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Background: Patient participation is essential for achieving high‐quality care and positive outcomes, especially among patients with multimorbidity, which is a major challenge for health care due to high prevalence, care complexity and impact on patients' lives. Objective: To explore the patient participation related to their own care among patients with multimorbidity in primary health‐care settings. Methods: A cross‐sectional survey was conducted among adult multimorbid patients who visited primary health‐care facilities. The key instrument used was the Participation in Rehabilitation Questionnaire. Data representing 125 patients were analysed using various statistical methods. Results: The respondents generally felt patient participation to be important, yet provided highly varying accounts regarding the extent to which it was realized by professionals. Information and knowledge and Respect and encouragement were considered the most important and best implemented subcategories of participation. Several patient‐related factors had a statistically significant effect on patient perceptions of participation for all subcategories and as explanatory factors for perceptions of total participation in univariate models. Most patients reported active participation in health‐care communication, positively associated with patient activation and adherence. Gender, perceived health, patient activation and active participation were explanatory factors for total importance of participation in multivariate models, while patient activation was retained for realization of participation. Conclusions: Multimorbid patients require individualized care that promotes participation and active communication; this approach may further improve patient activation and adherence. Poor perceived health and functional ability seemed to be related to worse perceptions of participation. Patient and public involvement: The study topic importance was based on the patients' experiences in author's previous research and the need to develop patient‐centred care. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Background: People with Parkinson disease (PD) are known to be at risk of physical inactivity and may therefore be especially vulnerable to negative health outcomes during the COVID-19 pandemic due to social distancing recommendations. Purpose: To investigate sensor-derived physical activity and perceived health of people with PD during the first wave of the COVID-19 pandemic, as well as the factors associated with these outcomes. Methods: Physical activity was measured over 7 days using the Actigraph GT3x accelerometer. Data were collected regarding perceived health status and physical activity habits, as well as rehabilitation attendance during the pandemic. Multiple linear and logistic regression analyses were used to identify factors associated with physical activity and perceived changes in health. Results: Of 89 participants, a majority (67%) reported a pandemic-related reduction in exercise habits. Women more commonly reported a reduction in scheduled exercise and cancelled rehabilitation than men. Study participants took on average 5876 ± 3180 steps per day. In the multivariate analysis, female gender, being 70 years of age and older, and greater reported mobility problems were associated with being less physically active. A pandemic-induced deterioration in health was reported by 42% and women were 5 times more likely than men to do so (odds ratio: 5.12, 95% confidence interval, 1.87-15.03; P = 0.002). Discussion and Conclusions: Despite a pandemic-related reduction in reported exercise habits and rehabilitation, the participants in this Swedish sample were relatively physically active. However, women were less active at moderate-vigorous levels and were at greater risk of deterioration in perceived health during this time. Video Abstract available for more insight from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A359). [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The work of health professionals often involves physical as well as psychological strain. They constantly deal with traumatic situations of pain and suffering, which destabilize the sense of well-being. Compassion fatigue is a feeling that appears in these cases and is related to other variables such as burnout or emotional drain.Aims: The principal aim of this project was to deepen the analysis of compassion fatigue and how it could be explained through the relationship with other constructs such as emotional intelligence and perceived health.Methods: This work followed the STROBE checklist for cross-sectional studies. In this study 1,521 nurses (Mage = 47.32; SD = 8.44) participated. The responses reported by the nurses were analyzed by classifying them as high or low compassion fatigue and the differences of both groups were analyzed for the variables of emotional intelligence, perceived health and quality of professional life.Results: It was obtained significant differences for all factors except for emotional intelligence factor. A linear regression analysis showed both emotional intelligence and perceived health helped to explain (12%) compassion fatigue.Conclusion: This study provides light on comprehending the conception of compassion fatigue. It highlights the importance of intervention programs that improve the quality of professional life.

The overall aim of this study was to investigate self‐reported cognitive difficulties, daily life activities, and health/sleep factors in former patients with exhaustion disorder (ED) who still fulfill the clinical criteria for exhaustion 7–12 years after seeking care. The Sahlgrenska Self‐reported Cognitive Impairment Questionnaire (SASCI‐Q) was used to measure cognitive difficulties, daily life activities, and health/sleep factors. Three groups were compared: previous patients still judged to be clinically exhausted seven years or more after seeking care (n = 51); previous patients considered clinically recovered (n = 98); and healthy controls (n = 50). Patients who still fulfilled the diagnostic criteria for ED reported widespread problems related to cognition, fatigue, and daily life functioning compared to the clinically recovered group. Furthermore, despite no longer fulfilling the clinical criteria, the recovered patients still reported more problems related to cognitive functioning and fatigue compared to healthy controls. Thus, this group appeared intermediary between the non‐recovered group and healthy controls regarding self‐reported cognitive functioning. To conclude, ED may have considerable negative long‐term effects, and it is possible that some of these residual symptoms, particularly the cognitive problems and persistent fatigue, are permanent in some patients. Preventive measures should be the primary focus for all stakeholders, since the consequences of stress‐related mental health problems seem to be extensive and long‐lasting. [ABSTRACT FROM AUTHOR]

Background: Adults with intellectual disability (ID) have poorer physical and perceived health than the general population. Knowledge of perceived health predictors is both limited and important for guiding the development of preventive actions. The aims of this study were to investigate (1) the associations between perceived health and demographics, degree of ID, physical health conditions, and weight and physical activity level and (2) lifestyle factors and multimorbidity as predictors for perceived health adjusted for age, gender, and level of ID. Method: The North Health in Intellectual Disability study is a community based cross‐sectional survey. The POMONA‐15 health indicators were used. Univariate and multivariate logistic regression analyses with poor versus good health as the dependent variable were applied. Results: The sample included 214 adults with a mean age 36.1 (SD 13.8) years; 56% were men, and 27% reported perceiving their health as poor. In univariate analyses, there were significant associations between poor health ratings and female gender, lower motor function, number of physical health conditions and several indicators of levels of physical activity. In the final adjusted model, female gender [odds ratio (OR) 2.4, P < 0.05], level of ID (OR 0.65, P < 0.05), numbers of physical health conditions (OR 1.6, P < 0.001) and lower motor function (OR 1.5 P < 0.05) were significant explanatory variables for poor perceived health, with a tendency to independently impact failure to achieve 30 min of physical activity daily (OR 2.0, P = 0.07). Conclusion: Adults with ID with female gender, reduced motor function and more physical health conditions are at increased risk of lower perceived health and should be given attention in health promoting interventions. A lack of physical activity tends to negatively influence perceived health. [ABSTRACT FROM AUTHOR]

