Lower Physical Health Research Articles

Psychological Distress among College Students: Role of Food Insecurity and Other Social Determinants of Mental Health.

Food insecurity is a major social determinant of health and an assessment of how it may impact college students’ mental health is imperative, as well as differential associations by self-identified gender. A cross-sectional survey was used among college students of a mid-size minority-serving institution with a final sample size of 302 participants aged 18 years or above. Descriptive, bivariate, and multivariable regressions were conducted, by gender, to assess the role of food insecurity (United States Department of Agriculture (USDA) six-item questionnaire), on mental health outcomes (Kessler-6 scale and self-perception). All the statistical analyses were conducted in SPSS version 24 (IBM, Corp.; Armonk, NY, USA) with an alpha less than 0.05 used to denote significance. Among those with food insecurity, the odds of reporting psychological distress (odds ratio (OR) = 3.645, p < 0.05) and an average to very poor self-perceived mental health status (OR = 2.687, p <0.05) were higher compared to their food-secure counterparts, with the results consistent in a gender-specific analysis as well. Compared to men, however, women had higher odds of psychological distress (OR = 2.280, p < 0.05), as well as reporting average to very poor self-perceived mental health statuses (OR = 2.700, p < 0.05). Among women, any alcohol use in the past 12 months (OR = 2.505, p < 0.05) and a low self-perceived physical health status (OR = 3.601, p < 0.05) were associated with an average to very poor self-perceived mental health status. Among men, a low perceived physical health status was associated with higher odds of psychological distress (OR = 3.477, p < 0.05). The results of our study highlight that food insecurity should be considered a social determinant of mental health wellbeing. In addition, gender-specific trends in mental health highlight the need for targeted interventions for prevention and treatment.

Obstructive lung disease and quality of life after cure of multi-drug-resistant tuberculosis in Uganda: a cross-sectional study

BackgroundPulmonary multi-drug-resistant tuberculosis (MDR TB) alters lung architecture and involves lengthy treatment duration, high pill burden, drug adverse effects, travel restrictions, and stigma. Literature about pulmonary function and health-related quality of life (QoL) of patients treated for MDR TB is limited. This study sought to determine the prevalence of chronic obstructive pulmonary disease (COPD) and QoL of patients who were treated for pulmonary MDR TB.MethodsParticipants who completed 18 months of pulmonary MDR TB treatment and considered cured were eligible to be evaluated in a cross-sectional study. We performed post-bronchodilator spirometry to measure forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). COPD was defined as FEV1/FVC < 0.7; health-related QoL was assessed using the Medical Outcomes Survey for HIV (MOS-HIV) and St. George’s Respiratory Questionnaire (SGRQ). Linear and logistic regression models were used to assess associations with COPD, health-related QoL, and other characteristics of the cohort.ResultsA total of 95 participants were enrolled. Median age of the cohort was 39 years (interquartile range (IQR), 29–45), and 55 (58%) were HIV-positive. COPD prevalence was 23% (22/95). Median SGRQ score was normal at 7.8 (IQR, 3.1–14.8). Median mental and physical health summary scores were significantly impaired, at 58.6 (IQR, 52.0–61.5) and 52.9 (IQR, 47.8–57.9), respectively, on a scale of 0 to 100 where 100 represents excellent physical or mental health. In this sample, 19% (18/95) of participants were in the lowest relative socioeconomic position (SEP) while 34% (32/95) were in the highest relative SEP. Belonging in the lowest SEP group was the strongest predictor of COPD.ConclusionIndividuals who have completed MDR TB treatment have a high prevalence of COPD and low mental and physical health summary scores. Our study highlights the need for pulmonary rehabilitation programs in patients with a low socioeconomic position (SEP) after MDR TB treatment.

Visual function and quality of life in children and adolescents with anophthalmia and microphthalmia treated with ocular prosthesis.

