

Seventy-two OW volunteered for this study. The sample was divided into Zone 1 (PM2.5 ≤ 15 µg/m3, n = 36) and Zone 2 (PM2.5 > 15 µg/m3, n = 36). The variables were quality of life-assessed through the SF-36v2.0 questionnaire, and FA-assessed through the GDLAM protocols. Differences between zones were tested by Student's t-test and Mann-Whitney test, both for independent samples (p < 0.05).

Results

All eight dimensions of quality of life were lower in Zone 2, of which the role emotional (RE) showed significant differences between zones (p < 0.05). Performance on the GDLAM protocols and the FA index were lower in Zone 2 (p ˃ 0.05).

Conclusion

OW in Zone 2 showed lower quality of life and FA. PM could affect the older population's physical and mental health and, therefore, the quality of life.

Psychological Impact of Covid-19 on Dental Students' - An Interventional Study

Background

COVID-19 pandemic impacts not only the physical health but also the mental health of every individual.

Aim and Objectives

To assess the impact of the COVID-19 pandemic on the mental and physical health of college students.

Method

An online survey was conducted using convenience sampling on 512 participants. The student's mental health was assessed by using DASS 21 analysis and sleep patterns were recorded on the PSQI scale.

Result

The overall effect of the pandemic on the mental health of college students was affected to varying degrees. On comparing all variables of DASS analyses, it was found that of the 512 college students, 57.4% were depressed and 51.6% fell into the anxious category.

Conclusion

It is concluded that young adults experienced increases in anxiety, stress, and depressive symptoms during this pandemic.

Longitudinal Associations Between Physical Health Conditions in Childhood and Attention-Deficit/Hyperactivity Disorder Symptoms at Age 17 Years

OBJECTIVE

Although evidence suggests significant cross-sectional relationships between attention-deficit/hyperactivity disorder (ADHD) and several physical health conditions, less is known about their longitudinal associations. We investigated the cumulative effect of childhood physical health conditions on ADHD symptoms at age 17 years, controlling for environmental factors, ADHD medication status, and ADHD symptoms at age 3 years.

METHOD

Using Millennium Cohort Study data (weighted n = 8,059), we assessed whether 4 physical health clusters (sensory, neurological, atopic, and cardio-metabolic) were associated with scores on the ADHD subscale from the Strengths and Difficulties Questionnaire at age 17 years. Environmental factors were grouped into 5 cumulative risk indices: prenatal, perinatal, postnatal environment, postnatal maternal well-being, and sociodemographic factors. Regression analyses determined whether each physical health cluster was associated with ADHD score while controlling for environmental factors, ADHD medication, and earlier symptoms.

RESULTS

Sensory, neurological, and cardio-metabolic clusters were all significantly associated with ADHD symptoms (β range = 0.04-0.09, p < .001). The overall model explained 2% of the variance. This rose to 21% (ΔR2 = 0.06) after adjusting for confounders. The sensory (β = 0.06) and neurological (β = 0.06) clusters remained significant (R2 = 0.21, ΔR2 = 0.06), but the cardio-metabolic cluster was no longer a significant predictor.

CONCLUSION

Sensory or neurological conditions in childhood were associated with higher ADHD symptoms aged 17 after adjustment of confounders. This was not the case for atopic or cardio-metabolic conditions. These findings have implications for the care of children with sensory/neurological conditions and future research examining ADHD etiopathophysiology.

Consequences of high school bullying on stress and health of Arab American college students

PROBLEM

Existing bullying research among Arab Americans is limited, focusing mainly on school-age adolescents and victimization. There is a lack of studies that examine retrospective bullying perpetration, bullying victimization, and physical fights during high school and their effect on current Arab American college students' stress and health outcomes. This study examines if bullying perpetration, bullying victimization, and physical fights during high school predict current stress and the physical and mental health of Arab American college students. In addition, we examined if perceived psychological stress mediates the relationships between bullying and fighting involvement and health.

METHODS

One hundred and sixty-two undergraduate Arab American college students were recruited from a Midwestern university and completed self-report measures of bullying, stress, and health (both physical and mental).

FINDINGS

Controlling for demographic variables, only high school victimization was significantly associated with current stress and physical and mental health. Stress fully mediated the relationship between victimization and health (both physical and mental).

