Impaired Physical Health Research Articles

Assessing civility at an academic health science center: Implications for employee satisfaction and well-being.

Incivilities are pervasive among workers in healthcare institutions. Previously identified effects include deterioration of employee physical and mental health, absenteeism, burnout, and turnover, as well as reduced patient safety and quality of care. This study documented factors related to organizational civility at an academic health sciences center (AHSC) as the basis for future intervention work. We used a cross-sectional research design to conduct an online survey at four of five campuses of an AHSC. Using the Organizational Civility Scale (OCS), we assessed differences across gender, race (White and non-White) and job type (faculty or staff) in the eleven subscales (frequency of incivility, perceptions of organizational climate, existence of civility resources, importance of civility resources, feelings about current employment, employee satisfaction, sources of stress, coping strategies, overall levels of stress/coping ability, and overall civility rating). Significant gender differences were found in six of the eleven subscales: perception of organizational climate (p < .001), existence of civility resources (p = .001), importance of civility resources (p < .001), frequency of incivilities (p < .001), employee satisfaction (p = .002), and overall civility rating (p = .007). Significant differences between respondents by self-identified race were found only in one subscale: existence of civility resources (p = .048). Significant differences were found between faculty and staff in four subscales: perception of organizational climate (p = .001), importance of civility resources (p = .02), employee satisfaction (p = .01), and overall levels of stress (p = .03). Results suggest that gender and employment type differences exist in the perception of organizational climate at the academic health center, while significant racial differences only occurred in reference to reported existence of civility resources. Attention to these differences should be incorporated into the development of programs to address the problem.

Coping strategies and physical health in police units dealing with serious crime: Does work experience count?

Abstract Police work is stressful and can lead to absenteeism, withdrawal, and impaired physical health. However, the stress brought by work can be reduced by effective coping strategies. The aim of our study is to explore the relationship between health and coping strategies of officers in three different units dealing with serious crime (homicide and sexual offences, juvenile crime, and crime scene investigation). The moderating role of work experience in this relationship is also explored. We used the Coping Responses Inventory questionnaire to assess coping strategies and the Pennebaker Inventory of Limbic Languidness to measure physical symptoms. Overall, the sample included 104 respondents. The approach coping strategies prevail among all three units. However, avoidance-coping strategy use is associated with more frequent somatic symptoms (P= 0.005). These are particularly linked to the emotional discharge (P &amp;lt; 0.001), especially in the group of officers with longer years of service (P = 0.01). Still, when this strategy is used rarely or not at all, more experienced officers report fewer symptoms than their younger colleagues. Preventive programmes promoting adaptive coping strategies would benefit police officers since avoidance-coping strategies are linked to more frequent physical symptomatology. More experienced police officers with somatic complaints should be focused on in particular.

WWII trauma impacts physical and mental health in the oldest old: results from a German population-based study

Introduction Epidemiological studies in different traumatised samples indicate an increased risk for numerous physical and mental diseases. It is suspected that this is due to chronic changes in fundamental processes in the immune, nervous, and endocrine systems, which take years to manifest pathologically. Previous studies have considered intervals of a few decades. However, little is known about whether a link between trauma and physical and mental health can be established over very long periods of time and in the oldest old population. Materials and methods A total of 1,299 German citizens aged 80 and above were interviewed about on-going suffering from the effects of traumatic World War II (WWII) events as well as about physical and mental health. Multiple linear and logistic regression models were used to assess the impact of suffering from the effects of traumatic events on general health, several medical conditions, multimorbidity, pain, and depression. Results 43.94% of the oldest old were still suffering from the effects of traumatic events in connection with WWII. Participants who were still suffering from the effects of traumatic events were more likely to be treated for heart failure, blood diseases, bladder problems, back pain, respiratory or lung diseases, and sleep disorders. They also had poorer general health, higher multimorbidity, more pain, and higher depression scores. Discussion Findings suggest that chronic psychological suffering from the effects of traumatic events in early life is associated with impaired physical and mental health even seven decades after the events.

