Health-related Behaviors Research Articles

Characterising the activity, lifestyle behaviours and health outcomes of UK university students: an observational cohort study with a focus on gender and ethnicity

BackgroundHealth-related outcomes and behaviours in university students are known to be poor relative to the general population. The substantial contextual shifts related to the COVID-19 pandemic, combined with increased numbers of students from minoritised ethnicity backgrounds and presenting as trans and gender diverse (TGD), means that up-to-date information is unavailable. The primary aim of this study was therefore to characterise the current movement, dietary and lifestyle behaviours, mental health, and Body Mass Index (BMI) of UK university students and assess differences between genders and ethnic groups.MethodsAn online, self-report survey was administered across three years (2021–2023). Three independent cohorts of university students’ (n = 6,327) completed the survey on four key topic areas. One-way ANOVAs were used to assess differences between genders (men, women, TGD), and independent samples t-tests were used to assess differences between ethnic groups (White, Minoritised Ethnicity).Results30% of students were not meeting physical activity guidelines, 54% were sedentary for ≥ 6 h·d− 1, 83% had poor diet quality, 51% were in high or increased risk groups for alcohol consumption, 18% experienced terrible or poor sleep quality, and 32% were overweight or obese. Gender differences were present for all variables other than walking physical activity (WPA) (P < 0.05), with men having better mental health and engaging in healthier movement and sleeping behaviours, whereas women had more healthful dietary and drinking behaviours, and TGD students had poorer outcomes compared to cis-gender students in most domains. Differences between White and minoritised ethnicity students were present for all variables other than sedentary behaviour, diet quality, WPA and BMI (P < 0.05); students of minoritised ethnicity engaged in better movement, drinking and sleep behaviours in addition to having more positive mental health than White students.ConclusionThe findings of the current study provide an update on the landscape of UK university students’ health and health-related behaviours. Overall, health-related outcomes and behaviours are poor in this population and these data suggest that gender and ethnicity play a role in determining students’ health and health-related behaviours. Therefore, these factors should be considered when developing strategies to promote healthy living in the context of higher education.

Selected aspects of biopsychosocial functioning of seniors

Introduction: Currently, depression affects at least350 million people across the world, and before2030, concerning the total global burden of non-contagious diseases, it will overtake cardiovascularconditions, becoming the most common disease.Aim od the study: To assess selected aspects ofbiopsychosocial functioning of seniorsMaterials and methods: The study involved 600males aged over 65 from Podlaskie Province,Poland. The following instruments were used: theoriginal questionnaire, Beck's Depression Inventory(BDI), Gotland Male Depression Scale (GMDS),Geriatric Depression Scale (GDS), De Jong GierveldLoneliness Scale (DJGLS), Generalized Self-Efficacy Scale by Schwarzer et al. (GSES), Health-Related Behaviour Inventory (HBI)), Satisfactionwith Life Scale (SWLS), General AnxietyDisorder(GAD-7) and Athens Insomnia Scale (AIS).Results: According to 76% of the study subjects,men can suffer from depression. Previously, 16%were diagnosed with depression and 28% with anxiety disorders. The Beck Depression Inventoryresults suggest a mild depressive episode; theGotland Male Depression Scale results suggest maledepression - a tendency for depression. Those on theGeriatric Depression Scale suggest mild depression.The mean values of the De Jong Gierveld LonelinessScale (DJGLS) -35.1 5.12, Generalized Self-Efficacy Scale by Schwarzer et al. (GSES) -24.4 4.42, Health-Related Behavior Inventory (HBI) -74.01 12.3, Satisfaction with Life Scale (SWLS) -20.3 3.87, General Anxiety Disorder (GAD-7)-16.1 3.2; general self-esteem (SES) was 28.5 8.3and Athens Insomnia Scale (AIS) -10 2,65 scores.Conclusions: The majority of male seniors cansuffer from depression. Significant correlations werefound between the tendency for depression and thelevel of loneliness, satisfaction with life, insomnia,ability to cope with problems, and preferred health-related behaviours.

COVID-19-related lockdowns and changes in overweight and obesity, movement behaviours, diet quality, and health-related quality of life among regional Australian primary school children: A repeat cross-sectional study.

