Differences In Health Perceptions Research Articles

Application of machine learning in predicting health perception through military personnel's sense of empowerment.

The promotion of health and provision of care services for new recruits are issues of constant concern for military leaders and healthcare providers, as they are crucial to maintaining and operating military forces. The enhancement of military personnel's empowerment has been recognized as a core value in promoting health perception. However, the pathways between military personnel's sense of empowerment and health perception have not been thoroughly explored. The primary aim of this study is to examine the predictive power of different dimensions of empowerment (personal, interpersonal, and socio-political) on new recruits' health perception, and to further observe differences among subgroups, which will help us grasp the nuances of future health intervention measures. The research data were extracted from the "Military Career Development Study," analyzing personal empowerment data from Wave 1 (W1) and perceived health data from Wave 2 (W2) (N = 2,232). In terms of analytical methods, five ML classifiers, including Decision Tree, Random Forest, Support Vector Machine, AdaBoost, and k-Nearest Neighbors (KNN) algorithms, were used for prediction in both the full sample and subsamples (gender and socioeconomic status). Results show that among the five ML classifiers, the Decision Tree performed best overall, achieving a prediction accuracy of 95.4%. The results by gender show that the ML models perform best for both males and females with the Decision Tree and Random Forest methods. For the Decision Tree, the accuracy rates were 94.9% for males and 95.1% for females; the F1 scores were 92.9% for males and 93.2% for females. For the Random Forest, the accuracy rates were 94.9% for males and 95.4% for females; the F1 scores were 92.7% for males and 93.2% for females. Regarding SES, the Decision Tree and Random Forest methods performed best. In the SES Low group, both methods achieved a prediction accuracy of 95.6% and an F1 score of 93.7%; in the SES high group, they achieved a prediction accuracy of 95.4% and an F1 score of 93.3%. However, the contribution of different dimensions of empowerment features varied significantly among subgroups. These findings can provide important information on the differences in health perception among military personnel.

Cumulative social disadvantage and health-related quality of life: national health interview survey 2013–2017

BackgroundEvidence for the association between social determinants of health (SDoH) and health-related quality of life (HRQoL) is largely based on single SDoH measures, with limited evaluation of cumulative social disadvantage. We examined the association between cumulative social disadvantage and the Health and Activity Limitation Index (HALex).MethodsUsing adult data from the National Health Interview Survey (2013–2017), we created a cumulative disadvantage index by aggregating 47 deprivations across 6 SDoH domains. Respondents were ranked using cumulative SDoH index quartiles (SDoH-Q1 to Q4), with higher quartile groups being more disadvantaged. We used two-part models for continuous HALex scores and logistic regression for poor HALex (< 20th percentile score) to examine HALex differences associated with cumulative disadvantage. Lower HALex scores implied poorer HRQoL performance.ResultsThe study sample included 156,182 respondents, representing 232.8 million adults in the United States (mean age 46 years; 51.7% women). The mean HALex score was 0.85 and 17.7% had poor HALex. Higher SDoH quartile groups had poorer HALex performance (lower scores and increased prevalence of poor HALex). A unit increase in SDoH index was associated with − 0.010 (95% CI [-0.011, -0.010]) difference in HALex score and 20% higher odds of poor HALex (odds ratio, OR = 1.20; 95% CI [1.19, 1.21]). Relative to SDoH-Q1, SDoH-Q4 was associated with HALex score difference of -0.086 (95% CI [-0.089, -0.083]) and OR = 5.32 (95% CI [4.97, 5.70]) for poor HALex. Despite a higher burden of cumulative social disadvantage, Hispanics had a weaker SDoH-HALex association than their non-Hispanic White counterparts.ConclusionsCumulative social disadvantage was associated with poorer HALex performance in an incremental fashion. Innovations to incorporate SDoH-screening tools into clinical decision systems must continue in order to accurately identify socially vulnerable groups in need of both clinical risk mitigation and social support. To maximize health returns, policies can be tailored through community partnerships to address systemic barriers that exist within distinct sociodemographic groups, as well as demographic differences in health perception and healthcare experience.