Application and validation of the bodily distress syndrome checklist in a psychosomatic outpatient sample

ObjectiveThe BDS checklist is a self-report measure to assess the most common somatic symptoms in functional somatic syndromes, based on the diagnostic concept of Bodily Distress Syndrome. The aim of the study was to examine the psychometric properties and validity of the BDS checklist in a psychosomatic sample and to investigate whether it is suitable to detect DSM-5 somatic symptom disorders (SSD). MethodIn a cross-sectional study, n = 368 patients from a psychosomatic outpatient clinic completed the BDS checklist and a semi-structured clinical interview on SSD. Item and scale characteristics and measures of reliability and validity were determined. ResultsThe BDS checklist showed good item characteristics and reliability (Cronbach α = 0.89). Factor analysis confirmed four symptom clusters (CFI = 0.95, TLI = 0.95, RMSEA = 0.091, 90% CI = 0.085–0.097). The BDS total score showed significant correlations with other measures of somatic symptom burden (r = 0.79, p < .001), health anxiety (r = 0.46, p < .001), depression (r = 0.45, p < .001), and general anxiety (r = 0.41, p < .001). Higher BDS checklist scores were associated with higher physical and mental health impairment and higher health care use. Diagnostic accuracy regarding somatic symptom disorder was moderate (AUC = 0.72, 95% CI: 0.67–0.77). ConclusionFindings of our study indicate that the BDS checklist is a reliable and valid measure to assess the most common somatic symptoms in a psychosomatic setting. It is however not sufficient to detect persons at risk for somatic symptom disorder. A combination with further questionnaires could probably improve diagnostic accuracy.

Vitamin D3 as possible diagnostic marker of Eating Disorders

Abstract Purpose Eating Disorders (EDs) refer to a group of psychiatric conditions in which disorderly food intake results in impaired psychological functioning or physical health. Nowadays, these disorders represent an increasing problem in modern society. There are no universally validated clinical parameters to confirm, disprove or simply help to identify EDs except for diagnostic criteria on psychiatric basis. The aim of this study was the assessment of Vitamin D3 level in patients with EDs to understand if it might be a valid clinical biochemistry parameter useful as prognostic marker. Methods The sample consists of 28 female patients, who suffer from EDs. Blood samples were examined in terms of blood count, glucose, cholesterol and Vitamin D3 levels. The other clinical biochemistry parameters were analysed to understand if the Vitamin D3 was the only altered parameter. Results The parameters that appear altered are glycemia, cholesterol and, in particular, Vitamin D3. Significant results were obtained comparing controls with restrictive-type anorexia nervosa (p value= 0,003) and with purging-type anorexia nervosa (p value= 0,007). Conclusion There are currently no universally validated and diagnostic reliable clinical biochemistry parameters for EDs but, in the light of the findings, but our research indicates the potential use of Vitamin D3 as a biomarker for anorexia nervosa. Level of evidence Level III: Evidence obtained from a single-center cohort study.

The Johns Hopkins Post-Acute COVID-19 Team (PACT): A Multidisciplinary, Collaborative, Ambulatory Framework Supporting COVID-19 Survivors

The Johns Hopkins Post-Acute COVID-19 Team (PACT): A Multidisciplinary, Collaborative, Ambulatory Framework Supporting COVID-19 Survivors

COVID-19 survivorship: How otolaryngologist-head and neck surgeons can restore quality of life after critical illness

Mortality from COVID-19 has obscured a subtler crisis – the swelling ranks of COVID-19 survivors. After critical illness, patients often suffer post-intensive care syndrome (PICS), which encompasses physical, cognitive, and/or mental health impairments that are often long-lasting barriers to resuming a meaningful life. Some deficits after COVID-19 critical illness will require otolaryngologic expertise for years after hospital discharge. There are roles for all subspecialties in preventing, diagnosing, or treating sequelae of COVID-19. Otolaryngologist leadership in multidisciplinary efforts ensures coordinated care. Timely tracheostomy, when indicated, may shorten the course of intensive care unit stay and thereby potentially reduce the impairments associated with PICS. Otolaryngologists can provide expertise in olfactory disorders; thrombotic sequelae of hearing loss and vertigo; and laryngotracheal injuries that impair speech, voice, swallowing, communication, and breathing. In the aftermath of severe COVID-19, otolaryngologists are poised to lead efforts in early identification and intervention for impairments affecting patients' quality of life.