CONCLUSIONS

Victimization during high school years may result in serious physical and mental health consequences during college years. However, perpetration and fighting may not have similar effects. Addressing stress among bullying victims may reduce the negative impact of this experience on immigrant Arab American college students. Implications for practice and future research are discussed.

The six-domain well-being framework in oral health sciences: A pathway from theory to practice

OBJECTIVES

Well-being is a complex and multifaceted construct that has gained popularity in oral health sciences education. Maintaining students' well-being is essential for their academic performance and quality of life. While many definitions and frameworks of well-being exist, their applicability to oral health sciences education remains unknown. This study aimed to evaluate the applicability of the Feeney and Collins's framework of well-being to oral health sciences education by exploring students' perceptions and experiences in the University of British Columbia METHODS: An Interpretive Description approach was used to conduct semi-structured interviews with dental and dental hygiene students. Interviews were transcribed, and transcripts were coded and analyzed with guidance from Feeney and Collins's well-being and thriving framework using content analysis. Domains were inductively developed within and beyond the organizing categories of the chosen framework.

RESULTS

Thirty-one oral health sciences students participated in the study. Study data can largely be explained by the five well-being domains suggested by Feeney and Collins: physical, psychological, eudaimonic, subjective, and social. Spirituality and gratitude emerged as an additional domain that contributes to students' well-being. Interdomain relationships were observed. The social domain seemed to contribute to all other well-being domains; while the subjective domain seemed to be shaped by all other domains CONCLUSIONS: Feeney and Collins's framework seemed to be useful to understand and conceptualize well-being in oral health sciences education but needed to be expanded to include spirituality and gratitude. Further evidence is needed to explore the applicability of this framework in other health professional education disciplines.

Promoting Physical and Mental Health among Children and Adolescents via Gamification-A Conceptual Systematic Review

The rapid growth in digital technology usage among children and adolescents has highlighted the need for novel approaches to promote their physical and mental health. This paper investigates the viability of gamification-the application of game mechanics to non-gaming contexts-as a potent instrument for health promotion and mental health support. This conceptual systematic review seeks to examine the various published articles promoting children and adolescents' physical and mental health through gamified techniques. These interventions can provide an interactive and engaging platform for encouraging physical activity, promoting healthy nutrition, enhancing emotional regulation, and promoting mental health. The significance of this topic stems from the pervasive use of electronic games, beginning at a young age, which makes them popular educational tools. For the review to be systematic and reproducible, the PsycINFO, Scopus, PubMed, and Elsevier databases were searched and the PRISMA method was utilized for the analysis. After analyzing the research data, empirical studies assessing the use of gamification in promoting adolescents' physical and mental health are discussed. In conclusion, gamification has demonstrated promise for promoting children's and adolescents' physical and mental health. It improves motivation, commitment, and adherence to healthy behaviors. However, additional research is required to evaluate gamification interventions' long-term effectiveness and sustainability in promoting health behaviors among this population.

The health status, social support, and subjective well-being of older individuals: evidence from the Chinese General Social Survey

Objectives

This study aims to investigate the impact of health status and social support on the subjective well-being of older individuals.

Methods

Using data from the China General Social Survey 2017, this research analyzed 5,187 Chinese citizens aged 60 years and older. The predicted effect of each variable on subjective well-being was evaluated through hierarchical regression analysis. The direct and indirect effects of social support and health status on subjective well-being are examined based on a structural equation model.

Results

The mental health and social support positively impact subjective well-being. Mental health mediates the effect of physical health on subjective well-being, and social support mediates the relationship between physical and mental health and subjective well-being.

Conclusion

The findings provide strong evidence for the interrelationship mechanisms among the factors influencing subjective well-being. Consequently, improving mental health services and social support systems is advantageous for enhancing the well-being of Chinese seniors.

Physical and psychosocial factors are crucial for maintaining physical and mental health in endometriosis: a longitudinal analysis

OBJECTIVE

To test the associations of physical and psychosocial factors with physical and mental health in individuals living with endometriosis (EM) by means of cross-sectional and longitudinal analyses.

