General Health Research Articles

The impact of gastroesophageal reflux disease on the quality of life of children and adolescents in the Republic of Tyva

Aim of the study was to investigate quality of life indicators in children and adolescents with gastroesophageal reflux disease (GERD) in the Mongoloid and Caucasian populations of the Republic of Tyva. Material and Methods. Schoolchildren aged 7–18 years of the indigenous (25 Mongoloids – Tuvans with GERD and 354 practically healthy) and newcomers population Republic of Tyva (5 Caucasians with GERD and 158 practically healthy) were examined using a cross-sectional method. Gastroenterological complaints and demographic information were recorded. To assess the quality of life of children, adapted Russian parent (CHQ-PF28) and child (CHQ-PF45) versions of the Child Health Questionnaire (CHQ) were used. The questionnaire allows you to assess various areas of a child’s life. Results and discussion. A decrease in the quality of life was established in schoolchildren of both ethnic populations in the presence of GERD on a number of scales as assessed by the children themselves and their parents. However, unlike parents, children’s assessments tended to decrease in the “family cohesion” section (p = 0.068), which, to a certain extent, may reflect the presence of intrafamily problems that can have a traumatic effect on the child. According to parents’ assessments, in schoolchildren with GERD in the Caucasian population, the decrease in indicators concerned only the “physical activity” scale (p = 0.039). In the Tuvan population, more extensive deviations were noted ‒ in sections “general health assessment” (p = 0.041), “physical activity” (p = 0.024), “changes in health status” (p = 0.006), “pain/ discomfort” (p = 0.037). According to the assessment of children, Caucasians with GERD did not show a decrease in indicators, and Tuvans with GERD had fewer deviations on the scales than, according to their parents. Conclusions. Tyva schoolchildren with GERD showed a decrease in quality of life indicators, which was more pronounced among Mongoloids - Tuvans, and there were differences in its assessment by the children themselves and their parents.

Initial treatment of severe soft-tissue injuries in closed and open fractures to prevent fracture-related infection

The management of soft tissue damage during fracture treatment requires surgical proficiency and meticulous care adhering to established treatment protocols. This approach is paramount for minimizing the risk of potentially limb- or even life-threatening complications such as fracture-related infection (FRI) in all age groups. There is a general consensus on essential measures such as wound assessment, surgical debridement and early use of antibiotics. Treatment should always be based on the correct classification of the fracture and the corresponding soft tissue injury, but needs to be adapted to the individual patient considering general health status, secondary diagnoses and currently available treatment options.

Chronic myelogenous leukemia: a case report from Azal Hospital, Sana'a, Yemen

Chronic myelogenous leukemia (CML) is a myeloproliferative disorder that is always associated with the presence of the BCR-ABL gene. In this article, we report the case of a 38-year-old male patient who presented with fever, fatigue, abdominal pain, and blurred vision. Investigations confirmed CML with leukemic-like retinal hemorrhages and anemia. The patient was immediately given imatinib 400 mg daily for 2 weeks, and then hydroxyurea 500 mg daily was added. After 4 months, the white blood cells, hemoglobin, and basophils returned to normal values, the retinal hemorrhages improved, and the patient's general health improved.

Formulation & Evaluation of Hair Growth Serum from Hibiscus Flowers and Leaves

The need for cosmetics is very high in this fast-paced environment. The pharmaceutical industry's use of cosmetics is growing daily. We use cosmetics on a daily basis. Cosmetics are meant to be used on teeth, nails, hair, and skincare. Note that toothpastes, hair oils, and hair dyes are all considered cosmetics that are used by everyone on a daily basis. Because using synthetic or chemical products might have unfavorable side effects, individuals are increasingly gravitating toward organic, natural, and herbal formulations that have negligible or no side effects. Herbal remedies are typically recognized for having "No side effect." People deal with a variety of issues, including premature greying of the hair, split ends, dandruff, hair thinning, and excessive sebum production. People are therefore searching for strategies to improve hair growth, prevention, and maintenance. The present investigation focuses at the preparation and evaluation of a herbal hair growth serum made with a combination of natural substances, including olive oil, peppermint oil, vitamin E, hibiscus flowers and leaves, Amla Powder, and curry leaves. The purpose of the serum is to improve scalp health, strengthen hair follicles, and promote hair growth. Hibiscus flowers and leaves are used to extract bioactive chemicals, which are then infused with curry leaves and Amla powder in olive oil. For added advantages, vitamin E and lavender oil are added. Hibiscus flowers are rich in amino acid, which is prime building block of keratin. The leaves also reduce the growth of dandruff-causing fungi, reduce dandruff flakes and prevent its recurrence. Amla Powder has antimicrobial and anti-inflammatory properties that can help reduce dandruff. Curry leaves are rich in antioxidants and proteins, these antioxidants neutralize the free radicals and keep hair healthy and strong. Coconut oil absorbs into your hair quickly, providing moisture to tame frizz and heal breakage. The effectiveness of the serum is assessed in the study using variables including hair growth rate, thickness, strength, scalp health, and general health of the hair. Preliminary findings point to encouraging results in terms of strengthening hair growth and enhancing hair quality.

