Perceived Health Rating Research Articles

Biophilic design: the case for Malta

The human need to relate with the natural environs is the foundation of biophilic design. Thus, such a design solution aims to establish a relation between the built environment and nature; it is fundamental to the well-being of the users of a given space. The objective of this study is to assess the relationship between employees’ sensation of well-being and work place design in Malta, the smallest-in-size member state of the European Union, during the COVID-19 pandemic. Based on an online questionnaire circulated to all employees in the civil service and public authorities of Malta, the present working environs were studied and proposed design solutions were put forward. The data collected was analyzed by making use of the Statistical Package for the Social Sciences. Apertures were found to have substantial impact on the employees’ mental well-being, health and mood; whilst reducing anxiety, they increase the perceived health ratings. Naturally lit and ventilated workspaces lead to higher productivity and less fatigue. The survey results provide a snapshot of the current work environs and provide data for improving their re-design along biophilic principles, an important consideration given that the island’s workforce suffers from the highest rates of depression, anxiety and elevated stress levels within the European Union.

Characteristics associated with cooking frequency among college students

The objective of this study was to determine cooking frequency and identify student characteristics associated with cooking frequency among students from the University of North Carolina at Chapel Hill. This cross-sectional study included data from 4845 students who completed an online survey in the fall of 2016. Cooking frequency was assessed using the question “How often do you cook for yourself or for others?” with the response options being “often,” “sometimes,” and “never.” Students also self-reported information on a variety of student characteristics. Descriptive statistics were calculated and associations between cooking frequency and student characteristics were assessed using Pearson's chi square tests, ANOVA, and multinomial logistic regression. Statistical significance was considered p < 0.05. Among students in the sample, 45.7% reported often cooking, 40.3% reported sometimes cooking, and 14% reported never cooking. Characteristics significantly associated with cooking frequency in the adjusted models were race/ethnicity, year in school, living on vs. off-campus, having a car, receiving financial aid, perceived health rating, weight status, having a meal plan, food security status, and perceived cooking skills. Age, gender, marital status, having dependent children, being an international student, part-time vs. full-time enrollment, and employment status were not significantly associated with cooking frequency in adjusted models. Cooking was common among college students in this sample, although there were differences in characteristics among students who reported different frequencies of cooking.

P22 Prevalence of and Characteristics Associated with Food Security Status Among International College Students

<h3>Background</h3> The majority of studies on food insecurity among US college students show higher prevalence rates than the general population. Past studies have looked at characteristics associated with food security status among US college students, but have not focused specifically on international students. <h3>Objective</h3> To estimate the prevalence of and identify characteristics associated with food insecurity among international students at the University of North Carolina at Chapel Hill. <h3>Study Design, Setting, Participants</h3> This cross-sectional study used data from 263 international students attending the University of North Carolina at Chapel Hill who completed an online survey in October and November of 2016. <h3>Measurable Outcome/Analysis</h3> Food security status was assessed using the 10-item US Adult Food Security Survey Module and students were categorized as having high food security, marginal food security, or food insecurity. Self-reported demographics and other student characteristics were also assessed. Descriptive statistics were calculated. Monte Carlo Estimates for the Exact Test and ANOVA were used to assess statistical significance for the association between food security status and student characteristics. Statistical significance was considered <i>P</i> < .05. <h3>Results</h3> Among students in the sample, 51% reported high food security, 24% marginal food security, and 25% food insecurity. Characteristics significantly associated with food security status were gender, year in school, having a car, and perceived health rating. Age, years in the US, academic performance, marital status, having dependent children, living on vs off-campus, employment status, receiving financial aid, weight status, cooking frequency, perceived cooking skills, and having a meal plan were not significantly associated with food security status. <h3>Conclusions</h3> Lack of food security is a serious issue among international students at the University of North Carolina at Chapel Hill, with nearly half reporting food insecurity or marginal food security. The characteristics identified in this study as being associated with food security status can help to inform future research and interventions for addressing food security status among international students.