To evaluate health-related quality of life (HR-QoL), vision-related (VR-)QoL and perceptual visual dysfunction (PVD) among individuals with anophthalmia (A) and microphthalmia (M) treated with ocular prosthesis. The study comprised 15 individuals (mean age 6.6years; range 1.7-14.1) with unilateral A or M. Three validated instruments measuring HR-QoL and VR-QoL were used: The Pediatric QoL Inventory (PedsQL), consisting of physical and psychosocial self-report and parent-proxy report (2-18years); Children's Visual Function Questionnaire (CVFQ); and Effects of Youngsters' Eyesight on Quality of Life (EYE-Q). Perceptual visual dysfunctions (PVDs) were assessed by history taking according to a specific protocol. A/M children and their parents showed low HR-QoL scores (PedsQL total score: 66.3; 69.6) compared with controls (83.0; 87.61) (p=0.0035 and <0.0001, respectively, unpaired t-test). No differences were found between A/M children and parents, but parents tended to underestimate their children's emotional state. A/M children with subnormal visual acuity (VA) for age scored lower in physical health compared with A/M children with normal VA (p=0.03, Mann-Whitney U-test). No significant VR-QoL differences between A/M children and references or between A/M children with subnormal or normal VA for age were found. More A/M children than controls exhibited PVDs in ≥1 area (7/11 versus 4/118; p<0.0001, Fisher's exact test). A/M individuals show poor HR-QoL and increased PVDs. No difference in QoL was found between children and parents, though the children tended to score lower in emotional well-being. A/M children with subnormal VA showed lower physical health score. These problems indicate the necessity of a thorough multidisciplinary assessment and follow-up of children with A/M.

Qualities of social relationships as mediators of the relationship between future perceptions and health

Objectives Foreshortened future perceptions relate to higher mental and physical morbidity. However, socioemotional selectivity theory (SST) maintains that psychological well-being improves as future perceptions narrow due to growing tendency to prioritize meaningful goals and close relationships. The objective of this study was to reconcile this contradiction by examining a model in which the focus on close relationships suppresses the direct relationship between narrow future perceptions and physical/mental morbidity. Method Community-dwelling older adults (N = 249, mean age = 75.60, SD = 7.54) recruited through social clubs and day centers were interviewed at home. They filled self-report questionnaires measuring future time perspective, subjective nearness to death, positivity of relationships with others and inclusion of others in the self, while rating several physical/mental health indices. A structural equation modeling analysis tested direct and indirect effects. Results Narrow future perceptions related to higher mental (|β| ranged .28 to .47, p < .001) and physical morbidity (|β| ranged .37 to .45, p < .001) and, surprisingly, also to lower positivity of close relationships (|β| ranged .24 to .31, p < .01) and less inclusion of others (|β| ranged .17 to .21, p < .01). Both social indices mediated the relationship with lower physical health, while positivity of close relationships also mediated the relationship with psychological distress. Conclusion The findings challenge SST assumptions by underscoring the negative effects of narrow future perceptions on social relationship, making the latter a mediator rather than suppressor in the link between future perceptions and physical/mental morbidity. The findings should be viewed in light of the study’s limitations, including convenience sampling and cross-sectional design.

Prevalence and Health related effects of Internet Addiction on Medical students in a Tertiary care center

Background: Internet usage has increased exponentially in recent years. This growing use of internet has become worrisome as to whether to consider this excessive use as an addiction and if it negatively impacts one’s physical, mental and social health Aim: To investigate the prevalence of internet addiction and its association with health related factors in Medical students. Methods and Materials: A cross-sectional study was conducted with a sample size of 250. The students were asked to self-administer a semi-structured proforma regarding internet usage, Young’s IAT and Duke’s Health Profile. Young’s IAT was used to measure the addition level. Duke’s Health Profile was used to assess the physical, mental and social status. Result: 250 students participated in the study, 62% male and 38% female. 86% were found to be average online user and 1.2% had scores of category of Internet addiction. There was a significantly positive association between monthly expenditure and Young Score Grade. Those falling in category of Internet Addiction had low physical, mental and general health score and high Anxiety and Depression Score. Conclusion: From this study it can be concluded that internet addiction may have negative impact on physical, mental and social well-being of Medical students.

