General Health Behaviors Research Articles

Repercussions of Pandemic and Preventive Measures on General Well-Being, Psychological Health, Physical Fitness, and Health Behavior: Mediating Role of Coping Behavior.

Pandemic prevention measures increased physical inactivity due to travel restrictions that led to negative physical fitness, health behavior, psychological health, and general well-being. The mediating role of coping behavior must be identified before developing interventional strategies for this pandemic. The study investigates the mediating role of coping behavior to mitigate the Coronavirus disease impact on physical fitness, health behavior, psychological health, and general well-being. A web-based survey was used under convenience sampling to collect the primary data. Smart-PLS 3.0 was used to analyze the collected data. All 14 direct correlations (H1-H14) were correct, and coping behavior's mediating impact was shown to be statistically significant (H9a- H14d). Our study findings indicate that mediating role of coping behavior in mitigating the pandemic impacts was statistically significant. It is concluded that coping behavior is a healthy adaptation to protecting the barrier against COVID-19 adverse effects on health.

Oral health literacy and its associated factors among nurses: A cross-sectional study.

To investigate the oral health literacy (OHL) of nurses and explore the factors affecting their OHL. OHL is important for improving the oral health outcomes. Nurses' OHL may affect the oral health of themselves, families, and patients. Few studies have examined the OHL and its related factors among nurses. A cross-sectional design following the STROBE guideline. A total of 449 nurses were recruited from tertiary hospitals in the minority areas of southwest China. The participants completed an online questionnaire, which contained questions related to the OHL, sociodemographic factors, general health, oral health and related behaviours, oral health knowledge, attitudes, and oral health-related quality of life. OHL was measured using the validated Chinese version of the short-form Health Literacy of Dentistry (HeLD-14) scale. Descriptive statistics, the Mann-Whitney U test, Spearman's correlation, and multiple linear regression analysis were used to analyse the data. The median HeLD-14 score (p25-p75) was 50.0 (44.0-54.0). The regression model for OHL was found to be significant. The factors that influenced OHL included oral health knowledge, oral health attitudes, self-reported oral health, annual household income, and dental flossing; these factors accounted for 13.9% of the variance in OHL. The nurse' OHL has room for improvement. Nurses' OHL could be improved by enriching their oral health knowledge, promoting their positive oral health attitudes, increasing their household income, and helping them build correct oral health behaviours. The findings of the study could be used to make a case for changing nursing curricula. Oral health knowledge curriculum or programmes targeted towards nurses should be developed to improve their OHL. No Patient or Public Contribution.

The Increasing Salience of Health in Social Forces Research

Global life expectancy at birth approximately doubled during the 100-year history of Social Forces (Heuveline 2022; Riley 2005). As the average length of life of the individuals and their experiences in the communities and institutions studied in the journal increased, health became more salient to social and economic life. The increasing prominence of health, embodied by an individual’s continuing physical, emotional, mental, and social ability to cope with his or her environment over the life course, is reflected in the trend of health-related articles in Social Forces. A handful of health-related articles appeared during the decades from 1920 to 1960, followed by a small but steady flow of publications from 1970 to 2000, after which there has been more growth and diversity in health-related publications in the twentieth-first-century issues of Social Forces. The trend in health research within Social Forces has been driven by three factors: (1) the substantive relevance of health status, behavior, and healthcare (i) within societal structures and institutional contexts, (ii) in relation to social behavior, and (iii) as influenced by social stratification processes; (2) increasing availability of high-quality health data; and (3) increased attention to measurement of health. While much of the early health research published in Social Forces focused on mental health and mental health systems, over time as new surveys delivered a greater range of health measures, research soon included diverse measures of general health status, health behavior, and physical health indicators and change in them over time.