An Analysis of Health Perceptions and Performance in Elementary Students in Korea during the ongoing COVID-19 Pandemic.

During the coronavirus disease 2019 (COVID-19) pandemic, social distancing guidelines changed lifestyles, including increased sedentary time, physical inactivity, and disrupted sleep patterns among children. The purpose of the present study is to analyze the health awareness (mental health, disease, physical activity, sleep, eating habit, and hygiene health management) of elementary school students during the COVID-19 pandemic, and use the importance-performance analysis (IPA) technique to identify gender differences in health perceptions. We collected data on 1006 students, which was analyzed using frequency analysis, reliability testing, independent sample t-tests, and importance-performance analysis (IPA). A median importance value of 0.163 and a median performance value of 4.048 were selected as cross points to distribute the IPA matrix into four quadrants. The highest performance was given for wearing a mask and sanitary practice; the IPA matrix indicated that the sense of belonging, happiness, trust, and movement activity were located in quadrant I. Children's regular physical activity and level of physical activity were low, especially that of girls. Children's sleep management was poor. Their physical activity and sleep-related factors must be improved under the facilitation of the national government, public education institutions, and families.

Unmet needs in Cushing's syndrome: the patients' perspective.

BackgroundCushing’s syndrome (CS) is a rare condition of chronically elevated cortisol levels resulting in diverse comorbidities, many of which endure beyond successful treatment affecting the quality of life. Few data are available concerning patients’ experiences of diagnosis, care and persistent comorbidities.ObjectiveTo assess CS patients’ perspectives on the diagnostic and care journey to identify unmet therapeutic needs.MethodsA 12-item questionnaire was circulated in 2019 by the World Association for Pituitary Organisations. A parallel, 13-item questionnaire assessing physician perceptions on CS patient experiences was performed.ResultsThree hundred twenty CS patients from 30 countries completed the questionnaire; 54% were aged 35–54 and 88% were female; 41% were in disease remission. The most burdensome symptom was obesity/weight gain (75%). For 49% of patients, time to diagnosis was over 2 years. Following treatment, 88.4% of patients reported ongoing symptoms including, fatigue (66.3%), muscle weakness (48.8%) and obesity/weight gain (41.9%). Comparisons with delay in diagnosis were significant for weight gain (P = 0.008) and decreased libido (P = 0.03). Forty physicians completed the parallel questionnaire which showed that generally, physicians poorly estimated the prevalence of comorbidities, particularly initial and persistent cognitive impairment. Only a minority of persistent comorbidities (occurrence in 1.3–66.3%; specialist treatment in 1.3–29.4%) were managed by specialists other than endocrinologists. 63% of patients were satisfied with treatment.ConclusionThis study confirms the delay in diagnosing CS. The high prevalence of persistent comorbidities following remission and differences in perceptions of health between patients and physicians highlight a probable deficiency in effective multidisciplinary management for CS comorbidities.

Impact of antiretroviral therapy regimens adherence on perceived health and wellbeing status among adults living with HIV in Ghana

Introduction The efficacy of antiretroviral medicines to improve health outcomes and wellbeing depends largely on how soon they are prescribed and how PLHIV adhere to their prescribed regimens. The objectives of this cross-sectional study were to examine adherence to antiretroviral therapy (ART) and to assess perceived health and wellbeing among people living with HIV(PLHIV) in two regions in Ghana. Methods Quantitative data were collected from 301 PLHIV at three HIV clinics in Volta and Oti regions in Ghana using descriptive cross-sectional study design. Data collected included sociodemographic characteristics, ART initiation and adherence, and perception of health and wellbeing and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Demographic and categorical variables were analyzed using descriptive statistics while Chi-squared analyses and binary logistics regression were used to determine variables that correlated with adherence to ART regimen. A Mann–Whitney U-test was used to measure differences in perception of health and wellbeing between male and female participants. Results 80% initiated ART within a month following diagnosis and 97.3% reported adhering to their ART regimens consistently. A Pearson χ2 revealed that the availability of alternatives to the current ART medications showed a significant association with ART adherence (χ2 =12.078, p= 0.002). 90% reported improvement in their health and personal wellbeing. High ART adherence and positive perceived health and wellbeing were found. Conclusion Regular supply of ART and investment in LA-ART to ensure more effective, efficient, and stress-free adherence to ART for PLHIV regardless of their residence in the country.