During the coronavirus disease 2019 (COVID-19) pandemic, the Australian state of Victoria (in particular, its capital, Melbourne) experienced some of the longest lockdowns in the world. This repeated cross-sectional study examined changes between March to June 2019 (pre-pandemic) and April to August 2022 (6 to 11 months following pandemic-related lockdowns) in overweight and obesity prevalence, physical activity, sedentary behaviour, sleep, diet quality, and health-related quality of life (HRQoL) among primary school children in north-east Victoria, Australia. Height and weight were measured for Grade 2, 4, and 6 students in 2019 (3889 children) and 2022 (1816 children). Grade 4 and 6 students self-reported on their movement behaviours, diet quality, and HRQoL. Participation declined among schools (2019:56%, 2022:34%) and students (2019:87%, 2022:75%). Compared to children in 2019, children in 2022 had a higher prevalence of overweight and obesity; were less likely to have met guidelines for moderate-to-vigorous physical activity, recreational screen time, and vegetable consumption; had higher intakes of takeaway food, energy-dense nutrient-poor snacks, and sugar-sweetened beverages; and had lower HRQoL. Children's health-related behaviours and outcomes seemed not to have returned to pre-pandemic levels 6 to 11 months after the final lockdowns lifted for their communities. Continued monitoring and interventions targeting the drivers of childhood obesity are urgently needed.

The mediating role of self-efficacy in the relationship between health literacy, health status and psychological well-being among German trainees and students in nursing

IntroductionHealth literacy is considered a determinant of several health-related behaviors and outcomes. Health literacy can be seen as a particularly relevant resource for health maintenance and promotion for young adults at the beginning of their challenging vocational training in nursing. However, the underlying mechanisms and the roles of other influencing factors such as self-efficacy remain unclear and need to be understood to successfully tailor interventions.MethodsThis cross-sectional study aims to examine the relationships between health literacy, self-efficacy, health behavior and health status among 556 German trainees and students in nursing. Data were collected using paper-pencil and online questionnaires between January and June 2021. Mediation models were assessed, consisting of the direct pathways between health literacy and health status; health literacy and health behavior; and indirect pathways via self-efficacy.ResultsThe findings showed that health literacy positively affected self-rated health status (ß = 0.05, t = 4.35, p &amp;lt; 0.001) and psychological well-being (ß = 0.28, t = 3.34, p &amp;lt; 0.001). The effect of health literacy on psychological well-being was fully mediated through self-efficacy (Z = 265 4.91, p &amp;lt; 0.001) while the effect of health literacy on self-rated health status was partially mediated through self-efficacy (Z = 5.06, p &amp;lt; 0.001). In this cohort, there was no significant association between either health literacy or self-efficacy and health behavior.ConclusionSelf-efficacy should be taken into account when investigating health literacy and its possible relationships with health-related outcomes. Furthermore, it should be considered as an objective for health literacy interventions as well as health promotion measures for nursing students and trainees.

Engagement and access to support for oral health, substance use, smoking and diet by people with severe and multiple disadvantage: A qualitative study.

Severe and multiple disadvantage (SMD) is the combined effect of experiencing homelessness, substance use and repeat offending. People experiencing SMD have high burden of physical and mental health issues. Oral health is one of the most common health problems in people experiencing SMD which interacts with substance use, smoking, and unhealthy diet to create a cycle of harm and disadvantage. However, burden of these conditions is worsened by poor access to health services. This study aimed to identify pathways to improve engagement and access to health interventions, for oral health, substance and alcohol use, smoking and diet. Using a qualitative methodology, interviews/focus groups were conducted with: (a) people experiencing SMD in Newcastle Upon Tyne/Gateshead; and (b) frontline staff, volunteer workers, policy makers and commissioners from London, Plymouth and Newcastle Upon Tyne/Gateshead. Data was analysed iteratively using thematic analysis. Twenty-eight people experiencing SMD (age range: 27-65 years; 21% females) and 78 service providers (age range: 28-72 years, 63% females) were interviewed or included in focus groups. Data were organized into two overarching factors: barriers to accessing health interventions and improving access to health interventions. Barriers included: wider disadvantages of people experiencing SMD leading to low priority for support for oral health and associated health behaviours, psychosocial factors, waiting period and physical space. Factors that improved access to interventions included: positive relationships between service provider and person experiencing SMD, including a support worker, location of services and outreach services. The findings suggest the need for flexibility in offering services for oral health and related health behaviours for people experiencing SMD. Training health care providers and co-developing services with people with lived experience of SMD can help prevent (re)stigmatization. Systems-based approach to address factors on an environmental, organizational, inter-personal and individual level is needed. The results from this study could be extrapolated to other health intervention such as vaccinations and sexual and reproductive health.