Poor Self-Rated Oral Health Status and Associated Factors Amongst Adults in Algeria

BackgroundUnderstanding the proportion and correlates of self-rated oral health (SROH) can assist in prioritising interventions. The aim of this study was to assess the prevalence of poor SROH and associated factors in a national community survey amongst adults in Algeria. MethodsThis World Health Organisation (WHO) STEPS cross-sectional survey in Algeria in 2016 and 2017 included 6989 people (18–69 years; median age, 37 years) selected by multistage cluster sampling. The assessment included questionnaire information, physical measures, and biochemistry tests. The measures included questions on SROH, oral conditions, oral health behaviour, general health behaviour, and measures of health status. ResultsThe sample included 6989 people aged 18 to 69 years. Of the total sample, 17.1% had removable dentures, 35.5% had 0 to 19 natural teeth, 43.9% had dental pain in the past year, 40.5% had impaired oral health–related quality of life (OHRQoL), 26.9% cleaned their teeth 2 times/d or more, 79.6% used toothpaste, and 41.2% had visited a dentist in the past year. The prevalence of poor SROH was 37.3%. In the final logistic regression model, older age (45–69 years) (adjusted odds ratio [AOR], 1.34; 95% confidence interval [CI], 1.09–1.65), having removable dentures (AOR, 1.46; 95% CI, 1.14–1.87), dental pain (AOR, 2.16; 95% CI, 1.82–2.57), impaired OHRQoL (AOR, 2.69; 95% CI, 2.26–3.20), current smokeless tobacco use (AOR, 1.45; 95% CI, 1.12–1.89), and inadequate fruit and vegetable intake (AOR, 2.69; 95% CI, 2.26–3.20) increased the odds of poor SROH. Men (AOR, 0.76; 95% CI, 0.65–0.90), having 20 or more teeth (AOR, 0.35; 95% CI, 0.28–0.42), twice or more a day teeth cleaning (AOR, 0.72; 95% CI, 0.60–0.86), and using toothpaste (AOR, 0.67; 95% CI, 0.55–0.82) were protective against poor SROH. ConclusionsAdults in Algeria reported a high prevalence of poor SROH, and several associated factors (sociodemographic, oral conditions, oral and general health–compromising behaviour) were found that can guide in oral health promotion strategies in Algeria.

The self-reported health of the Sámi in Sweden: the SámiHET study.

The Sámi are an ethnic minority and the only Indigenous people in the European Union. Population-based health studies among Sámi in Sweden are scarce and outdated. The aim of this study was to analyse the ethnic, Sámi vs. non-Sámi, health differences among men and women living in Sweden. This study combined two data sources: the national Health on Equal Terms (HET) survey and a similar study conducted among the Sámi population, the SámiHET study, both carried out during spring 2021. Twelve outcomes were used to capture different aspects of the population's health organized along four dimensions: general health, physical health, mental health and lifestyle behaviours. Prevalence ratios, adjusted for age, civil status, education and income, were used as the measure of effect with 95% confidence intervals to provide inference. Analyses were disaggregated by sex. The prevalence of poor self-rated dental health (and chronically ill health among men), asthma and overweight were higher among the Sámi; however, the mental health outcomes were similar or lower among the Sámi participants. The Sámi ate less vegetables and fruits, but they were smoking and drinking alcohol less than the national Swedish population. These patterns were similar among both men and women. Poor self-rated dental health, asthma, overweight and a low consumption of vegetables and fruits were a concern among the Sámi population in both men and women. These areas therefore require specific targeted interventions to decrease the observed ethnic health inequalities in Sweden. The design of this study opens the possibility for continuous monitoring of the health of the Sámi but also offers the best possible comparison with Swedish population health data.

Development of an acceptance based PrEP intervention (ACTPrEP) to engage young black MSM in the South utilizing the Adaptome Model of intervention adaptation