Testing The Feasibility Of Referred At-risk Patients Participating At A Hospital-based Healthy-lifestyle Management Program

PURPOSE: Facilitating health promotion programs within healthcare is supported by the Institute of Medicine, which is establishing a systematic implementation approach that incorporates eight social and behavioral vital signs including exercise in the electronic health record (EHR). Though limited time during clinic visits is a challenge for implementation. Using an established healthy-lifestyle management program (HLMP) to support this approach could reduce burden on clinical practitioner. The purpose was to test the feasibility of implementing fitness measures in an HLMP. METHODS: Healthy Me is a free HLMP offered to patients in a public, Midwest health system. Patients are enrolled through physician referral via EHR. Eligible patient have a BMI > 25, cardiovascular disease, pre /type II diabetes, and/or depression. Low-risk patients who meet eligibility criteria can enter Healthy Me through an EHR automated bulk referral process. Healthy Me is delivered by health coaches trained in motivational interviewing, group fitness, health promotion, and chronic disease management. Patients performed chair stand, arm curl and two-minute step tests. RESULTS: The sample included 1254 patients (80.1% women), who were 48.9 + 15.46 years of age, with a BMI of 37.4 + 10.46 and reported fair/good (74.9%), poor (16%) or very good/excellent (9.1%) health. Eighty-three patients (6.7%) completed multiple fitness tests and 654 (52.2%) completed one test. Only females completed multiple fitness tests. Chi-square test found those who completed one test had higher perceived health ratings (χ2 = 15.6, p = .048). Bivariate correlations found BMI was associated positively with waist measures (r = .88, p <.001), and negatively with chair the stand score (r = -.21, p = .015), march score (r = -.32, p = .029), general health rating (r = -.53, p <.001), general physical (r = .11, p = .054) and mental (r = .33, p = .043) health. CONCLUSIONS: Results revealed differential characteristics between patients who only visited Healthy Me and those who completed the health/fitness tests. Future directions include using tailored approaches to encourage fitness test completion. Multiple correlations with BMI and health/fitness parameters align with previous work and emphasize the importance of promoting healthy behaviors in HLMPs, such as exercise.

The importance of precision: differences in characteristics associated with levels of food security among college students.

To estimate the prevalence of high, marginal, low and very low food security among a sample of college students and identify characteristics associated with the four different food security status levels and note differences in associations from when food security status is classified as food-secure v. food-insecure. Cross-sectional online survey. A large public university in North Carolina. 4829 college students who completed an online survey in October and November 2016. Among study participants, 56·2% experienced high, 21·6% experienced marginal, 18·8% experienced low and 3·4% experienced very low food security. Characteristics significantly associated with food security status when using the four-level variable but not two-level variable were age, international student status and weight status. Characteristics that significantly differed between the marginal and high food security groups included age, race/ethnicity, year in school, international student status, employment status, financial aid receipt, perceived health rating, cooking frequency and participation in an on-campus meal plan. Characteristics with differences in significant associations between the low and very low food security groups were gender, international student status, having a car, weight status and participation in an on-campus meal plan. Even where similarities in the direction of association were seen, there were often differences in magnitude. We found differences in characteristics associated with food security status when using the four-level v. two-level food security status variable. Future studies should look separately at the four levels, or at least consider separating the marginal and high food-secure groups.

Abstract P562: Firefighters Have Worse Cardiovascular Health And Mental Health Characteristics Than Civilians And Different Blood Pressure Surge Responses To Pager Activation