Perceived health in caregivers is related to caregiver burden, psychological well‐being and social support. Women perceive poorer health and are more likely than men to experience caregiver overload. The objectives of this study were to analyse perceived health, perceived social support and caregiver overload in family caregivers of patients with Alzheimer's disease, as well as to study the effect of the perceived social support as a mediating variable between perceived health and caregiver overload was also analysed, taking into account the caregivers' gender. A cross‐sectional descriptive design was used. The sample consisted of 255 family caregivers of individuals with Alzheimer's disease in the Almería Health District (Spain). This study was conducted from January to December 2015. The caregivers' mean age was 55.35 years (SD = 12.35), with 85.5% (n = 218) being women and 14.5% (n = 37) being men. The following questionnaires were administered: Goldberg's General Health Questionnaire‐28; the Caregiver Strain Index, measuring caregiver overload; and the Duke‐UNC‐11 functional social support questionnaire. Poor perceived health, high caregiver overload and high perceived social support were found. Differences in perceived health and perceived social support were significantly higher in women than in men. In women, perceived social support was a mediating variable between perceived health and family caregiver overload. This mediation was not observed in men. This study suggests that perceived social support influences the emotional well‐being and the caregiver overload of family caregivers of patients with Alzheimer's. However, its effect differs according to gender. It would, therefore, be necessary to have an in‐depth understanding of the variables determining these differences in family caregivers. [ABSTRACT FROM AUTHOR]

Aging has been perceived as a period of decline and disability, and institutionalization is a response to the unavailability of family members to take care of the elderly. In this sense, nursing homes must be able to provide a good quality of life for their residents. Some studies document that despite the losses that occur at this stage of life, many elderly people show good adaptation and quality of life, satisfaction and resilience in the face of adversities in this process. Some variables such as perceived health, subjective and psychological well-being and social support are important variables for successful aging. The main objective of this study aimed to analyze the relationships between resilience, perceived health, subjective and psychological well-being and social support and its contribution to the adaptation to aging in institutionalized and non-institutionalized elderly. Through a cross-sectional, descriptive, exploratory and correlational study, 184 elderly people (N = 184), aged between 65 and 94 years (M = 76.0; SD = 8.12) participated in the study. Several instruments were used to analyze the defined variables. The results revealed the relevance of resilience, positive health perception, subjective and psychological well-being in adapting to aging. There are differences between institutionalized and non-institutionalized elderly. [ABSTRACT FROM AUTHOR]

Objectives: Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training.Design: Cross-sectional observational study.Participants: The sample comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years); divided into subgroups representing middle, early old, and advanced old age.Measurements: We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH).Results: Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training.Conclusions: Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables - alongside psychological variables - related to perceived cognitive losses. [ABSTRACT FROM AUTHOR]

Marcel Ballin1,2, Emmy Lundberg1,2, Niklas Sörlén1,2, Peter Nordström1, Andreas Hult2, Anna Nordström2,3 1Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, Umeå, Sweden; 2Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden; 3Department of Sport Science, School of Sport Sciences, The Arctic University of Norway, Tromsø, NorwayCorrespondence: Anna NordströmDepartment of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå 901 85, SwedenTel +46 70 606 4249Email anna.h.nordstrom@umu.sePurpose: To explore the effects of 10 weeks of progressive vigorous interval training as a single intervention on health-related quality of life (HRQoL) and cardiometabolic risk markers in centrally obese 70-year-old individuals.Participants and methods: A randomized controlled trial (ClinicalTrials.gov registration no. NCT03450655) including seventy-seven community-dwelling 70-year-old men and women with central obesity defined as > 1 kg visceral adipose tissue for women and > 2 kg for men. Participants randomized to the intervention group were offered a 10-week progressive vigorous interval training program performed three times per week. Control subjects were asked to maintain their daily living and routines throughout the trial. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation. Prespecified outcome measures included: changes in HRQoL using the Short Form Health Survey Questionnaire (SF-36), blood pressure; resting heart rate (HR) and blood lipids. All analyses were conducted on an intention-to-treat basis.Results: The intervention resulted in significant effects on the SF-36 mental component summary (MCS) score and the mental health (MH) subscale (P< 0.05 for both), when compared to the control group. Specifically, the intervention group increased their MCS score by 6.3 points (95% confidence interval [CI] = 0.3–12.3) and their MH score by 6.0 points (95% CI = 1.7–10.4) compared to the control group. Moreover, significant effects were seen on resting HR, total cholesterol and LDL-cholesterol (P

Abstract Background Self-rated health (SRH) allows for comparison and identification of the health status of various populations. The aim of this study was to conduct a systematic review of the literature to expand the understanding of SRH after stroke. Methods This systematic review was registered with PROSPERO (CRD42017056194) and conducted according to PRISMA guidelines. Studies published until December 2018 that evaluated the SRH of adults with stroke were included. Results Of the 2132 identified studies, 51 were included. Only four studies had experimental designs (7.8%). In 60.7% of the studies, SRH was assessed by variations on direct questions (i.e., general and comparative SRH). Analog visual scales and quality of life instruments were also used to evaluate SRH, but there is no consensus regarding whether they are appropriate for this purpose. The results of cross-sectional and longitudinal studies revealed significant associations between poor SRH and stroke as well as between SRH, function, and disability. The power of SRH to predict stroke mortality is still uncertain. Two interventions (a home-based psychoeducational program concerning stroke health care and family involvement in functional rehabilitation) effectively improved SRH. Conclusions Direct questions are the most common method of evaluating SRH after stroke. Studies reported significant associations between the SRH of individuals with stroke and several relevant health outcomes. However, few experimental studies have evaluated SRH after stroke. Interventions involving health education and family involvement had a significant impact on SRH.

The present study examined the relationship between the self-reported personal impact of the election of President Donald J. Trump, as measured by the Personal Impact of the Election Scale (PIES), and physical and mental health. A sample of 299 MTurk Amazon workers completed an online survey, including measures of the perceived personal impact of the 2016 presidential election, thought suppression, and mental and physical health. A mediation model was tested, with thought suppression included as a mediator of the relationship between the PIES and physical and mental health. Results indicated that thought suppression partially mediated the relationship between the PIES and physical and mental health. Specifically, the perceived impact of the election was positively associated with thought suppression (β = .51, SE = .01, p < .001), which was in turn negatively associated with physical health (β = -.25, SE = .44, p < .001) and mental health (β = -.50, SE = .47, p < .001). The results of this study suggest that perceptions of this sociopolitical event were related to the health of United States citizens and show a need for large-scale interventions to address this relationship, especially for those who feel threatened based on their ethnic or religious background.

Abstract Background Additional benefits of passive exposures to intermittent hypoxia and hyperoxia on cognitive performance and functional exercise capacity have been demonstrated in geriatric patients who performed a multimodal training program. The main goal of the present study was to evaluate effects of adding intermittent hypoxic-hyperoxic training (IHHT) to a multimodal training intervention (MTI) on mobility and perceived health in old individuals at a Geriatric Day Hospital. Methods Thirty-four patients between 64 and 92 years participated in the double blind, randomized and controlled clinical trial. The elderly patients attended in a 5–7 weeks lasting MTI (strength, endurance, balance, reaction, flexibility, coordination, and cognitive exercises) and performed IHHT (breathing 10–14% oxygen for 4–7 min followed by 2–4 min 30–40% oxygen) in the Hypoxic Group (HG) or placebo treatment with ambient air in the Normoxic Group (NG) in parallel. Before and after all treatments, mobility was assessed by the Tinetti Mobility Test (TMT), the Timed-Up-and-Go Test (TUG) and Barthel-Index, while perceived health was assessed by one part of the EQ-5D Test, the EQ visual analogue scale (EQ VAS). Results After the MTI plus IHHT or normoxia sessions, results of the TMT, TUG, Barthel Index and EQ-VAS revealed no significant difference between HG and NG (+ 14.9% vs + 15.4%, p = 0.25; − 21% vs − 26.3%, p = 0.51; + 4.2% vs + 3.6%, p = 0.56; + 37.9% vs + 33.9%, p = 0.24;). Conclusions IHHT added to MTI did not elicit additional improvements in perceived health and mobility compared to MTI alone.