ObjectivesHIV disproportionately affects young Black men who have sex with men (YBMSM) in the Southern United States. Pre-exposure prophylaxis (PrEP) is an efficacious, biomedical approach to prevent HIV. While Mississippi (MS) has among the highest rates of new HIV infections, it also ranks among the top three states for unmet PrEP need. Thus, increasing engagement in PrEP care for YBMSM in MS is imperative. A potential method to improve psychological flexibility and promote PrEP uptake, explored by this study, is the incorporation of Acceptance and Commitment Therapy (ACT) into PrEP interventions. ACT is an evidence-based intervention used to treat a wide range of mental and physical illnesses. MethodsTwenty PrEP-eligible YBMSM and ten clinic staff working with YBMSM in MS were surveyed and interviewed between October 2021 and April 2022. The brief survey covered PrEP structural barriers, PrEP stigma, and psychological flexibility. Interview topics included internal experiences related to PrEP, existing health behaviors, PrEP related personal values, and relevant constructs from the Adaptome Model of Intervention Adaptation (service setting, target audience, mode of delivery, and cultural adaptations). Qualitative data were coded based on ACT and the Adaptome model, organized using NVivo, then thematically analyzed. ResultsPatients identified side effects, costs, and taking a daily prescription as top barriers to taking PrEP. Staff reported the top barrier to PrEP for clients was concern others would believe they were living with HIV. Levels of psychological flexibility and inflexibility varied widely among participants. The resulting thematic categories derived from the interviews included 1) thoughts, emotions, associations, memories, and sensations (TEAMS) related to PrEP and HIV, 2) general health behaviors (existing coping techniques, views on medication, HIV/PrEP approach and avoidance), 3) values related to PrEP use (relationship values, health values, intimacy values, longevity values), and 4) Adaptome Model adaptations. These results informed the development of a new intervention, ACTPrEP. ConclusionsInterview data organized by the Adaptome Model of Intervention Adaptation determined appropriate ACT-informed intervention components, content, intervention adaptations, and implementation strategies. Interventions informed by ACT that help YBMSM endure short-term discomfort related to PrEP by relating it to their values and long-term health goals are promising for increasing individuals’ willingness to initiate and maintain PrEP care.

Well-being of professional older adults’ caregivers in Alberta’s assisted living and long-term care facilities: a cross-sectional study

BackgroundFor the care need of older adults, long-term care (LTC) and assisted living (AL) facilities are expanding in Alberta, but little is known about the caregivers’ well-being. The purpose of the study was to investigate the physical health conditions, mental and emotional health (MEH), health behaviour, stress levels, quality of life (QOL), and turnover and absenteeism (TAA) among professional caregivers in Alberta’s LTC and AL facilities.MethodsThis cross-sectional survey involved 933 conveniently selected caregivers working in Alberta’s LTC and AL facilities. Standardised questions were selected from the Canadian Community Health Survey, Patient Health Questionnaire-9, and Short Form-36 QOL survey revalidated and administered to the participants. The new questionnaire was used to assess the caregivers’ general health condition (GHC), physical health, health behaviour, stress level, QOL, and TAA. Data were analysed using descriptive statistics, Cronbach alpha, Pearson’s correlation, one-way analysis of variance, and multiple linear regression.ResultsOf 1385 surveys sent to 39 facilities, 933 valid responses were received (response rate = 67.4%). The majority of the caregivers were females (90.8%) who were ≥ 35 years (73.6%), worked between 20 to 40 h weekly (67.3%), and were satisfied with their GHC (68.1%). The Registered Nurses had better GHC (mean difference [MD] = 0.18, p = 0.004) and higher TAA than the Health Care Aides (MD = 0.24, p = 0.005). There were correlations between caregivers’ TAA and each of MEH (r = 0.398), QOL (r = 0.308), and stress (r = 0.251); p < 0.001. The most significant predictors of TAA were the propensity to quit a workplace or the profession, illness, job stress, and work-related injury, F (5, 551) = 76.62, p < 0.001, adjusted R2 = 0.998.ConclusionReducing the caregivers’ job stressors such as work overload, inflexible schedule, and poor remuneration, and improving their quality of life, health behaviour, and mental, emotional, and physical health conditions may increase their job satisfaction and reduce turnover and absenteeism.

Analyzing Factors Enabling Prostate Cancer Screening Behaviors Among African American Males in the South Region Using the Andersen's Behavioral Model of Healthcare Services Utilization.

Prostate cancer is the second leading cause of cancer death among men in the United States, and African American men especially represent a high risk population for prostate cancer. Although the overall prostate cancer incidence rates have been declining since 1992, the average annual prostate cancer incidence rates among African American men were still higher than any other racial groups, and the mortality rates were 2.1 times higher than that of Caucasian men. This study examined what factors including cultural mistrust were related with the prostate cancer screening behaviors among African American males in the South East region. Out of 496 prostate educational seminar attendees, 304 volunteers completed the survey about the behaviors of prostate cancer, cultural mistrust for health providers and general health beliefs and health behaviors. Using Anderson's Behavioral Model of Health Services Use, hierarchical multivariate logistic regression analysis was conducted to identify which predisposing, enabling, and need factors could predict prostate cancer screening behaviors and whether there was any interaction effects among these predictors. Findings revealed that annual household income and annual health check-up were significantly related with the prostate cancer screening behaviors while the effect of health insurance was diminished among older African American males. Overall, results highlight the importance of financial resources as a determinant of prostate cancer screening behaviors among African American males implying the need of substantial support to overcome the obstacles from financial adversity.

