Dimensions Of Health Research Articles

Interplay of age, gender, education, and heart rate in dementia among older adults in Wakiso, Uganda: a cross sectional study

Background In this cross-sectional study conducted in Wakiso, Uganda, from May to July 2023, we investigated the interactions among age, sex, education, and heart rate in relation to dementia and Mild Cognitive Impairment (MCI) among individuals aged 65 years and older. Methods We purposively sampled 106 participants, focusing on those with Alzheimer’s disease and related dementias, leveraging collaborations with local health teams. Data collection involved comprehensive questionnaires covering sociodemographic details and health parameters, and employed the Montreal Cognitive Assessment Tool for dementia screening. Results Our findings highlight a nuanced landscape of risk factors; each additional year of age was associated with a 1.19- and 1.22-times increased risk of MCI and dementia, respectively. Gender analysis revealed a protective effect against MCI in males, but no significant impact on dementia risk. Education emerged as a protective factor, with each additional year associated with a 28% reduction in MCI risk, although its effect on dementia risk remains ambiguous. Significantly, an elevated heart rate was strongly linked to an increased risk of both MCI and dementia, underscoring the potential cardiovascular dimension in cognitive health. Conclusions This study contributes to the understanding of the complex interplay of risk factors for dementia, emphasizing the need for further research to elucidate the underlying mechanisms and interventions for healthy cognitive aging in the older adult population.

Abstract PO2-17-03: Patient reported outcomes (PROs) and survival with toremifene versus aromatase inhibitors (AI) in patients with moderate/high-risk premenopausal hormone receptor (HR)-positive breast cancer: A real-world study

Abstract Background: The selective estrogen receptor modulator (SERM) toremifene, a synthetic analogue of tamoxifen, has shown similar efficacy to tamoxifen in patients with HR-positive breast cancer and is widely used in China for the treatment of premenopausal women with breast cancer. Multiple studies have confirmed the benefit of ovarian function suppression (OFS) combined with AI and SERMs in premenopausal women with HR-positive breast cancer. However, to date, there are no data comparing the efficacy and safety of toremifene plus OFS versus AI plus OFS. In this real-world study, we compared PROs and survival with toremifene or AI combined with OFS in patients with moderate/high-risk premenopausal HR-positive breast cancer. Methods: We enrolled premenopausal female patients with HR-positive, moderate/high-risk breast cancer who received OFS combined with toremifene or AI between January 1, 2010 and December 31, 2017 at the Breast Cancer Center of Sun Yat-sen Memorial Hospital. The primary endpoint was PROs, which were collected from January 1 to March 31, 2023, including the SF-36 and five-level EuroQol five-dimensional (EQ-5D-5L) questionnaires. Disease-free-survival (DFS) and safety were secondary endpoints. Associations between treatment group and SF-36 scores were evaluated using a Student’s t test and between treatment group and EQ-5D-5L scores using nonparametric tests. DFS was assessed using the Kaplan–Meier method and Cox regression. Results: A total of 392 patients were enrolled; 171 (43.6%) received toremifene and 221 (56.4%) received AI. Mean ± standard deviation scores for the role physical and general health dimensions of SF-36 were higher in the toremifene group versus the AI group (7.44±1.21 vs 7.15±1.48, P=0.034 and 22.90±3.95 vs 21.78±4.33, P=0.009, respectively). Scores on the anxiety/depression (AD) dimension of EQ-5D-5L were significantly different between the toremifene and AI treatment groups (mean rank: 184.14 vs 206.07, P=0.038); ‘no problems’ was selected by 49.7% and 37.1% of patients in the toremifene and AI groups, respectively. There were no significant differences in the other dimensions of SF-36 and EQ-5D-5L between the toremifene and AI groups (P>0.05). Similar estimated 5- and 8-year DFS rates were reported for the toremifene and AI groups; 96.5% (95% CI: 93.7-99.2) and 91.9% (95% CI: 88.2-95.5), and 87.4% (95% CI: 81.1-93.8) and 87.8% (95% CI: 81.1-94.4), respectively, and the hazard ratio for DFS was 0.75 (95% CI: 0.38-1.46), P=0.39. DFS was also comparable in the two treatment groups when stratified by HER2 status, age (≤40y vs >40y) and estrogen receptor expression level (≤20% vs >20%). Adverse event rates were generally similar in the two treatment groups, except for a higher rate of endometrial thickening (17.5% vs 1.8%, p< 0.001) and a lower rate of morning stiffness (7.6% vs 14.5%, p< 0.001) in the toremifene versus the AI group. Conclusion: Patients who received toremifene plus OFS had better role physical and general health dimensions on SF-36 and AD dimensions of EQ-5D-5L than those receiving AI plus OFS. There were no significant differences in 5- or 8-year DFS between the toremifene and AI groups. Both treatments were generally well tolerated. Citation Format: Yaping Yang, Fengxia Gan, Wenqian Yang, Yuan Xia, Qiang Liu, Chang Gong. Patient reported outcomes (PROs) and survival with toremifene versus aromatase inhibitors (AI) in patients with moderate/high-risk premenopausal hormone receptor (HR)-positive breast cancer: A real-world study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-17-03.