Multidimensional employment trajectories and dynamic links with mental health: Evidence from the UK Household Longitudinal Study.

Low-quality and precarious employment have been associated with adverse mental health and wellbeing. More evidence is needed on how the quality of employment trajectories - including transitions in and out of unemployment, inactivity, and employment of varying quality - are associated with individuals' mental health over time. This paper aimed to derive a typology of multidimensional employment trajectories and assess associations with mental health in the UK. Data from waves 1-9 of the UK Household Longitudinal Study were used (2009-2019). Individuals aged 30-40 at baseline were included (N=1603). Using multichannel sequence and clustering analyses, we derived a typology of employment trajectories across employment statuses and four employment quality indicators. We assessed associations with subsequent psychological distress, accounting for baseline mental health. Changes in average General Health Questionnaire scores are described. A typology of five trajectory clusters highlighted stable and secure and precarious/low-quality trajectories for both men and women. Women who reported being economically inactive at most waves had higher odds of experiencing psychological distress than did women in 'standard' trajectories, regardless of baseline mental health. Women's scores of psychological distress in the 'precarious' group on average increased along their trajectories characterized by instability and transitions in/out of unemployment, before a move into employment. Men who likely moved in and out of unemployment and economic inactivity, with low probability of paid employment, reported increased psychological distress at the end of follow-up. This may partly be due to pre-existing mental ill-health. This paper shows the importance of high-quality employment for individuals' mental health over time. Researchers need to consider dynamic associations between employment quality and mental health across the life-course.

Neuronutrition and Its Impact on Post-Stroke Neurorehabilitation: Modulating Plasticity Through Diet.

The recovery of neurological deficits after ischemic stroke largely depends on the brain's ability to reorganize its undamaged neuronal circuits and neuronal plasticity phenomena. The consolidated evidence highlights the involvement of the patient's impaired nutritional conditions in post-stroke recovery and unsatisfying rehabilitative outcomes. Standardized nutritional protocols usually applied in hospitalized patients in a rehabilitation setting aim mainly to improve the general health conditions of patients, do not consider the high inter-individual variability in neurorehabilitation outcomes, and are not sufficiently modifiable to provide neuroprotective and restorative dietary patterns that could promote neuronal plasticity and functional recovery during neurorehabilitation. Neuronutrition, an emergent scientific field of neuroscience, represents a valid model of a personalized nutritional approach, assuring, for each patient, nutrients having antioxidant and anti-inflammatory properties, ensuring a balanced microbiota composition, and providing adequate neurotrophic support, essential for improving neuronal plasticity, brain functional recovery, and rehabilitative outcomes. In the present narrative review, we provide an overview of the current knowledge on neuronutrition as an adjuvant strategy of a personalized nutritional approach potentially effective in improving post-stroke neuroplasticity and neurorehabilitation by counteracting or at least limiting post-stroke oxidative/nitrosative stress, neuroinflammation, and gut-brain axis disturbance.

Evaluating Seismocardiography as a Non-Exercise Method for Estimating Maximal Oxygen Uptake.