Introduction: Heart-related incidents cause over 50% of LODD in firefighters (FF). Physical, health-related, and emotional stress are all part of the FF job; and these all increase BP levels and cardiac risk. Using ambulatory BP (ABP) monitoring to measure BP over time and quantify the BP surge with alarm is a novel way to assess risk, so we compared a group of FF to Civilians. We hypothesized that FF would have worse CV health and higher BP surges compared to civilians. Methods: We included 43 FF and 30 Civilians who completed 3 visits: ABP monitoring with pager activation, a fasted clinical appt, and fitness testing. Participants wore the ABP cuff for a 12-hr period, during which they were paged by a pager app (OnPage) or by emergency service dispatch. When the pager sounded, they were instructed to force an ABP reading to assess the BP surge. Average BP levels and surges were determined. Fasted visit included BP, body fat, lipid panel, and vascular health measures. Fitness test included a treadmill VO 2peak and a battery of other fitness tests. Participants also completed a health history form and the DASS-21 questionnaire assessing stress, anxiety, and depression. Results: We found that FF (39.4 ± 2.2 yrs) had worse CV health, better fitness, but higher stress and depression levels compared to Civilians (39.7 ± 2.7 yrs), P&lt;0.05 for differences. FF had higher clinic SBP (128.7 ± 1.7 vs 119.7 ± 1.9), clinic DBP (81.8 ± 1.2 vs 75.7 ± 1.7), central arterial pressures measured by SphygmoCor® XCEL (121.8 ± 2.7 vs 112.3 ± 2.9 and 84 ± 1.5 vs 78.3 ± 2.3), and average SBP measured by ABP (130.9 ± 1.5 vs 119.6 ± 4.3 mmHg). FF had higher Pre-Alarm SBP levels (126.9 ± 3.3 vs 112.5 ± 4.8 mmHg) but similar Post-Alarm SBP levels. Thus, FF had a smaller SBP surge with alarm (12.5 ± 2.3 vs 16.2 ± 5.5 mmHg). Clinically, FF had similar cholesterol (183.5 ± 5.3 vs 188.9 vs 9.9) and LDL levels (117.9 ± 4.8 vs 116 ± 10.2 mg/dl), had similar BF percentages (29.4 ± 1.5 vs 31.7 ± 1.5 %), but were heavier (203.9 ± 5.5 vs 182.7 ± 7.3 lbs). FF also had lower HDL (46.8 ± 2.6 vs 59.9 ± 3.6 mg/dl), percent flow-mediated dilation (8.4 ± 0.8 vs 10.1 ± 1 %), and SEVR (156.1 ± 4.1 vs 172.6 ± 5.4) levels. For fitness, FF had similar VO 2peak (35.2 ± 0.9 vs 37.1 ± 1.8 ml/kg-min) but better plank pose (110.1 ± 9.5 vs 73.8 ± 6.7), wall sit (112.7 ± 15.9 vs 59.4 ± 5.2 sec), and #steps climbed in 2 min (320.8 ± 10.1 vs 280.2 ± 11.8). FF had worse overall psychometric characteristics: higher DASS-21 total score 13.9 ± 2.3 vs 5.5 ± 1.3; depression score 5.1 ± 1.3 vs 0.7 ± 0.3; stress score 5.9 ± 0.9 vs 2.7 ± 0.7; but similar anxiety scores 2.9 ± 0.4 vs 2 ± 0.6. Conclusions: In conclusion, with this subset of baseline data, we confirmed that FF have worse CV health, stress, depression and perceived health ratings. It is known that exercise and diet can improve all of these. Therefore, our participants are currently undergoing a diet and exercise intervention to assess changes in health, psychometric scores, and BP surge levels.

P23 Examining Characteristics Associated with Cooking Frequency Among College Students

Background Cooking has been shown to be associated with improved dietary intake, yet little research exists on cooking frequency among college students. Objective To determine cooking frequency and identify student characteristics associated with cooking frequency among UNC Chapel Hill students. Study Design, Settings, Participants This cross-sectional analysis used data from 4,845 UNC Chapel Hill students who completed an online survey in October and November of 2016. Measurable Outcome/Analysis Cooking frequency was assessed using the question “How often do you cook for yourself or for others?” with the response options being “often,” “sometimes,” or “never.” Self-reported data on a variety of student characteristics was also collected. Descriptive statistics were calculated and multinomial logistic regression was used to assess the association between cooking frequency and student characteristics. Statistical significance was considered P Results Among students in our sample, 46% often, 40% sometimes, and 14% never cooked. African American students were significantly less likely to often cook compared with non-Hispanic white students. Compared to students with a perceived health rating of excellent, students with a perceived health rating of fair were less likely to often cook and students with a perceived health rating of poor were less likely to often or sometimes cook. Having higher perceived cooking skills, a lower food security status, and a car were associated with an increased adjusted odds of sometimes or often cooking. Students receiving financial aid were significantly more likely to often cook. Students living on-campus and Freshman were significantly less likely to often or sometimes cook. Having a meal plan and experiencing overweight were associated with a significantly lower adjusted odds of cooking often. Conclusion A variety of characteristics were associated with cooking frequency among UNC Chapel Hill students, including perceived cooking skills. Understanding characteristics associated with cooking frequency can help to inform the development of cooking interventions for college students. Funding None.