Adverse childhood experiences and smoking status in children: A systematic review and meta‐analysis

AbstractAdverse childhood experiences are a factor that can have a broad impact on different dimensions of health in different eras. This research aimed to investigate the relationship between adverse childhood experiences and smoking in children through a systematic review and meta‐analysis. Three databases, including PubMed, Web of Science and Scopus, were selected for manuscript searches. These three databases were searched until July 2022. This search was limited to English. For this study, the odds ratio or risk ratio and 95% confidence interval were extracted. The odds ratio pool was performed using the random‐effects method reported. An analysis was done based on the types of adverse childhood experiences and an analysis based on sex. The year of publication of the earliest and last publication included in this analysis was, respectively, 2003 and 2022. After screening the manuscripts, finally, 39 studies remained for this study. Adverse childhood experiences are associated with an increased risk of smoking in children [odds ratio 1.69; CI = 1.55–1.85; z = 11.80; p < 0.001; I2 = 92.6%]. Components of adverse childhood experiences, including emotional abuse, emotional neglect, physical abuse, physical maltreatment and physical neglect, were associated with increased smoking. The present study showed that adverse childhood experiences provide a context that increases the possibility of smoking in children. It is necessary to pay attention to the dimensions of health and behaviour in this group.

Dual-factor Models of Mental Health: A Systematic Review of Empirical Evidence.

Objective: Dual-factor models of mental health propose that mental health includes two interrelated yet distinct dimensions - psychopathology and well-being. However, there is no systematization of the evidence following these models. This review aims to address the following research question: what evidence exists using dual-factor models? Method: The current systematic review was conducted using PRISMA guidelines on the following databases: Web-of-science, Scopus, Academic Search Complete, APA PsycArticles, APA PsycInfo, Psychology and Behavioral Sciences Collection, ERIC, and MEDLINE. The screening process resulted in 85 manuscripts that tested the assumptions of dual-factor models. Results: Evidence revealed psychometric substantiation on the two-dimensionality of the dual-factor model, and 85% of the manuscripts provided evidence related to classifying participants into different mental health groups. Most studies showed that the Complete Mental Health or Positive Mental Health group is the most prevalent status group, and longitudinal evidence suggests that most participants (around 50%-64%) remain in the same group across time. Regarding the factors associated with mental health status groups, studies reviewed in this manuscript focus mainly on school-related outcomes, followed by supportive relationships, sociodemographic characteristics, psychological assets, individual attributes, physical health, and stressful events. Conclusions: This review highlights the importance of considering the two dimensions of mental health when conceptualizing, operationalizing, and measuring mental health. Fostering mental health must go beyond reducing symptoms, and practitioners would be able to include well-being-related interventions in their regular practice to improve individuals' mental health outcomes.