ІНФОРМАЦІЙНИЙ КОМПЕНДІУМ ЯК ОСНОВА ЗДОРОВ’ЯФОРМУВАЛЬНОГО СЕРЕДОВИЩА СТУДЕНТСЬКОЇ МОЛОДІ

Мета. Розробити інформаційний Компендіум, визначити його функції та мету, структурувати основні завдання. Методи. Аналіз і систематизація науково-методичної літератури та документальних матеріалів; абстрагування, логіко-теоретичний аналіз, системний підхід; аналіз і синтез, спостереження, опитування, анкетування, моделювання, методи математичноїстатистики. Під час констату- вального педагогічного експерименту нами проводилося анкетування студентів та викладачів щодо специфіки змісту здоров’яформуючих технологій і створення здоров’яформуючого середовища та обговорено відповідно питання анкети та власне суть передбачуваного інформаційного Компендіума. Результати. Узагальнення змісту наукових праць дало змогу виявити протиріччя між об’ємом накопичених,представлених у вільному доступі знань щодо здоров’язбереження та низьким рівнем фізичного здоров’ястудентської молоді, рівнем їх теоретичних знань щодо власного здоров’ябереження та здоров’яформування. Можемо констатувати, що сформованого у суспільстві в останні роки легкого доступу до будь якої інформації засобами інформаційних технологій є недостатньо для охоплення всієї молоді і задоволення їхніх потреб щодо конкретизації та глобалізації власне знань щодо здоров’яформування. Вроботі описано основні функції авторської розробки – інформаційного Компендіума: інформування, акцентування, орієнтування, супроводження, консультування та представлено завдання інформаційного Компендіума, як практичної частини реалізації технології здоров’яформуючого середовища студентської молоді. Висновок. В сучасному інформаційному просторі є потреба реалізації інформаційного Компендіума, з метою консультування студентів з питань організації власного здоров’яформуючого середовища. Використання Компендіума не повинно зводитися до формування тієї або іншої якостей або тільки до оволодіння знаннями, навиками, уміннями, оскільки цього недостатньо. Для реалізації здоров’яформуючих технологій в процесі фізичної підготовки потрібна мобілізація мотивів, вплив на відношення до дійсності, розвитку здоров’язберігаючої компетентності.Ключові слова: здоров’язбереження, здоров’яформуюче освітнє середовище, інформаційний Компендіум.

Caregiver Burden Due to Pulmonary Exacerbations in Patients with Cystic Fibrosis

To describe the poorly understood burden of pulmonary exacerbations experienced by primary caregivers of children (aged 2-17years) with cystic fibrosis (CF), who frequently require prolonged hospitalizations for treatment of pulmonary exacerbations with intravenous (IV) antibiotics. In this prospective observational study, 88 caregivers in Germany, Ireland, the United Kingdom, and the US completed a survey during pulmonary exacerbation-related hospitalizations (T1) and after return to a "well state" of health (T2). The impact of pulmonary exacerbations on caregiver-reported productivity, mental/physical health, and social/family/emotional functioning was quantified. Primary caregivers of children with CF reported significantly increased burden during pulmonary exacerbations, as measured by the 12-item Short-Form Health Survey mental health component and the Work Productivity and Activity Impairment: Specific Health Problem absenteeism, presenteeism, work productivity loss, and activity impairment component scores. Compared to the "well state," during pulmonary exacerbations-related hospitalization caregivers reported lower physical health scores on the Child Health Questionnaire-Parent Form 28. Quality-of-life scores on the Caregiver Quality of Life Cystic Fibrosis scale and total support score on the Multidimensional Scale of Perceived Social Support did not differ significantly between T1 and T2. More caregivers reported a negative impact on family/social/emotional functioning during pulmonary exacerbations than during the "well state." Pulmonary exacerbations necessitating hospitalization impose a significant burden on primary caregivers of children with CF. Preventing pulmonary exacerbations may substantially reduce this burden.

Physical Health and Psychological Outcomes in Adult Patients with Long-bone Fracture Non-unions: Evidence Today.

Background: Research has suggested that bone fractures can hinder the health status of patients’ life. However, limited research has examined the impact that the healing process of a fracture has on the physical health and psychological state of individuals, particularly in considering the short- and long-term impact of having a fracture that fails to heal and drops into a non-union. The aim of this systematic review is to better understand the impact of fracture non-union to physical health and to respective psychological outcomes. Methods: Electronic databases ‘PubMed’, ‘Cochrane’, ‘PsycInfo’, ‘Medline’, ‘Embase’, ‘Web of Science’, and ‘CINAHL’ were used. Search terms used were nonunion OR non-union OR “non union” OR “long bone” OR “delayed union” AND “quality of life” OR qol OR depression OR anxiety OR psycholog* OR PTSD OR “post-traumatic stress disorder”. Studies published in the years 1995 to 2018 were included. Two independent reviewers carried out screening and data extraction. Studies were included if (1) participants were adult (human) patients with a traumatic non-union secondary to fracture/s; (2) outcomes measured included physical health and psychological wellbeing (e.g., PTSD, psychological trauma, depression, anxiety, etc.). Studies received emphasis if they compared those outcomes between: (1) The “non-union” group to a normative, matched population and (2) the “non-union group” to the same group after union was achieved. However, studies that did not use comparison groups were also included. Results: Out of the 1896 papers identified from our thorough literature search, 13 met the inclusion criteria. Quality assessment was done by the Methodological Index for Non-Randomized Studies (MINORS). Findings suggested that non-unions had a detrimental impact on physical health, and psychological difficulties often after recovery. Conclusions: Patients who experience a long bone non-union are at risk of greater psychological distress and lower physical health status. There is a need for early identification of psychological distress in patients with fracture non-unions and psychological provision should become part of the available treatment.

