Poor Health Perception Research Articles

Health and Safety Improvement Amongst Ghanaian Communities as A Corporate Social Responsibility of Construction Companies

Purpose–The purpose of this paper is to juxtapose construction site hazards with hazards present in typical Ghanaian communities to engender some safety knowledge transfer from construction companies to project host communities as a corporate social responsibility to the construction companies. Design/Methodology/Approach–Fifty-one volunteers who are health and safety professionals in Ghana part took in the survey to determine the common health and safety hazards present in most Ghanaian communities. The identified hazards were compared to typical construction site health and safety hazards identified from the literature. The survey also sought to establish the general health and safety awareness levels among Ghanaian communities. Findings – Findings of the study reveal that H&S awareness in the Ghanaian community is poor, and therefore needs improvement. It also identified 26 construction hazards that are also common in the Ghanaian communities and established that H&S knowledge in the Ghanaian construction industry is more advanced than that of the Ghanaian community. The findings further reveal that the respondent’s perception of poor health and safety in the Ghanaian community was influence by their job positions in the communities. Originality/Value–The poor state of H&S knowledge among Ghanaian communities has been recognized by various researchers, but this study is the first attempt to compare this state with the construction industry and to present a wide-ranging lesson to be learnt from health and safety improvement in the construction industry.

Factors Associated with the Caregivers' Perception of the Oral Health of Individuals with Cerebral Palsy

Objective: To evaluate factors associated with the caregivers’ perception of the oral health of children and adolescents with cerebral palsy. Material and Methods: A cross-sectional study was carried out with 80 children and adolescents with cerebral palsyaged 2-18 years, registered at a reference institution and their respective caregivers. Caregivers provided socioeconomic, systemic and health perception and access to dental services data. A calibrated researcher (Kappa=0.75-0.98) performed oral examinations using DMF-T, dmf-t, dental trauma, gingival bleeding index, community periodontal index, malocclusion index and the dental aesthetic index. The Poisson Regression was used ( α =0.05). Results: According to the caregivers’ perception, the oral health reports of children and adolescents with cerebral palsy considered good and poor was 73.8% and 26.3%, respectively. The poor oral health perception is associated with the presence of dental caries in anterior teeth (PR 1.34, 95% CI=1.11-1.63) and bleeding during tooth brushing (PR 1.20, 95% CI=1.04-1.40). Conclusion: Children and adolescents with cerebral palsywho presented lesions of caries in the anterior teeth and gingival bleeding during tooth brushing, more frequently, had poor oral health by their caregivers.

Pesticides Handling and Risks Associated with Cassava Production in Apoje Farm Settlement: Farmers’ Knowledge, Attitude and Perception

The study was carried out to evaluate the farmers’ knowledge, attitudes and perception of the pesticides handling, application, and residue on the cassava roots produced and associated health and environmental risk exposures factors among the farmers in Apoje Farm Settlement Ogun State Southwestern Nigeria. A total of twenty-five (25) cassava root samples produced on the farm were collected and analyzed for the presence of any residues while fifty (50) farmers were randomly sampled with the administration of structured questionnaires/interviews. The results obtained showed the detections of polychlorinated biphenyl (PCB), Nitrate (NO3) and Hydrogen sulphide (H2S) with mean values of 0.01934mg/kg, 0.012564mg/kg and 0.00058mg/kg respectively that fall within the regulated limits. However, the knowledge of the farmers on pesticides handling and application are low, some cannot read the labels on the pesticides to understand the poison and hazards signs. Then, they exhibit poor attitudes and perceptions of health and environmental risks associated with the exposure to the pesticides. The majority of the farmers do not put on personal protective gadgets to prevent themselves from the exposures. The study concluded that there should be health talks organized for the farmers on the subject matter and there is an urgent need for resuscitations of farm extensions services where relevant government agencies support the local and semi-illiterates farmers given them adequate and necessary information on the handling and application of pesticides in order to reduce the risks to the farmers, the inhabitants, and the environment. Then, monitoring studies of human exposure, the soil and water bodies in the study area are required to evaluate the effects the pesticides.

