Risk Factor For Physical Health Research Articles

The Influence of Loneliness on Pain Outcomes for Adolescents: A Cross-Sectional Survey

ABSTRACT Background Loneliness, the perception that one’s social relationships do not meet the desire for social connection, is a risk factor for poor mental and physical health. Adolescents with chronic pain experience higher rates of peer loneliness which persists over time. Previous studies used a single loneliness measure, limiting our understanding of the nature of their loneliness. This study describes the types of peer loneliness (intimate, relational, and collective) experienced by these adolescents and the impact that peer loneliness has on pain-related outcomes. Methods A cross-sectional online survey was completed by 128 Canadian adolescents aged 12–18 years who experienced pain for at least 3 months. Validated measures captured demographics, pain-related characteristics, types of peer-related loneliness, measures of social well-being, and mental and physical health outcomes. Results Friedman’s tests of z-scores indicate that participants equally experienced dyadic, relational, and collective peer loneliness. MANCOVA revealed that those who identify as Black were lonelier after controlling for socioeconomic status. Multiple regression showed that loneliness was a robust predicter of worse scores on social well-being and mental health outcomes with males and females equally impacted by loneliness. Despite moderate correlations between loneliness and pain interference and pain intensity, loneliness did not predict school absences, suggesting that loneliness’ influence on physical pain outcomes may be temporally earlier (e.g. contribute to pain chronification). Conclusions Peer loneliness among adolescents with chronic pain negatively impacts their social well-being and mental health outcomes. Interventions addressing loneliness to target all three types of peer loneliness may be key to improving pain-related outcomes.

How can healthcare professionals assist in improving mothers’ health?

Abstract Background Mothers’ health is crucial as it significantly impacts the overall health of their children and families. The first year of motherhood can be especially difficult and can lead to a considerable decline in mental health and well-being. However, studies have shown that these challenges persist throughout early childhood. This study examined the association between mothers’ self-compassion, social support, and self-care behaviors and their physical and mental well-being. Methods In August 2023, a survey was conducted among 521 Israeli mothers (437 Jewish and 84 Arab mothers) of children aged three and under. Linear regression models were used to assess the factors that predict the mothers’ physical and mental health. These models explained 11% of the variance in the mothers’ physical health and 39% of the variance in their mental health. Results Respondents’ ages ranged from 19 to 48, with a mean age of 31.5 years. Reported physical health was relatively high (n = 442, M = 78.36, SD = 21 on a scale of 0-100). However, the reported mental health was lower (n = 401, M = 65.88, SD = 20.28 on a scale of 0-100). Reported Physical health was found to be higher for Jewish mothers, younger mothers, and mothers with higher income levels. Further, higher social support and higher self-compassion levels were associated with better perceived physical health (Adj R2=0.11, P < 0.001). Mental health was higher for Jewish mothers, younger mothers, and full-time employed mothers. Further, higher social support, self-compassion, and reported self-care were associated with better perceived mental health (Adj R2=0.39, P < 0.001). Conclusions Health practitioners who work with mothers of young children should take a proactive approach to helping them establish a nurturing environment, practice self-compassion, and engage in self-care activities. Key messages • Encouraging self-compassion and self-care in postpartum mothers is crucial, as it is essential to prioritize the mother’s health alongside her baby. • Low socioeconomic background and Ethnicity are risk factors for lower physical and mental health after childbirth. Reducing health disparities and targeting these vulnerable populations is crucial.

Effects of acoustic environment on sleep and mental health in residential regions near railways

Noise is an important environmental risk factor for physical and mental health. Furthermore, long-term noise exposure is burdensome for the mind and body and has become a serious problem. Rail transportation is one of the main methods used to transport goods in China; however, the noise and vibrations generated by freight trains have serious impacts on residents in nearby regions. To further investigate the relationship between railway noise and road noise exposure and changes in sleep duration and mental health scores, a field study in Harbin, China, was conducted and a health risk prediction model was constructed. The results showed that for every 1 dB increase in the Equivalent continuous A-weighted sound pressure level (LAeq), the percentage of deep sleep among residents living near the railway decreased by 0.2 %. Although residents near the railway reported similar sleep evaluations compared to those living farther away, they exhibited poorer mental health. Cox risk modeling indicates that the risk of mental health problems is approximately three times higher for those living near the railway. These findings potentially provide benefits in developing strategies to reduce the risk of mental illness for people residing near railways.