Sex-based differences in TB treatment compliance: A mediating factor for sputum conversion among newly diagnosed pulmonary TB patients in Chennai, South India

BackgroundTuberculosis (TB) remains a global health concern, particularly in India, which carries a significant portion of the global burden. The role of sex as a determinant of health is increasingly recognized, impacting various aspects of TB, including treatment compliance and outcomes. This study aimed to determine the mediating role of treatment compliance in the relationship between sex and sputum conversion in newly diagnosed pulmonary TB patients in Chennai, South India. MethodsWe conducted a retrospective cohort study among patients newly diagnosed for TB at ESIC Medical College & PGIMSR between April 2020 and April 2022. A causal mediation analysis was performed to identify the direct and indirect effects of sex on sputum conversion via the mediator, treatment compliance. We employed logistic regression models and the “paramed” package for the analysis, with bootstrapping technique for examining the significance of indirect and direct effects. ResultsThe Marginal Total Effect (MTE) suggested that females were more likely to have sputum positivity compared to males (OR: 6.77; p = 0.003). Direct effect of being female increased the odds of sputum positivity at the end of the intensive phase (OR: 3.42; p = 0.03). The indirect effect of being female via treatment compliance significantly increased the odds of sputum positivity at the end of the intensive phase (OR: 1.98; p = 0.03). ConclusionThe study provides evidence that treatment compliance significantly mediates the relationship between sex and sputum conversion in TB patients, highlighting the necessity to consider gendered dimensions of health in TB control strategies.

Assessing the Social Dimension of Health in Rural India: A Transverse Study

Abstract Introduction: Social health will be formed with the help of a healthy family, a healthy and communicating society, an individual having basic knowledge of good and healthy living practices, an individual giving equal respect to all genders and each age group, and full utilization of his productive time with his own choice of work. Promoting health and active participation of people in social and civic behaviors is considered one of the indicators of youth development. The present study focuses on assessing the social health status of study participants in rural areas in terms of illiteracy, gender discrimination, unemployment, and substance abuse. Objectives: To assess the social health profile of the study population (illiteracy, unemployment, male gender preference, and domestic violence) and to associate the social health profile with the demographic profile of the study participants. Materials and Methods: The present study is a cross-sectional study done at the Rural Demographic Surveillance Site of the Native Institute. A total of 430 individuals in the 15–59 years age group, both male and female, were included in the study. Data are analyzed using percentage, proportion, mean, and standard deviation. The association between social health problems and demographic factors was estimated by confidence interval, significance level. Results: The most prevalent social health problem among the study participants was unemployment (45%), followed by illiteracy (43%), substance abuse (18%), domestic violence (11%), and attitudes favoring male gender preference (7%) in the descending order. On correlation analysis, illiteracy found to be associated with age, gender, marital status, family type, education, occupation, and socioeconomic status (SES). Male gender preference attitude is associated with age, marital status, education while domestic violence is associated with age, gender, marital status, education, occupation, and SES. Unemployment found to be associated with age, gender, marital status, education, occupation, and SES. Substance abuse is associated with age, gender, marital status, and type of family. On multivariate analysis, unemployment was found to be associated with gender, illiteracy was associated with age, gender, and type of family, substance abuse was found to be associated with age, gender, and education level, and attitudes favoring male gender preference were found to be associated with marital status, age, and education level. Conclusion: Various social health problems are prevalent in rural India, and these problems are not only associated with education level but also dependent on various other factors. A targeted approach can help reduce these problems and ultimately improve the social health status of rural populations.

The Association of Multidimensional Sleep Health With HbA1c and Depressive Symptoms in African American Adults With Type 2 Diabetes.

Sleep is important for diabetes-related health outcomes. Using a multidimensional sleep health framework, we examined the association of individual sleep health dimensions and a composite sleep health score with hemoglobin A1c (HbA1c) and depressive symptoms among African American adults with type 2 diabetes. Participants (N = 257; mean age = 62.5 years) were recruited through local churches. Wrist-worn actigraphy and sleep questionnaire data assessed multidimensional sleep health using the RuSATED framework (regularity, satisfaction, alertness, timing, efficiency, duration). Individual sleep dimensions were dichotomized into poor or good sleep health and summed into a composite score. HbA1c was assessed using the DCA Vantage™ Analyzer or A1CNow® Self Check. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Regression models examined the association of individual sleep dimensions and composite sleep health with HbA1c and depressive symptoms. Higher composite sleep health scores were associated with a lower likelihood of having greater than minimal depressive symptoms (PHQ-9 ≥ 5) (odds ratio [OR] = 0.578, 95% confidence interval [CI] = 0.461-0.725). Several individual sleep dimensions, including irregularity (OR = 1.013, CI = 1.005-1.021), poor satisfaction (OR = 3.130, CI = 2.095-4.678), and lower alertness (OR = 1.866, CI = 1.230-2.833) were associated with a greater likelihood of having depressive symptoms. Neither composite sleep health scores nor individual sleep dimensions were associated with HbA1c. Better multidimensional sleep health is associated with lower depressive symptoms among African American adults with type 2 diabetes. Longitudinal research is needed to determine the causal association between multidimensional sleep health and depressive symptoms in this population. ClinicalTrials.gov identifier NCT04282395.