Risky sexual behavior and self-rated mental health among young adults in Skåne, Sweden – a cross-sectional study

BackgroundRisky sexual behavior is a public health challenge that significantly affects young people’s health and well-being in Sweden and throughout the world. Moreover, poor mental health, anxiety and depression among adolescents and young adults have increased in recent years. However, although hypothesized, the associations between general mental health and risky sexual behavior among young adults are less established. Thus, this study aimed to examine the association between self-rated mental health and risky sexual behavior among young adults in southern Sweden.MethodsPopulation-based, cross-sectional survey data from 2968 participants aged 18–30 years old residing in southern Sweden was used (response rate 42%). The survey included questions on sexual behavior, alcohol habits, sociodemographic background, and mental health. Logistic regression was used to examine the associations between mental health, depression, anxiety, and risky sexual behavior, stratified by sex (gender). Indicators for risky sexual behavior included not using a condom, non-condom use with casual partner, and multiple (≥2) sexual partners during the last year.ResultsGenerally, male participants rated their depression and anxiety levels considerably lower than their female counterparts. Poor mental health, high depression, and high anxiety scores (levels) were significantly associated with having multiple sexual partners among among female participants; adjusted odds ratios (aOR) was 1.3 (95% CI 1.01 to 1.71). However, findings among males were not statistically significant. Furthermore, overall results indicated that higher depression and anxiety scores were associated with 1.4 and 1.6 higher odds, respectively, of not using condom with a casual partner in the most recent sexual encounter. Similarly, higher anxiety scores were associated with non-condom use in the latest sexual encounter, aOR 1.4 (1.1–1.7), but no significant gender-specific associations were found.ConclusionThe associations found between poor mental health factors and multiple sex partners among females warrant consideration in future public health interventions. Further research to increase the understanding of the causal mechanisms that link mental health factors and risky sexual behavior, especially multiple sex partners, among young adult females is needed to support evidence-based interventions.

지역사회 1인 가구의 특성이 건강행동에 미치는 영향: 서울시 2개 자치구 비교

Objectives: This study aims to compare health behaviors of one-person and multi-person households between two districts in Seoul to identify the causes of community differences in health behaviors. Methods: Two districts (Districts A and B) in Seoul with similar levels of economic development but different levels of health outcomes were selected. Community health survey data (2018-2020) revealing the health behaviors of the two districts’ residents were used. The general characteristics and health behaviors of one-person and multi-person households were compared between the two districts using a chi-test. After controlling for socio-economic level, logistic regression analysis was performed considering sex and age of the household members. Results: The results showed that one-person households in district A were less likely to practice non-smoking and low-risk drinking than multi-person households but engaged in more walking. In District B, one-person households were ahead of multi-person households in practicing various health behaviors, including low-risk drinking and walking, except non-smoking. Young one-person households in District A practiced less healthy living, non-smoking, and low-risk drinking than multi-person households. Among young women and middle-aged people in District B, one-person households practiced less healthy living, non-smoking, and walking than multi-person households. Conclusion: It was confirmed that differences in health behaviors between one-person and multi-person households can further be understood by including socio-demographic characteristics such as age and gender in the analysis.