Sex-specific social, lifestyle, and physical health risk factors in cataracts development.

Cataract is a leading cause of blindness worldwide. However, little is known about sex differences in cataracts. Our study aimed to explore potential sex differences in the relationships between key social, lifestyle, and physical health risk factors and the incidence of cataracts. A total of 117,972 participants from the UK Biobank were included in this prospective cohort study. Cox proportional hazard models were used to calculate hazard ratios (HRs) and female-to-male ratios of HRs (RHRs) with 95% confidence intervals (CIs) for cataract risk factors. Poisson regression was used to assess the incidence of cataracts (per 10,000 person-years). A total of 117,972 individuals without preexisting eye diseases were enroled in the analysis. 4172 subjects (54.8% female) were diagnosed with cataracts during follow-up. The crude incidence rates per 10,000 person-years were 35.06 for females and 29.15 for males. The incidence of cataracts increased in both males and females with factors such as Asian or Black ethnicity, smoking status, obesity, diabetes, and myopia. However, males who consumed alcohol or were unemployed suffered a greater risk of cataracts compared to their female counterparts, while high socioeconomic status, elevated blood pressure and metabolic syndrome were associated with a greater risk of cataracts in females than in males. This study provides a comprehensive overview of sex differences in the associations between cataracts and various risk factors. Our findings highlight that socioeconomic and lifestyle risk factors are more strongly linked to cataract risk in males, whereas females with systemic diseases face a greater risk of developing cataract.

The risk and protective factors on the mental health of healthcare workers during the lockdown period due to covid-19 pandemic

This study aimed to analyze the impact of the lockdown period due to COVID-19 pandemic on the mental health status of healthcare workers and identify the related risk factors of psychosomatic distress. We conducted an online questionnaire survey to investigate the general demographic characteristics, perceived stress level, adult attachment style (AAS), family cohesion and adaptability, social support, sleep state, emotional state, and physical health of healthcare workers during the lockdown period due to the pandemic in 2022. We compared the mental health status between doctors and nurses, and further analyzed the factors influencing sleep, emotions, physical symptoms, and severe psychosomatic distress separately. For factors that showed statistical significance in the univariate analysis, forward stepwise regression was used for logistic regression analysis to identify risk factors for the corresponding issues. A total of 622 healthcare workers participated in the survey. Among the participants, 121 (19.5%) reported sleep problems, 209 (33.6%) had negative emotional states, and 147 (23.6%) reported physical health problems. There were 48 (7.7%) healthcare workers with severe psychosomatic distress. Compared to the group of nurses, the group of doctors exhibit a higher prevalence of emotional issues, physical health problems and psychosomatic distress. Perceived stress was identified as a risk factor for sleep disturbance, while living with others during quarantine and family adaptability were identified as protective factors. Higher educational background and perceived stress were identified as risk factors for negative emotion, while subjective support was identified as a protective factor. Perceived stress and coming from a rural area were also identified as risk factors for physical health. Overall, for the comparison between the no psychosomatic distress and severe psychosomatic distress groups, perceived stress was identified as a risk factor for severe psychosomatic distress, while subjective support was identified as a protective factor. Healthcare workers’ potential mental and physical health problems are related to their educational background, family cohesion and adaptability, perceived stress and social support. This makes it clearer on how to deal with and prevent adverse consequences when facing stressful situations.

Adverse childhood experiences and subsequent physical and mental health among young adults: Results from six universities in China

Research has shown that individuals with adverse childhood experiences (ACEs) are more likely to encounter heightened risks of physical and psychological challenges later in life. However, limited research has explored the comprehensive impact on the physical and mental health of young adults. Thus, we conducted a study to investigate the associations of ACEs with the physical and mental health of 18,723 college students in China. Their physical and mental health status was assessed using self-perceived health assessments, self-reported disease diagnoses, and the Generalized Anxiety Disorder-7-item scale. Results showed that 82.6 % of participants had experienced at least one ACE, with 10.7 % reporting exposure to four or more ACEs. Compared to participants with low ACEs exposure (≤ 1), participants with high ACEs exposure (≥ 4) had a nearly twofold increase in the odds of cardiometabolic diseases (OR [95 % CI] = 2.06 [1.55-2.74]) and fractures (2.32 [1.88-2.87]). Additionally, individuals with high ACE exposure exhibited a threefold increased odds of severe anxiety symptoms (3.78 [2.59-5.51]) and bipolar disorder/schizophrenia (3.38 [2.18-5.23]). These findings highlight ACEs as a significant risk factor for poor physical and mental health among young adults. Targeted support and interventions for individuals with multiple ACEs may help mitigate their long-term disease burden.