Background: Sarcopenia is defined as a progressive age-related loss in muscle mass and strength affecting physical performance. It is associated with many negative outcomes including falls, disability, cognitive decline, and mortality. Protein enriched diet and resistance training have shown to improve muscle strength and function but there is limited evidence on impact of dual-task exercise in possible sarcopenia.Objective: To evaluate impact of community-based dual-task exercise on muscle strength and physical function in possible sarcopenia defined by either slow gait (SG) or poor handgrip strength (HGS). The secondary aims include effect on cognition, frailty, falls, social isolation, and perceived health.Methods: Community-dwelling older adults ≥60 years old were recruited from screening program intended to identify seniors at risk, and invited to participate in dual-task exercise program called HAPPY (Healthy Aging Promotion Program for You). One hundred and eleven participants with possible sarcopenia completed 3 months follow-up. Questionnaire was administered on demographics, frailty, sarcopenia, falls, perceived health, social network, functional, and cognitive status. Physical performance included assessment of HGS, gait speed, and Short Physical Performance Battery test (SPPB).Results: The mean age of the Exercise group was 75.9 years old and 73.0% were women. The Exercise group had more female (73.0 vs. 47.5%), were older (75.9 vs. 72.5 years old), had higher prevalence of falls (32.4 vs. 15.0%), lower BMI (23.7 vs. 25.8), and education (4.0 vs. 7.2 years). The gait speed of the Exercise group increased significantly with significant reduction in the prevalence of SG and poor HGS. All components of SPPB as well as the total score increased significantly while the prevalence of pre-frailty and falls dropped by half. The risk of social isolation reduced by 25% with significant improvement in perceived health and cognition in the Exercise group. Significant impact on improvement gait speed and SPPB persisted after adjustment for baseline factors.Conclusion: Dual-task exercise program is effective in improving gait speed, SPPB score, and reducing the prevalence of poor HGS with significant improvement in perceived health, cognition, and reduction in falls and frailty. Future prospective randomized control trials are needed to evaluate the effectiveness of dual-task interventions in reversing sarcopenia.

By taking 22 OECD countries from 2010 to 2017 as sample, we study the effect of pharmaceutical manufacturing innovation on perceived health by using the panel Tobit model from the entire sample and sub-samples, respectively, as well as analyze their transmission channels by adding moderating effect. Based on the above, we get the following results: first, the pharmaceutical manufacturing innovation 4 years ago has a positive influence on perceived health, which means the improvement of perceived health is closely related to pharmaceutical manufacturing innovation 4 years ago. Second, pharmaceutical manufacturing innovation has a heterogeneous impact on perceived health, which, including the size and direction of the impact effect, is mainly reflected in different pharmaceutical manufacturing innovation levels, population aging degrees, and education levels. Third, income level can positively regulate the impact of pharmaceutical manufacturing innovation on perceived health.

Background: We examined health behaviors and perceptions among medical students and compared them with the results of a previous survey among residents and senior physicians. Methods: This cross–sectional study was performed among second-year medical students (2015–2018) and among physicians (2015) using an online questionnaire. Univariate and multivariate analyses were performed. Results: Significantly more physicians perceived their health as bad, compared with students. Half of the residents, compared with one-third of senior physicians and one-fifth of students, reported high emotional stress. Residents reported the worst, and students - the best, eating habits. Logistic regression models demonstrated that lower emotional stress, healthy eating habits, adequate sleep, lower body mass index and not having a regular physician, explained good perceived health. Female gender, being a resident, bad perceived health, unhealthy eating habits, less sleep and not having a regular physician, were correlated with high emotional stress. Conclusions: The healthy lifestyle of medical students declines towards residency. Given the workload and emotional stress of their chosen profession, it is advised that medical school curriculum provide students with measures to help them to adopt healthier lifestyles, allowing students and physicians to be better role models and the healthcare system to perform better. [ABSTRACT FROM AUTHOR]

Aim: Perceived health status, including physical and cognitive fitness, will be negatively associated with future health conditions among old‐old adults. The coronavirus disease 2019 (COVID‐19) pandemic has caused sudden changes in lifestyle. Thus, this study examined the associations of participation in an exercise class before the COVID‐19 pandemic and the exercise habits and disruption to the rhythms of daily life during the COVID‐19 state of emergency with perceived declining physical and cognitive fitness among community‐dwelling old‐old adults. Methods: In July 2020, we carried out a mail survey of community‐dwelling old‐old adults aged between 77 and 99 years in Bibai, Hokkaido, Japan, to determine their perceived declining physical and cognitive fitness during the COVID‐19 state of emergency. Results: Of the 774 responders, 339 (43.8%) participants reported a decline in physical fitness, whereas 259 (33.5%) perceived declining cognitive fitness during the COVID‐19 state of emergency. In a multivariate logistic regression model adjusted for potential confounders, exercise habits during the COVID‐19 state of emergency were significantly associated with a lower perception of declining physical fitness. Disruption to the rhythms of daily life during the COVID‐19 state of emergency was significantly associated with a higher perception of declining physical and cognitive fitness. Conclusions: Approximately half and more than one‐third of community‐dwelling old‐old adults perceived declining physical and cognitive fitness, respectively, during the COVID‐19 state of emergency. During this period, exercise habits were positively correlated with perceived health status among old‐old adults, whereas disruption to the rhythms of daily life was negatively correlated. Geriatr Gerontol Int 2021; 21: 364–369. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is a pressing phenomenon whose consequences are associated with severe physical and mental health outcomes. Every minute, around 24 people in the United States are raped, physically injured, or emotionally abused by their intimate partner. Although having experienced IPV is not modifiable, emotional support is a protective factor to prevent victims from committing suicide. The psychological state of IPV victims is critical in post-traumatic events and this is evidenced in numerous qualitative interviews. Therefore, the objective of this study is to explore the association between IPV with emotional support, life satisfaction, and perceived health status in the United States.Methods: This study analyzed the data from the 2007 Behavioral Risk Factor Surveillance System. Univariate analyses, multivariable logistic regression analyses, and ordinal logistic regression analyses were used to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) for factors associated with IPV. Analyses were conducted using SPSS version 25.Results: The analyses show that there is a strong association between IPV experience and emotional support (AOR:1.810; 95% CI = 1.626-2.015). Participants who had either physical violence or unwanted sex with an intimate partner in the past 12 months have 2.28 higher odds to receive less emotional support and 2.05 higher odds to perceive poor life satisfaction. Also, participants who reported experiencing IPV were associated with (AOR: 3.12; 95% CI =2.68-3.62) times the odds of having ≥6 days more mentally unhealthy days in a month. For perceived health outcomes, people who had been threatened with violence by a sex partner have 1.74 (95% CI =1.54-1.96) times the odds of having poor perceived general health status. IPV survivors have 3.12 (95% CI =2.68-3.62) times the odds of having ≥6 days more mentally unhealthy days in a month.Conclusions: People reported with any IPV experience are more likely to receive less emotional support, perceive dissatisfaction in life, and poor health outcomes. This study shows the need for policies centered on the development of interventions that focus on mental health for those who have experienced IPV. [ABSTRACT FROM AUTHOR]