AGE DIFFERENCES IN DEPRESSION AND ANXIETY LEVELS OF OPEN HEART SURGERY PATIENTS

Abstract Age, as well as gender, are key demographic measures in cardiac patients. Further, depression and anxiety have been long established to be comorbidities of heart disease (HD). In this prospective study, to examine the impact of age and gender in preoperative depression and postoperative anxiety symptoms of HD patients receiving open heart surgery (OHS), we collected two waves of survey data along with medical indices from patients at a top-10 heart center in the USA (n = 481, mean age = 62.18 ± 12.04, female 42%). The collected survey data included socio-demographic information (age, gender, race), religious affiliation and other religious factors, general health and health behaviors, medical comorbidities, cardiovascular health indices, dispositional optimism, hope, social support, depression symptoms, and anxiety symptoms. Statistical analysis was carried out using hierarchical linear regression analyses. Findings support that higher age correlates with increased levels of cardiac symptoms. Further, younger age was associated with higher levels of postoperative depression, while older age was associated with higher levels of postoperative anxiety. Higher levels of dispositional optimism were consistently associated with lower levels of both postoperative depression and postoperative anxiety regardless of age. Female gender had an impact on depression scores but not on anxiety scores. Findings suggest that medical practitioners might benefit from being more attentive to non-medical conditions such as mood states, dispositional optimism, and general positive expectations about the future in post-OHS life. The findings also suggest that there might be age and gender differences in expected postoperative psychosocial symptomology for OHS patients.

Interplay of health literacy, healthcare access and health behaviors with oral health status among older persons.

This study contributes to the ongoing debate on social determinants of oral health of older persons. Specifically, it examines the direct and indirect effects of health literacy and access to healthcare on oral health status of older persons. The study also investigates whether general health status and health behavior (routine medical check-ups) explain the association of health literacy and healthcare access with oral health status. The gender dimensions of these relationships are also explored. Data were derived from 522 participants aged 50 years and older located in five regions in Ghana. Path analyses in structural equation modeling (SEM) were used to analyse the data. General health status (β = -0.049, p < 0.005), medical check-up (β = 0.124, p < 0.01), and health literacy (β = 0.133, p < 0.01) were positively associated with oral health status. General health status mediated the positive relationship between health literacy and oral health status (β = 0.048, p < 0.01). General health status (β = 0.016, p < 0.05) and medical check-ups (β = 0.025, p < 0.05) mediated the association between access to healthcare and oral health status. The mediational role of routine medical check-up in the association between access to healthcare and oral health status was significantly stronger (B = 0.063, p < 0.01) among men (β = 0.051, p < 0.01) than women (β = 0.003, p > 0.05). Analyses of oral health issues among older persons in Ghana and settings alike must recognize the complex interplay among critical social determinants to initiate pragmatic health and social policy interventions.

Effects of Recreational Physical Activity on Abdominal Obesity in Obese South Korean Adults.

This study investigated the effects of general characteristics, health behaviors, and level of physical activity on abdominal obesity in obese adults (BMI (body mass index) ≥ 25 kg/m2) using data from the seventh period (2016-2018) of the Korea National Health and Nutrition Examination Survey (KNHANES). We also prepared basic data on the improvement and management of abdominal obesity. The participants were 2343 obese adults (men, 1338; women, 1005) from the KNHANES. Factors relevant to abdominal obesity in obese Korean women were general characteristics (age, marital status, occupation, education, and menopause) and health behaviors (time for recreational physical activities and energy intake). In men, these factors tended to be health behaviors, including time spent on leisure physical activity, and sitting. It was found that over 600 Mets/week of recreational physical activity for both adult men and women reduced the incidence of abdominal obesity after adjusting for general characteristics and health behaviors (odds ratio (95% CI); men 0.69 (0.51-0.92); women, 0.61 (0.40-0.94)). Therefore, to prevent or improve abdominal obesity in obese adults in Korea, it is necessary to consider general characteristics and health behaviors according to sex. In addition, maintaining a physical activity rate of over 600 Mets/week is also recommended.

Improving Health and Diabetes Self-Management in Immigrants with Type 2 Diabetes Through a Co-Created Diabetes Self-Management Education and Support Intervention

To examine the impact of a co-created culturally sensitive diabetes self-management education and support (DSMES) intervention on the physical and mental health of immigrants with type 2 diabetes (T2D). Pre- and post-test among people with T2D whose primary language was Urdu, Arabic or Turkish (n = 97). Participants were offered a six-week intervention based on a person-centred approach using research-based dialogue tools to facilitate learning and reflection, which was developed in co-creation with immigrants and healthcare professionals. Data were collected at baseline, post-intervention and after 6 months and analysed using paired t-tests, Wilcoxon signed-rank tests, chi-square tests and regression models when appropriate. Several clinical outcomes were improved post-intervention, including HbA1c (P < 0.001), body fat percentage (P = 0.002), self-rated general health (P = 0.05), well-being (P = 0.004) and several self-management behaviours, e.g., physical activity (P < 0.001). Most outcomes remained improved after 6 months, but the effect on HbA1c was no longer statistically significant. Some outcomes were improved only at 6 months, including waist circumference (P < 0.001) and diabetes-related emotional distress (P < 0.001). Fatigue did not change. Attendance at more programme sessions was associated with better outcomes. The DSMES intervention developed in a co-creation process was highly effective in improving the health of immigrants with T2D.