EFFECTS OF CHILDCARE, WORK, AND CAREGIVING INTENSITY ON MALE AND FEMALE FAMILY CAREGIVERS

Abstract Objectives The Behavioral Risk Factor Surveillance System sampled 54,076 caregivers between 2015 and 2017 providing an opportunity to evaluate risk factors for poor mental and physical health among a representative sample of U.S. adult caregivers. This study aimed to evaluate the impact of childcare, work status, and intensity of caregiving among men and women caring for older adults (n = 17,271). Methods Controlling for sociodemographic factors, separate logistic regression analysis for women and men were carried out to assess the main and interaction effects of childcare, work status, and intensity of caregiving on number of poor mental and physical health days in the last month. Results Intensive caregiving demands had adverse effects on both women and men, but being in the workforce was beneficial to both men and women. Women with children at home reported adverse mental health effects but better physical health, while men with children at home reported adverse physical health effects. For women, the combination of not working, children in the household, and high-intensity caregiving were most detrimental to their mental health. Among men, those not working with children in the household, regardless of caregiving intensity, were at highest risk of adverse mental health effects. Discussion Our findings identify caregivers at high risk of adverse outcomes but also point to the need for more fine-grained analyses of how families negotiate the allocation of childcare, work, and caregiving responsibilities over time.

Risk factors of chronic course of anxiety and depressive disorders: a 3-year longitudinal study in the general population.

Risk factors of a chronic course of anxiety and depressive disorders were previously studied using a limited definition of recovery, i.e. remission of the index disorder. However, frequently, other mental disorders are present at follow-up. Thus, the course of anxiety and depressive disorders was represented too rosy and the identified determinants may not apply when using a broader, more realistic definition. Additionally, physical health risk factors have often been ignored. Data were used from two waves of the Netherlands Mental Health Survey and Incidence Study-2 including 509 respondents with 12-month anxiety disorder (panic disorder, social phobia, agoraphobia or generalized anxiety disorder) or/and major depressive disorder at baseline. Chronic course was defined as (1) presence of index disorder; and (2) presence of any anxiety, mood or substance use disorder (overall course) during the subsequent three years. Regression models were built with sociodemographic, clinical, and lifestyle/physical health indicators. Predictive accuracy was evaluated with area under the curve (AUC). Chronic course of the index disorder was present among 24.8% of cases, whereas 38.7% had a chronic overall course. The accuracy of prediction of chronic course of the index disorder was suboptimal (AUC = 0.68) compared to prediction of overall course (AUC = 0.75). The main risk factors were baseline number of mental disorders, neuroticism, childhood abuse, parental psychopathology and alcohol use. Lifestyle and physical health indicators were marginally relevant. Transdiagnostic risk factors are important in predicting overall course of anxiety and depressive disorders but cannot accurately predict chronic course of the index disorder.

Circumstances that promote social connectedness in older adults participating in intergenerational programmes with adolescents: a realist review

ObjectivesLimited social connectedness in older adults is a risk factor for poor physical and mental health. Older adults who are socially isolated, lonely and disconnected have a higher risk of...

Physical Health Outcomes of Trauma Exposure Across the Lifespan.