A caring and compassionate attitude toward the self (i.e., self-compassion) has been linked to various mental and physical health benefits. The Self-Compassion Scale (SCS) is widely used in psychology literature in order to assess global self-compassion. However, recent evidence suggests that the single factor model comprising positive and negative items of the SCS in fact measures two distinct constructs (i.e., self-criticism/self-coldness and self-compassion) with different psychological correlates. Given these recent findings, in addition to other research that highlights cultural differences in self-conceptualizations and self-evaluations, the present study examined potential ethnic differences in the relationships between self-criticism, self-compassion, and perceived health. Participants included 728 college students (141 Asian American, 449 European American, and 138 Hispanic/Latinx individuals) attending a university in the northeast United States. Results indicated that the relationship between self-criticism and self-compassion was significantly different across ethnicity. In addition, the relationships between these two constructs (i.e., self-criticism and self-compassion) and perceived health were moderated by ethnicity. Our findings suggest that focusing on global self-compassion scores (i.e., total SCS scores) may miss some of the important cultural or ethnic differences in the relationships between self-criticism, self-compassion, and perceived health. [ABSTRACT FROM AUTHOR]

We animals have evolved a variety of mechanisms to avoid conspecifics who might be infected. It is currently unclear whether and why this "behavioral immune system" targets unfamiliar individuals more than familiar ones. Here I answer this question in humans, using publicly available data of a recent study on 1969 participants from India and 1615 from the USA. The apparent health of a male stranger, as estimated from his face, and the comfort with contact with him were a direct function of his similarity to the men in the local community. This held true regardless of whether the face carried overt signs of infection. I conclude that our behavioral immune system is finely tuned to degrees of outgroupness — and that cues of outgroupness are partly processed as cues of infectiousness. These findings, which were consistent across the two cultures, support the notion that the pathogens of strangers are perceived as more dangerous. [ABSTRACT FROM AUTHOR]

Résumé: La réalisation d'une étude de santé perçue fait partie du dispositif de réponse épidémiologique à l'incendie industriel survenu à Rouen en septembre 2019. Cette enquête transversale en population, intitulée « Une étude à l'écoute de votre santé », a pour objectif d'évaluer l'impact sanitaire à court et à moyen termes de l'accident, dans sa dimension physique et mentale. Le présent article décrit la méthode d'enquête. La zone exposée à l'accident, qui couvre 122 communes et regroupe environ 350 000 habitants, a été divisée en quatre strates. Le Havre et sa périphérie nord ont été définis comme zone témoin. Un sondage stratifié aléatoire simple a été réalisé pour constituer un échantillon représentatif de la population des deux zones. Les données ont été collectées par un questionnaire structuré. Sa première partie est principalement destinée à décrire les expositions et les symptômes ressentis lors de l'incendie et dans ses suites. La seconde partie porte sur la période au moment de la collecte des données, un an après l'accident. Elle intègre un instrument normalisé de mesure de la santé globale, le MOS SF-12 (Medical Outcomes Study Short Form Health Survey). Un questionnaire additionnel a été administré dans un deuxième temps d'enquête pour évaluer l'impact de l'événement sur l'anxiété, la dépression et les symptômes de stress post-traumatique. L'analyse des données permettra de décrire les expositions à l'accident, les symptômes rapportés par la population et les recours aux soins qu'ils ont motivés, et d'estimer leur prévalence en population. Des modèles de régression multivariés seront développés pour quantifier, si elle existe, la relation entre les expositions environnementales perçues et, d'une part, les symptômes post-accidentels, et, d'autre part, la santé physique et mentale un an après l'accident. A perceived health study is part of the epidemiologic response to the industrial fire that occurred in Rouen (France) in September 2019. This cross-sectional population survey, entitled "A study that listens to your health", aims to assess the short and medium-term impact of the accident on both physical and mental health. The exposed area, encompassing 122 municipalities with a total of 350,000 inhabitants, was divided into four strata. Le Havre and its northern periphery were designated a control zone. A simple stratified random drawing was carried out to constitute a representative sample from the population of the two zones. Data collection used a structured questionnaire whose first section was mainly intended to describe the exposures and symptoms experienced during the fire and its aftermath. The second section covered the data collection period, one year after the event. It incorporated a standardized instrument for measuring global health: the MOS SF-12 (Medical Outcomes Study Short Form Health Survey). An additional questionnaire was administered at a later stage of investigation to assess the impact of the industrial fire on anxiety, depression, and post-traumatic stress. Data analysis will make it possible to describe the exposure to the accident, the symptoms reported by the population and any medical treatment sought, and thus to estimate their prevalence in the population. Multivariate regression models will be developed to quantify any relation between perceived environmental exposures and, on the one hand, post-accident symptoms, and on the other, perceived health one year after the accident. [ABSTRACT FROM AUTHOR]

Unemployment is a major concern of societies and people around the world. In addressing this phenomenon, the literature has suggested a change in unemployed people’s perceptions of this transition period. In this paper, we apply a differential approach to explore the concept of unemployment normalization, an individual emotional regulation process. The results show how the global socioeconomic context and some individual and psychological variables influence the normalization of unemployment. Thus, the age of the person but also work involvement, coping strategies, locus of control, and level of self-esteem have indirect differential effects, mediated by unemployment normalization dimensions, on unemployed people’s perceived health. Only neuroticism has a direct link to subjective well-being. These results offer a new understanding of the perception of unemployment and are also discussed in the area of career and vocational counseling.

Objective: To derive cluster analysis-based groupings for adults with congenital heart disease (ACHD) when it comes to perceived health, psychological functioning, health behaviours and quality of life (QoL).Methods: This study was part of a larger worldwide multicentre study called APPROACH-IS; a cross sectional study which recruited 4028 patients (2013-2015) from 15 participating countries. A hierarchical cluster analysis was performed using Ward's method in order to group patients with similar psychological characteristics, which were defined by taking into consideration the scores of the following tests: Sense Of Coherence, Health Behavior Scale (physical exercise score), Hospital Anxiety Depression Scale, Illness Perception Questionnaire, Satisfaction with Life Scale and the Visual Analogue Scale scores of the EQ-5D perceived health scale and a linear analogue scale (0-100) measuring QoL.Results: 3768 patients with complete data were divided into 3 clusters. The first and second clusters represented 89.6% of patients in the analysis who reported a good health perception, QoL, psychological functioning and the greatest amount of exercise. Patients in the third cluster reported substantially lower scores in all PROs. This cluster was characterised by a significantly higher proportion of females, a higher average age the lowest education level, more complex forms of congenital heart disease and more medical comorbidities.Conclusions: This study suggests that certain demographic and clinical characteristics may be linked to less favourable health perception, quality of life, psychological functioning, and health behaviours in ACHD. This information may be used to improve psychosocial screening and the timely provision of psychosocial care. [ABSTRACT FROM AUTHOR]