Decisional conflict among people with diabetes mellitus or hypertension attending primary care

Decisional conflict refers to the personal uncertainty about which course of action to take when the choice involves risk, regret, or challenge to personal life values. To determine the level of decisional conflict (DC) of people with Diabetes Mellitus (DM) or High Blood Pressure (HBP) attending primary care centers (PCC) in Chile. A Spanish version of the Decisional Conflict Scale (DCS) was applied to patients who were recruited if they had DM or HBP, were 18 years old or older, and had an appointment at the PCC the day of the recruitment. The scale was self-administered. Analysis of covariance (ANCOVA) was used to determine association between DC and other variables of interest while controlling confounding variables. The scale was answered by 1075 participants from 24 PCC aged 62 ± 14 years (74% female). Average score for the DCS scale was 16.8 ± 12.9 of a maximum of 100 points indicating a higher DC. The sub-scale "information" had the highest score (19.9 ± 20.0). Low educational level and older age were significantly associated with higher DCS scores (p < 0.05). Having a bad health perception, deciding to initiate a medical treatment and being attended by a doctor were significantly associated with higher DC. These associations persisted when confounding variables such as sex, age and education were controlled. People with DM or HBP who have a poor health perception, who initiated their treatment and were attended by a doctor had higher levels of DC, independent of their age and educational level.

Does oral health influence school performance and school attendance? A systematic review and meta-analysis.

To examine the evidence on the influence of oral health status on school performance and school attendance in children and adolescents. A systematic review was performed in accordance with PRISMA included epidemiological studies that assessed concomitantly oral health measures, participants' school performance and/or school attendance. Electronic search was conducted on MEDLINE, SCOPUS, Web of Science, ScienceDirect, and LILACS. Studies published up to May 2018 in any language were eligible. The risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was used to obtain pooled estimates between oral health measures and school performance and school attendance. Eighteen studies were included. Of them, fifteen studies were used for the meta-analyses. Most studies were assessed as moderate quality. Children with one or more decayed teeth had higher probability of poor school performance (OR=1.44 95%CI: 1.24-1.64) and poor school attendance (OR=1.57 95%CI: 1.08-2.05) than caries-free children. Poor parent's perception of child's oral health increased the odds of worse school performance (OR=1.51 95%CI: 1.10-1.92) and poor school attendance (OR=1.35 95%CI: 1.14-1.57). Children and adolescents with dental caries and those reporting worse oral health experience poor school performance and poor school attendance.

Determinants of Self-Rated Health Perception in a Sample of a Physically Active Population: PLENUFAR VI Study.

The aim of this study was to investigate determinants of self-rated health (SRH) perception in Spanish adults. This cross-sectional study including data from 11,342 participants from the Spanish PLENUFAR VI study. SRH status was grouped in two categories (‘good’/‘poor’) and the associations of socio-demographic characteristics, lifestyles, diet adequacy and chronic disease with SRH were assessed. After adjusting for relevant confounders, the risk ratios (RR) and (95% confidence intervals) for poor SRH were 1.05 (1.03–1.07) for each hour of increment of sitting, 1.56 (1.30–1.88) for short (≥5 h vs. 7–8 h) sleep duration, 0.63 (0.55–0.72) for vigorous (vs. light) physical activity, 0.61 (0.50–0.74) for adequate (vs. non-adequate) diet. Activities like jogging [RR for each unit of increment in the METs-h/day = 0.87 (0.82–0.92)], gymnastics [0.87 (0.81–0.93)], biking [0.91 (0.85–0.98)], and track and field [0.94 (0.89–0.98)], were associated with better health perception. Normally weight participants with any chronic disease had lower probability to report poor SRH than overweight/obese participants with any chronic disease. Frequent consumption of bread (>2 servings/day) was associated with a lower adjusted mean of health perception scale, while higher consumption of vegetables and fruit or fish were associated with higher values, concerning good SRH. We can conclude that normal-weight participants even suffering a chronic disease had lower probability to report poor health perception than participants with overweight/obesity and a chronic disease especially for hypertension and diabetes. Activities like jogging, gymnastics, biking, and track and field, and a higher consumption of fruits, vegetables and fish, were associated with better health rated perception.