Racial and Ethnic Differences in the Perceptions of Health, Work Environment and Experiences of Work-Related Symptoms Among Cleaning Workers

This study explored racial and ethnic differences in perception of work environment, safe work practices, general health status, experience of work-related injury or illness and subsequent symptom reporting and health care seeking behaviors among cleaning workers. This study analyzed cross-sectional data obtained from 183 cleaning workers employed in a university hospital or a health sciences campus in Northern California. The sample included 120 Asians (65.6%), 37 Hispanics (20.2%), and 27 other ethnicities (14.2%); 85.7% were foreign-born. Asian workers perceived lower job control and supervisor support and higher job strain than other workers. The odds of perceiving general health as excellent or very good were lower among Asians compared to Hispanics and Others. Asians who experienced chemical-related symptoms were less likely than Hispanics and others to report the symptoms to their supervisor or seek healthcare. Our study findings indicated racial/ethnic differences in perceptions of work and general health, seeking healthcare, and reporting behaviors among cleaning workers. Asian workers, specifically, may need special attention to improve their experiences of work environments and health in the workplace.

Sugar-Sweetened Beverages Perceived as Healthier Than Soda Among Young Adults and Groups at Risk for Misperceptions (P04-186-19)

ObjectivesTo reduce sugar-sweetened beverage (SSB) consumption, public health campaigns have focused on soda. However, intake of other SSBs has increased, perhaps due to perceptions that they are healthier. Thus, we sought to examine differences in health perceptions between soda and four types of SSBs among young adults and determine if socioeconomic characteristics were associated with perceptions. MethodsIn a cross-sectional study, 1339 undergraduate students from three universities participated in an online survey in August-November of 2018. Items used 7-point Likert scales to assess 1) perceived healthfulness of daily consumption of soda, sweetened tea, Vitamin Water, fruit-flavored drinks and sports drinks and 2) agreement or disagreement that these beverages increase risk of diabetes. Surveys also assessed demographic characteristics and food insecurity as a proxy for socioeconomic status. Analyses used Chi-square tests with dichotomized outcomes and linear regression models adjusting for race/ethnicity, university, gender and age. ResultsStudents were more likely to perceive daily consumption of fruit-flavored drinks, sweetened tea, sports drinks, and Vitamin Water as healthy compared to soda (9%, 5%, 6%, and 14% vs. 2%, respectively, all P-values < 0.05) and were less likely to agree that these SSBs increase risk of diabetes compared to soda (67%, 67%, 61%, and 46% vs. 95%, respectively, all P-values < 0.001). Food insecure students rated all SSBs (except Vitamin Water) as healthier than did food secure students (P-values < 0.05). Food insecure students were also less likely than food secure students to agree that soda and Vitamin Water increase risk for diabetes (P-values < 0.05). ConclusionsTo reduce SSB consumption, public health policies and programs should focus on all types of SSBs, not just soda. Policies like SSB warning labels, which apply to all SSBs, may help correct misperceptions of SSB healthfulness and potentially reduce health disparities. Funding SourcesResearch reported in this publication was supported by the National Institute Of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health and the United States Department of Agriculture National Institute of Food and Agriculture. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or USDA.