Social isolation stress facilitates chemically induced oral carcinogenesis.

Social isolation has affected a large number of people and may lead to impairment of physical and mental health. Although stress resulting from social isolation may increase cancer progression, its interference on tumorigenesis is poorly known. In this study, we used a preclinical model to evaluate the effects of social isolation stress on chemically induced oral carcinogenesis. Sixty-two 21-day-old male Wistar rats were divided into isolated and grouped groups. After 90 days of age, the rats from both groups underwent oral carcinogenesis with 4-nitroquinoline 1-oxide (4NQO) for 20 weeks. All rats were assessed for depressive-like behavior and euthanized for oral squamous cell carcinoma (OSCC) diagnosis and measurement of inflammatory mediators in the tumor microenvironment. Social isolation stress increased the OSCC occurrence by 20.4% when compared to control. Isolated rats also showed higher tumor volume and cachexia than the grouped rats. Social isolation did not induce changes in the depressive-like behavior after carcinogenic induction. Tumors from stressed rats had increased levels of the inflammatory mediators, TNF-alpha, IL1-beta and MCP-1. The concentrations of TNF-alpha and MCP-1 were significantly increased in the large tumors from isolated animals. Higher tumor levels of TNF-alpha, IL-6, IL1-beta and MCP-1 were positively correlated with OSCC growth. This study provides the first evidence that social isolation stress may facilitate OSCC occurrence and tumor progression, an event accompanied by increased local levels of inflammatory mediators.

Correlation of Depression with the Functional Profile of Elderly People Living in Homes for the Aged

Introduction: Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in an increasing demand for homes for the aged (HA). It is necessary to understand how the impairment of physical health, mental health and the level of depression can affect the functional capacity of the institutionalized elderly who live in homes for the aged. Objective: To describe the correlation between depression and functionality of elderly people who live in homes for the aged. Method: A cross-sectional, descriptive study with 70 elderly people of both sexes, aged 60 years or older, who live in HA in the state of Rio de Janeiro. Result: It was verified that the female gender was predominant in the HA consulted. The majority of elderly live in HA voluntarily 48.6% and that 41.43% did not complete elementary school. The majority of the elderly 81.43% had the ability to perform basic activities of daily living and the elderly 52.86% had normal psychological pictures. The worsening of the depressive picture is associated with the worse functioning of elderly who live in HA (p < 0.02). Conclusion: Depression is a factor that is associated with the functional capacity of the institutionalized elderly. The worse the functional level of the institutionalized elderly, the greater the chances of presenting a depressive state.

Optimizing Care for People Experiencing Homelessness and Serious Mental Illness amidst COVID-19: A Street Outreach Perspective.

The COVID-19 pandemic has disproportionately affected marginalized individuals with multiple vulnerabilities, including those experiencing serious mental illness and homelessness. This population is adversely affected by the pandemic due to loss of opportunities for social connection and support, decreased engagement with community services, and increased risk of mental and physical health deterioration. Multidisciplinary street outreach teams have employed an instrumental service model in the provision of community-based, comprehensive care for individuals experiencing homelessness, often with concurrent challenges with mental illness and addictions. However, during this period of unprecedented and additional vulnerability, street outreach teams must adapt their existing practices to meet the evolving needs of their client population. This article aims to highlight the impact of COVID-19 on people with serious mental illness experiencing homelessness, and then share lessons learned and recommendations for action to optimize care and support to this vulnerable population amidst COVID-19.