The value of maximal oxygen uptake (VO2MAX) is a key health indicator. Usually, VO2MAX is determined with cardiopulmonary exercise testing (CPET), which is cumbersome and time-consuming, making it impractical in many testing scenarios. The aim of this study is to validate a novel seismocardiography sensor (Seismofit®, VentriJect DK, Hellerup, Denmark) for non-exercise estimation of VO2MAX. A cohort of 94 healthy subjects (52% females, 48.2 (8.7) years old) were included in this study. All subjects performed an ergometer CPET. Seismofit® measurements were obtained 10 and 5 min before CPET in resting condition and 5 min after exhaustion. The CPET VO2MAX was 37.2 (8.6) mL/min/kg, which was not different from the two first Seismofit® estimates at 37.5 (8.1) mL/min/kg (p = 0.28) and 37.3 (7.8) mL/min/kg (p = 0.66). Post-exercise Seismofit® was 33.8 (7.1) mL/min/kg (p < 0.001). The correlation between the CPET and the Seismofit® was r = 0.834 and r = 0.832 for the two first estimates, and the mean average percentage error was 11.4% and 11.2%. Intraclass correlation coefficients between the first and second Seismofit® measurement was 0.993, indicating excellent test-retest reliability. The novel Seismofit® VO2MAX estimate correlates well with CPET VO2MAX, and the accuracy is acceptable for general health assessment. The repeatability of Seismofit® estimates obtained at rest was very high.

Cost-utility and clinical outcome analysis of surgery or oral corticosteroids treatment in patients with chronic rhinosinusitis with nasal polyps

Background: Surgery and oral corticosteroids are recommended therapies for chronic rhinosinusitis with nasal polyps (CRSwNP) patients who are nonresponsive to intranasal corticosteroid treatment. Objective: This study aimed to compare the effectiveness of these 2 treatments in terms of improving sinus-related symptoms, enhancing quality of life, and economic costs and duration costs. Methods: This prospective study enrolled CRSwNP patients. All participants were instructed to complete the 22-item Sino-Nasal Outcome Test (SNOT-22), visual analog scale, and 36-item short-form (SF-36) questionnaire at baseline and 3 months after treatment. The nasal polyp score (NPS) was assessed via endoscopic examination. Additionally, patients were requested to maintain records of economic direct costs, other indirect costs, and duration costs throughout the 3-month period and to report them during each follow-up visit. Results: A total of 40 patients who underwent surgery or received oral corticosteroids were enrolled in this study. After 3 months of treatment, significant improvements were observed between baseline and 3 months after treatment in the NPS, total SNOT-22 score, and nasal congestion, runny nose, facial pain, olfactory function, and overall symptoms measured. Only headache and sleep order were improved in the surgery group. Both physical functioning and general health, as measured by the SF-36, improved after both treatments, and the role-physical, bodily pain, and social functioning domains of the SF-36 improved only in the surgery group. The changes in the NPS, nasal congestion, runny nose, olfactory function, and sleep disorders in the surgery group were greater than those in the oral corticosteroid group (P values = 0.0003, 0.0092, 0.0258, 0.0284, and 0.0164, respectively). Changes in the total SNOT-22 score and SF-36 subscores were not different between the 2 treatment groups. The direct economic costs and duration costs of surgical treatment were 4.5 times and 17.0 times higher, respectively, than those of oral corticosteroid treatment. Conclusions: Both surgical and oral corticosteroid treatments effectively improved clinical symptoms and quality of life in patients with CRSwNP. Patients who underwent surgery exhibited greater improvements in sinus-related symptoms. Nevertheless, oral corticosteroid treatment presented notable advantages in terms of economic cost and duration cost of disease-related care.

Impact of Orthopedic Surgical Intervention on Difficult-to-Treat Rheumatoid Arthritis: A Propensity Score Matched Study.

To elucidate the therapeutic effect of orthopedic surgical intervention (OSI) in difficult-to-treat rheumatoid arthritis (D2T RA) compared with non-D2T RA. A total of 534 recent surgeries were analyzed only in patients who had undergone OSI since 2016 and for whom a 12-month post-operative follow-up was available. D2T RA was determined according to the EULAR definition, and patients with D2T RA were matched to patients with non-D2T RA using propensity scores calculated by a logistic regression analysis. The Health Assessment Questionnaire-Disability Index (HAQ-DI), Disease Activity Index 28 (DAS28), face scale, and patient's assessment of general health (GH) were measured repeatedly at baseline and 6 and 12 months and were compared using a two-way analysis of variance. The HAQ-DI, DAS28, face scale, and GH showed significant post-operative improvements, and there were significant differences in the HAQ-DI and face scale scores between D2T RA and non-D2T RA. An additional analysis with DAS28 as a covariate showed no significant interaction for either, suggesting that these improvements in clinical assessment were due to OSI rather than improved disease activity. In the absence of an effective pharmacological treatment strategy, OSI may be an effective treatment modality for the management of D2T RA.