Percent Body Fat and Poor General Health Perception are Strongly Associated with Appearance Satisfaction in African American Women

Percent Body Fat and Poor General Health Perception are Strongly Associated with Appearance Satisfaction in African American Women

Factores asociados a la sobrecarga en el cuidador primario. Medellín, 2017

Introducción: El aumento de personas dependientes conlleva a la necesidad de cuidadores que asuman tareas básicas de cuidado; la responsabilidad de cuidar es asumida principalmente por familiares y el cuidado constante repercute en cambios de índole personal, familiar, laboral y social. Objetivo: Identificar los principales factores sociodemográficos y del cuidado, asociados a la sobrecarga en el cuidador primario de la ciudad de Medellín para el año 2017. Materiales y métodos: Estudio transversal, cuantitativo, de fuente de información primaria obtenida por encuestas telefónicas. La muestra fue de 340 cuidadores. El consentimiento fue verbal. Resultados: El 92,6% de los cuidadores eran mujeres, la edad promedio fue de 57 años; el 53,8% percibía su salud como regular o mala. La prevalencia de sobrecarga fue 39,7% y las características asociadas fueron la mala percepción de salud, el abandono de actividades y el no recibir capacitación previa al cuidado. Conclusiones: El cuidador es un sujeto con derechos que requiere atención en programas de prevención de riesgos que se derivan del cuidado. Es necesario brindar educación y acompañamiento a las personas encargadas del cuidado para que se empoderen de su salud.

Difficulties and motivations for physical exercise in women older than 65 years. A qualitative study.

ABSTRACTObjective:to identify difficulties and motivations for the practice of physical exercise in women older than 65 years. Method:qualitative study based on the phenomenological theory, with focus groups and in-depth interviews. The nursing staff selected 15 women by intentional sampling using the following criteria: age, time dedicated to physical exercise, independence, and absence of cognitive impairment and contraindication for this activity. Two focus groups were formed (one of them did physical exercise for less than 150 minutes per week and the other at least 150 minutes per week) in addition to conducting five in-depth interviews. Qualitative analysis of the data was performed through transcription, coding, categorization, and verification of results. Results:the difficulties to start and develop physical exercise were circumscribed to the perception of poor health and lack of free time; both circumstances result from care obligation, being represented as a gender imposition. However, the motivations are related to perception of strength, need for socialization, and perception of autonomy and freedom. Conclusions:the ideological representation of gender determines the women’s decision to exercise. Knowing the meaning and significance that women give to health and their role in the socio-family environment allows nurses to develop relationships and interventions to encourage the practice of physical exercise.

Out-of-pocket health expenditure in rural population

Objectives The aim of this study was to distinguish between the different determinants of out-of-pocket (OOP) health expenditure in rustic Egypt. Background OOP well-being expenditure represents 60% of total health expenditures in Egypt. Numerous families in Egypt depend on OOP to fund healthcare services. This specifically impacts their entrance to quality well-being administrations. Creating knowledge about the determinants of OOP is a need to configuration polices that shield family units from impoverishment. Patients and methods The study was a cross-sectional one that was directed in country zone, lower Egypt, from September 2015 to October, 2016. The calculated sample size was 380 participants selected by means of systematic random sampling. They were divided according to the health expenditure in last medicinal services required in the recent weeks into the OOP and the non-OOP group. A predesigned questionnaire was utilized to recognize different determinants of OOP well-being use (e.g., age, sex, and health status). Results An overall 85% of studied shared members had OOP costs over the most recent 4 weeks for healthcare. There was a statistically significant difference (P < 0.001) between displaying OOP and being a woman in childbearing age, living in high socioeconomic level, having chronic disease, absence of health insurance coverage, poor perception of health, and private care. Conclusion OOP health expenditure is more predominant in specific gatherings of population and is affected by basic determinants. Tending to such determinants ought to have a noteworthy impact on getting legitimate medicinal services and thus in the expectations for everyday comforts.