Gambling with Your Health: Associations Between Gambling Problem Severity and Health Risk Behaviours, Health and Wellbeing

The current study examined the association between gambling problem severity and health risk behaviours, health and wellbeing. A cross-sectional survey (including representative population and supplementary convenience samples) was conducted with 2303 adult residents of a British Island. Gambling problem severity was assessed using the Problem Gambling Severity Index. The EQ-5D-5L, WEMWBS and AUDIT-C were used to measure general health, mental wellbeing and alcohol use, respectively. Other measures included diet, physical exercise and tobacco use. Differences between gambling severity levels for each measure were analysed using logistic regression adjusting for age, sex and income. Compared to non-problem gamblers, moderate/high severity gamblers had higher odds of a poor diet, low physical exercise and poor general health. Tobacco use was associated with both low and moderate/high severity gambling. Low severity, but not moderate/high severity gambling, was significantly associated with binge and higher risk drinking behaviours. Health risk behaviours tended to cluster, with a graded relationship between gambling problem severity and odds of reporting at least two health risk behaviours. Compared to non-problem gamblers, low severity gamblers were approximately twice as likely and moderate/high severity gamblers were three times as likely, to have low mental wellbeing. Findings suggest associations between gambling problems and a range of health risk behaviours and health issues, and crucially that such issues are not limited to gamblers with the highest severity of problems. Addressing gambling across the whole continuum of risk should be a key public health priority.

Food stamps, food insecurity, and health outcomes among elderly Americans

This study examined associations between very low food security and health outcomes in older adults, and tested whether participation in the Supplemental Nutrition Assistance Program (SNAP) mitigates adverse health consequences associated with very low food security. Data were drawn from the 1998–2014 waves of the Health and Retirement Study (N = 148,138 from 27,281 persons). A longitudinal analysis of the relationship between very low food security and health condition depending on SNAP participation was conducted using the individual fixed effects regression. Respondents' health status was assessed by self-rated health, grip strength, and depressive symptoms. The correlations between very low food security and physical health outcomes were negatively significant prior to SNAP enrollment (p < 0.05) but became insignificant upon participation, indicating that SNAP may have prevented poor physical health resulting from very low food security. However, results concerning mental health showed that SNAP enrollment does not modify the association between very low food security and depression; very low food security remained a significant risk factor of depressive symptoms conditional on SNAP enrollment (p < 0.001). Further analyses showed that SNAP participation is correlated with negative self-attitudes (p < 0.05), and that the correlation between SNAP and depression becomes insignificant after controlling for self-attitudes. These results suggest that a stigma effect arising from welfare use may have reduced self-esteem and resulted in depressive moods. Future research needs to delve into whether reforms to the food assistance program aimed at reducing stigma can help alleviate emotional distress among welfare recipients.

Health-related quality of life outcomes in pediatric patients with cardiac rhythm devices: a cross-sectional study with case-control comparison