Barriers and facilitators of compliance with infection prevention and control measures during the COVID-19 pandemic in health facilities in Kampala city, Uganda.

During the COVID-19 pandemic, Infection Prevention and Control (IPC) was crucial to reduce the spread of the virus in health facilities. This study explored the barriers and facilitators of IPC compliance among healthcare workers (HCWs) during the COVID-19 pandemic in Kampala City, Uganda. Key informant interviews were conducted with 14 participants in 12 health facilities located in Nakawa division, Kampala City. Of these facilities, 3 were government-owned, and 9 were private not-for-profit. Each health facility's participant was either the IPC focal person or a HCW knowledgeable about the IPC measures implemented there. Transcripts were coded using a newly generated codebook in Atlas.ti version 9, and thematic analysis was carried out to analyze the study findings. Participants identified the fear of contracting the virus as one of the primary facilitators for IPC compliance among HCWs during the COVID-19 pandemic. They explained that the sustainability of IPC measures in health facilities was partly due to HCWs' belief that they served as role models in the community for observing and implementing health-related behaviors, especially regarding COVID-19. Among the barriers, participants mentioned that not all HCWs got the opportunity to be trained on COVID-19 IPC. Only HCWs working in high-risk departments for COVID-19 such as triage or Intensive Care Units were prioritized. However, regardless of the department, all HCWs were exposed to potential COVID-19 patients, and the high workload led them to sometimes skip the required IPC measures. This study found that addressing the spread of COVID-19 among HCWs necessitated a comprehensive approach to IPC in health facilities. This approach should encompass capacity building, as well as provision of necessary supplies. In addition, HCWs, the hospital management and government have a role to play to ensure that IPC is fully implemented in the case of future related outbreaks.

Explain the behavior change and maintenance in diabetic patients using MTM-HAPA framework

ObjectivesThe aim of the study was to to uncover the factors influencing the initiation and maintenance of health behaviors indiabetes mellitus (DM) patients, utilizing baseline data from a randomized controlled trial to construct a structural equation model based on the Multi-Theory Model (MTM) and Health Action Process Approach (HAPA) scales.MethodsThe study recruited participants with type 2 diabetes, aged between 18 and 75 years, from 45 distinct locations in Beijing, China.Patients [N = 406, n = 232 (57.1%) females, n = 232 (42.9%) males; Mean (SD) age = 56.7(10.9)] completed self-reported questionnaire about constructs from integrated theories concerning health behavior. To test the associations between the variables, structural equation modeling with latent variables was employed. Based on the path coefficients of Structural Equation Modeling(SEM), we verified all the hypotheses.ResultsDisadvantages, Advantages, Self-efficacy for Initiating Behavior, and Changes in Physical Environment are all prove to have an effect on intention, with the effect of Disadvantages being negative. Intention positively influenced Action Planning and Coping Planning, both of which in turn significantly predicted Initiation of Behavior Change. Practice for change, Emotional Transformation, Changes in Social Environment, and Self-efficacy for Sustaining Behavior were all affected by Outcome Expectancies and Risk Perception positively. Meanwhile, Practice for change, Emotional Transformation, Changes in Social Environment and Self-efficacy for Sustaining Behavior- would have a significant predictive effect on Maintenance of Behavioral Change.ConclusionThe empirical evidence from this study robustly validates the majority of its theoretical constructs, affirming that MTM-HAPA possess significant explanatory capability in delineating the factors that underpin both the Maintenance of health-related behaviors and the Initiation of Behavior Changes in individuals suffering from DM.

Does the intervention of the school-based health promotion programme “Join the Healthy Boat” have equal or differential effects on weight status and health-related behaviours in children from a high or low socio-economic background? – A randomised controlled trial