METHODS AND MEASURES

Data were gathered via an online survey between February and August 2021. At survey date t1, sociodemographic, EM-related and psychosocial factors as well as physical and mental health of people with EM were assessed. At survey date t2 three months later, physical and mental health was reassessed. The sample consisted of n_t1 = 723 (30.60 ± 6.31 years) and n_t2 = 216 (30.56 ± 6.47 years) cis women with EM. Statistical analyses included bivariate and partial correlation analyses and hierarchical regression analyses.

RESULTS

The participants' physical health was within the average range and their mental health was below-average at t1 and t2. Cross-sectional analyses revealed that worse health was associated with longer diagnostic delay, more surgeries, greater pelvic pain and lower sense of coherence, self-efficacy, sexual satisfaction and satisfaction with the gynecological treatment. In longitudinal analyses, pelvic pain and participants' satisfaction with the gynecological treatment remained significantly associated with health.

CONCLUSION

Treatment should address both pelvic pain and psychosocial factors to improve long-term physical and mental health in EM.

Homeostasis Theory of Well-being

The Homeostasis Theory of Well-being proposes a homeostatic modular system for the creation of human well-being. This article aims to: (i) provide a proof-of-concept demonstration of the feasibility of the theory in its biopsychosocial context; (ii) indicate prima facie empirical support for the homeostatic nature of the 16 proposed modules; (iii) discuss the similarities to and differences from other homeostasis theories of well-being. Following the Central Limit Theorem, any homeostatic system with multiple inputs produces outputs with a Gaussian distribution. The data-base of studies contains approximately 2000 publications reporting U- or inverse U-shaped curves for the 16 homeostatic domains specified in the theory. The Homeostasis Theory of Well-being remains speculative and requires controlled longitudinal study to determine the scientific validity of the causal network proposed by the theory. The theory has implications for our understanding of humans' drive for balance, equilibrium and stability in this increasingly uncertain world.

Quality criteria of nature-based interventions in healthcare facilities: a scoping review

Introduction

Implementing integrated nature-based interventions that simultaneously serve human health and the restoration of biodiversity in healthcare facilities is considered a promising strategy. As an emerging field of research and practice in healthcare, identification of quality criteria is necessary to support desired outcomes related to biodiversity, human health and intervention processes. This study is part of a larger research project in collaboration with the Flemish Agency of Nature and Forest in Belgium.

Methods

A scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews, in PubMed, Medline, Web of Science and Scopus. A step-by-step tabular screening process was conducted to identify relevant studies and reviews of nature-based interventions, published in English between January 2005 and April 2023. A qualitative content analysis was conducted and the results were then presented to the project steering group and a panel of stakeholders for refinement.

Results

After filtering on the eligibility criteria, and with focus on healthcare facilities, 14 articles were included in this study. A preliminary nature-based interventions quality framework with a set of quality indicators has been developed.

Discussion

When designing integrated nature-based interventions, a needs analysis of users and the outdoor environment should be conducted. Next, the integration of a One Health and biodiversity perspective and the application of a complex intervention framework, could support the quality of the design and implementation of nature-based interventions in healthcare facilities and facilitate their assessment. In future work, more rigorous research into the design and implementation of integrated nature-based interventions is needed to test and refine the quality criteria in practice.

Relationship between Phase Angle and Physical Activity Intensity among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

This cross-sectional study aimed to determine the association between phase angle (PhA) and physical activity intensity in community-dwelling older Japanese adults. The intensity and time of physical activity for predicting high PhA were also examined. This study involved 67 community-dwelling older adults (mean age: 78.3 ± 5.5; female: 83.6%). We measured the physical activity and body composition of the participants. Physical activity was measured using a triaxial accelerometer, and light-intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) hours per day were calculated from the results. Body composition was measured using Inbody S10, and the PhA was calculated from the measurements of the right side of the body. Bayesian statistical modeling revealed an association between PhA and MVPA (β = 0.256; p = 0.022; 95% Bayesian confidence interval [CI] = 0.001, 0.012), but not LPA (β = -0.113; p = 0.341; 95% Bayesian CI = -0.002, 0.001), even after adjustment for confounders. The cutoff value of MVPA predicting high PhA, calculated by the receiver operator characteristic curve, was 19.7 min/d (sensitivity = 0.906; specificity = 0.429). These results can be used to develop strategies to increase PhA in older adults and suggest that MVPA is important in this population.