Fatores associados à mortalidade de adultos e idosos residentes no município de Rio Claro - SP: um estudo de coorte

The factors associated to mortality may be distinct in each region and identifying them can contribute to develop public policies related to health promotion and prevention. Thus, the aims of this study were verify the factors associated with mortality and the influence of physical activity on the mortality rates of adults and elderly living in the city of Rio Claro, SP. The first moment of the cohort study was conducted in 2008 and the second in 2014. Participants answered questions about socio-demographic level, level of physical activity (PA), health and eating habits variables. In the case of individuals who were not found after three attempts, neighbors and relatives were questioned about whether they had the contact with that person or if he/she had passed away. To analyze factor associated to mortality, three independent Logistic Regression models for complex samples were used (total PA; commuting PA; leisure PA), as well as the SPSS software version 21.0, considering p&lt;0.05. The variables that were associated with mortality in the three models were: “male sex”, “elderly” and “poor/very poor health perception”. Further, individuals who spent 150 min/week of physical activity did not showed any protection against mortality when compared with those who did not achieve the recommendation. These results can guide public policies, mainly, to the health of the elderly, people with poor health perception and men.

Yaşlılarda yeti yitimi ve aleksitimi

Amaç: Yaşlılık döneminde yeti yitimi ve aleksitimi kişilerin sağlık ve sosyal durumlarına etkili olabilen önemli kavramlardır. Bu çalışmada, Gümüşhane İl Merkezinde evde yaşayan yaşlılarınyeti yitimi ve aleksitimi özelliklerinin değerlendirilmesi amaçlanmıştır. Yöntem: Kesitsel tipte olan araştırma, Gümüşhane İl Merkezinde bulunan 14 aile hekimliği birimine kayıtlı nüfustan sistematik örnekleme ile seçilen 65 yaş ve üzeri 437 kişi ile yürütülmüştür. Örnekleme alınan yaşlılara, içerisinde Kısa Yeti Yitimi Anketi ve Toronto Aleksitimi Ölçeği-20 (TAÖ-20)’nin de yeraldığı bir anket yüz yüze görüşme ile uygulanmıştır. Tanımlayıcı veriler sayı, yüzde, ortanca ve min-max olarak gösterilmiştir. İstatistiksel analizlerde, p&amp;lt;0.05 değerleri anlamlı olarak kabuledilmiştir. Bulgular: Araştırma kapsamına alınan yaşlıların yaş ortalaması 74.3±7.15 yıl (min:65, max:100) olup, %63.4’ü kadın, %36.6’sı erkektir. Yaşlıların Kısa Yeti Yitimi puan ortalaması 10.25±5.03 (min:0, max:22), TAÖ-20 puan ortalaması ise 49.28±9.58 (min:25, max:85)’dir. Yaşlıların %86’sında çeşitli derecelerde yeti yitimi saptanmıştır. Kadın olmanın, dul/boşanmış olmanın, düşük eğitim düzeyine sahip olmanın, herhangi bir ruhsal sorun yaşamanın, mobilizasyonda kısıtlılık artışının, egzersiz yapmamanın, genel-fiziksel-zihinselduygusal ve sosyal sağlık düzeylerinde kötü sağlık algısına sahip olmanın TAÖ-20 puan ortalamasını arttırdığı saptanmıştır (p&amp;lt;0.05). Hayatı boyunca herhangi bir şiddet türüne maruz kalmış olanların şiddet görmeyenlere, aile içinde kendini ifade edemeyenlerin ya da kısmen ifade edenlerin böyle bir sorun yaşamayanlara göre aleksitimi toplam puanları daha yüksek bulunmuştur (p&amp;lt;0.05). Sonuç: Bu araştırmada, yaklaşık olarak her beş yaşlıdan dördünde yeti yitimi bulunmuştur. Ortalama aleksitimi puanı ise ölçeğin maksimum puanın yarısının altındabulunmuştur. Yaşlılarda yeti yitimi ve aleksitimiyi etkileyen faktörlere yönelik iyileştirici yönde çalışmalar planlanmalı ve uygulanmalıdır.