Linking ecosystems to public health based on combination of social and ecological systems

Promotion of public health is one of the most important benefits of ecosystems. Nevertheless, the relationship between ecosystems and social health’ needs is not well understood. Therefore, a study was done to investigate the potential of natural (forests and rangelands) and artificial (urban parks and gardens) ecosystems in ensuring the five dimensions of public health (i.e. physical, mental, spiritual, social and environmental) in the social systems (urban and rural societies). Therefore, 47 health indicators were used in order to relate different ecosystems and social’ needs to five dimensions of public health through questionnaire. The results indicated that natural ecosystems had the greatest potential in providing mental, spiritual and environmental health due to ecological characteristics of wilderness and aesthetic. The artificial ecosystems had the greatest potential in providing physical and social health due to their easy access. However, there was a match between social health’ needs and ecosystem potential in the rural areas. The study highlighted the need for promotion of ecological indicators related to mental health in urban areas by enhancing silence and aesthetic in artificial ecosystems. Presented framework can provide comprehensive information on the weaknesses and strengths of different ecosystems to promote public health based on social needs and fixing the weaknesses of artificial ecosystems in urban areas.

Sleep Patterns and Traditional Cardiovascular Health Metrics: Joint Impact on Major Adverse Cardiovascular Events in a Prospective Cohort Study.

This study examines the association between traditional cardiovascular health (CVH) metrics and major adverse cardiovascular events (MACE) incidence in individuals with diverse sleep patterns. We analyzed data from 208 621 participants initially free of cardiovascular disease (CVD) in the UK Biobank study. Sleep patterns were assessed using scores for chronotype, duration, insomnia, snoring, and daytime dozing. Traditional CVH scores were derived from the Life's Simple 7 metrics. Cox proportional hazards multivariate regression assessed associations between distinct combinations of CVH and sleep scores and MACE, including nonfatal myocardial infarction, nonfatal stroke, and CVD mortality. Over a mean follow-up of 12.73 years, 9253 participants experienced incident MACE. Individuals with both a healthy sleep pattern and ideal CVH levels had the lowest MACE risk compared with those with a poor sleep pattern and poor CVH levels (hazard ratio, 0.306 [95% CI, 0.257-0.365]; P<0.001). Elevated CVH scores were associated with a reduced risk of MACE across different sleep patterns. Similar trends were observed for individual MACE components, heart failure, and all-cause mortality. These findings remained robust in sensitivity analyses and across various subgroups. In individuals without known CVD, maintaining a favorable sleep pattern and achieving optimal CVH levels, as measured by traditional metrics, were associated with the lowest MACE risk. Enhanced CVH significantly reduced CVD risk, even in individuals with a poor sleep pattern. These results emphasize the importance of considering multiple dimensions of sleep health alongside CVH to mitigate CVD risk. URL: https://www.ukbiobank.ac.uk; Unique identifier: 91090.

Spiritual Health Status and Related Factors Among Medical Students in Kermanshah

Background: Spirituality constitutes an integral aspect of health, encompassing religiosity and spirituality, and is deemed essential alongside physical, mental, and social well-being, contributing to individual and societal health development. Objectives: This study aims to assess the level of spiritual health and its associated factors among medical students at Kermanshah Medical School. Methods: This research employed a cross-sectional descriptive design. The study population comprised 258 medical students in Kermanshah, selected through random and available sampling methods. Data were collected using a standardized questionnaire for evaluating spiritual health in Iranian society, developed by the Academy of Medical Sciences. The questionnaire consists of 48 items, measuring behavioral, attitudinal, and perceptual dimensions. Its reliability and validity have been established by Amiri et al. using Cronbach's alpha method. Data analysis was conducted using SPSS-23 software. Results: The mean age of participants was 21.59 years, with 50.4% females and 94.6% single individuals. A majority (59.3%) were enrolled in basic science, and 73.4% lived with their parents. The average spiritual health score among students was 205.03. Female and single students scored higher than male and married counterparts, respectively. Additionally, students residing in dormitories or private homes scored higher than those living with their parents. There was a significant difference between genders and academic disciplines, particularly in the dimensions of attitude and overall spiritual health. Moreover, students' living arrangements significantly influenced their scores in terms of attitude and overall spiritual health. Conclusions: The overall spiritual health score among medical students was relatively low, with higher scores observed in the areas of attitude and perception compared to behavioral aspects.