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Background: Personal social capital, which refers to the scope and quality of an individual's social networks within a community, has received increasing attention as a potential sociological factor associated with better individual health; yet, the mechanism relating social capital to health is still not fully understood. This study examined the associations between social capital and self-rated health while exploring the roles of leisure-time physical activity (LTPA) and socioeconomic status (SES) among middle-aged and older adults.Methods: Cross-sectional data were collected from 662 middle-aged and older adults (Mean age: 58.11 ± 10.59 years old) using the Qualtrics survey panel. Personal Social Capital Scale was used to measure bonding and bridging social capital and the International Physical Activity Questionnaire was used to assess LTPA levels. SES was assessed by education and household income levels. Self-rated health was assessed using a single item, by which the participants were categorized into the two groups, having 'good' vs. 'not good' self-rated health. A series of univariate and multivariate logistic regression models were established to examine the independent and adjusted associations of social capital with self-rated health and to test mediating and moderating roles of LTPA and SES, respectively.Results: Bonding and bridging social capital were positively associated with self-rated health (Odds ratios = 1.11 and 1.09; P's < .05, respectively), independent of LTPA that was also significantly associated with greater self-rated health (P-for-linear trends = .007). After adjusting SES, the associations of social capital were significantly attenuated and there was a significant interaction effect by household income (P-for-interaction = .012). Follow-up analyses stratified by household income showed that beneficial associations of social capital with self-rated health were more apparent among the people with low and high levels of household income; yet, LTPA was the stronger predictor of self-rated health among those in the middle class of household income.Conclusions: Findings suggest that both social capital and LTPA are associated with better self-rated health; yet, these associations vary by SES. The health policymakers should address both social capital and LTPA for enhancing perceived health among aging populations but may need to consider varying SES backgrounds. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the association between socio-demographic characteristics and perceived health among Syrian refugees in Jordan. Method: A cross-sectional quantitative descriptive design was adopted, where a sample of 151 Syrian refugees living inside and outside camps in Amman, Jordan was surveyed for physical, psychological, social and environmental perceived health using a 12-item questionnaire. Results: Each domain's score was computed out of 60. The mean perceived physical health was 27.6±11.5; perceived psychological health 27.1±10.1; perceived social health 32.6±10.3; and perceived environmental health 30±9.1. Predictors of perceived physical health included age group F(2) = 3.12, p = .012, marital status F(3) = 4.71, p = .004, and income level F(2) = 1.75, p = .047. Predictors of perceived psychological health included income level F(2) = 2.79, p = .005, place of living t = 3.32, p = .007, and marital status F(3) = 4.09, p = .034. Predictors of perceived social health included gender t = 2.04, p = .026, age group F(2) = 3.64, p = .000, living place t = -3.61, p = .031, and household size r = .61, p = .048. And the only predictor of perceived environmental health included was place of living t = 5.64, p = .000. Conclusion: Living inside refugee camp, large household, poverty, older age, and being divorced or widow are associated with lower perceived health. Modifying some factors may help improve perceived health among Syrian refugees in Jordan and beyond. [ABSTRACT FROM AUTHOR]

In Norway, many communities offer low-rent plots of land on which city dwellers can build summer cottages and grow crops. These allotment gardens serve as recreational escapes from urban life. However, little is known about the impact these gardens have on their members. This study attempts to shed light on today's impact of allotment gardens in a public health setting in Norway. The study was based on 17 semi-structured interviews and 2 in-depth interviews with allotment house owners. Informants were mainly recruited by "snowball sampling". Our data show that maintaining an allotment promotes exercise and provides a positive impact on self-perceived well-being and physical health through outdoor activities. Spending time in the garden contributes to new knowledge and experiences. Owning an allotment garden has provided new knowledge, new skills, new hobbies, and thereby an improvement in lifestyle. The allotment garden has a strong impact on perceived health, well-being, and sense of coherence (SOC) for the individuals. It promotes outdoor activities along with social interaction and can prevent feelings of loneliness and isolation.

Unemployment is a major concern of societies and people around the world. In addressing this phenomenon, the literature has suggested a change in unemployed people's perceptions of this transition period. In this paper, we apply a differential approach to explore the concept of unemployment normalization, an individual emotional regulation process. The results show how the global socioeconomic context and some individual and psychological variables influence the normalization of unemployment. Thus, the age of the person but also work involvement, coping strategies, locus of control, and level of self-esteem have indirect differential effects, mediated by unemployment normalization dimensions, on unemployed people's perceived health. Only neuroticism has a direct link to subjective well-being. These results offer a new understanding of the perception of unemployment and are also discussed in the area of career and vocational counseling. [ABSTRACT FROM AUTHOR]

Background: The global financial crisis emerging in 2008 struck Greece especially hard, whereas Scandinavian countries were less affected. This has created a unique opportunity to study the long-term effect of community stress on populations. Increasing frequencies of mental health issues and poorer perceived health among the Greek population have been reported. The physiological marker of long-term stress, cortisol in hair, is applied in this study together with measures of perceived health and stress, depression and anxiety. Our aim was to study self-reported and physiological stress, perceived health, including mental health, in the general population of Greece compared to Scandinavia, in order to assess long-term effects of the economic crisis on these parameters. Methods: A cross-sectional comparative study of adult (18–65 years) Primary Health Care visitors from semi-rural areas in Greece (n = 84) and Scandinavia (n = 140). Data collection was performed in 2012, and encompassed a questionnaire with a variety of health and stress indicators as well as hair samples for analyzes of cortisol levels. Results: The Greek sample reported significantly poorer overall health (p < 0.0001) than the Scandinavians and a significantly higher perceived stress (p < 0.0001). The Greeks were also less hopeful of the future (p < 0.0001), and to a larger extent fulfilled the HAD criteria for depression (p < 0.0001) and anxiety (p = 0.002). The strongest predictors explaining ill health in logistic regressions were being Greek (p = 0.001) and feeling hopeless about the future p = 0.001, OR = 6.00 (CI 2.10–14.88). Strong predictors in logistic regressions for high perceived stress were anxiety: high (p < 0.0001) and medium (p = 0.0001), as well as medium depression (p = 0.02). Conclusions: Greek adult Primary Health Care visitors perceived their health more negatively than the Scandinavians, including a higher presence of depression, anxiety, and a lower hope for the future. The Greeks also reported higher perceived stress, but this was not reflected in higher cortisol levels. The findings presented here, identify possible adverse long-term effects of the economic crisis in the examined Greek population that are not seen in the Scandinavian cohort. These differences may also be interpreted against the background of socio-cultural differences in the northern and south-eastern corners of Europe. [ABSTRACT FROM AUTHOR]