Travel Health Survey: Risk Perception, Health-Seeking Behavior, and Subjective Evaluation of Travel Health Services in Egypt

Introduction: Travel health practice and research in Egypt lag behind both needs and demands. This study was done in two parts to assess travel health knowledge, attitude, and practice (KAP) among Egyptian travelers. Methods: This survey was conducted at the departure halls of Cairo International Airport and included 1500 travelers to Africa (excluding North Africa), Southeast Asia, and Latin America. An interview questionnaire was used to measure the KAP of travelers inquiring about different aspects of pre-travel health. Subjective evaluations of travel health services and suggestions for improvement were also solicited. Results: Travelers in this study were mainly males (89.3%), less than 40 years of age (82%), living in urban residences (89.1%), married (65.9%), university educated (83.3%), traveling for work (69.1%) with destinations of Africa (61.3%), Asia (28.4%), and Latin America (10.3%). They had poor travel-associated risk perception, and only 13.4% had risk management plan. Less than half (42.4%) sought information about their destination, and 11.9% sought health information; their source of information was mainly the internet (98.7%). The majority had poor scores on various travel-related practices, including seeking pre-travel health services (87.9%), receiving pre-travel vaccines (91.3%), and using malaria chemoprophylaxis (90.6%). The travel health services were rated good by 0.5% of travelers and bad, very bad, or undetermined by 11.4%, 61.3%, and 26.9% respectively. Conclusion: Egyptian travelers, although mostly educated, had poor travel health perceptions and practices and are unsatisfied with the travel health services in Egypt.

Similarities and differences in estimates of sleep duration by polysomnography, actigraphy, diary, and self-reported habitual sleep in a community sample

ObjectivesTo compare estimates of sleep duration defined by polysomnography (PSG), actigraphy, daily diary, and retrospective questionnaire and to identify characteristics associated with differences between measures. DesignCross-sectional. SettingCommunity sample. ParticipantsThe sample consisted of 223 Black, White, and Asian middle- to older-aged men and women residing in the Pittsburgh, PA area. InterventionsNot applicable. MeasurementsTwo nights of in-home PSG; 9 nights of wrist actigraphy and sleep diaries; retrospective sleep questionnaires; and measures of sociodemographic, psychosocial, and adiposity characteristics. ResultsAll measures of sleep duration differed significantly, with modest associations between PSG-assessed and retrospective questionnaire-assessed sleep duration. Individuals estimated their habitual sleep duration about 20-30 minutes longer by questionnaire and their prospective sleep diaries compared with both PSG- and actigraphy-assessed sleep duration. Persons reporting higher hostility had smaller associations between PSG-assessed sleep duration and other methods compared with those with lower hostility; those reporting more depressive symptoms and poorer overall health had smaller associations between actigraphy-assessed sleep duration and questionnaire and diary measures. Apnea-hypopnea index was not related to differences among estimates of sleep duration. ConclusionsPSG, actigraphy, diary, and retrospective questionnaire assessments yield different estimates of sleep duration. Hostility, depressive symptoms, and perceptions of poor health were associated with the magnitude of differences among some estimates. These findings may be useful in understanding the health consequences of short or long self-reported sleep duration and for guiding investigator decisions about choices of measures in specific populations.

The interaction effects between race and functional disabilities on the prevalence of self-reported periodontal diseases - National Health and Nutrition Examination Survey 2011-2012.