Draw-and-write technique elicits children’s perceptions of health in the USA and Guatemala

Objective: Using the draw-and-write methodology, this study examined cross-cultural similarities and differences in children’s perceptions of health. Design: Cross-sectional design. Setting: One public elementary school in the USA and in Guatemala. Method: The total sample included 161 children 9–10 years of age, 80 in the USA and 81 in Guatemala. Children in each setting were asked to draw-and-write responses to two prompts regarding things that make someone healthy/unhealthy. Responses were coded for the presence of themes for each topic, and statistical tests were performed to test for significant differences by gender and country. Results: Food is central to children’s perceptions of healthy and unhealthy in both locations, as over 90% of children overall depicted food items for both topics. Fruit, in particular, constitutes the majority of depictions for healthy items in both countries, followed by vegetables. In terms of differences, children in the USA were more likely to depict drinking water and exercise as things that make someone healthy and fast food as being unhealthy. Guatemalan children, in contrast, were more likely to depict hygiene and the environment as both healthy and unhealthy. Conclusion: There are more cross-cultural similarities than differences in children’s perceptions of health. While similarities derive from the centrality of food in perceptions of health, differences in perceptions of health emerge from unique national health conditions and initiatives, local socio-ecological contexts and school curricula.

Impact of Gender Disparities on Short-Term and Long-Term Patient Reported Outcomes and Satisfaction Measures After Elective Lumbar Spine Surgery: A Single Institutional Study of 384 Patients.

There is a paucity of data determining the impact that gender disparities have on spine outcomes, particularly perception of health and satisfaction. The aim of this study was to determine whether there is a difference in 3-month and 1-year patient-reported outcomes and satisfaction after elective lumbar spine surgery. This was a retrospectively analyzed study from a maintained prospective database of 384 patients who underwent elective lumbar spine surgery. Patients were categorized by gender (men, n= 199; women, n= 185). Patient-reported outcome instruments (Oswestry disability index, visual analogue scale-back pain/leg pain, EuroQol visual analogue scale, and EuroQol 5 dimensions questionnaire) were completed before surgery, then at 3 and 12 months after surgery along with patient satisfaction measures. Baseline patient demographics, comorbidities, and operative variables were similar between both cohorts. The female cohort had a slightly longer hospital stay than male cohort (P= 0.007). Baseline patient-reported outcome measures were different between both cohorts, with female patients having more Oswestry disability index (23.8 vs. 20.4; P ≤ 0.0001) and visual analogue scale-back pain (7.2 vs. 6.2; P= 0.0004), and a lower EuroQol 5 dimensions questionnaire (0.34 vs. 0.49; P= 0.0001) compared with the male cohort. At 1-year follow-up, the male cohort had a significantly more mean change in visual analogue scale-leg pain (-3.9 vs.-2.8; P= 0.04) and trended to have more mean change in visual analogue scale-back pain (-3.4 vs.-2.5; P= 0.06) and EuroQol visual analogue scale (8.6 vs. 3.4; P= 0.054) scores compared with the female cohort. At 1-year a significantly more portion in the male cohort found that surgery met their expectations compared with the female cohort (65.0% vs. 49.5%; P= 0.02). Our study suggests that there may be differences in perception of health, pain, and disability between men and women at baseline, short-term and long-term follow-up that may influence overall patient satisfaction.

Prospective Assessment of Sex-Related Differences in Symptom Status and Health Perception Among Patients With Atrial Fibrillation.

BackgroundWe prospectively assessed sex‐specific differences in health perception, overall symptom status, and specific symptoms in a large cohort of patients with atrial fibrillation.Methods and ResultsWe performed a prospective multicenter observational cohort study of 1553 patients with atrial fibrillation. Patients completed questionnaires about personal characteristics, comorbidities, and symptoms on a yearly basis. Mean age was 70±11 years among women and 67±12 years among men. Health perception on a visual analogue scale ranging from 0 to 100 (with higher scores indicating better health perception) was significantly lower in women than in men (70 [interquartile range: 50–80] versus 75 [interquartile range: 60–85]; P<0.0001). More women than men had any symptoms (85.0% versus 68.3%; P<0.0001), palpitations (65.2% versus 44.4%; P<0.0001), dizziness (25.6% versus 13.5%; P<0.0001), dyspnea (35.7% versus 21.8%; P<0.0001), and fatigue (25.3% versus 19.1%; P=0.006). At 1‐year follow‐up, symptoms decreased in both sexes but remained more frequent in women (49.1% versus 32.6%, P<0.0001). In multivariable adjusted longitudinal regression models, female sex remained an independent predictor for lower health perception (ß=−4.8; 95% CI, −6.5 to −3.1; P<0.0001), any symptoms (odds ratio [OR]: 2.6; 95% CI, 2.1–3.4; P<0.0001), palpitations (OR: 2.6; 95% CI, 2.1–3.2; P<0.0001), dizziness (OR: 2.9; 95% CI, 2.1–3.9; P<0.0001), dyspnea (OR: 2.1; 95% CI, 1.6–2.8; P<0.0001), fatigue (OR: 1.6; 95% CI, 1.2–2.2; P=0.0008), and chest pain (OR: 1.8; 95% CI, 1.3–2.6; P=0.001).ConclusionsWomen with atrial fibrillation have a substantially higher symptom burden and lower health perception than men. These relationships persisted after multivariable adjustment and during prospective follow‐up.