Being a refugee in childhood and health in adulthood

Abstract Aim To examine whether individuals who migrated to Sweden as refugees in childhood are more likely to experience poor mental and general health and violence in adulthood, compared to individuals born in Sweden, or who were migrants but not refugees. Methods This study included 151,614 individuals who answered the Swedish National Public Health Survey in 2018 or 2020. We grouped the participants into refugees in childhood, migrants in childhood, or non-migrants. Information about outcomes - mental health, general health, and risk behaviors - was collected through questionnaires. We analyzed the associations using logistic regressions. Results Overall, having been a refugee in childhood was generally not associated with poor general health and mental ill-health, risk behaviors, or exposure to violence, compared to those who were migrants or born in Sweden. However, there were some exceptions. For example, young men, who were refugees in childhood, had a higher likelihood of suicide attempts than non-migrants. Interestingly, childhood refugees and childhood migrants were less likely to use drugs and to have risky alcohol use as adults, compared to non-migrants, but were more likely to be risk gamblers. Conclusions Being a refugee in childhood was not, in general, associated with negative health consequences in adulthood with some exceptions, such as gambling, that will be discussed in the presentation. Key messages • In this study, refugee experience in childhood is not, in general, associated with worse health outcomes in adulthood. • There are certain risk groups that need to be highlighted such as young males with refugee experience in childhood.

Health-Related Expectations Regarding Aging among Middle-Aged and Older Japanese: Psychometric Performance and Novel Findings from the ERA-12-J.

Background and objectives: Health-related expectations regarding aging is a gerontological construct that is potentially predictive of morbidity and mortality in later life. The Expectations Regarding Ageing scale (ERA-12) is a widely used measure of health-related expectations, although it has not previously been administered in Japanese. The present research aimed to elucidate the psychometric properties of the first Japanese translation of the ERA-12 and evaluate health-related expectations among middle-aged and older Japanese. Research design and methods: Repeated online surveys were conducted with representative quota samples of middle-aged and older adults in Tokyo during 2021 (N = 1600). Primary outcome measures included total and subscale scores on a Japanese translation of the ERA-12 (ERA-12-J) addressing perceptions of physical, mental, and cognitive health. Standard measures were also used to gather information regarding respondent demographic details, general health, and health-related behavior. Results: The ERA-12-J and associated subscales showed acceptable test-retest reliability (t(1598) = 0.60, p = 0.63), internal consistency (α > 0.80), inter-item correlation (r = 0.21–0.78) and item-total correlation (r = 0.53–0.73). Confirmatory Factor Analysis verified the hypothesized three-factor structure and construct validity on four common indices of fit (GFI = 0.968; CFI = 0.978; AGFI = 0.950; RMSEA = 0.059). ERA-12-J scores among Japanese respondents revealed prevailing negative sentiments concerning physical and cognitive health, with less negative sentiment regarding mental health. Significant and independent differences emerged concerning gender and age cohort, with middle-aged adults and females holding more negative expectations about their future health. Discussion and implications: The ERA-12-J provides a sound basis for the elucidation of health-related expectations about aging in Japan and a useful tool for international comparative studies. Education and workplace intervention may be required in Japan to address age and gender disparities in health-related expectations.