Racial minority groups and adults with functional disabilities (FDs) disproportionally experience periodontal diseases. However, little is known about the interactions of these two characteristics in disease prevalence. The purpose of this study was to examine the association between FDs and periodontal experiences, and to identify whether race has a particular influence on this relationship. Data were derived from the National Health and Nutrition Examination Survey 2011-2012, in a representative sample of adults aged 30 years and older. FDs were defined as experiencing limitations in activities of daily living. The weighted logistic regression models were performed using SAS software. The incidence of FDs was associated with a poor self-rated perception of teeth and gum health, gum disease, bone loss, and loss of teeth. The racial minority groups with FDs were more likely to report poor teeth and gum health, loose teeth, and a history of gum disease treatment. Mexican Americans with FDs reported poor teeth and gum health, gum disease, and had been previously treated for gum disease. African Americans with FDs were more likely to be diagnosed with bone loss and loose teeth. Racial minority groups with FDs were more likely to be associated with periodontal disease and poor oral health. To improve oral health, access to dental care among minority populations is important, particularly for people with FDs in community settings. Dentists should reach out to these underrepresented groups to address their oral health needs.

Health Care Use and Status Among Abused Young People

BackgroundChildhood abuse negatively affects young people's health. Little is known about its effect on health care usage patterns or on perception of health status during a life stage when learning to use care independently is a key developmental task. ObjectivesIn nonclinical study settings, abuse has been found to be associated with disorganized use of care and perceived poorer health. Our objective was to determine whether abused youth receiving health care had similar outcomes. MethodsThis observational study, conducted between December 5, 2005 and April 13, 2007, screened for childhood abuse in 532 young people seeking services at a primary care clinic. The setting was a New York City young people's free health clinic. Participants were aged 12-24 years, recruited during a visit, mostly female (86%), Latino or black (94%), and currently in school or college (79%). Exclusions included not being fluent in English or having difficulty understanding the study/consent process. ResultsHealth care use (routine vs urgent care) in the prior 12 months and perceived health status were measured using the Health Service Utilization Scale. Potential demographic covariates were controlled for, as was depression (using the Beck Depression Inventory for Primary Care—Fast Screen). A total of 54% disclosed abuse. Compared with those who were not abused, those reporting sexual abuse had 1.4 times greater odds of choosing both urgent and routine care over routine care only. Those reporting any type of abuse had lower odds of selecting urgent care only over routine care. No association was found between childhood abuse and perceived health status. ConclusionsIn contrast to studies conducted among youth in nonclinic settings, in this study childhood abuse was not associated with health care usage patterns or with poorer perception of health. Further research is needed regarding the impact receiving health care has on perceived health and health care use in abused youth. Annals of Global Health 2017;0:000-000

A purposeful approach for implementing preventive measures among European teaching professionals: bullying, deteriorated organizational factors and the mediating role of job dissatisfaction in poor health perception

This research aims at examining how workplace bullying, a collection of predominant organizational factors and job dissatisfaction may both directly and indirectly influence the emergence of negative health perception among teaching professionals in occupational settings. The method utilized for testing the research hypotheses is based on Partial Least Squares Structural Equation Modeling (PLS-SEM), which enables the simultaneous assessment of construct measurement and the estimation of hypothesized relationships. A sample population of 2328 European educators has been employed to reach research objectives. Results suggest that negative health perception escalates when there is a direct conditioned correlation between this factor and either bullying or certain working conditions, while indirect effects are unveiled when dissatisfaction is added to the research framework as mediating construct. From a theoretical perspective, this work contributes to human resource management research on the subject of detection and prevention of those underlying organizational constituents that might potentially undermine occupational health. From a utilitarian perspective, the findings of this research encapsulate promising implications not only for teaching professionals but also for educational institutions that pursue the continual improvement of health and performance in their educators through human resource management.