Abstract 13213: Sex-related Differences in Symptom Status Among Patients With Atrial Fibrillation

Background: Many patients with atrial fibrillation (AF) have symptoms related to the arrhythmia, but little is known about sex-specific differences. We therefore prospectively assessed sex-specific differences in health perception, overall symptom status and a comprehensive panel of specific symptoms in a large cohort of AF patients. Methods: We performed a prospective multicenter observational cohort study of 1550 AF patients, who were enrolled between 2010 and 2014. All patients completed questionnaires about personal characteristics, co-morbidities and symptoms on a yearly basis. Results: Mean age was 70±11 years among women and 67±12 years among men. Health perception on a visual analogue scale was significantly lower in women than in men (67±20 vs. 72±18 respectively; p&lt; 0.0001). Compared to men, more women had any symptoms (85.0% vs. 68.3%; p&lt; 0.0001), palpitations (65.2% vs. 44.4%; p&lt; 0.0001), dizziness (25.6% vs. 13.5%; p&lt; 0.0001), dyspnea (35.7% vs. 21.8; p&lt; 0.0001) and fatigue (25.3 vs. 19.1; p= 0.006). One year after baseline, symptoms decreased in both sexes, but remained more frequent in women (49% vs. 33%, p&lt; 0.0001). These findings persisted after two years (48% vs. 32%, p&lt; 0.0001) and after three years (41% vs. 31%, p= 0.02). After multivariable adjustment, female sex remained an independent predictor for a lower health perception (ß = -5.4 [95% confidence (CI) -7.4; -3.3] p&lt; 0.0001), any symptoms (odds ratio (OR) 3.0 [95%CI 2.2; 4.1] p&lt; 0.0001), palpitations (OR 2.8 [95%Cl 2.2; 3.7] p&lt; 0.0001), dizziness (OR 2.3 [95%Cl 1.7; 3.1] p&lt; 0.0001), dyspnea (OR 2.0 [95%Cl 1.5; 2.6] p&lt; 0.0001) and fatigue (OR 1.7 [95%Cl 1.3; 2.3] p&lt; 0.0001). Similar results were obtained one year after baseline (follow-up) as presented in the Table. Conclusions: Women with AF had a substantially higher symptom burden and a lower health perception than men. These relationships persisted after comprehensive multivariable adjustment and during prospective follow-up.

Correlation between Health Perception, Body Image, and Eating Habits in High School Students

Background : Mental disorders, including eating disorders, mostly begin during youth. Moreover, negative body image is found to cause unhealthy eating habits in the context of several cross-cultural settings. This study aimed to examine the correlation between health perception and body image with eating habits among high school students. Methods : A structured, anonymous questionnaire was distributed to students of a private high school in Bandung, Indonesia in June-October 2014. The questionnaire included questions about health perception, body image, eating habits, body weight and height, and also other demographic parameters. The school was selected as the study object through purposive sampling, and 140 high school students (72 male and 68 female) were ramdomly selected. Results : Male and female did not show considerable differences in health perceptions. Out of 13 statements, 12 statements of male respondents showed better body image than female. While in eating habits statements, female respondents seemed to maintain healthier eating habits than male respondents. No significant correlation was observed between body image and eating habits (r=-0.015, p=0.858). There was significant correlation between health perception and eating habits (r=0.374, p<0.001). Correlation between sex and eating habits was found (p=0.020), there was not significant relationship between eating habits and Body Mass Index (BMI) (p=0.368). Conclusions : The negative relationship between body image and eating habits is not significant. However there was a significant positive relationship between health perception and eating habits. Furthermore, there was correlation between sex and eating habits, while the positive relationship between eating habits and BMI was still not found. [AMJ.2016;3(2):216–21] DOI: 10.15850/amj.v3n2.770