Trauma exposure and posttraumatic stress symptoms (PTSS) are established risk factors for poorer physical health. Prior work has focused on childhood adversities and PTSS in relation to physical health conditions, but trauma exposure over the lifespan has been overlooked. Further, the associations between trauma and PTSS and other physical health markers, such as diet and exercise, are less clear. Very little is known regarding how different trauma types (i.e., interpersonal, non-interpersonal), may be tied to aspects of physical health. To expand this area of research, this study aimed to: (a) examine the links between cumulative trauma and PTSS, and body mass index (BMI), diet, and exercise; and (b) investigate the relations between interpersonal and non-interpersonal trauma and these three health indices, while controlling for PTSS. Participants were 493 Midwestern University students (Mage = 23.87, standard deviation [SD] = 6.90, range = 18-63; 79.3% female; 57.4% White). Cumulative trauma corresponded with higher BMIs and less exercise use (B = 0.10; B = -0.09), while PTSS were unrelated. Conversely, PTSS were tied to greater consumption of added sugars (B = 0.11), and cumulative trauma was not linked with diet. Interpersonal and non-interpersonal traumas were not tied to BMI or exercise, although interpersonal trauma and PTSS were linked with greater sugar intake and non-interpersonal trauma was associated with fruit and vegetable consumption. Trauma exposure and PTSS may have complicated and distinct associations with physical health indices, such as BMI, diet, and exercise, and additional research is needed to further parse out these relations.

Effects of a prenatal mindfulness program on longitudinal changes in stress, anxiety, depression, and mother–infant bonding of women with a tendency to perinatal mood and anxiety disorder: a randomized controlled trial

BackgroundStress is a risk factor for poor physical and mental health, affecting new mothers’ ability, especially those with perinatal mood and anxiety disorders, to maintain their everyday lives. Over the past 50 years, global incidences of depression and anxiety disorders have increased, reaching pandemic levels. These incidences represent major public health issues that are challenging to detect and treat. Mindfulness programs are viable for reducing stress, anxiety, and depression. The present study evaluates mindfulness intervention effects on stress, anxiety, depression, and mother–infant bonding.MethodsWe collected data on 102 women participating in a prenatal mindfulness program between July 2021 and March 2022; they were parallel and randomly assigned to experimental or control groups. The intervention group received an 8-week course in a prenatal mindfulness program, and the control group received usual standard prenatal care. The self-reported stress, pregnancy-related anxiety, and depression were assessed before and after the intervention and at 36 weeks of gestation. At 2 and 4 months postpartum, all participants provided self-reported their levels of stress, depression, and quality of mother-infant bonding.ResultsCompared to the control group, the experimental group that received the prenatal mindfulness intervention experienced reduced prenatal stress, anxiety, and depression and reduced postnatal stress and depression. Despite this, there was no significant difference between the groups in terms of the quality of mother-infant bonding.ConclusionsMindfulness prenatal programs are convenient and effective methods of decreasing stress, anxiety, and depression during the perinatal period. Based on our findings, prenatal mindfulness may play a role in mitigating mood and anxiety disorders and should be considered in future approaches to preventing psychological distress.Trial registration numberThis trial has been prospectively registered at ClinicalTrials.gov (NCT04693130) and the first registration date was 12/24/2020.

Body Image among Girls in Indonesia: Associations with Disordered Eating Behaviors, Life Engagement, Desire for Cosmetic Surgery and Psychosocial Influences.

Body image is an important risk factor for mental and physical health during adolescence. Nonetheless, few studies have empirically investigated body image among girls in Southeast Asia. This cross-sectional study examined the prevalence of body esteem (a holistic measure of body image assessing the degree of satisfaction with one's appearance, weight, and shape), associated behavioral outcomes, and potential psychosocial influences on body image among Indonesian girls to inform future intervention efforts. Girls across Indonesia with internet access (N = 318, Mage = 13.59 years) completed a questionnaire that assessed body image, disordered eating behaviors, appearance-related life engagement, desire for cosmetic surgery, appearance ideal internalization, media literacy, appearance-related teasing, and self-esteem. The younger girls' (10-13 years) responses were analyzed separately from those of the older girls (14-17 years). Over half of the girls did not have high body esteem. Approximately a quarter of the girls across both age groups reported restricting their food intake, emotionally eating, and/or engaging in excessive exercise, and over half desired cosmetic surgery. Disordered eating behaviors and a desire for cosmetic surgery were negatively correlated with body esteem. Hierarchical regression analyses found BMI, internalization, appearance-related teasing, and self-esteem were uniquely associated with body esteem among younger girls. Appearance-related teasing and self-esteem were positively associated with body esteem among older girls. These findings suggest body image interventions may be important for this population, with appearance-related teasing and self-esteem potentially useful targets for intervention efforts. Further prospective research to investigate these findings would be beneficial for a deeper understanding of body image risk factors for girls across Indonesia.