Objectives: The identification of psychological markers of the posttraumatic stress reaction after a cardiac event is relevant in the management of cardiovascular risk factors. The aim of the study to test the contribution of experiential avoidance, anxiety sensitivity, and depressive symptoms to acute coronary syndrome posttraumatic stress symptoms and perceived health (both measured 6 months later), and to determine whether the associations between experiential avoidance, anxiety sensitivity, and depressive symptoms with perceived health were mediated by the posttraumatic stress symptoms. Design: 180 patients with acute coronary syndrome completed a survey over a 6-month period. Results: Anxiety sensitivity and depressive symptoms but not experiential avoidance contributed significantly to posttraumatic stress symptoms. Depressive symptoms and posttraumatic symptoms but neither anxiety sensitivity nor experiential avoidance had a significant association on perceived health. Acute coronary syndrome posttraumatic symptoms significantly mediated the association of depressive symptoms with perceived health. That is, increased depressive symptoms was significantly associated with higher levels of posttraumatic symptoms, which in turn predicted lower levels of perceived health. Conclusions: Understanding the psychological factors that are associated with post-acute coronary syndrome posttraumatic stress symptoms may help to identify patients at risk in order to refer them to the appropriate psychological care service. [ABSTRACT FROM AUTHOR]

Le modèle de financement des soins en France était jusqu'à présent basé sur la quantité de soins produite. Le financement au forfait des sujets atteints d'une maladie rénale chronique au stade IV ou V introduit, en plus d'une incitation à favoriser une prise en charge globale, la notion de paiement à la qualité. Une partie de cette évaluation de la qualité portera sur le ressenti des patients vis-à-vis de leur santé et de leur prise en charge. L'objectif de cet article est de faire le point sur les outils utilisables en néphrologie par les patients pour évaluer leur état de santé (« Patient Reported Outcomes »). Certains outils évaluent l'impact de la maladie ou des soins (« Patient Reported Outcomes Measures »), tandis que d'autres évaluent l'expérience avec le système de santé ou le parcours de soins (« Patient Reported Experience Measures »). Ces concepts sont plus larges que celui de la qualité de vie. Les « Patient Reported Outcomes » sont mesurés à l'aide de questionnaires standardisés et validés, génériques ou spécifiques. L'initiative « Standardised Outcomes in Nephrology » a montré que les « Patient Reported Outcomes Measures », souvent négligés au profit de critères biologiques, sont au contraire privilégiés par les patients. Dans une perspective de déploiement large d'un suivi de la santé perçue à des fins d'évaluation de la prise en charge, hors protocole de recherche, la Commission d'épidémiologie de la Société francophone de néphrologie, dialyse et transplantation préconise un recueil annuel des indicateurs suivants : pour les « Patient Reported Outcomes Measures », l'« EuroQol 5D » ou le « 12- Item Short Form Health Survey », qui semblent à même d'assurer le meilleur compromis entre faisabilité et pertinence ; et pour les « Patient Reported Experience Measures », le « e-SATIS », du fait de sa large utilisation par les établissements en attendant un outil plus court et mieux adapté. In France, the method of financing is mainly based on the quantity of care produced. The fixed-rate financing of patients with chronic kidney disease at stage IV or V introduces the notion of payment to quality. Part of the quality assessment will focus on the patients' feelings about their care. The objective of this paper is to assess these indicators used in nephrology, markers in their own right of the quality of care. The patients reported outcomes measures considering the impact of illness or care and the Patient Reported Experience Measures considering their perception of their experience with the health care system or care pathway, are broader than quality of life. These PROs are measured using standardized and validated questionnaires, generic or specific. The Standardised Outcomes in Nephrology initiative has shown that PROs, too often neglected in favor of biological criteria, are instead favored by patients. In the context of a broad deployment of monitoring the quality of life for the purpose of evaluation of care, outside research protocol, the Commission recommends one of the following 2 tools: EuroQol 5D and 12-Item Short Form Health Survey, a compromise between feasibility and relevance and e-SATIS given its great use in health facilities, with an annual follow-up. [ABSTRACT FROM AUTHOR]

No previous study has explored the structure of self-rated health (SRH), a measure holding strong predictive value for future health events, in the oldest old or in individuals with dementia. The aim was to construct a structural equation model of SRH for oldest old in general and for oldest old with dementia, and to explore direct and indirect associations between health-related factors and SRH. Cross-sectional data from the Vitality 90+, a population-based study in the city of Tampere, Finland, was used. Data were gathered by a mailed questionnaire in 2014. Altogether 1299 nonagenarians, of which 408 had self-reported dementia or cognitive decline, were included. Structural equation models were constructed for all participants and separately for participants with dementia. Diseases (heart disease, stroke, diabetes, arthritis, hip fracture, cancer and dementia for the model for all), dizziness, hearing, vision, mobility, activities of daily living, fatigue, depression and SRH were included in the models. Among all participants, fatigue, depression, problems in mobility, dizziness, deficits in vision and heart disease were directly associated with poor SRH. Among participants with dementia, only fatigue, dizziness and deficits in vision were directly associated with poor SRH. Among all participants, dementia and arthritis were indirectly associated with poor SRH through problems in mobility, depression and fatigue. Among the oldest old, the effects of diseases on SRH were mainly manifested through the consequences of diseases, namely fatigue, dizziness, deficits in vision and problems in mobility. Depression has an important direct and indirect role, and dementia and arthritis an important indirect role in the structure of SRH. Dementia weakens many of the direct and indirect associations for SRH.

This study wants to examine effects of job insecurity on several work-related outcomes (perceived work-related symptoms, job satisfaction, and turnover intentions) by developing a moderated mediation model. The model emphasizes the role played by the quality of leader–member exchange (LMX) in mediating the relation between perceived job insecurity and outcomes related to work, and the moderating role of perceived organizational support (POS) in influencing the mediation. Survey data from 510 workers at Italian organizations were collected, and regression was used to evaluate the hypotheses. After age, gender, education, and organizational tenure were controlled, results showed that perceived quality of LMX carried the effect of job insecurity on all outcomes, and that this relationship was stronger for employees who reported higher levels of POS. This study makes important theoretical and practical contributions to job insecurity, LMX, and POS research, underlining the importance of promoting the leader–member relationship’s quality in an ethical and supportive work environment.

Green Infrastructure (GI) facilities have the capacity to enhance health and mitigate Environmental Sustainability Challenges (ESC). However, the extent of the mitigation and health benefits is unclear in developing countries. This study examined the impact of GI on ESC and Perceived Health (PH) of urban residents in Lagos Metropolis, Nigeria. Multi-stage sampling technique was used to select 1858 residents of Lagos Metropolis who completed semi-structured questionnaires. Descriptive statistics and chi-square test were used to explore data distributions and assess the association of the availability of GI with resident’s PH and ESC. Odds ratio with 95% confidence interval (OR;95%CI) were estimated for good health and ESC mitigation. Participants were mostly men (58.9%) and younger than 50 years old (86.3%). Good health (20.5%) and high mitigation of ESC (collection and disposal of waste-52.7% and official development assistance-63.9%) were reported where GI is mostly available. Participants were more likely to report good health (OR:1.40; 95%CI:1.02-1.92) and high mitigation of ESC [water quality (OR:1.42; 95%CI:1.12-1.81) passenger transport mode (OR:1.41; 95%CI:1.06-1.89)] where GI are mostly available. Availability of Green infrastructure is supporting health and mitigating environmental sustainability challenges in the study area. Green infrastructure should be provided in urban areas where environmental sustainability is under threat.