BackgroundWorldwide, the prevalence of childhood overweight and obesity increases. Children with low socioeconomic status (SES) are more often affected by overweight and obesity. SES is also associated with health behaviours. In order to avoid health disparities, school-based health promotion programmes such as “Join the Healthy Boat” can help. Intervention outcomes can differ by SES; therefore, the purpose of this study was to investigate whether the intervention had equal or differential effects both on weight status and health-related behaviours in children from high and low SES.MethodsOne thousand six hundred twenty children’s data (7.1 ± 0.6 years; 50.6% male) was analysed; anthropometric data was taken on-site, other health-related parameters, such as physical activity, nutrition, and screen media use, as well as SES were assessed subjectively. Logistic regression models and GEEs were calculated.ResultsComparisons by SES show that there were significant differences in children’s characteristics and health behaviours such as migration background, height, weight, BMI percentiles, weight status, family education level, household income, physical activity behaviour, screen media use, soft drink intake and breakfast skipping. After one year, there were no intervention effects for overweight status, physical activity, or screen media use, but children with high SES in the intervention group skipped breakfast significantly less often than in the control group (5.34 [1.44;19.85], p = 0.01). Parental education level and household income were also assessed separately, with similar results. Interaction analysis revealed no significant effects apart from an interaction effect for breakfast behaviour (p = 0.02).ConclusionsThe health-promotion programme “Join the Healthy Boat” has the potential to promote children’s health via a school-based intervention and therefore, reach all children independent from their background. This study shows vast gaps between several health behaviours of primary school children depending on their SES, favouring those children coming from more privileged families. A longer implementation may possibly show more effects.Trial registrationDRKS00000949.

Improving Communication with Financial Consumers: Insights from a Study of Phone Call Phobia

A phone call phobia is a symptom of avoiding real-time communication that ranges from mild nervousness to a debilitating fear of making or receiving phone calls. The situation of avoidance of real-time communication, including phone call phobia, can potentially influence personal finance, particularly if it limits an individual's ability to communicate effectively with not only family, friends, and employers but also financial service providers. As the COVID-19 pandemic has affected ways of socializing and communicating, it is important to understand the situation and related factors of phone call phobia. This study, therefore, examined factors related to three types of phone call phobia (employer, family, and friends) and six types of communication preferences (face-to-face, phone calls, letters, email, text messaging, and online messaging apps). Using data from an online survey conducted in 2021, this study considered a list of comprehensive factors, including psychological factors, financial-psychological factors, financial status, job-related factors, health-related behavior, and demographic factors, in ordered logistic regression and seemingly unrelated regression estimation models. The findings provide insights to improve communication between financial consumers and financial services providers.

Factors associated with psychological distress among sexuality and/or gender diverse university students at an Australian university: A cross-sectional study

ObjectivesWhile mental ill-health — such as psychological distress — is prevalent among university students, less is known about sexuality and/or gender diverse university students’ mental health. This study aimed to determine whether sociodemographic factors, basic needs security, resilience, and health-related behaviours were associated with psychological distress among a sample of sexuality and/or gender diverse students at an Australian university. MethodsThis study involved a quantitative cross-sectional subgroup analysis of eligible student responses to a larger institutional survey at an Australian university. A multiple linear regression analysis assessed sociodemographic factors (age and gender identity), basic needs security (financial stress, food security and experience of sexual assault and/or sexual harassment during time at university), resilience (specifically ‘bounce back’ resilience), and health-related behaviours (alcohol use, other drugs use, physical activity, and sleep duration), with psychological distress as the outcome of interest. ResultsAnalysis of 411 sexuality and/or gender diverse students’ responses yielded significant results (F [6,387] = 50.493, p < .001) explaining over 40% of the variance in psychological distress (adj. R2 = .430). Identifying as a woman and experiencing food insecurity were associated with higher psychological distress. Younger age, greater ‘bounce back’ resilience, and longer sleep duration were associated with lower psychological distress. ConclusionFurther research should investigate how these associations may change among sexuality and/or gender diverse university students in Australia — across different institutions, over time, and amid broader social and structural factors. Implications for future practice — particularly institutional interventions and data-gathering — are also discussed.

Employee well-being in the digital age: Assessing the impacts of a smartphone application in the workplace

Recently, providing smartphone-based health-improving applications to employees has emerged as a promising strategy for sustaining their well-being. This study estimates the impact of the routine use of an application, introduced in 2020 by a Japanese manufacturing company, on various health-related behaviours and outcomes among employees by exploiting a distinctive large-scale longitudinal dataset and personnel records. The analysis addresses potential selection biases arising from the non-random nature of application usage by employing the instrumental variable approach. Regular application use generates significant positive impacts on health-related habits, including moderate alcohol consumption, regular breakfast intake and refraining from eating two hours before bedtime. Furthermore, regarding physical and psychological stress, noteworthy reductions in physical burden and less frequent experiences of annoyance are observed. Employees also report a lower frequency of dizziness, headaches and palpitations, albeit an increase in the frequency of strained eyes is noted. Additionally, application use is associated with lower systolic and diastolic blood pressure, as well as decreased levels of triglycerides and gamma-GTP.