Why did this happen to me? Causal attributions of illness and cultural health capital

This study examines how conversations between patients and clinicians about the causes of their health conditions relate to patient engagement in care. Leveraging cultural health capital (CHC) theory, we find that patient-physician discussions of health attributions are one mechanism to build patient understanding and activate engagement. We present a qualitative interpretive analysis of data collected in three phases with adult home health care patients: phone interviews (n = 28), field observations (n = 61), and semi-structured field interviews (n = 38). We find that engaging in discussions of causal health attributions with clinicians enables patients to overcome uncertainty, envision preventive actions, and engage in setting future goals. Such discussions must be supported by acknowledgement of the co-responsibility of individual factors and structural factors such as social determinants of health. These discussions are not easy to navigate but they can potentially help patients transition from a mindset of treating the disease (pathogenic approach) to an awareness of their available capabilities to improve health (salutogenic approach). This study contributes to research on attribution theory and cultural health capital theory by demonstrating how discussing causes for poor health can enable patients resolve doubts and accrue instrumental and symbolic resources that facilitate healing.

A Step towards Sustainability of Qualitative Life in Juvenile Delinquents

Juvenile delinquency is a complex social problem that affects the individual in all strata of society. It implies the involvement of juveniles in activities which is illegal by the law. These antisocial acts of juveniles can be due to an inappropriate upbringing, lack of emotional support and material deprivation of family. Therefore, this study aimed to look at quality of life and psychological health among juvenile delinquents in Udaipur. Subjects for this study were 30 juvenile delinquents using a purposive sampling technique, 15 boys and 15 girls between 14-18 years of age who were undergoing institutionalized in two rehabilitation centers. Quality of life scale was used to measure quality of life and self-structured questionnaire was used to assess psychological health. The Pearson correlation showed that there was positive correlation between psychological health and all the six dimensions of psychological health: spirituality/religion/personal beliefs and thinking/learning/memory and concentration. In the light of research findings, we recommend a strong need to educate every child this may further help to eradicate poverty. There is also a strong need on the part of parents to keep check on their children in this way they will restrain them to develop delinquent personality.

Study on Predictor Variables for Different Dimensions of Mental Health among Melavoi Village of Covid-19 Affected Young Adults Living in Anantapuram District, Andhra Pradesh

Early adulthood is an extremely diverse period of life. it encompasses a wide range of lifestyle choices and responsibilities. The pandemic has impacted the mental health of young adults very severely. Covid-19 pandemic there has been an increased risk of psychiatric disorders, chronic trauma with an eventual risk of increased suicidality and suicidal behavior linking this to immune mediated mechanisms of stress. For better dealing with these psychosocial issues of different strata of the society, psychosocial crisis prevention and intervention models should be urgently developed by the government, health care personnel and other stakeholders. Apt application of internet services, technology and social media to curb both pandemic and infodemic needs to be instigated. The main focus of the study was to swot on “Study on predictor variables for different dimensions of mental health among Melavoi village of Covid-19 affected young adults living in Anantapuram district, Andhra Pradesh”. Purposive random sampling technique was selected for the study. The respondents were selected from Melavoi village of Anantapuram district, Andhra Pradesh. Male and Female who are in the age group of 18-35 years affected with Covid-19 was selected for the study. The group consists of 30 Covid-19 affected young adults of 15 males and 15 females from Melavoivillage for the study. The study found that Covid-19 outbreak made respondents to experience lot of mental health problems like emotional distress, anxiety, stress, despair, dissatisfaction, impatience irrespective of gender.