Three hundred and sixty-one students participating in university physical activity classes completed questionnaires assessing perceived health and self-regulated learning. In addition, 20 students (11 men; 9 women) were interviewed about their reasons for enrolling, participation and goals in the class. Results indicated the students endorsed intrinsic regulation, were autonomous, and the males scored significantly higher on intrinsic regulation and perceived health. Of four regulators, intrinsic regulation predicted student perceived health. The social nature of regulation also cannot be overlooked in providing practicable opportunities and relationships that influence learning in university physical activity classes. [ABSTRACT FROM AUTHOR]

Astrid Fjell,1,2 Berit Seiger Cronfalk,1,3 Nina Carstens,4 Arvid Rongve,5,6 Lars M Rosseland Kvinge,7 Åke Seiger,8 Knut Skaug,9 Anne-Marie Boström1,2,10 1Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; 2Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway; 3Department of Nursing Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden; 4Hospital Pharmacies Enterprise, Western Norway, Bergen, Norway; 5Department of Research and Innovation, Helse Fonna, Haugesund Hospital, Haugesund, Norway; 6Institute of Clinical Medicine, University of Bergen, Bergen, Norway; 7FOUSAM, Western Norway University of Applied Sciences, Haugesund, Norway; 8Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden; 9Department of Medicine, Helse Fonna, Haugesund Hospital, Haugesund, Norway; 10Theme Aging, Karolinska University Hospital, Huddinge, Sweden Background: Preventive home visits (PHV) may contribute to identify risks and needs in older people, and thereby delay the onset of functional decline and illness, otherwise often followed by home care or admission to hospital or nursing homes. There is a need to increase knowledge about which factors are associated with different risk areas among older people, so that the PHV questionnaire focuses on relevant tests and questions to make the PHV more specific and have a clear focus and purpose.Objective: The objective of this study was to examine associations between five kinds of risks: risk of falls, malnutrition, polypharmacy, cognitive impairment, and risk of developing illness and factors related to lifestyle, health, and medical diagnoses among older people living at home.Methods: A cross-sectional study design was applied. PHV were conducted by nurses among 77-year-old people in an urban municipality and among ≥75-year-old people in a rural municipality. A questionnaire including tests and a risk assessment score for developing illness was used. Descriptive and inferential statistics including regression models were analyzed.Results: The total sample included 166 persons. Poor perceived health was associated with increased risk of developing illness and risk of fall, malnutrition, and polypharmacy. Lifestyle and health factors such as lack of social support, sleep problems, and feeling depressed were associated with risk of developing illness. Risk of falls, malnutrition, polypharmacy, and cognitive impairment were also associated with increased risk of developing illness. None of the independent factors related to lifestyle, health, or medical diagnosis were associated with risk of cognitive impairment.Conclusion: Poor perceived health was associated with health-related risks in older persons living at home. Preventive health programs need to focus on social and lifestyle factors and self-reported health assessment to identify older people at risk of developing illnesses. Keywords: preventive home visits, older adults, risk assessment, developing illness, perceived health, social factors, logistic regression analysis, lifestyle

Abstract Background The EQ-5D has been frequently used in national health surveys. This study is a head-to-head comparison to assess how expanding the number of levels from three (EQ-5D-3L) to five in the new EQ-5D-5L version has improved its distribution, discriminatory power, and validity in the general population. Methods A representative sample (N = 7554) from the Catalan Health Interview Survey 2011–2012, aged ≥18, answered both EQ-5D versions, and we evaluated the response redistribution and inconsistencies between them. To assess validity of this redistribution, we calculated the mean of the Visual Analogue Scale (VAS), which measures perceived health. The discriminatory power was examined with Shannon Indices, calculated for each dimension separately. Spanish preference value sets were applied to obtain utility indices, examining their distribution with statistics of central tendency and dispersion. We estimated the proportion of individuals reporting the best health state in EQ-5D-5L and EQ-5D-3L within groups of specific chronic conditions and their VAS mean. Results A very small reduction in the percentage of individuals with the best health state was observed, from 61.8% in EQ-5D-3L to 60.8% in EQ-5D-5L. In contrast, a large proportion of individuals reporting extreme problems in the 3 L version moved to severe problems (level 4) in the 5 L version, particularly for pain/discomfort (75.5%) and anxiety/depression (66.4%). The average proportion of inconsistencies was 0.9%. The pattern of the perceived health VAS mean confirmed the hypothesis established a priori, supporting the validity of the observed redistribution. Shannon index showed that absolute informativity was higher in the 5 L version for all dimensions. The means (SD) of the Spanish EQ-5D-3L and EQ-5D-5L indices were 0.87 (0.25) and 0.89 (0.22). The proportion of individuals with the best health state within each specific chronic condition was very similar, regardless of the EQ-5D version (≤ 30% in half of the 28 chronic conditions). Conclusion Although the proportion of individuals with the best possible health state is still very high, our findings support that the increase of levels provided by the EQ-5D-5L contributed to the validity and discriminatory power of this new version to measure health in general population, as in the national health surveys.

Abstract Background Compared to higher socioeconomic status (SES) groups, those in lower SES groups are financially strained, experience higher rates of smoking-related morbidity, are in poorer health and have reduced life expectancy. This is especially true for the city of Rotterdam, where a large inequality in health is observed between low and high SES groups. The BeHealthyR study (Dutch: Grip en Gezondheid) is a randomized controlled trial (RCT) which will evaluate the impact of a theory-based multicomponent behavior intervention aiming to reduce stress, smoking, and improve financial health by means of a group-based stress management program combining cognitive and behavioral techniques, and nudges in low-SES residents living in Rotterdam. Methods The BeHealthyR study is a three-arm RCT. Between February 2018 and July 2019, low-SES participants who perceive stress, smoke, are financially strained and reside in Rotterdam (one of the four largest cities in The Netherlands) are recruited. Subsequently, participants are randomly assigned to either a stress management condition (SM), stress management with a buddy condition (SM-B) or a control condition (CC). Participants in the SM and SM-B conditions will attend four weekly group sessions (1.5 h/session) and a follow-up session eight weeks later. The SM condition includes psychoeducation and exercises, and cognitive and behavioral intervention techniques. Demographic data and objective measures will be collected at baseline (T0), four weeks post-baseline (T1), and twelve weeks post-baseline (T2). Primary outcome measures are to reduce stress, smoking and improve financial health. We hypothesize that low-SES participants in the intervention conditions, compared with those in the control condition, will experience less stress, smoke less and have improved financial health. Discussion This study is a group-based intervention which aims to investigate the effects of a theory-based behavioral change intervention employing several components on reducing stress, smoking, and improving financial health in low-SES residents living in Rotterdam. If effective, the findings from the present study will serve to inform future directions of research and clinical practice with regard to behavioral change interventions for low-SES groups. Trial registration ClinicalTrials.gov (ID: NCT03553979). Registered on January 1 2018.