Impact of the coronavirus (COVID-19) disease pandemic on healthy lifestyle behaviors in persons with and without disabilities in Qatar

Purpose

This study aimed to examine the impact of the COVID-19 pandemic on the lifestyle behaviors which included physical activity, sedentariness, healthy eating habits, sleep habits, and tobacco use in persons with and without disabilities in Qatar.

Methods

This cross-sectional study used a structured, online questionnaire. The collected data included demographics, mental health, physical health, eating habits, body weight, sleep, and nicotine intake. This study was conducted between September 25, 2020, and December 31, 2020.

Results

Seventy respondents from Qatar participated in the study. Pre-pandemic healthy lifestyle behaviors (physical activity, healthy diet, sleep, etc.) showed no significant differences between people with and without disabilities. However, perceived changes in mental and physical health and eating habits during the pandemic lockdown differed between people with and without disabilities. People with disabilities reported worsening mental health (64.7%), physical health (53%), and dietary habits compared to the pre-pandemic levels. Furthermore, the more severe the disability, the more significant is its impact on mental and physical health.

Conclusion

This study indicated that the pandemic has had a significant impact on the mental and physical health of people with and without disabilities in Qatar. These findings reveal how closely individuals with disabilities and their lifestyle choices are related to their mental and physical well-being. This will enable the development of specific interventions for similar situations in the future.

Family-friendly work conditions and well-being among Malaysian women

BACKGROUND

Although participation in paid work improves women's quality of life and well-being, the health benefits decline for women with young children. Implementing family-friendly work conditions is one strategy for improving working women's well-being, especially those with competing unpaid work responsibilities.

OBJECTIVE

This study investigated the extent to which accessibility and use of 11 specific family-friendly work conditions were associated with physical health, anxiety and depression in Malaysian women with young children.

DESIGN

A cross-sectional design using a retrospective self-complete, anonymous, online survey was conducted between March and October 2021.

METHODS

Women with a child aged 5 years or less (N = 190) completed an online survey measuring their exposure (availability and use) to 11 specific family-friendly work conditions, and their physical health, anxiety, and depression. The sample included women who were currently and recently working and with both formal and informal employment.

RESULTS

After accounting for potential confounders, women who used paid maternity leave have a lower likelihood of having anxiety symptoms.

CONCLUSION

Future research is needed to extend the findings from this study by over-sampling women who are informally employed and not currently working. Policy creation and development processes, including research and decision-making, should be led by and inclusive of women. For example, research funding could be allocated to 'lived experience' research that privileges the co-design of research with consumers. Based on these findings, the extent to which family-friendly work conditions fulfill their intent to improve the well-being for working women requires further critique.

Daily Functional Characteristics and Health Among Older Adults During COVID-19: A Structural Equation Modeling Approach

Within a few years, 1 in 6 people will be aged 60 years or older. Extreme situations, such as the COVID-19 crisis, constitute a challenge to older adults. However, the literature on the daily functional characteristics of older adults in the past and during the COVID-19 crisis and their relationships to their physical and mental health is scarce. This study aimed to examine the past and present daily functional factors associated with physical and mental health in older adults. Using an online platform, 204 Israelis aged 60 years and older reported their physical health symptoms and anxiety levels. They completed questionnaires about past (negative life events and childhood daily functional self-actualization) and present (adulthood daily functional self-actualization, functional cognition and sleep quality) factors. Structural equation modeling revealed correlations between functional cognition and childhood daily functional self-actualization (β = -.18) and anxiety (β = .15); adulthood daily functional self-actualization and past negative life events (β = -.18), anxiety (β = -.50), and physical symptoms (β = -16); and sleep quality and past childhood daily functional self-actualization (β = -.19), negative life events (β = .22), anxiety (β = .18), and physical symptoms (β = .40). These findings shed light on potential functional factors for older adults' health, indicating that these functional factors play a vital role in reducing health problems in later life.