Analysis of Organizational Capacity Development National Food Agency

National food security is the nation's main capital in realizing prosperity and increasing competitiveness and facing global challenges. In response to these conditions, the Government has taken a number of steps to improve national food management, one of which is through Law No. 18 of 2012 regarding Food and its derivative regulations which mandate the formation of a National Food Agency. Nearly three years after its formation, the performance of the National Food Agency still has a number of obstacles in terms of limited infrastructure, limited budget, limited human resources, and performance indicators that are not in accordance with the authority of the Agency. The article entitled Analysis of Organizational Capacity Development of the National Food Agency aims to analyze the development of the organizational capacity of the National Food Agency so that it is able to carry out its duties and functions optimally through the concept of organizational capacity development theory. Data collection in this research used a qualitative approach through analysis of literature studies from journals, books and statutory regulations documents as well as making observations, then comparing the results of the literature study collection and observations. Based on the analysis that has been carried out, the organizational capacity of the National Food Agency needs to be increased through development in the dimensions of staffing, human resources , resource development, financial health, and financial systems, and strategic planning, mission, and vision.

Health, psychosocial and cognitive factors associated with anxiety symptoms

Anxiety disorders are the most prevalent psychological conditions among adults worldwide. However, further research is needed on the role of variables such as health indices, stressful events, social cognition, and executive functioning in predicting anxiety symptoms. We conducted two studies to explore the association between these variables and anxiety symptoms in adults. In the first study, we evaluated 548 participants ranging in age from 18 to 73. We administered two anxiety scales and two instruments to assess physical and mental health dimensions and the number of threatening life events experienced. A subsample of 275 participants participated in the second study, where they completed tasks measuring working memory, verbal fluency, and emotion recognition. We used linear regression models to identify the relationship between participants’ anxiety levels and demographic, health, and psychosocial variables. In the first study, our findings revealed that participants with poorer mental and physical health and those who had experienced more stressful events displayed higher anxiety levels. Age, sex, physical and mental health were significant predictors of anxiety scores. In the second study, we identified negative correlations between anxiety and social cognition and executive function scores. However, only executive functions emerged as a predictor for anxiety. Overall, the factors of sex, age, mental and physical health, and executive function performance appear to be relevant in understanding anxiety levels and symptoms in adults.

The “bubbles”-study: validation of ultra-short scales for the assessment of positive mental health, life satisfaction, and perceived social support

Abstract Aim The positive dimension of mental health should be considered to assess the complete state of a person’s mental health and to protect it. Very brief valid screening instruments implemented in general mental health programs and in therapeutic setting are supportive tools hereby. In the present work, we aimed to develop such tools. Subject and methods In two studies (Study 1: N = 1,004; Study 2: N = 1,000) on representative German population samples, we developed and validated three ultra-short scales – the “bubbles” – that consist of only one item per construct based on Positive Mental Health Scale (PMH-Scale; Lukat et al. 2016), Satisfaction with Life Scale (SWLS; Diener et al. 1985), and Social Support Questionnaire (F-SozU K-6; Lin et al. 2019) for the assessment of the positive mental health dimension. The bubbles are designed in a graphical/visual format. Results The results of Study 1 and Study 2 revealed that the bubbles are valid instruments that fit the original instruments on the factor level; the bubbles mostly replicated their association pattern with demographic variables, and with variables that belong to the negative and the positive dimension of mental health. Conclusions The shortness of the bubbles prevents participants’ fatigue and motivation decrease. Thus, due to their time- and cost-efficiency, the bubbles can be used as brief screening tools in research (e.g., large-scale studies, longitudinal studies, experience sampling paradigms) and in praxis (e.g., mental health programs). Future research should validate the bubbles in clinical context and cross-national.

Factors influencing consumers’ green purchase behavior for sustainable organic food by Botswana university students

Sustainability issues are increasingly becoming important in business and society with many businesses in the food sector adopting green organic food production. The understanding of factors influencing consumers' green purchasing behavior will be more important to food marketers. The purpose of this study was to investigate the factors influencing consumers' green purchasing behavior for sustainable organic food by Botswana university students. To achieve this purpose the study followed an investigative qualitative approach. In-depth interviews were used to gather data. A sample of 15 university students was selected using a purposive sampling method. A thematic and narrative analysis method was used for this study. Results show that the factors influencing university students' green purchasing behavior for organic foodstuffs are multi-faceted. These factors include selection criteria such as price. distribution, product performance, and health attributes), consumers' environmental consciousness (environmental awareness, environmental knowledge), and consumers' green attitudes. The practical implications are that the businesses involved in organic food need to intensify the promotion and education of consumers on green and sustainable organic foods. The focus should be on the impact of green products on society, people, and the environment.