A quantitative investigation in a territory of Italy on citizens' attitudes towards medicines through the COVID-19 pandemic: the importance of possible indirect effects caused by the pandemic.

The COVID-19 pandemic has greatly influenced many aspects of everyday life, particularly that of the general population health. In order to better understand the potential impacts of the COVID-19 pandemic on people's attitudes toward medicines use, a quantitative investigation was conducted in a territory of Sardinia region, Italy. Stratification of the random multilevel population sample was based on gender, age range, and territory. The methodological strategy to verify the potential approach changes towards medicines due to the COVID-19 pandemic consisted of oral interviews with adult citizens and unrecognizability preservation. Investigation, also supported by a study completed before the insurgence of the pandemic about taking medicines, interrupting treatments without consulting, and reading the information leaflet, allowed to explore citizens' attitudes before and during pandemic, and changing. The most relevant findings are the tendency towards a higher occurrence of self-interruption of treatments and an increased interest in the information leaflet (package leaflet), but not an increased self-administration of medicines. These results indicate new indirect effects of the COVID-19 pandemic that could exert an additional impact on the state of citizens' health and health systems. The study, with reference to prophylactic medical treatments and based on some considerations concerning the pandemic from its insurgence to today, also provides solutions for related problems for the present or future periods of health emergencies.

BURNOUT IN HEALTHCARE PROFESSIONALS: IMPACTS ON QUALITY OF LIFE AND WELL-BEING

The research aimed to analyze the relationship between burnout and the quality of life of health professionals, identifying the main risk factors and proposing mitigation strategies. To this end, a qualitative approach was used, including interviews and questionnaires applied to professionals from different health areas. The results showed a high prevalence of burnout symptoms, with emotional exhaustion and depersonalization being the most common. The analysis indicated that factors such as work overload, lack of institutional support and absence of mental health policies contribute significantly to the development of the syndrome. The conclusion emphasized the urgency of interventions that promote healthy work environments, focusing on psychological support and self-care strategies, in addition to highlighting the importance of an organizational culture that prioritizes the well-being of professionals, which can result in improvements in the quality of care provided and in the general health of workers.

Gastrointestinal Conditions Affect Chronic Pain and Quality of Life in Women

Pain is a chronic condition in many women; drugs used for its treatment are often accompanied by detrimental effects on many organs, including the gut. Once inflamed, the gut can affect pain processes. The aim of this study was to evaluate the general health of women suffering chronic pain, with particular attention to gastrointestinal (GI) conditions. The possibility to improve pain and quality of life through personalized nutritional advice was also tested. Forty women suffering from chronic pain were contacted for the administration of questionnaires to define their pain features and gastrointestinal conditions. Their psychological, clinical and reproductive states were also recorded. Pain scores were correlated with GI, psychological and clinical scores. Diet suggestions were given, and evaluation was repeated after 4 weeks. Thirty-eight women were included in the study: 32 suffered chronic widespread pain and had 6 pelvic pain. Pain had been present in all women for years; more than 80% of women reported various types of disorders related to the gut. Pain scores were worse in the women intolerant to milk and dairy products. The GI score was positively correlated with the pain score. The Dietary Inflammatory Index was very high in all subjects. Personalized nutritional advice followed by 26 subjects for 4 weeks resulted in a significant improvement of pain and quality of life parameters. We describe women with chronic pain as being particularly affected by GI alterations. The change in feeding habits had a beneficial effect on pain and other quality of life parameters.