Perceived anxiety control is associated with sleep disturbance in young and older adults

Objective: This study examined the extent to which perceived anxiety control was related to subjective sleep disturbance in young and older adults.Method: Fifty-one young adults (18 to 30 years old) and 48 older adults (aged 65 years and older) completed questionnaires including the Pittsburgh Sleep Quality Index (PSQI) to assess sleep disturbance, Anxiety Control Questionnaire to assess perceived control over anxiety, a perceived health rating, and demographic questionnaire. Correlation and multivariable adjusted hierarchical regression analyses examined the extent to which anxiety control was associated with sleep disturbance.Results: Anxiety control and health status were associated with global sleep quality on the PSQI, but no age differences in PSQI scores were found. In post hoc analyses, greater anxiety control was related to shorter sleep latency. Both older age and greater anxiety control were associated with less daytime dysfunction, whereas only older age was associated with better sleep quality.Discussion: Although some variations in sleep quality by age were found, overall findings suggest that perceived anxiety control contributes to sleep disturbance in young and older adults. Greater anxiety control could lead to shorter sleep latency through reduced anxiety and worry symptoms at bedtime. Future studies should examine whether improved anxiety control with psychological treatments is one mechanism through which beneficial and lasting effects on sleep disturbance can be achieved.

Interrelationship of PTSD, perceived health, and treatment satisfaction

Purpose – The residential therapeutic community (TC) treatment modality has been shown to effectively reduce drug use and improve psychiatric/medical health among clients who are often disproportionately impacted by medical conditions and have a co-occurring psychiatric disorder such as Posttraumatic Stress Disorder (PTSD). Yet not much is known regarding how clients’ health may impact their treatment satisfaction. Using path analysis, the interrelationship between PTSD, perceived health, and treatment satisfaction was examined. The paper aims to discuss these issues. Design/methodology/approach – A survey including the Posttraumatic Stress Disorder Checklist-Specific (PCL-S), a perceived health rating, and a Treatment Satisfaction Scale was collected from 303 clients at three comparable long-term residential TC treatment programs in New York City. Findings – Findings indicated that clients with PTSD rated their health significantly worse than those without PTSD. Although no direct relationship between PTSD and treatment satisfaction was found, there was a significant positive correlation between perceived health and treatment satisfaction. Research limitations/implications – Findings likely constitute a regional sample thus generalizability is limited. Practical implications – Simultaneously addressing addiction, PTSD, and medical issues can improve clients’ treatment satisfaction, consequently increasing treatment retention and producing greater positive post-treatment outcomes. Originality/value – Few if any studies have examined the extent to which PTSD and perceived health impact treatment satisfaction within residential substance abuse treatment programs.

Pathways to depressed mood for midlife women: observations from the Seattle Midlife Women's Health Study.

The purpose of this study was to develop and test a multidimensional model of depressed mood experienced by women during midlife. Three pathways to depressed mood were tested for their explanatory power, including menopausal transition, stressful life context, and health status pathways in a multiethnic sample (N = 337). Multiple measures for each variable in the three paths included the CESD and SCL 90 depression scales, menopausal changes questions, vasomotor symptoms rated in a daily health diary. Life Events Scale, Attitudes toward Menopause and Attitudes toward Aging Scales, and chronic health problems and perceived health ratings. The stressful life context pathway was most influential in accounting for depressed mood. Health status had a direct effect on depressed mood and an indirect effect through stress. The menopausal changes pathway had little explanatory power. These results support the need for clinicians to look beyond menopausal status to the broader context of midlife women's lives.