The Role of CAM in Public Health, Disease Prevention, and Health Promotion.

As the worldwide burden of chronic disease continues to rise, disease prevention and health promotion become increasingly important components of public health. Although many complementary and alternative medicine (CAM) practices have emphasized health promotion and the area of CAM health care holds much opportunity and challenge for issues of public health, CAM research to date has been dominated by more clinically restrictive issues [1, 2]. However, CAM practitioners can constitute a public health resource to increase the population's access to certain clinical preventive services if integrated into mainstream public health practice. As part of this integration of CAM practices, it is important to investigate methods of effective interprofessional collaboration involving both CAM and mainstream professions. It is also essential to identify issues that might be challenging to integration from the perspective of both mainstream and CAM providers such as professional biases on both sides, differences in perception of health and disease, common language, and adherence to evidence-based principles. This special issue includes original research papers and systematic reviews investigating the issues related to CAM practices in the public health arena as well as outcomes of CAM treatment for chronic disease prevention and/or management (tertiary prevention). There are 14 articles in this issue, from six countries and on a wide variety of topics. The topics addressed are almost equally divided between treatment of specific conditions of public health importance and disease prevention through risk factor reduction. A smaller number of articles address issues related to traditional medicine use among the general public. Articles on treatment of conditions include a large clinical study by J.-F. Tang et al. on safety and evaluation of Danhong injection; a basic science study on Brucea javanica oil by Y. Liu et al.; a systematic review and meta-analysis of the efficacy of compound kushen on cancer pain by X. Ma et al.; an analysis of Qigong's effect on chronic fatigue syndrome by L. P. Yuen et al.; a systematic review of acupuncture for allergic rhinitis and asthma by L. Zhou et al.; and an analysis of the effects of guided imagery on patients on mechanical ventilation by B. Brakovich et al. Articles on prevention and risk factor reduction were a randomized controlled trial of Tai Chi on weight loss, metabolic syndrome, and bone mineral density by T. C.-Y. Kwok et al.; an analysis of body constitution through Traditional Chinese Medicine by C.-H. Lee et al.; a survey of apitherapy use for disease prevention by S. Trumbeckaite et al.; an exploration of the possible effect of CAM on antibiotic resistance by W. B. V. Leeuwen et al.; and a survey of the effect of Traditional Chinese Medicine on decreasing stroke risk among users of corticosteroids for dermatitis by J.-L. Shen et al. Finally, F. Xu et al. described the validation of a questionnaire based on Traditional Chinese Medicine to assess health status; S. H. Ng et al. described use of the Theory of Planned Behaviour related to Traditional Chinese Medicine use; and G. D. Hughes et al. characterized the use of herbal medicines for noncommunicable disease. These articles tended to focus more on single herbal or other traditional preparations or procedures for both treatment and prevention, with very little emphasis on health behaviour, which is typically a cornerstone of public health programs. Behaviours related to diet, physical activity, and stress reduction are known to be increasingly important factors in determining the health of the public and are also areas of importance and emphasis for many CAM practitioners. It is necessary for CAM professions to become visible in this arena and for CAM research to extend into this direction rather than focusing narrowly on specific therapies if these efforts are to be recognized and utilized for the benefit of populations. Cheryl Hawk Jon Adams Jan Hartvigsen

Symptom attribution and risk perception in individuals with idiopathic environmental intolerance to electromagnetic fields and in the general population