Work and disability benefit unraveled in chronic gastrointestinal patients

Abstract Background Persons with a chronic disease, such as chronic gastrointestinal and hepato-pancreatico-biliary (GI-HPB) disease, have a lower work participation (WP) than the healthy population. Instead, they might receive a disability benefit (DB). Positive Health (PH) is a newly developed, holistic view of health and comprises six dimensions: bodily functions, mental well-being, meaningfulness, quality of life, participation, and daily functioning. In this study we aim to determine whether the dimensions of PH relate to WP and DB in persons with GI-HPB. Methods GI-HPB patients attending the outpatient clinic of the Maastricht University Medical Center between 2019-2021 received validated questionnaires (Gastrointestinal Symptom Rating Scale, Short Nutritional Assessment Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Short Form-36, Disease Experience Questionnaire, EuroQol-5D-5L) and items regarding WP and DB. The relation between the six dimensions of PH, and WP and DB, were tested with univariate and multivariate statistics. Results 448 patients (Mage = 45 years; 69% female) were included. Univariate analysis revealed that, except for meaningfulness, all dimensions were significantly associated with WP (p≤.02) and DB (p≤.005). In multivariate analyses, lower age (p=.010), better general health (p=.044) and better physical functioning (p&amp;lt;.001) related to WP. Higher age (p=.002) and lower physical functioning (p=.011) related to DB. Conclusions Among GI-HPB patients, physical functioning related to both WP and DB. The chance of working was higher among younger patients and those with better general health while those with a higher age received DB more often. The PH concept was only partially relevant to work status and DB. Key messages • Within the dimensions of Positive health, work participation was associated with a lower age, a better general health and a better physical functioning. • Within the dimensions of Positive health, disability benefit was associated with higher age and lower physical functioning.

Type 2 diabetes risk is associated with poorer general health and mental health in women and men

Abstract Background Increasing evidence points to a relation between cardiometabolic and mental health, but population-based data are scarce. We investigated the association of type 2 diabetes (T2D) risk to general and mental health with a focus on potential differences between women and men. Methods The study population comprised 5,192 adults (18+ years) without known diabetes based on data of the German Health Update (GEDA) 2022. T2D risk was assessed by the German Diabetes Risk Score (GDRS), that estimates the 5-year probability of developing T2D and was categorized into low, still low, elevated, and high risk. Sex-specific Poisson regression analyses were conducted including self-rated health (SRH), self-rated mental health (SRMH), depressive symptoms (PHQ-2) and anxiety symptoms (GAD-2) as dichotomous dependent variables and age, educational level, living alone, region of residence, and social support as covariables. Results Women had a higher prevalence of low T2D risk (66.1%) and a lower prevalence of high T2D risk (9.4 %) than men (55.3% vs. 16.3%). Compared to those with low T2D risk, women and men with a high T2D risk were less likely to report very good/good SRH (women: prevalence ratio: 0.63; 95% confidence interval: 0.51-0.79; men: 0.69; 0.57-0.84) or excellent/very good SRMH (women: 0.53, 0.39-0.73; men: 0.85, 0.63-1.15). Further, those with a high T2D risk had a higher risk of depressive symptoms (women: 1.71, 1.05-2.81; men: 2.23, 1.22-4.05) and anxiety symptoms (women: 1.84, 1.03-3.29; men: 2.73, 1.09-6.81). No statistically significant interactions between sex and T2D risk were observed regarding the included health outcomes. Conclusions A high T2D risk is associated with a lower probability of a favourable SRH and SRMH and a higher risk of depressive and anxiety symptoms in men and women. The underlying mechanisms need further identification, in order to design synergistically beneficial health promotion for cardiometabolic and mental health. Key messages • No sex-specific differences in general and mental health were found in people at high T2D risk. • Further research is needed to identify the underlying mechanism to improve general and mental health.

Psychological Distress and Quality of Life Among Military Trauma Patients.

Military trauma has a significant impact on soldiers, affecting many aspects of their lives, with the highest impact on their quality of life and psychological wellness. This study aimed to measure psychological distress and its relationship with the quality of life among Jordanian military trauma patients. A descriptive cross-sectional study was conducted in The Hashemite Protection Departments for military causalities in Amman, Irbid, and Al-Karuk. The authors used the WHO Quality of Life Scale-Brief and Trauma Symptoms Checklist-40 scales for assessing the quality of life and psychological distress among Jordanian military trauma patients. A total of 145 trauma survivors participated in the study and responded to all questionnaires out of 173 distributed. The study was approved by the institutional review board of Al-Zaytoonah University. The result of this study revealed that military trauma survivors had high levels of psychological distress with a mean of 85.66 (SD = 19.418). The subscale of "Dissociation symptoms" had the highest rating (M = 19.92, SD = 5.096), while the "sleep disorders" subscale had the lowest rating (M = 10.000, SD = 3.501). On the quality of life scale, a moderate level of quality of life resulted among the participants with a mean of 61.620 (SD = 17.190). The "general health" subscale scored the highest among the other domains (M = 18.241, SD = 5.434), while the "physical health" domain scored the lowest (M = 4.910, SD = 2.078). Furthermore, a statistically significant negative relationship between psychological distress and quality of life was reported (r =-0.178, P < .05). Jordanian injured military persons had a moderate quality of life level and high level of psychological distress. A structured follow-up program is required to be developed to improve those patients' health and quality of life. Furthermore, additional research is needed to investigate the impact of military trauma and services on soldiers in Jordan and the Middle East.