Physical Activity Pattern of Adults With Metabolic Syndrome Risk Factors: Time-Series Cluster Analysis.

Physical activity plays a crucial role in maintaining a healthy lifestyle, and wrist-worn wearables, such as smartwatches and smart bands, have become popular tools for measuring activity levels in daily life. However, studies on physical activity using wearable devices have limitations; for example, these studies often rely on a single device model or use improper clustering methods to analyze the wearable data that are extracted from wearable devices. This study aimed to identify methods suitable for analyzing wearable data and determining daily physical activity patterns. This study also explored the association between these physical activity patterns and health risk factors. People aged >30 years who had metabolic syndrome risk factors and were using their own wrist-worn devices were included in this study. We collected personal health data through a web-based survey and measured physical activity levels using wrist-worn wearables over the course of 1 week. The Time-Series Anytime Density Peak (TADPole) clustering method, which is a novel time-series method proposed recently, was used to identify the physical activity patterns of study participants. Additionally, we defined physical activity pattern groups based on the similarity of physical activity patterns between weekdays and weekends. We used the χ2 or Fisher exact test for categorical variables and the 2-tailed t test for numerical variables to find significant differences between physical activity pattern groups. Logistic regression models were used to analyze the relationship between activity patterns and health risk factors. A total of 47 participants were included in the analysis, generating a total of 329 person-days of data. We identified 2 different types of physical activity patterns (early bird pattern and night owl pattern) for weekdays and weekends. The physical activity levels of early birds were less than that of night owls on both weekdays and weekends. Additionally, participants were categorized into stable and shifting groups based on the similarity of physical activity patterns between weekdays and weekends. The physical activity pattern groups showed significant differences depending on age (P=.004) and daily energy expenditure (P<.001 for weekdays; P=.003 for weekends). Logistic regression analysis revealed a significant association between older age (≥40 y) and shifting physical activity patterns (odds ratio 8.68, 95% CI 1.95-48.85; P=.007). This study overcomes the limitations of previous studies by using various models of wrist-worn wearables and a novel time-series clustering method. Our findings suggested that age significantly influenced physical activity patterns. It also suggests a potential role of the TADPole clustering method in the analysis of large and multidimensional data, such as wearable data.

Caregiver strain among non-Hispanic Black and Hispanic male caregivers with self-reported chronic health conditions

ABSTRACT Objectives Caregiver strain often stems from unmet needs and is a risk factor for poor physical and psychological health. This study aims to identify factors associated with caregiver strain among middle-aged and older non-Hispanic Black and Hispanic male caregivers living with one or more chronic conditions. Design Data were analyzed from 418 male caregivers collected through Qualtrics Online Panels using an internet-delivered survey instrument (55.7% non-Hispanic Black, 44.3% Hispanic). Three ordinal regression models were fitted to assess factors associated with Caregiver Strain Scale tertiles: one for all men, one for non-Hispanic Black men only; and one for Hispanic men only. Results Similarities and differences were observed between the two groups in terms of factors associated with higher caregiver strain (i.e. lower disease self-management efficacy scores, providing ≥20 h of care per week). Uniquely for Non-Hispanic Black male caregivers, higher caregiver strain was associated with living with more children under the age of 18 (β = 0.35, P = 0.011) and feeling more socially disconnected (β = 0.41, P = 0.008). Uniquely for Hispanic male caregivers, higher caregiver strain levels were associated with experiencing lower pain levels (β = −0.14, P = 0.040) and higher fatigue levels (β = 0.23, P < 0.001). Conclusion Findings from this study suggest that non-Hispanic Black and Hispanic men with chronic conditions have differing caregiving experiences. While bolstering social connectedness and caregiver support services may offset caregiver strain, tailored mental health and disease management programming are needed to meet the specific needs of non-Hispanic Black and Hispanic male caregivers.