Prevalence and severity of periodontal disease in the host community and Rohingya refugees living in camps in Bangladesh.

To assess the prevalence and severity of periodontal disease of the Rohingya refugees and host community in Bangladesh. An unpublished pilot was conducted for the sample size calculation. Two-stage cluster sampling method was used to select 50 participants from refugee camps and 50 from the host community. Structured questionnaire and periodontal examination were completed. Composite measures of periodontal disease were based on the World Workshop (WW) and Centers for Disease Control and Prevention-American Academy of Periodontology. Linear regression models, for clinical attachment level and periodontal pocket depth (PPD) and ordered logistic regression models, for composite measures, were fitted to test the association of periodontal measures and refugee status. Compared to the host community, a smaller percentage of refugees reported good oral health-related behaviours. Refugees exhibited lower levels of bleeding on probing but higher PPD, hence a higher proportion had severe stages of periodontitis. As per the WW, prevalence of periodontal disease was 88% and 100% in the host and refugee groups, respectively. In the unadjusted models, refugees were three times more likely to have severe stages of periodontitis; this association was attenuated when adjusted for confounders (sociodemographic variables and oral health-related behaviours). Prevalence of periodontitis was high both in the host community and refugees. The refugees exhibited a more severe disease profile. The oral health of both groups is under-researched impacting the response of the health system. Large-scale research systematically exploring the oral health of both groups will inform the design and delivery of community-based interventions.

Healthcare professionals’ promotion of physical activity to people living with and beyond head and neck cancer: a cross-sectional survey

PurposePhysical activity (PA) can improve health-related outcomes for head and neck cancer (HaNC) patients, and PA guidance from healthcare professionals’ can increase patients’ PA levels. However, less than 9% of HaNC patients are physically active. This study explored healthcare professionals’ promotion of PA across the National Health Service (NHS) in North West England and North Wales, to HaNC patients.MethodsA cross-sectional online survey exploring healthcare professionals’ promotion of PA in HaNC. The International Physical Activity Questionnaire–Short Form was used to estimate healthcare professionals’ PA levels. Quantitative data were analyzed using descriptive or inferential statistics and qualitative data were analyzed using reflexive thematic analysis. Data were synthesized drawing on the capability-opportunity-motivation-behavior model and theoretical domains framework.ResultsEighty-one professionals participated. Fifty-three percent self-reported high levels of PA. Seventy-five percent considered PA promotion as part of their role; however, only 39% discussed PA with their patients (reflective motivation and social/professional role and identity). Only 38% felt confident initiating PA discussions and 76% reported needing further training. Training on the benefits of PA for HaNC patients and how to encourage health-related behavior change were identified as beneficial (psychological capability and knowledge).ConclusionHealthcare professionals are influential in enabling patients to adopt health-related behavior change; however, PA promotion was not routine practice for professionals involved in the care of HaNC patients. Training should be provided to professionals on PA promotion, with a focus on behavior change techniques. Future research should explore how behavior change techniques can be implemented into clinical practice to improve health-related outcomes in HaNC.

Determinants of Smart Healthcare Utilization: A Focus on Individual Characteristics and Goal-setting Behavior

Objectives: This study aims to investigate the relationship between individual characteristics and health-related behaviors in the context of wearable devices and information and communications technology (ICT) healthcare technology adoption and use. Methods: Using large data from the Smart Healthcare Pilot Project Phase 1, implemented by the Seoul Metropolitan government, we estimate the relationship between individual characteristics and health-related behaviors, namely, physical activity level and sustained usage of ICT. Results: Our empirical analysis reveals variations in physical activity levels and smart healthcare usage sustainability based on participants’ gender, age, obesity status, and goal-setting behavior at program initiation. Notably, we find that setting specific goals is positively associated with higher step counts and sustained engagement in wearable device usage. Conclusions: These findings suggest that future smart healthcare programs should adopt tailored approaches based on participant characteristics and emphasize the importance of goal-setting. Our research contributes to the understanding of factors influencing the effectiveness of wearable devices and ICT healthcare technologies in promoting health-related behaviors.