Health Outcomes of Social Pension Expansion: A Quasi-Experiment Among Older Adults in Hong Kong

A social pension, regarded as a reliable source of income, has the potential to significantly influence the overall wellbeing of vulnerable older adults. This study aimed to extend the understanding of the effects of social pension expansion beyond its economic impacts to encompass recipients' health status. Using three-wave data from a representative sample of older adults, we employed a quasi-experimental assessment model to evaluate the impact of a recent social pension expansion in Hong Kong on health-related consumption and health outcomes among older adults. The results of the triple difference estimations revealed that an increased social pension significantly enhanced older people's engagement in entertainment activities, utilization of healthcare services, and expenditures on preventive health products. Furthermore, the increased social pension was found to have a significant positive effect on mitigating poor self-rated health and poor sleep quality. However, it did not have a significant impact on the prevalence of depression. These findings suggest that social pension expansion should be coordinated with other policy initiatives to comprehensively improve the physical and mental health of older adults.

Relationship mindfulness, negative relationship quality, and physical health

Romantic relationships have the potential to be a great source of support or a significant stressor depending on the quality of the relationship. Given the importance of these relationships, it is important to explore possible predictors of relationship quality, primarily if such predictors can be targeted in a clinical setting. Relationship mindfulness, or the propensity to be mindful in the setting of a romantic relationship, is one such option. The current study explored the associations between relationship mindfulness, negative relationship quality, and physical health. An online assessment was completed by 116 middle-aged different-sex couples that measured the variables of interest. In addition, an Actor-Partner Interdependence Mediation Model was utilized to determine significant associations between relationship mindfulness, negative relationship quality, and physical health for both actors and partners. The clinical implications are that relationship mindfulness may help to decrease negative relationship quality and subsequently benefit individual physical health.

Structured physical exercise interventions and children and adolescents with attention deficit hyperactivity disorder: A systematic review and meta-analysis

BACKGROUND

The efficacy of structured physical exercise (SPE) has been examined in empirical studies to treat attention deficit hyperactivity disorder (ADHD). This review aimed (i) to systematically review and quantify the effects of SPE on ADHD symptomology and executive function (primary outcomes) and on physical health, physical fitness and mental health issues (secondary outcomes) in children/adolescents with ADHD; (ii) to evaluate the study quality and explore moderation of the effects of SPE; and (iii) to summarize the design of SPE interventions.

METHODS

An extensive literature search in the databases of PubMed, Web of Science and EBSCOhost was conducted to identify eligible intervention studies for meta-analysis. A descriptive account of the features of the studies is provided, including assessment of risk/quality (ROB-2/ROBINS-I). Standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated with random effects models to compare post-intervention effects.

RESULTS

A total of 18 studies were included in the review. The majority of the studies examined the effects of SPE lasting for 3-12 weeks. Assessment of bias/quality indicated half of the included studies as high quality. The meta-analysis (pooled n = 627) revealed that SPE had a positive effect on primary and secondary outcomes, that is, inattention (SMD = -1.79), executive function (SMD = 2.19), physical fitness (SMD = 1.39) and mental health issues (SMD = -0.89). Subgroup analysis showed that long-term practice of SPE, featured/tailored SPE, non-Chinese participants, taking methylphenidate and study with low quality had larger effects.

CONCLUSIONS

There is emerging evidence that SPE is a promising option to enhance symptom management and physical/mental health in children/adolescents with ADHD.

Racial and Ethnic Disparities in the Physical Health Outcomes of Children in Foster Care: A Systematic Review

Children of color-especially Black and Indigenous children-are disproportionately overrepresented in foster care and experience barriers in accessing services and receiving physical and behavioral healthcare compared to their White counterparts. Although racial disparities in mental health outcomes of children in foster care have been examined systematically, less is known about racial disparities in their physical health outcomes. This systematic review aimed to examine disparities in physical health outcomes (i.e., general health, developmental delays and disability, chronic illness, health-compromising behaviors, all-cause mortality) of children in foster care by their race and ethnicity (PROSPERO ID: CRD42021272072). Systematic literature searches were conducted in PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, and Psychology and Behavioral Sciences Collection. Of the 6,102 unique studies identified, 24 met inclusion criteria: peer-reviewed journal article; published from 1991 to 2021; written in English; involved children in the U.S. foster care system; children were primarily in family-based placements; included health outcomes; included children's race and ethnicity; conducted quantitative analyses; and had an observational study design. There was limited evidence to suggest racial disparities among physical health domains examined, in part, due to the small number of studies, variability across study measures and designs, how race and ethnicity were categorized, and how related results were reported. Research that disaggregates results by more nuanced race and ethnicity categories, goes beyond including race and ethnicity as control variables, and uses more robust study designs to understand where racial disparities lie is necessary to inform practice and policy efforts to attain race and health equity in child welfare.