BackgroundLittle is known about health-related quality of life (HRQoL) in pediatric patients with cardiac rhythm devices. This study aims to compare self- and proxy-reported HRQoL in patients with pacemaker (PM) and implantable cardioverter-defibrillator (ICD) to that in sex- and age-matched healthy controls and to examine predictors for generic and disease-specific HRQoL.MethodsThe study included 72 PM and ICD patients (39% females) and 72 sex- and age-matched healthy controls from 3 to 18 years of age. HRQoL data was obtained by the PedsQL 4.0 Generic Core Scales and Pediatric Cardiac Quality of Life Inventory. Medical data was collected retrospectively from medical records.ResultsPatients had significantly lower self- and proxy-reported generic overall HRQoL and lower physical health than healthy controls, and ICD patients also had lower psychosocial health. On multivariate analyses, generic overall HRQoL and physical health was significantly predicted by current cardiac medication (β = −.39, p = .02 for overall HRQoL, respectively β = −.44, p = .006 for physical health). Disease-specific overall HRQoL was only marginally predicted by child age, device type, and the presence of a structural congenital heart disease (p < .10).ConclusionsThis study shows that PM and ICD patients have lower HRQoL than healthy controls and that patients who need cardiac medication are seen by their parents at great risk for lower generic overall HRQoL. Our study also indicates a trend towards higher risk for low disease-specific HRQoL in younger patients, ICD patients, and patients with a structural congenital heart disease. Special attention should be given to these patients as they may benefit from a timely clinical evaluation in order to provide supportive interventions.

364 Shorter Esophageal Length Is Associated With Increased Proximal Reflux and Symptom Severity in Patients Presenting With Laryngopharyngeal Reflux (LPR) Symptoms

INTRODUCTION: Laryngopharyngeal reflux (LPR) is a heterogeneous condition with various underlying pathologies. The effect of esophageal anatomy on LPR is unclear. Shorter distance between lower esophageal sphincter (LES) and upper esophageal sphincter (UES) may allow refluxate to more easily reach the pharynx. We aimed to examine the effect of esophageal length on reflux parameters and symptoms. METHODS: 115 consecutive patients (64% female, mean age 53.9 yrs) with suspected LPR referred for high-resolution manometry (HRM) and combined hypopharyngeal-esophageal multichannel intraluminal impedance-pH testing (HEMII-pH) at a tertiary center in 3/2018-5/2019 were enrolled. Validated symptom surveys were prospectively collected at time of testing, including Reflux Symptom Index (RSI) and 12-item short-form health survey (SF-12) for health-related quality of life (HRQOL). Esophageal length was measured from the distal margin of UES to the proximal margin of LES on HRM. Univariate analyses were performed with Pearson correlation or Student’s t-test. Generalized linear regression was used for multivariate analysis. RESULTS: Mean esophageal length on HRM was 20.4 cm (SD = 2.2). Esophageal length was significantly shorter among patients with a hiatal hernia ≥2 cm (19.2 cm vs 20.6 cm, P = 0.01), but did not correlate with any primary motility disorder per Chicago classification v3.0. Shorter esophageal length was significantly associated with higher acid exposure time and proximal reflux events on impedance, with a trend toward more total reflux events (Table 1). Esophageal length was also shorter among patients with pharyngeal reflux events on HEMII-pH compared to those without (20.0 cm vs 20.9 cm, P = 0.04). Even after controlling for hiatal hernia size, esophageal length remained independently predictive of reflux severity and pharyngeal reflux events. There was a correlation between shorter esophageal length and more severe symptoms on the heartburn/chest pain/indigestion subscore of RSI, but not total RSI or throat symptom subscores (Table 2). Shorter esophageal length was associated with lower physical health scores on SF-12 for HRQOL (Figure 1). CONCLUSION: Shorter esophageal length is independently associated with increased reflux severity, proximal reflux, and pharyngeal reflux, even after controlling for hiatal hernia size. It also correlates with more severe typical reflux symptoms and physical HRQOL. Decreased esophageal length may play a role in the pathophysiology of reflux in patients with LPR symptoms.

ПОРІВНЯЛЬНА ХАРАКТЕРИСТИКА ПОКАЗНИКІВ ЯКОСТІ ЖИТТЯ У ПАЦІЄНТІВ З ХРОНІЧНОЮ СЕРЦЕВОЮ НЕДОСТАТНІСТЮ ЗІ ЗНИЖЕНОЮ ФРАКЦІЄЮ ВИКИДУ ЛІВОГО ШЛУНОЧКА ЗАЛЕЖНО ВІД ВАРІАНТУ ЗАЛІЗОДЕФІЦИТУ