Oral Health Status of Korean Students and Associated Fasting Plasma Glucose in Overweight/Obese Individuals

This study aimed to evaluate the current oral health status of Korean children and adolescents and investigate the correlation between fasting plasma glucose levels and oral health in individuals with overweight and obesity. A total of 121,682 participants were selected from the Survey of School Health Examination data provided by the Ministry of Education over the last 5 years to assess recent oral health status and related factors. Among them, 18,105 students with overweight or obesity who had their fasting plasma glucose levels measured were assessed for blood glucose-related analysis. Based on fasting blood glucose levels, the participants were categorized into normal, impaired fasting glucose, and diabetes groups. The associations of these groups with dental caries, oral hygiene, and periodontal diseases were investigated. There were significant associations between demographic factors, health-related behaviors, and blood glucose levels with oral health. Increased fasting blood glucose levels were associated with poor oral health. These results suggest that glycemic management is important in enhancing the oral health of overweight and obese children and adolescents.

The role of motivational interviewing in the management of obesity in adults

Introduction: The last 50 years have seen a significant global increase in the obesity rate. The prevalence of excess weight gain has doubled worldwide since 2000 and approximately one-third of the world's population is obese or overweight. Purpose: To identify the role of motivational interviewing in the management of obesity in adults. Methodology: This narrative review was based on the bibliographic search of reviews and research studies drawn from international databases. The exclusion criterion of the articles was the language other than English and Greek. Results: There is evidence for the effectiveness of family-based behavioral treatment for controlling weight and improving health outcomes. Obesity-related health risks have been documented such as metabolic syndrome. The importance of dietary prevention is also a major modifiable factor in cardiovascular disease and diabetes mellitus. One of the most prevalent health-related behavior modification models is Motivational Interviewing which is a patient-centered communication style that uses specific methods such as reflective listening, autonomy support, shared decision-making, and eliciting change talk. Conclusion: Recent studies support the use of motivational Interviewing for weight loss in primary care.

The influence of parents’ oral health literacy and behavior on oral health of preschool children aged 3–6 years- evidence from China

BackgroundDirect and indirect associations have been identified among health literacy, health behavior, and health status. Thus, we aimed to investigate the influence of oral health literacy and behaviors in parents on their children's oral health status. Moreover, we aimed to analyze the mentioned mediating effects through oral health behavior management.MethodsOral health information of 1,102 preschool children aged 3 to 6 years was collected from five primary schools in Jinjiang District, Chengdu City, Sichuan Province, China. The decay-missing-filled teeth (DMFT) index and soft scale plaque index (PI) were used by professional dentists aided by school teachers to assess caries and periodontal health among the children. Simultaneously, we conducted a questionnaire-based survey among the parents to determine their oral health literacy and health behavior and their children's oral health behavior. The probit model, instrumental variables, and mediation effect model were used to evaluate the association of parents' oral health literacy and behavior with their children's oral health status.ResultsThe DFMT index was 1.58 among the children, with zero caries in 646 (58.6%) children. The PI was 0.68, with zero gum disease in 517 (46.9%). The univariate analysis suggested that the parents' health literacy and behavior were correlated with their children's oral health status (P < 0.01). Parents' oral health behavior significantly affected their children's oral health status. Simultaneously, a stronger correlation was observed upon using parents' health literacy as an instrumental variable to assess the endogeneity, indicating endogeneity problems. Parents' health-related behaviors exerted a mediating effect on children's oral health, with parents helping children brush their teeth demonstrating the strongest effect.ConclusionParents' oral health-related behaviors can affect their children's oral health status. We recommend enhancing parents' oral health literacy to improve children's oral health status.

Communication Experiences of Conscious Indonesian Patients Who Underwent Mechanical Breathing in an Intensive Care Unit: A Phenomenological Approach