To investigate differences in health perception and electromagnetic fields (EMF) between people within the general population reporting sensitivity or non-sensitivity to EMF, and people who registered themselves as sensitive to EMF at a non-governmental organisation (NGO). Correlations and regression analysis to compare a sample of the general population recruited via internet panel to individuals with idiopathic environmental intolerance to EMF (IEI-EMF) recruited via an interest group. The general population sensitive group was more similar to the non-sensitive group in personal characteristics than to the NGO sensitive group. They experienced more - and more frequent - non-specific symptoms, reported higher perceived risk of EMF, and attributed their symptoms more to EMF than the non-sensitive group, but less than the NGO sensitive group. There was a positive association between attribution of symptoms to EMF and reported intensity of non-specific symptoms, which was stronger for the NGO sensitive subjects than for the general population. People sensitive to EMF and recruited via an internet panel differ from people sensitive to EMF and recruited via an NGO, who reported a higher frequency of non-specific symptoms. Attribution of symptoms to EMF is one of the predictors of the intensity of physical symptoms. Changing the perceived association between EMF and health problems in individuals with IEI-EMF might contribute to a better health experience.

Rheumatoid Arthritis in Minorities

Rheumatoid Arthritis in Minorities

Developing a Holistic Understanding of Health and Health Behavior in People Undergoing Resocialization in Prison under the “Active Today, Different Tomorrow”

AbstractThe main purpose of detention in a modern, humanitarian prison system is to bring the prisoners to live in a free society in a manner consistent with applicable laws and morals. The indicators of modernity are also ways and means by which attempts are made to achieve this goal. In many European and non-European prisons, physical culture achievements are commonly used in working with prisoners. They organize programmed resocialization activities for prisoners with a substantial share of physical education and recreational free time activities. Sometimes, prisoners are offered the chance to take their own initiatives to encourage healthy lifestyles. In addition to teaching, during which the prisoners participate in physical activity, they use interaction with sports authorities in the form of discussion meetings between prisoners and athletes. Such meetings are also organized at the House of Detention in Inowrocław, which operates a half-open unit for the convicts. These meetings are the part of the activities of “Paragraph”, the Olympian club (based at the Inowrocław prison) subject to the Polish Olympic Committee. The author participated in several such meetings as an invited guest or co-organizer and observed that they are primarily of a recollective character. But it was hard to find in them specific, praxeologically structured and conceptually implemented resocialization interactions. Teleological vagueness initiated the search for the real purpose of these meetings by means of observation. The meetings clearly appeared to have more of an ad hoc (referring to the conditions in prison) than a prospective character (undertaken with a view to the period after release). These findings were the inspiration for the development of the main objectives of a two-step strategy of a change in scenarios of the meetings between the convicts and athletes, the ultimate goal of which was to give them the characteristics of programmed rehabilitation. They defined the procedure for involving sportsmen to accomplish the objectives in the area of mental health and social development and made the selection and development of tools to measure the effects of these interactions. The article is a report on research designed to determine differences in perception of health, as well as on conducting health activities among those inmates who participated in the program “Active today, different tomorrow” and those who did not participate in it. The study involved 67 penitentiary recidivists. Two questionnaires by Siegfried Juczyński were used: the List of Health Criteria and Health Behaviour Inventory. The results gave the possibility to formulate important methodological implications for practitioners who involve prominent sportsmen in resocialization. They also proved useful in efforts to create another resocialization program that uses sports activity in resocialization.

Health perceptions in Latin America

The influence of cultural patterns and economic conditions on health perceptions in Latin America is studied using the results of the 2007 Gallup World Poll. The differences in health satisfaction between countries around the world have a robust association with variables that may reflect cultural differences rather than with aggregate economic variables or traditional health indicators. Simple health self-rating indicators reveal huge cultural differences in health perceptions in Latin America. However, within each country, differences correlate strongly with individuals' economic and health conditions. Lower-income groups recognize more health problems, but are less tolerant of some of them than the rich.