Introduction. Quality of life (QoL) indicators in case of chronic heart failure (CHF) are associated with a number of clinical and instrumental indicators, which makes it possible to consider its assessment as one of the leading indicators of its severity. From a practical point of view, the identification of QoL indicators as the markers of CHF severity in patients with concomitant iron metabolism disorders, including different variants of latent and manifest iron deficiency (ID)is rather interesting. Purpose. To compare QoL parameters by means of MOS SF-36 and MLHFQ questionnaires in patients with CHF with reduced left ventricular ejection fraction with different iron deficiency types. Materials and Methods. 152 patients with CHF functional class (FC) II-III according to NYHA with reduced left ventricular (LV) ejection fraction (EF) of hypertensive and ischemic etiology with/and without iron deficiency (ID) were examined. All patients were divided into three clinical groups: the first clinical group (which is presented as a comparison group) amounted to 30 (19.7 %) patients with CHF with reduced LV EF without ID, the second one amounted to 60 (39.5 %) patients with CHF with reduced LV EF and latent ID, which included a number of patients with functional and absolute ID and the third clinical group amounted to 62 (40.79 %) patients with I-II severity degree of concomitant iron deficiency anemia (IDA). In order to assess QoL, all patients were interviewed using MOS SF-36 and MLHFQ. The comparison of the obtained findings was carried out among groups of patients with CHF with reduced LV EF without iron metabolism disorders, with functional ID and absolute ID, and among groups of patients with CHF with reduced LV EF without iron metabolism disorders, with I degree of IDA and II degree of IDA. Research findings. It was detected that in comparison with the group of patients without ID, QoL indicators according to MLHFQ questionnaire in patients with functional ID and absolute ID were significantly worse – 49.5 versus 53.5 (p = 0.05) and 60 points (p = 0.009), respectively. Physical health (PH) in these groups was 37.9 (p = 0.033) and 37.2 (p = 0.0068), respectively, which significantly differed from PH value in the comparison group – 41.2 points. In patients with functional ID and absolute ID lower PH values were detected due to significantly worse indicators of physical functioning (PF), role-physical functioning (RP) resulting from physical condition and general health (GH). Similar results were obtained during the analysis of QoL in patients with IDA of different degrees. In patients with mild IDA and moderate IDA as compared to the group of patients without ID, QoL indicators, according to MLHFQ questionnaire, were significantly worse (p = 0.007) and (p < 0.00001) 57 and 62 versus 49.5 points, respectively. In addition, it was detected that PH value according to SF-36 questionnaire results in the groups with IDA was also significantly lower than PH value in the group without ID due to low values of PF, RP and GH and amounted to 36.8 (p = 0.01) and 33.6 (p < 0.00001) versus 41.2 points, respectively. According to the conducted analysis, mental health (MH) decreased with the presence of functional and absolute ID and with an increase of IDA from mild to moderate degree, however significantly lower value was detected only in the group with moderate IDA as compared to the group of patients without ID (p = 0.02). In addition, a number of significant relations between QoL indicators according to MLHFQ, PH and MH scale SF-36 and hematological parameters and a number of iron metabolism indicators were detected during the study. This confirms the dependence of the patients’ QoL on existing iron metabolism disorders. Conclusions. Patients with CHF with reduced left ventricular ejection fraction and concomitant ID, regardless of the presence of anemia, are characterized by the worse QoL level as compared to the patient without ID. Whereas, latent functional and absolute ID has the same clinical relevance in terms of deterioration of QoL of patients with CHF. Reduction of iron metabolism levels can be considered as predictors of deterioration of patients' QoL and severe CHF.

Health related quality of life (HRQoL) in mothers of premature infants at NICU discharge.

Premature delivery and a potential Neonatal Intensive Care Unit admission may be associated with the risk of poor maternal health. We aimed to examine the mothers' health-related quality of life (HRQoL) at the time of infant discharge. Fifty mothers completed the Medical Outcomes Study-Short Form 12. It has a Physical Component Score (PCS) and Mental Component Score (MCS), both with a mean of 50 and standard deviation of 10. Analysis included infant, maternal, and pregnancy-related characteristics. In multivariable analyses, a household income of <150K lowered the PCS by 10 points (p = 0.003) compared to those with higher incomes. Marginal significance was noted in GA, for every week gained the PCS score was lower by 1.5 points. Several risk factors are associated with lower physical health ratings in mothers of preterm infants at discharge. This information can be used to inform providers in their anticipatory guidance to the family and follow-up plans.