Cognitive Impairment and Self-Reported Dementia in UK Retired Professional Soccer Players: A Cross Sectional Comparative Study

BackgroundPrevious studies based on death certificates have found professional soccer players were more likely to die with neurodegenerative diseases, including dementia. Therefore, this study aimed to investigate whether retired professional male soccer players would perform worse on cognitive tests and be more likely to self-report dementia diagnosis than general population control men.MethodsA cross-sectional comparative study was conducted between August 2020 and October 2021 in the United Kingdom (UK). Professional soccer players were recruited through different soccer clubs in England, and general population control men were recruited from the East Midlands in the UK. We obtained self-reported postal questionnaire data on dementia and other neurodegenerative diseases, comorbidities and risk factors from 468 soccer players and 619 general population controls. Of these, 326 soccer players and 395 general population controls underwent telephone assessment for cognitive function.ResultsRetired soccer players were approximately twice as likely to score below established dementia screening cut-off scores on the Hopkins Verbal Learning Test (OR 2.06, 95%CI 1.11–3.83) and Verbal Fluency (OR 1.78, 95% CI 1.18–2.68), but not the Test Your Memory, modified Telephone Interview for Cognitive Status, and Instrumental Activities of Daily Living. Analyses were adjusted for age, education, hearing loss, body mass index, stroke, circulatory problems in the legs and concussion. While retired soccer players were younger, had fewer cardiovascular diseases and other morbidities and reported healthier lifestyles, 2.8% of retired soccer players reported medically diagnosed dementia and other neurodegenerative disease compared to 0.9% of controls (OR = 3.46, 95% CI 1.25–9.63) after adjustment for age and possible confounders.ConclusionsUK male retired soccer players had a higher risk of performing below established cut-off scores of dementia screening tests and were more likely to self-report medically diagnosed dementia and neurodegenerative diseases, despite having better overall physical health and fewer dementia risk factors. Further study is needed to determine specific soccer-related risk factors.

Maternal Prenatal Risk Phenotypes and Neurobehavioral Outcomes among Infants Born Very Preterm

To assess whether prenatal risk phenotypes are associated with neurobehavioral impairment for childrenborn <30weeks of gestation at discharge from the neonatal intensive care unit (NICU) and at 24-month follow-up. We studied infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) study, a multisite investigation of infants born <30weeks of gestation. There were 704 newborns enrolled in the NOVI study; of these, 679 (96%) had neonatal neurobehavioral data and 556 (79%) had 24-month follow-up data. Maternal prenatal phenotypes (physical and psychological risk groups) were characterized from 24 physical and psychological health risk factors. Neurobehavior was assessed at NICU discharge using the NICU Network Neurobehavioral Scales and at 2-year follow-up using the Bayley Scales of Infant and Toddler Development and the Child Behavior Checklist. Children born to mothers in the psychological risk group were at increased risk for dysregulated neonatal neurobehavior (OR,2.04; 95% CI,1.08-3.87) at NICU discharge, and for severe motor delay (OR,3.80; 95% CI,1.48-9.75), and clinically significant externalizing problems (OR,2.54; 95% CI,1.15-5.56) at age 24months, compared with children born to mothers in the low-risk group. Children born to mothers in the physical risk group were more likely to have severe motor delay (OR,2.70; 95% CI,1.07-6.85) compared with the low-risk group. High-risk maternal prenatal phenotypes were associated with neurobehavioral impairment for children born very preterm. This information could identify newborns at risk for adverse neurodevelopmental outcomes.

Objective and Subjective Stress among Grandparents Providing Assistive Regular Grandchild Care.

Research on stress and coping has differentiated the effects of objective stress and subjective perceptions of stress on psychological and physical health, including in old age. This study examined the moderating role of social support in the relationship between objective and subjective stress with depressive and somatic symptoms in the context of Israeli grandparents. This cross-sectional study involved 243 grandparents who provided at least 5 hours a week of assistive regular care to their grandchildren, divided into lower and higher support groups. The results show that the levels of depressive and somatic symptoms were higher in the lower support group. Social support moderated the association between the intensity of care and perceived stress. Social support moderated the association between subjective stress and somatic symptoms. To conclude, the combination of high subjective stress and lower social support constitutes a risk factor for impaired psychological and physical health.

Occupational Risk Factors for Physical and Mental Health in Primary Healthcare Providers: A National Cross-Sectional Survey from 62 Urban Communities in China.