How to measure the general Environmental Health Literacy

Abstract Background Many environmental factors, both natural or man-made, are associated with health risks. To make informed decisions about these potential risks, certain skills and competencies are necessary. The concept of Environmental Health Literacy (EHL) which integrates aspects of Science Literacy, Health Literacy and Environmental Literacy encompasse these competencies. To assess to what extent individuals or groups are environmental health literate, a general Environmental Health Literacy Scale is necessary. To the best of our knowledge, there is no validated instrument to measure general EHL. Methods Two phases of scale construction were conducted: 1) Item development with deductive methods which includes a literature review and assessment of existing scales resulting in two suitable studies for scale construction. Included items were translated to German language. 2) Scale development with pre-testing of items followed by applying potential items (n = 38) to a sample of of 454 students. Internal consistency (Cronbach’s alpha), Kaiser-Meyer-Olkin Criterion (KMO), Bartlett’s test, Velicer’s minimum average partial (MAP) test for number of underlying factors and Exploratory Factor Analysis using Principal Component Analysis with oblimin rotation and stepwise item reduction were assessed. Results Velicer’s MAP identified 3 factors, Cronbach’s alpha = .92, KMO = .92, Bartlett’s Test revealed significant correlation. Seven items were removed from the scale due to low factor loadings (&amp;lt; .3). Factor 1 (access) explains 18% of variance, factor 2 (knowledge) 12% and factor 3 (reflection) 10%, respectively. Overall, the model explains 40% of variance. Model fit represented by RMSEA index = .05. Conclusions A new general EHL scale has been developed and proven to be suitable for a students sample. This marks the first step towards a validated tool for multiple purposes. Cultural adaptation as well as multiple language validations are in process. Key messages • The process towards a general Environmental Health Scale has started. • The development of a validated EHL scale will improve understanding on whether the general population or subgroups are able to gain, understand and act upon information regarding environmental health.

The Impact of a 12-Week Workplace Physical Activity Program on the Quality of Life of Sedentary Workers: A Pilot Study

Office workers frequently display behavioral patterns marked by extended periods of sedentary and seated work. In this context, the implementation of a workplace exercise program has been shown to be effective in mitigating health-related risk factors. This study aimed to evaluate the impact of a 12-week workplace exercise program on the quality of life of employees whose primary occupational duties involve prolonged sitting. The final sample comprised 19 participants (6 females and 13 males), aged between 21 and 48 years (M = 32.26; SD = 9.03). Among these participants, 78.9% reported engaging in a hybrid work arrangement, 15.8% followed an on-site work regimen, and 5.3% worked remotely. Furthermore, 84.2% of participants reported sitting for 6 to 8 h per day, while 15.8% reported sitting for between 9 and 12 h daily. The quality of life of participants was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey. A paired samples t-test was employed to examine differences between dependent variables. The results revealed a statistically significant improvement in general health (p &lt; 0.01), vitality (p &lt; 0.01), social functioning (p &lt; 0.05), and the mental health summary measure (p &lt; 0.04). Promoting physical activity through workplace exercise programs offers substantial benefits for workers’ health and quality of life, contributing to the prevention of occupational diseases.

Self-determination and self-affirmative paths of trans* and gender diverse people in Portugal: Diverse identities and healthcare