A validation of the concept of current perceived health and the Current Perceived Health-42 (CPH-42) questionnaire.

Perceived or self-rated general health in its trait form reliably predicts subsequent mortality among certain sections of the community. In an investigation of the predictive value of health status at the time of assessment, 574 cases drawn from five groups (police trainees, firemen, students, out-patients and in-patients) were used to validate what we have called current perceived health (CPH) and the CPH-42, a measure of CPH is described. Results indicate those rating CPH as poorer were more likely to consult a doctor (chi 2 = 45.9, df = 1, p < 0.0000) and use medication (chi 2 = 61.0, df = 1, p < 0.0000). In comparison, general perceived health ratings did not predict either consultation or medication use. The instrument has good psychometric properties, with high divergent validity from general mental health and general health, with a Guttman split-half reliability > 0.79. Discriminant analysis using the CPH-2 achieved high correct classification rates (up to 100%). Comparison of a scoring method based on canonical coefficients (83% correct classification) with that based on summative scores (74% correct classification) indicate the former method to be more accurate. Age, and among people 40 years or older, gender were significant independent predictors of current perceived health status, with older people rating their current health less positively than younger, and females over 40 years rating their current health less positively than their male counterparts.

Nebivolol in Hypertension

Nebivolol is a selective beta 1-adrenoceptor antagonist with a particular hemodynamic profile, suggesting an ancillary vasodilating property. The nature of this ancillary property is still unknown. The present double-blind placebo-controlled multicenter study investigated the effect of 4 and 8 weeks treatment with nebivolol 5 mg once daily on blood pressure (BP), heart rate (HR), blood parameters, and ECG. The effect on quality of life perception and the adverse effect profile were also studied. Nebivolol 5 mg once daily had a good antihypertensive effect in supine (10/8 mm Hg) as well as in standing position (16/10 mm Hg). Of 114 patients studied, 65% had either normalization of or > 10% reduction in diastolic BP (DBP). No evidence of drug tolerance was observed during the 8-week treatment period. Quality of life perception, as measured with the Inventory of Subjective Health (ISH) and the perceived health rating scale, was not impaired with nebivolol during the entire 8-week study. Nebivolol showed a favorable adverse effect profile and appeared to be devoid of central nervous system (CNS) adverse effects. The total number of complaints with nebivolol treatment did not differ from the number of complaints with placebo treatment. ECG and blood analyses, also show that nebivolol is safe and well tolerated. This study also shows that absolute drug-induced changes in quality of life perception can be assessed only in a placebo-controlled study and that comparison with baseline might be incorrect and misleading.

Understanding the context of perceived health ratings: The case of spousal bereavement in later life

Using a sample of 339 older adults at 2 to 3 months of bereavement the following research questions are addressed: What objective physical and psycho-emotional factors influence the perceived health ratings of older adults following the death of their spouses and how much of the variance in their ratings can be explained by the specific set of characteristics? This investigation helps to identify the major factors that older adults take into account in rating their perceived health. Perceived health status was most strongly related to the number of symptoms reported. The objective physical health indicators as well as grief and depression were significantly correlated with perceived health ratings. Nearly 41% of the variance in perceived health was explained by six factors of which 25.9% was due to the number of reported symptoms. Depression and medical conditions made a moderate contribution while the role of unresolved grief was minimal. Physician visits and days sick also made minor contributions. The general conclusion is that the bereavement context influences the factors that older adults take into account in their perceived health ratings and that it is important to recognize that perceived health ratings occur within and are influenced by personal and situational factors of the context.

Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort.

The association between perceived health ratings ("excellent," "good," "fair," and "poor") and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California, and a subsequent nine-year follow-up. Risk of death during this period was significantly associated with perceived health rating in 1965. The age-adjusted relative risk for mortality from all causes for those who perceived their health as poor as compared to excellent was 2.33 for men and 5.10 for women. The association between level of perceived health and mortality persisted in multiple logistic analyses with controls for age, sex, 1965 physical health status, health practices, social network participation, income, education, health relative to age peers, anomy, morale, depression, and happiness.