Health, Retirement and Economic Shocks

We explore the effects of retirement on both physical and mental ill-health and whether these change in the presence of economic shocks. We employ inverse probability weighting regression adjustment to examine the mechanisms influencing the relationship between retirement and health and a difference-in-differences approach combined with matching to investigate whether the health effects of retirement are affected by the Great Recession. We estimate these models on data drawn from the English Longitudinal Study of Ageing (ELSA) and find that retirement leads to a deterioration in both mental and physical health, however there seems to be considerable effect heterogeneity by gender and occupational status. Our findings also suggest that retiring shortly after the Great Recession appears to improve mental and physical health, although only among individuals working in the most affected regions. Overall, our results indicate that the health effects of retirement might be influenced by the presence of economic shocks.

ВИДИ МАРКЕТИНГОВИХ СПОЖИВЧИХ РИЗИКІВ ПІД ЧАС КУПІВЛІ ПРОДУКТІВ ХАРЧУВАННЯ НА ОНЛАЙН-РИНКУ

The aim of this paper is to develop scientific-theoretical approaches to separate types of marketing risks that consumers perceive in online purchases, with the purpose of identification and neutralization of risk situations in the process of consumer decision making during purchase of goods on the online market. With the steady growth of online sales and the growth of global online sales through Covid-19, the role of consumer risk in buying food on the online market is growing. Consumer risk has a significant impact on the behavior of consumers who focus on avoiding potential losses and this online shopping risk differs from the risks that are present when buying offline goods. The article considers the approaches of scientists to identification of components of consumer risk and loss as a result of risk. The concept of consumer risk is defined and the consumer risk is actually perceived in the online purchase of food products in order to develop a theoretical basis for the theory of marketing risk management. The authors determined that consumer risk of online food purchase is a subjective probability of financial loss, time loss, loss of personal information, social status, deterioration of physical or mental health of the consumer as a result of online shopping, which did not meet consumer expectations and significantly reduced his loyalty to the place of online purchase of products. The types of consumer risks are distinguished: functional, financial, physical, temporal, psychological, social, service. It is determined that the functional (operational risk) is connected with the use of the purchased online goods for the purpose, financial risk is connected with financial losses due to the online purchase, physical risk is connected with the possibility of health damage due to consumption of the goods of poor quality, time risk is connected with loss of time, psychological risk connected with internal consumer dissatisfaction, social risk is connected with negative reaction of others to online purchase of goods, service risk is connected with process of service of online purchase of goods. For each component of consumer risk, the nature of the risk, the factors causing the risk and the possible negative consequences of the risk are determined. Identification of consumer risks will allow developing a methodology for their assessment and measures to neutralize consumer risks. Reducing consumer risks will allow food producers and online retailers to increase customer satisfaction and loyalty, which will facilitate further growth of online sales.

Who are the people with Alzheimer's disease in Brazil? Findings from the Brazilian Longitudinal Study of Aging.

To describe the socioeconomic, behavioral, clinical, and health-related characteristics of Brazilian older adults with Alzheimer's disease (AD). Baseline data from the Brazilian Longitudinal Study of Aging were analyzed. This nationwide survey interviewed 9,412 adults aged at least 50 years. Self-reported medical diagnosis of AD and exposure variables (sociodemographic, clinical, behavioral, and health-related) were assessed by face-to-face questionnaire-based interview. Multivariate analyses accounted for possible confounding factors, and values were reported in prevalence ratio (PR) and 95% confidence interval (95%CI). Participants with AD have important demographic differences compared with older non-AD participants such as low education level and retirement. Clinically, these patients reported more medical appointments, falls, and higher frequency and duration of hospitalizations compared with non-AD participants. These characteristics may be related to worse physical and mental health observed in this population. Indeed, two out of five older adults with AD in Brazil reported always feeling lonely, while two out of three said they felt depressed or sad much of the time. Adjusted analyses showed that patients with AD were 95% (95%CI 1.08 - 3.50) more likely to be hospitalized in a year compared with non-AD older adults. People with AD in Brazil were more likely to be diagnosed with diabetes (PR = 1.83 [95%CI 1.08 - 3.12]), depression (PR = 3.07% [95%CI 1.63 - 5.79]), Parkinson's disease (PR = 17.63 [95%CI 6.99 - 44.51]), and stroke (PR = 3.55 [95%CI 1.90 - 6.67]) compared with non-AD participants. Older adults with AD in Brazil reported impaired physical and mental health compared with the non-AD population.