Abstract Background Trans* and gender diverse (TGD) people are very heterogeneous. While legal contexts and healthcare practices have been growingly endorsing self-determination and consent for gender affirmative care in some countries, gender affirmation trajectories need to be understood as unique and fluid processes, constructed and negotiated by each individual in a given social and cultural context. This study aimed to characterize diverse profiles of TGD people in Portugal, regarding individual choices and trajectories in social, legal, and medical gender affirmative processes. Methods A questionnaire, first developed in France and used in Brazil, Italy, Norway, and Chile, was adapted to the Portuguese context. The conducted survey is comprised of 120 questions, organized into six sections: 1) sociodemographic variables; 2) gender affirmation processes and medical and psychological care; 3) general health and sexual health; 4) mental health; 5) sexuality and sexual concerns; 6) experiences of discrimination and gender identity. Data were collected from a convenience sample of 115 adults who identified as TGD. Content analysis was performed on the written responses, and later categorized. Results Approximately 21% of people identified as men, 17% as trans men, 7% as women, 12% as trans women, 26% as non-binary persons, and 17% as agender or other identifications. Differences were calculated among profiles of TGD participants and their choices for affirmative care, social, and legal transition, revealing an association between the way people self-identify and the request for legal recognition of gender identity, as well as the choices of procedures (or aspirations) for medical affirmation (i.e., hormonal treatments, top surgery, bottom surgery). Conclusions The provision of health care practices consistent with the principles of self-determination requires training of health care professionals and adjustment of public policies, to allow for unique trajectories and profiles.

Educational achievement and health during adolescence in second generation immigrants in Sweden

Abstract Background Over the last decades, immigration have increased markedly in Sweden. Educational achievement is essential for successful integration; however, second generation immigrants have been shown to lag behind. There is a complex intertwinement between educational attainment and health outcomes. Thus, schooling is crucial in terms of integration but also from a public health perspective. We aim to compare school performance and health in children of immigrant parents and children of parents born in Sweden. Methods In this population-based cohort study, 1723 children were followed from birth to age 20. Of these 246 (14.3%) had at least one parent born abroad. Logistic regression was performed controlling for gender, language spoken at home and sociodemographic data obtained at 3 months, 3-, 12- and 20 years. Outcome measures were school performance at age 12 (n = 984), grades from compulsory and upper secondary school (n = 1668) and register data on psychiatric diagnoses (n = 737). Self-response questionnaires on general health, long term health problems and psychiatric conditions were administered at age 20 (n = 731). Results There were no differences in reading (p = 0.676) or mathematics (p = 0.324) at age 12, eligibility to upper secondary school (p = 0.298) or university (p = 0.232) between second generation immigrants and children of native-born parents. No differences in frequency of psychiatric diagnoses (p = 0.112), presence of long-term health problems (p = 0.267) or self-reported health (p = 0.595) were shown. Conclusions The results indicate that young adults born in Sweden in the middle of the 1990’s with immigrant parents perform similarly in school compared to children of parents born in Sweden. They are not at increased risk for mental illness, long-term health conditions and report their general health equivalently to children of native-born. The comprehensive school system and child health programs used in Sweden are likely important factors to promote education and health. Key messages • In a birth-cohort of children followed into early adulthood, no difference in educational achievement or health was shown between second generation immigrants and children of parents born in Sweden. • International comparative studies are needed to highlight the importance of underlying structural and socio-cultural factors.

Promoting active ageing: The positive impact of older people’s participation in Urban Gardens

Abstract Background The socio-health and economic consequences of the progressive population ageing constitute a global challenge for public health, which is committed to the promotion of active and healthy ageing as a strategy to mitigate these consequences. The European project U-GARDEN has evaluated from a comprehensive and innovative approach the impact of urban gardens on the promotion of active ageing through the participation of older people in urban agriculture. Methods A qualitative methodology was designed and implemented in order to analyse the information provided by people over 65 years of age, who actively participated in urban gardens, from a personal and subjective perspective through semi-structured in-depth interviews. The benefits obtained from participation in urban gardens were analysed, considering the different dimensions that make up the paradigm of active ageing: physical, psychological, economic, health, behavioural and personal impact. A total of 20 interviews were used to reach the saturation point. Results Qualitative analysis showed multiple benefits of active and healthy aging. Participants reported increased physical activity and psychosocial improvements such as higher personal satisfaction, reduced stress, and enhanced self-esteem, strengthening community connections and fostering a sense of belonging. Economically, they reported savings on food costs and increased food security. Overall, respondents noted improvements in general health and quality of life, highlighting urban gardening as valuable for well-being and social-economic integration. Conclusions The findings reported in the framework of the U-GARDEN project support the importance of implementing innovative strategies that encourage participation in urban gardens as a tool to improve the overall wellbeing and health of older people, effectively addressing some of the main challenges of ageing such as loneliness unwanted frailty and disability. Key messages • The U-GARDEN project is an example of good practice in the use of urban gardens as a platform for promoting active and healthy ageing. • The promotion of green spaces through the establishment of urban gardens should be considered by health and political authorities for their ability to promote the general well-being of society.