Background: One's house is believed to be the safest and the healthiest place to live in. Indoor air pollution (IAP) means the presence of unwanted substances in the indoor air at concentration toxic to health. Objective: The objective of this study is to study the presence of IAP, its associated factors and impact on health of women residing in an urban slum of Kolkata, West Bengal, India. Methods: It was a cross-sectional study done from January 2017 to March 2017 among 120 households of a slum. Data were collected using a pre-designed pre-tested schedule from the homemaker of the households. All analyses were conducted with R: A Language and Environment for Statistical Computing. Results: About 60% households used kerosene as cooking fuel predominantly. Smoke from the neighbouring houses troubled 57.5% respondents. More than 60% houses were overcrowded and more than 70% houses were poorly ventilated. IAP-related symptoms such as irritation in the eye, suffocation, dry cough significantly correlated with the presence of IAP sources and its contributory factors. Of 120, 78 (65%) perceived the presence of IAP in their houses. Lower per capita income (PCI), ground floor, and joint family were found to have higher odds of sources of IAP. Younger age, lower PCI, and ground floor were found to be strongly associated with higher contributory factors of IAP. Conclusion: The present study found that the majority of the households were exposed to IAP due to kerosene, neighborhood smoke while overcrowding and ill-ventilation accentuated it. Effective intervention with intersectoral coordination is the need of the hour.

In India, a growing middle class and rising lifestyle diseases put prevention in the spotlight. This study assesses the impact of health behaviors (tobacco use and exercise) as well as psychological states (positive emotional style, hope, and perceived stress) on the health of 314 middle class participants from Mumbai. Logistic regression predicting objective health revealed that positive emotional style was a protective factor. Linear regression predicting perceived health indicated perceived stress and positive emotional style as the significant factors. An intersectional approach focusing on psychological factors and health behaviors, nested within class and gender, will lead to effective preventive strategies. [ABSTRACT FROM AUTHOR]

Objective: Falun Gong (FLG) is a practice of mind and body focusing on moral character improvement that includes meditative exercises. In this study, we explored perceived health status, healthcare resource utilization, and related factors among Taiwanese FLG practitioners, compared to themselves before practicing FLG, and also to the general Taiwanese norm, as reported by the 2001 National Health Interview Survey (NHIS). Methods: This cross-sectional study was based on a voluntary, paper-based survey conducted from October 2002 to February 2003 using the same Taiwanese SF-36 instrument employed by the NHIS. Primary outcomes included 8 SF-36 domain scores and the number of outpatient visits. One-sample t-tests, oneway ANOVA, and multivariate linear regression analyses were used. Results: The response rate was 75.6% (1210/1600). Compared to the norm, the study cohort had significantly higher scores in 6 of 8 SF-36 domains across sex and age (p < .05). Among those with chronic diseases, 70% to 89% reported that their conditions were improved or cured. Additionally, 74.2% and 79.2% participants stopped drinking alcohol and quit smoking; 62.7% reported decreased outpatient visits (mean before = 11.96; mean after = 5.87; norm = 14.4). Conclusions: In this cohort, FLG participants had higher perceived health scores than the population norm and reduced outpatient visits than before practice. [ABSTRACT FROM AUTHOR]

Background & Aims: Previous investigations have aimed at investigating parameters affecting age perception on several ethnicities. Perceived health has been a newer focus on Caucasian skin, yet little is known on the skin features used to estimate the health status of Chinese women and we aimed to investigate whether these cues are the same as those used for age perception. Methods: Age and health appearance of 276 Chinese female volunteers were estimated from their photographs by 1025 female naïve Chinese graders 20–69 years old. Models were built to predict perceived age and health from topographic, colour and biophysical measured variables, in two subsets of the studied volunteers: below and above 50 years. Machine learning‐based predictive models for age and health perception were built on the collected data, and the interpretability of the models was established by measuring feature importance. Results: Age perception was mostly driven by topographic features, particularly eye bags and eyelid sagging in the group below 50 years old. Wrinkles, notably from the lower part of the face and oval of the lower face, were found to be more relevant in the group above 50 years. Health appearance was primarily signalled by skin imperfections and global pigmentation in the subset below 50 years, whereas colour‐related parameters and skin hydration acted as health cues for the subset above 50 years. Conclusion: Distinct skin features were acting as cues for age perception and/or health perception and varied per age subset. Their contribution should be borne in mind when designing products for 'younger looking skin' and 'healthier looking skin'. [ABSTRACT FROM AUTHOR]

Objectives: Fruit and vegetables are essential for a healthy diet. College age is a crucial period of development and formalization in personal behavior, and the perceived health status (PHS) of college students may influence their health-promoting behavior. Therefore, this study aimed to explore the factors of fruit and vegetable consumption behavior of college students by understanding their fruit and vegetable consumption profile and PHS. Methods: We enrolled 403 students from a university of technology in Hsinchu county by using stratified sampling and a self-administered questionnaire. We received 375 valid questionnaires with an effective rate of 93.1%. Results: The daily vegetable and fruit consumption of participants which met the recommendation were only 1.6% and 8%, respectively. Less than half the participants meet the fruit and vegetables consumption recommendation for more than three days per week. The PHS of the participants was relatively positive. They had the highest PHS score for interpersonal interaction and the lowest score for emotional status. Male participants and those with low income and high score for life adjustment of PHS had fewer weekly recommendation-meeting days of fruit and vegetable consumption. The participants with low income and high score for interpersonal interaction of PHS had inadequate daily servings of vegetables. Underclassman, those in off-campus housing, and those scoring high in interpersonal interaction and low in emotional status of PHS had inadequate daily servings of fruit. Conclusions: We suggest that the health education for the students who are require improvement in their fruit and vegetable consumption behavior should be planned preferentially and be supported by their social group. [ABSTRACT FROM AUTHOR]

Health care professionals often face irregular working hours and high work pace. We studied associations of the five working time dimensions duration (weekly working hours), timing (shift work and weekend work), on-call work, working time autonomy, and work tempo (deadline and performance pressure) with well-being among health care employees in Finland and Germany. We used data on working time dimensions and indicators of well-being (work-life conflict, poor perceived health, sleep difficulties, and fatigue) from a cohort of 5050 hospital employees (Working Hours in the Finnish Public Sector Study 2015, WHFPS) and 1450 employees in the health care sector in Germany responding to the German BAuA-Working Time Survey in 2015 (BAuA-WTS). Findings from logistic regression analyses showed that high work tempo was associated with increased work-life conflict (WHFPS: odds ratio [OR] = 3.64, 95%CI 3.04–4.36 and BAuA-WTS: OR = 2.29, 95%CI 1.60–3.27), sleep difficulties (OR = 1.75, 95%CI 1.43–2.15 and OR = 1.33, 95%CI 1.03–1.71) and fatigue (OR = 2.13, 95%CI 1.77–2.57 and OR = 1.64, 95%CI 1.29–2.10) in both datasets. Weekend work was associated with increased work-life conflict (OR = 1.48, 95%CI 1.27–1.72 and OR = 1.61, 95%CI 1.12–2.32); and high working time autonomy with decreased work-life conflict (control over the timing of breaks: OR = 0.65, 95%CI 0.55–0.78 and OR = 0.52, 95%CI 0.33–0.81). The associations between other working time dimensions and well-being were less consistent. These results suggest that tight deadlines, performance pressure, weekend work and lack of working time autonomy are linked to impaired well-being among health care employees. [ABSTRACT FROM AUTHOR]