A Network Model of Health-Related Changes after a Lifestyle-Enhancing Treatment in Patients with Severe Mental Illness: the MULTI Study VI

Background/Objective

The effects of lifestyle interventions on physical and mental health in people with severe mental illness (SMI) are promising, but its underlying mechanisms remain unsolved. This study aims to examine changes in health-related outcomes after a lifestyle intervention, distinguishing between direct and indirect effects.

Method

We applied network intervention analysis on data from the 18-month cohort Multidisciplinary Lifestyle enhancing Treatment for Inpatients with SMI (MULTI) study in 106 subjects (62% male, mean age=54.7 (SD=10.8)) that evaluated changes in actigraphy-measured physical activity, metabolic health, psychopathology, psychosocial functioning, quality of life and medication use after MULTI (n=65) compared to treatment as usual (n=41).

Results

MULTI is directly connected to decreased negative symptoms and psychotropic medication dosage, and improved physical activity and psychosocial functioning, suggesting a unique and direct association between MULTI and the different outcome domains. Secondly, we identified associations between outcomes within the same domain (e.g., metabolic health) and between the domains (e.g., metabolic health and social functioning), suggesting potential indirect effects of MULTI.

Conclusions

This novel network approach shows that MULTI has direct and indirect associations with various health-related outcomes. These insights contribute to the development of effective treatment strategies in people with severe mental illness.

Health Outcomes of Sexual Minority Women Who Have Experienced Adverse Childhood Experiences: A Scoping Review

Sexual minority women (SMW; e.g., lesbian, bisexual) report higher rates of almost every negative physical health (e.g., asthma, arthritis, cardiovascular disease), mental health (e.g., depression, anxiety), and substance use outcome compared to heterosexual women. Adverse Childhood Experiences (ACEs) have been identified as risk factors for negative health outcomes. Despite this, no study to date has synthesized existing literature examining ACEs and health outcomes among SMW. This gap is important because SMW are significantly more likely than heterosexual women to report every type of ACE and a higher total number of ACEs. Therefore, using a scoping review methodology, we sought to expand understanding of the relationship between ACEs and health outcomes among SMW. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for. Scoping Reviews protocol, we searched five databases: Web of Science, PsycInfo, CINAHL, PubMed, and Embase for studies published between January 2000 and June 2021 that examined mental health, physical health, and/or substance use risk factors and outcomes among adult cisgender SMW who report ACEs. Our search yielded 840 unique results. Studies were screened independently by two authors to determine eligibility, and 42 met full inclusion criteria. Our findings provide strong evidence that ACEs are an important risk factor for multiple negative mental health and substance use outcomes among SMW. However, findings were mixed with respect to some health risk behaviors and physical health outcomes among SMW, highlighting the need for future research to clarify these relationships.

Perceived social support mitigates the associations among household chaos and health and well-being in rural early adolescents

PURPOSE

Previous studies have demonstrated that early adolescents residing in chaotic households experience adverse health and well-being outcomes. However, the potential protective factors that mitigate the relationship between household chaos and early adolescents' health and well-being remain unknown. Accordingly, this study aims to investigate whether perceived social support moderates the link between household chaos and the health and well-being among Chinese rural early adolescents.

METHODS

Physical health difficulties were assessed using two measures: general health and allostatic load (AL). Mental health difficulties were measured by depression. Well-being was reflected by life satisfaction. Specifically, this study included early adolescents (N = 337; Mage  = 10.88 ± 1.36 years) from rural counties in China who reported their household chaos, perceived social support, general health, depression, and life satisfaction. AL scores were determined based on six physiological indices.

RESULTS

Household chaos exhibited a negative relationship with the general health and life satisfaction while a positive correlation with depression. Moreover, perceived social support was found to moderate the association between household chaos and these health and well-being indicators of early adolescents. Specifically, early adolescents who reported higher levels of perceived social support exhibited weaker negative connections among household chaos and their general health, depression, and life satisfaction. Furthermore, no significant relationships were observed between the adolescents' AL and household chaos, perceived social support, or their interactions.

CONCLUSIONS

Household chaos poses a significant risk to health and well-being. Furthermore, the findings indicate that perceived social support can mitigate these negative effects.