To understand the physical and mental health status of primary healthcare providers (PHPs) including physicians, nurses and other staff and the workplace risk factors for depression, anxiety and intention-to-leave. In December 2021, a national cross-sectional survey was conducted from 62 urban communities in China, and all PHPs were invited to complete a standardized questionnaire. Information on demographic, health-related lifestyle, cardiovascular risk factors and physical health status, occupational stress and intention-to-leave was collected. Depression and anxiety were assessed using the Zung Self-Rating Anxiety/Depression Scale (SAS/SDS). A total of 4901 PHPs were included. 67.0% males currently drank alcohol vs 25.3% in females; 36.0% males currently smoked cigarettes vs 1.4% in females. Notably, more than half males were overweight or obese, but this proportion was 24.2% in females. The prevalence of chronic diseases, including hypertension, diabetes, dyslipidemia, non-alcoholic fatty liver disease, gout, and disease clustering were higher in males than in females. The prevalence of depression and anxiety were high, 50% had depression, of whom 15.6% had moderate/severe depression. Over 15% participants had varied levels of anxiety, and approximately 4% had moderate/severe anxiety. PHPs who aged 18-29 (OR: 1.31, 95% CI: 1.05-1.64), were males (OR: 1.34, 95% CI: 1.14-1.57), with lower professional title (comparing with staff with senior title, the ORs of the intermedium, junior and none were 1.83, 2.18 and 2.49, respectively), took charge in nursing (OR: 1.41, 95% CI: 1.20-1.65), with higher perceived stress level (OR: 1.82, 95% CI: 1.41-2.34), and suffering from severe fatigue (OR: 2.55, 95% CI: 1.99-3.27) were more likely to have depression. Likewise, PHPs who were younger, with intermedium professional title, had higher perceived pressure level, and higher fatigue levels were more likely to have anxiety. The mental health of PHPs is worrisome, with a high burden of chronic diseases and occupational risk factors. Younger PHPs, nurses, and those with higher levels of work pressure and fatigue are more vulnerable to psychological problems. The high prevalence of intention-to-leave calls for strategies that relieve the workplace stress and enhance the human resource capability.

Childhood Social Isolation as a Predictor of Retinal Neuronal Thickness in Middle Age: A Lifecourse Birth Cohort Study.

We investigated whether childhood social isolation was associated with retinal neural layer changes in adulthood, and whether this association was independent of other childhood or adulthood risk factors, including adult social isolation. Participants were members of the Dunedin Multidisciplinary Health and Development Study, a longitudinal population-based birth cohort from Aotearoa New Zealand ( n = 1037), born 1972 to 1973 and followed until age 45 years, with 94% of the living cohort still participating. Social isolation was recorded prospectively at ages 5, 7, 9, and 11 years, from teacher and parent report. Retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer thicknesses were measured via optical coherence tomography at age 45 years. Childhood social isolation was associated with thinner average RNFL ( B = -0.739, p = .02), nasal RNFL ( B = -1.118, p = .005), and inferior RNFL ( B = -1.524, p = .007), although only nasal RNFL remained significant after adjustment. These associations were not fully explained by other psychosocial or physical health risk factors in childhood or adulthood, nor were they mediated by adult loneliness or social support. Childhood social isolation was an independent predictor of RNFL thickness in middle age. Highlighting prospective links between childhood psychosocial adversity and retinal neuronal measures will help to inform future research into the utility of retinal neuronal thickness as a biomarker for neurodegeneration.

Effects of Childcare, Work, and Caregiving Intensity on Male and Female Family Caregivers.

The Behavioral Risk Factor Surveillance System sampled 54,076 caregivers between 2015 and 2017 providing an opportunity to evaluate risk factors for poor mental and physical health among a representative sample of U.S. adult caregivers. This study aimed to evaluate the impact of childcare, work status, and intensity of caregiving among men and women caring for older adults (n = 17,271). Controlling for sociodemographic factors, separate logistic regression analysis for women and men were carried out to assess the main and interaction effects of childcare, work status, and intensity of caregiving on number of poor mental and physical health days in the last month. Intensive caregiving demands had adverse effects on both women and men, but being in the workforce was beneficial to both men and women. Women with children at home reported adverse mental health effects but better physical health, while men with children at home reported adverse physical health effects. For women, the combination of not working, children in the household, and high-intensity caregiving were most detrimental to their mental health. Among men, those not working with children in the household, regardless of caregiving intensity, were at highest risk of adverse mental health effects. Our findings identify caregivers at high risk of adverse outcomes but also point to the need for more fine-grained analyses of how families negotiate the allocation of childcare, work, and caregiving responsibilities over time.