한국 중년 여성의 폐경 후 기간과 수면 시간의 관계

Objectives: This study aimed to investigate the relationship between the postmenopausal period and sleep duration in middle-aged Korean women using data from the eighth Korea National Health and Nutrition Examination Survey (VIII-2, 2020). Methods: The subjects were 1,455 middle-aged Korean women, and the study used complex sample frequency, descriptive statistics, cross analysis and multinominal logistic regression analysis. Results: The main finding revealed that sleep duration did not significantly correlate with the postmenopausal period after being simultaneously adjusted for general health behavior characteristics. However, “may be appropriate” sleep duration was significantly reduced in the absence of a spouse. “Not recommended” sleep duration was significantly reduced in the lower stress group that did not binge drink, and they displayed significantly increased poor health perception. Conclusion: Finally, it is necessary to re-examine the relationship between the postmenopausal period and sleep duration in middle-aged women, and it is worth considering whether to live with a spouse. In addition, it is important to practice responsible drinking behavior, improve stress management, and become aware of one’s own health.

Prevalence and associated factors of self-reported halitosis among institutionalized adolescents: Cross-sectional study.

To assess the prevalence and associated factors of self-reported halitosis in institutionalized adolescents in a city in southern Brazil. This cross-sectional study involved male institutionalized adolescents, aged 15-19 years old, at the Socio-Educational Assistance Center in the city of Passo Fundo, Brazil. Data collection was performed by a research team composed of two interviewers, two clinical examiners of oral health and two examiners of salivary flow. A structured questionnaire was applied, which included demographical, socioeconomical, general health behaviour, presence of health problems and oral health self-perception variables. Decayed, Missing, Filled Index was used for the clinical examination. The salivary flow collection was performed using the mechanically stimulated total saliva method, in which only the liquid component was measured. The prevalence of self-reported halitosis in this sample was 51.5% (n=35). In the final multivariate analysis, halitosis was significantly associated with the non-white racial group (prevalence ratio [RP]:1.703; 95% confidence interval [95%CI]:1.101-2.634), use of crack (RP:1.857; 95%CI:1.270-2.714) and number of decayed teeth (PR: 1.123; 95%CI:1.008-1.252). The use of alcohol and access to dental care in the last 12months were not significantly associated with self-reported halitosis. It was concluded that non-white and crack-user youngsters had a high occurrence of self-reported halitosis. Higher rates of dental caries are also associated with halitosis.

Does persistent precarious employment affect health outcomes among working age adults? A systematic review and meta-analysis

ObjectiveTo evaluate the impact of persistent precarious employment (lasting 12+ months) on the health of working age adults, compared with more stable employment. Persistent precarity reflects a shift towards less...

Association between early childhood caries and diet quality among Chinese children aged 2-5 years.

Early childhood caries (ECC) is a major oral problem affecting the health and wellbeing of children worldwide. Diet quality is a better predictor of ECC risk than single foods or specific nutrients. The purposes of this study were to assess the associations between ECC and diet quality among 2- to 5-year-old Chinese children. A total of 150 eligible children were included in this study. The decayed, missing, or filled surface (dmfs) score was recorded for each child by dental examination. All participants were divided into three groups based on their age and dmfs score [the caries-free group, the ECC group, and the severe early childhood caries (S-ECC) group]. Parents were invited to complete a questionnaire on the general characteristics and oral health behaviors of the participants. The information of 24-h dietary intake from each child was captured via a mobile APP. The Chinese diet balance index for preschool children (DBI_C) indicators score, high bound score (HBS), low bound score (LBS), and diet quality distance (DQD) score were calculated to assess the diet quality of study subjects. The associations of ECC with HBS, LBS, DQD score, and DBI_C indicators score were analyzed by Mann-Whitney U test and multivariable logistic regression analysis. In this study, 21, 31, and 98 children were diagnosed with caries-free, ECC, and S-ECC, respectively. Statistical analysis revealed that the risk of ECC and S-ECC were significantly increased with the DQD score (OR = 1.283 and 1.287, respectively), but both were not associated with HBS and LBS (P > 0.05). In the meantime, the risk of ECC and S-ECC were significantly increased with the Grains score (OR = 1.623 and 1.777, respectively), and significantly decreased with the Food diversity score (OR = 0.271 and 0.315, respectively). Moreover, the risk of S-ECC also significantly decreased with the Vegetables score (OR = 0.137). Both ECC and S-ECC were associated with a high degree of dietary imbalance and grains intake as well as a low degree of food diversity among Chinese children aged 2-5 years. In addition, S-ECC was also associated with a low degree of vegetable intake.