Self-rated health among teachers: prevalence, predictors, and impact on absenteeism, presenteeism, and sick leave.

Introduction:Self-rated health is an important indicator of health in the population, but among teachers, predictive sociodemographic, occupational, and health variables and the impact of self-rated health on absenteeism, presenteeism, and sick-leave are unknown.Objectives:The objectives of this study were to determine the prevalence of and factors associated with poor self-rated health among elementary school teachers and to investigate whether poor self-rated health can predict absenteeism, presenteeism, and sick leave.Methods:The sample comprised 493 elementary school teachers from Londrina, Paraná, Brazil. A self-report questionnaire was used to assess self-rated health and sociodemographic, occupational, and lifestyle factors, health indicators, chronic diseases, disabilities, and number of days of absenteeism, presenteeism, and sick leave. Poisson regression was used to estimate prevalence ratios and rate ratios.Results:The prevalence of poor self-rated health was 16.4% and the variables positively associated with this outcome were health insurance (prevalence ratio = 2.35), inadequate school infrastructure (prevalence ratio = 1.56), physical activity (prevalence ratio = 0.60), poor perceived fitness (prevalence ratio = 2.44), voice disorders (prevalence ratio =1.46), common mental disorders (prevalence ratio = 1.74), emotional exhaustion (prevalence ratio = 1.61), low personal accomplishment (prevalence ratio = 1.64), chronic disease (prevalence ratio = 2.39), and disability (prevalence ratio = 1.57). Poor self-rated health was positively associated with both absenteeism (rate ratio=1.71) and presenteeism (rate ratio = 1.74).Conclusions:Occupational and individual characteristics associated with impaired physical and mental health should be targeted to improve self-rated health among teachers. Furthermore, a single question on self-rated health is a useful tool for monitoring and preventing absenteeism and presenteeism among teachers.

Analysis of physical violence incidents against physicians in Turkey between 2008 and 2018.

Violence against physicians is a global issue that causes impaired physical and mental health, declined work quality, resignations, and even suicides. Studies regarding violence against physicians are very limited. Therefore, our aim is to investigate the physical violence incidents against physicians presented in print media between 2008 and 2018. A total of 8612 news reports acquired in national news database via 45 keywords were assessed. Five hundred and sixty-four of the reports met the inclusion criteria and were retrospectively analyzed. Of 5964 news reports, 3754 (62.9%) were reprimands and protests against violence incidents. In 11 years, 560 individual incidents occurred where 647 physicians were physically assaulted, with 2267 news reports written on those incidents. The number of incidents increased over the years, and in 2012 both the number of incidents (n=91) and news reports count per incident were found highest. About 77.7% of assaulted physicians were male, and incident rate was higher in Western Turkey (42.15%). In 11 years, ten dedicated physicians have lost their lives in the line of duty. Emergency medicine (20.4%), primary care (9.89%) were the departments most exposed to physical violence. The claim of receiving inadequate medical attention was noted to be the primary allegation of the assailants. The frequency of physical violence incidents against physicians is increasing. Throughout the study period, news reports containing condemnations, critiques, and protests are also more frequently, yet not adequately, placed in print media. Thus, social and public awareness ought to be enhanced through national and global media outlets. Furthermore, extensive measures must be taken by governments in order to prevent and eliminate violence.

Scoping review of health outcomes for people with disabilities in user-led organisations.

A user-led organisation (ULO) may be defined as an organisation that is run and controlled by the people who use the services provided by that organisation. ULOs provide services to their members, such as information, advice, support, treatment and training. ULOs may also be involved in advocacy, influencing local service provision, government policy and public perceptions of disability. This scoping review concentrated on health outcomes achieved by ULOs for people with disabilities, including physical, sensory, cognitive, intellectual, neurological or mental health impairments. Based on a search of the academic literature up to 30 June 2020, 26 articles were included. Twenty-four articles were on ULOs for mood disorders, schizophrenia or psychosis, and there was one article each on ULOs for cross-disability and chronic non-malignant pain. There was some evidence that peer-run and inclusive ULOs for members with mood disorders, schizophrenia or psychosis can reduce the number of times people with these illnesses access traditional mental health services. There was no evidence that ULOs can replace traditional mental health services. Therefore, ULOs for mood disorders, schizophrenia or psychosis could be considered an adjunct to traditional mental health services, not a replacement. For other disabilities, a lack of evidence means that no recommendation can be made. However, the organisational structure of ULOs may be as important as the support and services offered.