Quality of life of children with achondroplasia and their parents - a German cross-sectional study

BackgroundAchondroplasia is the most common form of disproportionate short stature and might affect not only the quality of life of the affected child but also that of the parents.ObjectivesWe aimed to investigate the quality of life of children with achondroplasia from child- and parent perspective as well as the parental quality of life.MethodsForty-seven children with achondroplasia and 73 parents from a German patient organization participated. We assessed children’s quality of life using the generic Peds QL 4.0™ as self-reports for children aged 8–14 and parent-reports for children aged 4–14 years. Parental quality of life we assessed using the short-form 8-questionnaire.ResultsChildren with achondroplasia showed significantly lower quality of life scores compared to a healthy reference population from both the child- and parent-report (p = ≤.01), except the child-report of the emotional domain (t (46) = − 1.73, p = .09). Parents reported significantly lower mental health in comparison with a German reference population (t (72) = 5.64, p ≤ .01) but no lower physical health (t (72) = .20, p = .85). While the parental quality of life was a significant predictor of parent-reported children’s quality of life (F (6,66) = 2.80, p = .02), it was not for child-reported children’s quality of life (F (6,66) = .92, p = .49).ConclusionsAchondroplasia is chronically debilitating. Thus special efforts are needed to address patients’ and parent’s quality of life needs. This special health condition may influence the daily life of the entire family because they have to adapt to the child’s particular needs. Therefore, clinicians should not only focus on the child’s quality of life but also those of the parents.

Patterns of Sedentary Behavior in the First Month After Acute Coronary Syndrome.

BackgroundSedentary behavior is a key contributor to cardiovascular disease. Few data exist on the sedentary behavior patterns of patients with acute coronary syndrome.Methods and ResultsWe characterized patterns of sedentary time and their correlates in 149 patients with acute coronary syndrome over the first month postdischarge, a critical period when lifestyle behaviors are formed. Sedentary time was measured by accelerometry for 28 days postdischarge. Group‐based modeling at the day level was used to characterize sedentary patterns. Participants spent a mean of 9.7±2.0 hours per day sedentary during the 28 days postdischarge, with significant decreases in sedentary time observed in each consecutive week (P<0.01 for all). Three distinct sedentary patterns were identified: high (20.6% of participants), moderate (47.9%), and low (31.5%). The high and moderate sedentary groups spent a mean of 12.6±0.8 and 10.0±0.7 hours per day sedentary, respectively, and had only minimal decreases in their sedentary time (<3 minutes per day) over the 28 days. The low sedentary group spent a mean of 7.3±0.8 hours per day sedentary, with a rapid decrease in sedentary time (14 minutes per day) observed during the first week postdischarge followed by a relatively smaller decrease (≈5 minutes per day) that persisted until day 21 postdischarge. Non‐Hispanic ethnicity, left ventricular ejection fraction <40%, lower physical health–related quality of life, and not having a partner were associated with an increased likelihood of being in the high sedentary group.ConclusionsSurvivors of acute coronary syndrome accrued high volumes of sedentary time during the first month postdischarge, with most showing little change over time. Interventions targeting reductions in sedentary time among survivors of acute coronary syndrome may be warranted, particularly for those with poor physical health and greater disease severity.

Assessing quality of life in patients with heart failure in Cyprus

Background Heart failure is a chronic disease with a serious impact on patients' quality of life which is influenced by several factors. Aims The purpose of this study is to evaluate the quality of life of patients with heart failure in the city of Limassol in Cyprus. Methods The proposed study is characteristically descriptive quantitative research. The sample includes 99 patients with heart failure in Limassol Hospital, using the Minnesota Living with Heart Failure Questionnaire in the Greek Language. The data were collected from October 2017 to November 2017. Findings Our sample consisted of 99 individuals from the Limassol district, 40 (40.4%) were females and the average age of the patients was 68.5±14 years. Patients with heart failure who had a primary education averaged 9.69 points on the quality of life scale. This is lower than patients with higher education (b=9.69 P=0.057), lower physical health by 7.35 points (b=7.35 P=0.008) and lower by 2.26 Social health units (b=2.26 P=0.030). Conclusion Patients with heart failure experience many and complex problems. Through this research, it appears that different dimensions of quality of life are affected, such as physical, social and emotional health. The older the age of the patient, the lower levels of education and the sex of the patient have an impact on the quality of life of patients with heart failure.