Extra Burden of Psychosomatic Complaints Among Adolescents Suffering From Chronic Conditions

To determine whether there are differences in health perception and health care use among adolescents with psychosomatic symptoms (PS), with chronic conditions (CCs), and with both conditions compared with healthy controls. By using the SMASH02 database, 4 groups were created: youths with PS but no CCs (N = 1010); youths with CCs but no PS (N = 497); youths with both psychosomatic symptoms and chronic conditions (PSCC, N = 213); and youths with neither PS nor CC (control, N = 5709). We used χ(2) tests and analysis of variance to compare each variable between the 4 groups. In a second step, all health and health care use variables were included in a multinomial regression analysis controlling for significant (p < .05) background variables and using the control group as the reference. Overall, PS and PSCC youths were significantly more likely to rate their health as poor, to be depressed, and to have consulted several times their primary health care provider or a mental health professional than their healthy peers. With the exception of being depressed, PSCC adolescents reported worse health perception and higher health care use than CC and PS. Although PS youths do not define PS as a CC, it should be considered as one. Moreover, having PS represents an additional burden to chronically ill adolescents. Health professionals dealing with adolescents must be aware of the deleterious health effects that PS can have on adolescents and have this diagnosis in mind to better target the treatment and improve their management.

Work and health: A comparison between Norwegian onshore and offshore employees

The effect of work-related variables on self reported health complaints were examined among Norwegian onshore and offshore oil workers. Differences in work and health perceptions were also examined as part of the paper. Employees working onshore and offshore in the maintenance and modification division of a large contractor company took part in the study (N=414, response rate 47.1%). The design of the study was a cross-sectional survey. A questionnaire was distributed to onshore personnel while at work - in cooperation with the personnel safety representative - and sent to the home addresses of the offshore personnel. Offshore workers perceived significantly more hazards associated with the work and experienced less control over the work pace compared to onshore workers. Onshore workers experienced significantly more pressure at work and their work tasks as more repetitive. Differences in health perceptions were identified in terms of job type in the onshore and offshore groups respectively. Different work-related factors influenced the self-reported health complaints among onshore and offshore workers. Workers in different work environments and in different job types encounter different type of threats to employee health, indicating that job type must be taken into account when studying the relationship between work-related factors and employee health.

The long-term outcome after severe trauma of children in Flanders (Belgium): a population-based cohort study using the International Classification of Functioning—related outcome score

Important long-term health problems have been described after severe paediatric trauma. The International Classification of Functioning (ICF) was developed as a universal framework to describe that health. We evaluated outcome in children after ‘severe’ trauma (defined as: hospitalised >48 h) by means of a questionnaire based on this ICF construct (IROS). Questionnaires were sent to children; one year after this trauma and to ‘control’ children without any previous ‘severe’ trauma. We created propensity score-matched pairs (n = 133) and evaluated differences in health perception. IROS characteristics were investigated by means of Item Response Theory models. We then estimated the health state of each individual based on his/her response pattern (factor score z01) and investigated the effect of selected covariates with simple linear regression. Significant odds ratios for differences between matched groups (p < 0.05) were observed for among others emotional problems, mobility, societal life and family burden, but not for chronic pain. Children in the trauma group showed, e.g. significant more physician (estimated relative risk R′ 1.7) and psychologist (R′ 3.5) visits. IROS primarily provides information from medium to high health burden levels and factor scores ranged from 0.41 (lowest) to 0.967 (highest burden). A significant impact on health burden could only be proven for the ‘state at discharge’ (p = 0.015), although there was a tendency towards worse factor scores for children that were older, had a higher Injury Severity Score or after traffic injury. In conclusion, we showed that the burden of health problems for children and families after severe trauma is still high and physical, as well as psychosocial in nature. The health state at discharge seems to predict long-term outcome, which might be of importance in view of, e.g. trajectory assistance. IROS may provide an improved scoring system to evaluate outcome after (paediatric) injury or critical illness.Electronic supplementary materialThe online version of this article (doi:10.1007/s00431-010-1271-y) contains supplementary material, which is available to authorized users.