Weight-Stigma and Body Satisfaction among Preschool Children

Introduction: The worldwide obesity pandemic has far reaching consequences for the overweight individual. Overweight itself can lead to impaired physical health, the associated weight stigma to impaired mental health. As weight bias starts as early as in preschool age, it is important to find out what sociodemographic and psychosocial factors promote weight stigma in children and how to prevent them.

Psycho-physiological Considerations on Low Self-Esteem

This document is a short review article on the psycho-physiological considerations of low self-esteem. The methodology used was the bibliographic review of those selected texts that are related to the subject in question. Addressing from the definition of low self-esteem, to its symptoms, physiological repercussions and some final considerations. It is concluded that this critical emotional episode should be dealt with in a timely manner by psychology specialists, to avoid the general deterioration of physical and mental health.

Dementia Caregiving, Care Recipient Health, and Financial Burdens

Objective: While about 75% of people with ADRD receive care informally by their family members, relatively little is known about the effect of the quality of caregiving on maintaining carerecipient’s health and financial burden of out-of-pocket (OOP) healthcare costs. The goal of this study is to examine the quality of caregiving on the out-of-pocket healthcare costs among ADRD patients and if caregiving prevents deterioration of physical health of carerecipients. Data and Sample: We used a nationally representative sample of people diagnosed with ADRD from the Aging Demographic and Memory Study, subsample of the Health and Retirement Study. The study sample includes carerecipients whose caregivers participated in the survey (N=261). Outcome measures: Primary outcomes were deterioration of carerecipients’ health (1=yes, 0=no) and annual OOP healthcare costs. The quality of caregiving is captured by if caregiving made them feel good, feel useful and fee closer to carerecipients. More than 70% caregivers reported that caregiving make them feel good or useful. About 60% of carerecipients’ physical health was maintained, and average out-of-pocket costs was $3,701/year ($0-$31,051). Multivariable logit for binary health outcome and OLS regression for OOP cost were estimated. Results: The likelihood of health deterioration was significantly lower for carerecipients whose caregivers reported that caregiving made them feel useful (AOR=5.1, 95% CI: 1.9- 14.5) and lower OOP remained significantly associated with presence of usefulness of caregiving (cost decrease, $3000 [95% CI: $6309-$918). Positive feeling of caregiving is independently associated with lower OOP cost and deterioration of physical health among ADRD patients.

Changes in Family Caregiver Roles and Interactions During the COVID-19 Pandemic

Family caregivers provide the majority of support for older adults and people with disabilities in the U.S. The onset of the COVID-19 pandemic forced radical changes in duties and relationships between family caregivers and care recipients. These changes can be attributed to fears of virus transmission as well as federal, state and local government mitigation strategies resulting in social distancing and quarantining limiting caregiving interactions. This qualitative investigation conducted 55 Zoom interviews over summer 2020 with family caregivers to explore their changing roles and duties during the pandemic. Researchers utilized a semi-structured interview guide to explore caregiver experiences with COVID-19. The average age of the caregiver participants was 59 and the average age of the care recipients for whom they provided care was 74. All participants provided unpaid care for family members. Interviews were conducted in English (n=40), Spanish (n=5), Somali (n=5) and Korean (n=5). Care recipients resided in a facility (nursing home, memory care, ICF-DD, or other assisted living) (70%) with the caregiver (20%), and in a separate independent setting (10%). Data from each interview were coded into themes by two researchers. Themes that emerged from the analyses included concerns about care recipient mental and physical health deterioration, lack of communication from formal providers, change in relationships with other family members, and future concerns. Implications for additional research and practice are included.