THE ASSOCIATION BETWEEN INFORMAL CAREGIVING AND BEHAVIORAL RISK FACTORS: AN ANALYSIS BASED ON DATA OF THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)

18.2 % of the U.S. adult population are informal caregivers (CG) [1]. Previous studies found that CG have lower physical health compared to non-caregivers (NCG) [2]. Detrimental health behavior to cope with the burdensome caregiving experience is one hypothesis to explain this association [2]. As dementia caregivers (DCG) seem to be an especially vulnerable group, they may also differ from other CG in terms of health behavior. This study aims to (1) compare DCG to NCG regarding alcohol consumption, tobacco use, obesity and physical activity and (2) to identify caregiving-related factors, which are associated with behavioral risk factors in DCG. We used cross-sectional data from the 2017 wave of the Behavioral Risk Factor Surveillance System (BRFSS). Dependent variables were overweight/obesity, smoking, risky alcohol consumption and insufficient physical activity. Independent variables were (1) caregiver status (yes/no) or (2) CG intensity, length of CG, relationship to the CG recipient and type of CG task. Comparability between groups was achieved by means of the entropy balancing approach. Logistic regression analyses adjusted for sociodemographic characteristics and other behavioral risk factors were performed. The study sample consisted of 45,925 NCG and 12,044 CG of which 1,214 were DCG. DCG were on average older and more often females than NCG. DCG odds of overweight/obesity and smoking were higher (OR=1.19 and 1.23, p<0.05), but odds of binge drinking were lower (OR=0.72, p<0.05). For DCG, results were non-significant for insufficient physical activity (OR=0.91, ns). Caregiving-related variables seem to influence the likelihood of the outcomes to some extent, but depending on the outcome variable in different directions. Being a CG/DCG is associated with risky as well as health-promoting behavior. However, the effects are rather low which leads to the conclusion that future studies need to consider health behavior in a multifactorial model to give a causal explanation for lower physical health in CG. [1] National Alliance for Caregiving (NAC), AARP Public Policy Institute: Caregiving in the U.S. 2015 [Internet]. 2015. Available from: https://www.aarp.org/content/dam/aarp/ppi/2015/caregiving-in-the-united-states-2015-report-revised.pdf. Accessed 08 Nov 2018. [2] Bauer JM, Sousa-Poza A. Impacts of Informal Caregiving on Caregiver Employment, Health, and Family. Journal of Population Ageing. 2015;8:113-145.

Factors predicting physical and mental health-related quality of life among post-myocardial infarction patients: Bayesian model averaging analysis

Coronary artery disease was the cause of half of morbidity and mortality due to cardiovascular diseases in 2013. Myocardial infarction (MI) has been a common medical emergency with high mortality rate and complications unless it is early and appropriately treated. Health-related quality of life (HRQoL) has been popularly used in assessment of health state among coronary artery disease patients undergone both medical and surgical therapies. Bayesian model averaging approach statistically facilitated for identifying potential predictors of HRQoL among post-MI patients following up at University Medical Center, Ho Chi Minh City. The cross-sectional descriptive study was conducted on 146 participants diagnosed and treated with acute myocardial infarction from April 1st 2017 to June 30th 2017. The better HRQoL in physical component summary was associated with higher educational levels (coefficient = 1.2) and weekly moderate - intensity physical activity (coefficient = 0.002) but the contrast status for the female (coefficient = -3.7) in the fit model with R2 = 0.24, BIC = -25.7 and posterior probability = 11.7%. The good economic household (coefficient = 9.8), more daily sitting time (coefficient = 1.4) and weekly moderate - intensity physical activity (coefficient = 0.004) predicted the increase of mental component summary score in the given model with R2 = 0.08, BIC = -20.3 and posterior probability = 25%. The post - MI patients experienced low physical health much more than mental health. The female and suitable physical activity should be concerned in the rehabilitation program as well as follow-up care during the discharge process.

The glass is not half empty: optimism, pessimism, and health among older adults.

Optimism and pessimism are distinct constructs that have demonstrated independent relationships with aspects of health and well-being. The purpose of this study was to investigate whether optimism or pessimism is more closely linked with physical and mental health among older adults. Cross-sectional survey. Community-dwelling older adults (N = 272) ages 59-95 in the southern United States. The Life Orientation Test-Revised and the Short Form 8. At the bivariate level, optimism was associated with higher physical health and mental health, while pessimism was associated with lower physical health and mental health. Multiple-regression analyses as well as comparison of correlation coefficients found that pessimism was more closely associated with physical health and mental health than optimism. These results add to the literature suggesting that, in terms of older adults' health and well-being, avoiding pessimism may be more important than being optimistic.