Healthy life expectancy: acritical look at the benefits and potential of the demographic health indicator

Demographic ageing yields many societal consequences that depend strongly on the health status of the population. Special indicators have been developed for tracking and assessing population health, which are referred to with the overarching term healthy life expectancy (HLE). The derivation of HLE is intuitive and easily comprehensible. However, an overly simplistic interpretation hides the extreme complexity inherent in adding the health dimension to the life table. This makes HLE compared to classic life expectancy (LE) extremely sensitive to certain conceptual and methodological features. In the article, this is presented in more detail for three aspects: the underlying definition of health, the choice of survey data as abasis for estimating health status, and the reporting behavior of survey participants. It is shown that the impact on HLE can be enormous, leading to considerable bias in the interpretation of levels and trends, but also in the analysis of differences between populations. Nevertheless, the extension of classical LE to HLE is an important achievement that must not be abandoned. Therefore, the article also discusses ways in which the HLE indicator could be made more robust and reliable. Until this is achieved, however, the high methodological sensitivity of HLE must not be ignored if it is used to assess the health status of populations and as abasis for health policy measures.

Exposure to maternal experiences of IPV in early childhood and sleep health in adolescence

BackgroundHalf of US women will experience intimate partner violence (IPV), and nearly all children in families experiencing such violence will be exposed. The negative effects of IPV exposure on children's mental and physical health are well-documented; however, less is known about effects on children's sleep health, a key marker of well-being. ObjectiveThis study examines the associations of early childhood exposure to maternal experiences of IPV with sleep health in adolescence, focusing on multiple dimensions of sleep health and differences by child sex. Participants and settingWe rely on data from the Future of Families and Child Wellbeing Study, a population-based study following 5000 children in large US cities, from birth to age 15. Analyses are based on 2687 adolescents interviewed at the year-15 follow-up. MethodsEarly childhood exposure to IPV is based on mothers' reports of her experiences of IPV from the child's birth to age 5. Adolescent sleep health is measured using 6 items approximating the BEARS sleep problem scale, at age 15. We estimate multivariate linear regression models to examine associations of early childhood IPV exposure with adolescent sleep health and stratify models by child sex. ResultsEarly childhood IPV exposure is associated with worse overall sleep health (β = 0.08; p < 0.001) and multiple dimensions of poor sleep health in adolescence. Associations are notably stronger among girls than boys. ConclusionsThe strong and lasting associations of early childhood exposure to IPV with adolescents' sleep health, particularly among girls, has important consequences for addressing adolescent health disparities.

Working effectively with consumers: Perspectives from students, teachers, nurses, and consumers.

Preparing enrolled nurses (ENs) to effectively work with mental health consumers is crucial to meeting Australia's healthcare demands. This qualitative study aimed to explore various stakeholders' perceptions regarding the mental health knowledge, skills, and attributes (KSAs) required by ENs to engage with individuals experiencing mental health issues, thus guiding future training priorities. The sample comprised 44 participants including 18 students, 3 graduate ENs, 5 experienced ENs, 5 registered nurses (RNs), 4 nurse unit managers (NUMs), 5 teachers, and 5 consumers of mental health services. Focus groups were used to collect data from the students, whilst individual interviews were conducted with all other participants. A thematic analysis revealed communication was the most vital skill for effectively working with mental health consumers. Skills such as critical thinking and clinical reasoning were also deemed crucial, given the volatile nature of the mental health inpatient environment, necessitating effective responses to acute escalations to prevent adverse outcomes for both staff and consumers. Essential knowledge components included understanding mental health disorders, symptoms, and treatments, particularly medications used for mental health issues. Participants also emphasised the importance of attributes like confidence and empathy in supporting and caring for consumers, who often experienced trauma and vulnerability. These findings provide valuable insights into the content that should be incorporated into the diploma of nursing (DN) training to produce competent graduate ENs.