Background: Mechanical ventilation is equipment used by patients in ICU. These patients may experience stress due to inadequate communication, including psycho-emotional pressure with a tendency to depression, anxiety, and frustration. It is important to facilitate effective communication during mechanical ventilation to monitor these patients. Nursing staff need to understand patients regarding their inability to communicate. The installation of mechanical ventilation is a barrier to nurse-patient communication. The culture in which a person lives has an impact on their health-related attitudes and behaviors. Thus, this study aims to determine the experience of the communication needs of conscious patients with experience of mechanical ventilation in ICU. Methods: The research method uses qualitative research with a phenomenological approach. The population in this study were former ICU patients with experience mechanical ventilation who were conscious. The sampling of informants was carried out using a purposive method. This study involved three research informants of various ages. This research was conducted in Yogyakarta, a province of Indonesia. Data collection used in-depth interviews. Data analysis in this study used the Colaizzi method to generate themes. Results: The themes obtained in this study were experience of discomfort disturbance in mechanically ventilated conscious patients; mechanically ventilated patients' communication perceptions; the need for social interaction when mechanically ventilated; and the beliefs experienced by patients while unconscious in ICU. We found a new insight that trusting something the patient has experienced is something that needs to be respected. When patients were unconscious, all participants experienced a spiritual journey that brought them into a state of belief about the dying phase. Conclusion: Communication between patients and nurses is beneficial in providing better nursing care following patient needs. This communication is also needed for patients with mechanical ventilation in ICU. It shows the importance of communication between mechanically ventilated patients and nurses in ICU.

Health-Related Behaviors and Risk of Common Age-Related Brain Diseases Across Severities of Genetic Risk.

The 21-point Brain Care Score (BCS) is an index that ranks behaviors and clinical measurements with the aim of encouraging lifestyle adjustments to lower the incidence of age-related brain disease, including stroke, late-life depression (LLD), and dementia. A higher BCS at baseline is associated with a lower risk of these outcomes. We aimed to investigate whether the associations between BCS and stroke, LLD, and dementia risks are independent of genetic predisposition for these conditions and quantify the effect of healthy lifestyle across genetic risk distributions for these outcomes. Using the UK Biobank (UKB) prospective cohort study, we computed baseline BCSs and polygenic scores to estimate genetic predisposition for stroke and LLD and APOE ε allele status to stratify dementia risk. As for outcomes again in UKB, we measured incidence of stroke, LLD, and dementia. We used multivariate Cox proportional hazard models to assess associations between BCS, genetic predisposition, and these outcomes. We also conducted stratified and interaction analyses to estimate the incidence of these outcomes across quartiles of genetic risk and BCS. We included 368,340 UKB participants (median age 58 years (interquartile range 51-63 years), 46.3% male). Independent of genetic risk, a 5-point increase in BCS corresponded to lowered hazards of stroke (hazard ratio [HR] 0.70, 95% CI 0.68-0.73), LLD (HR 0.65, 95% CI 0.63-0.67), and dementia (HR 0.82, 95% CI 0.78-0.85). Incidences of all 3 outcomes were higher among participants with high genetic risk of these outcomes. However, these increased risks were offset for individuals with a higher BCS (incidence rates per 1,000 person-years were 2.76 vs 1.19 for stroke, 7.34 vs 4.46 for LLD, and 3.64 vs 2.05 for dementia, when comparing low and high BCS). Across different genetic predispositions for stroke, LLD, and dementia, healthier lifestyle behaviors are protective for brain health, demonstrating the nondeterminism of genetic risk. Furthermore, differences in BCS behave as aggregate risk estimators of all 3 outcomes. Further work is needed to prospectively investigate the utility and performance of the BCS as a targeted intervention in populations at elevated genetic risk of age-related brain disease.

Dental Caries and Extrinsic Black Tooth Stain in Children With Primary, Mixed and Permanent Dentitions: A Cross-Sectional Study.

Dental caries and extrinsic black tooth stain (EBS) are prevalent among children, with current evidence suggesting a negative correlation between them. It is unclear whether the factors contributing to developing or preventing dental caries and EBS are connected or aligned. To investigate the prevalence and associated factors of caries and EBS among children with primary, mixed and permanent dentitions. This was designed as a cross-sectional study. Probability proportionate to size sampling and simple random sampling methods were used to recruit children aged 5, 9 and 12. Three calibrated paediatric dentists conducted intra-oral examinations. Nutritional supplements, oral health-related behaviours and family background were collected. Bivariate analysis, negative binomial and binary logistic regression were performed. Caries and EBS prevalence were 83.7% and 4.7%, respectively. A decreasing trend in caries and an increasing trend in EBS prevalence were observed across three dentitions. Caries were associated with EBS, oral hygiene, vitamin intake, gender, food-pocketing habits, toothbrushing duration, dental attendance and socioeconomic status. EBS was more likely to occur in caries-free children (OR = 4.42, 95% CI 2.97,6.58, p < 0.001) and children without vitamin consumption (OR = 1.59, 95% CI 1.07, 2.36, p = 0.021). The occurrence of caries and EBS varied across different dentition stages. Their risk and protective factors were not significantly aligned.