Factors Associated with Excess Weight in a Sample Population of School Adolescents

Introduction: Overweight has been reported as a public health problem. Consequently, this suggests epidemiological studies for nutritional surveillance.Objective: To analyze the prevalence and factors associated with overweight among high school students in Capital of the Brazilian Western Amazon.Methods: cross-sectional study of 2694 adolescents from public and private schools. They collected demographic, socioeconomic and sedentary behavior through self-responded questionnaire. Overweight rating followed the recommendations of the World Health Organization (2007). The prevalence rates were calculated, odds ratio and their confidence intervals were calculated at 95%. They identified the factors associated with excess weight by multiple binary logistic regression.Results: The overall prevalence of overweight was 24.2% and 26.3% for males and 22.4% for females. After adjustment factors associated with overweight were economic class A / B (OR = 1.30, 95% CI 1.02 to 1.45), private school type (OR = 1.21, 95% CI 1,02-1.46) and poor health perception (OR = 1.27, 95% CI 1.03 to 1.58). It was concluded that excess weight showed high prevalence in economy class adolescents and B and private schools in Porto Velho, RO, Brazil.Conclusion: Therefore, the practice of physical activity associated with a diet should be encouraged, in addition to reducing sedentary behavior, to prevent the development of overweight and obesity.

Inequities in visual health and health services use in a rural region in Spain

ObjectiveTo analyse perceived visual health and health services use in a rural population in relation to socioeconomic characteristics and compared with the general population in Spain. MethodCross-sectional study in a rural population using a structured questionnaire including questions comparable to the Spanish National Health Survey (2012). A descriptive analysis was carried out through the calculation of frequencies and prevalence, the χ2 test for independent variables, contrasts of proportions and logistic regression to obtain associations between the rural and general populations and socioeconomic variables. ResultsFor the rural population studied, the prevalence of poor perceptions of visual health is 40.8% in men and 39.4% in women, and is strongly associated with age, employment situation, income and presence of chronic diseases (p ˂0.001). Compared with the general population, the rural population has a higher risk of presenting with serious difficulties related to farsightedness (OR: 2.56; 95% CI: 1.32-4.95) and make less use of optical correction (OR: 0.57; 95%CI: 0.44-0.74). The use of health services is not sufficient for adequate prevention, particularly in diabetics. For those affected by poor vision, the distance to travel to receive an eye exam, the belief that eyesight problems come with age and the cost of glasses are the principal reasons used to explain why eyesight problems are not resolved. ConclusionsThe rural population presents worse visual health that is influenced by social and economic factors. Improving accessibility and reducing barriers is essential to tackle avoidable visual disability and reduce health inequities.

Depression in older adults: prevalence and risk factors in a primary health care sample

Background: Depression in the geriatric population has been identified as a significant problem in view of the associated negative outcomes regarding poor functioning, increased perception of poor health and increased utilisation of medical services. Significantly associated with increased morbidity and mortality, depression has been found to be an independent cause of disability as well as adding to disability due to primary physical illnesses. Early identification and treatment of depression reduces medical costs and lessens caregiver burden. Epidemiological data and prevalence rates of geriatric depression in Africa are limited, although such data are vital to mobilise and plan government mental health initiatives aimed at screening and early intervention. Objective: To determine the prevalence of depression and associated clinical and socio-demographic factors amongst older adult patients attending a primary health care clinic in the Ethekwini District in Kwa-Zulu Natal, South Africa. &#x0D; &#x0D; Methods: The 15-item Geriatric Depression Scale and a socio-demographic questionnaire were administered in English to 255 geriatric outpatients, randomly selected, at a local community clinic in Durban. &#x0D; &#x0D; Data analysis: Data were analysed using SPSS version 23®. Descriptive statistics were used to summarise the sample demographics and response rate and non-parametric statistics were used to test for associations and differences.&#x0D; &#x0D; Results: A Cronbach’s alpha for the GDS was calculated (p = 0.793). Some 40% of participants screened positive for depression. Female gender, widowhood and a negative subjective health status rating were significantly associated with depression and marriage appeared to be protective (p &lt; 0.001). Participants with a poor subjective health rating were 21 times more likely to be depressed and widowhood conferred an almost fourfold increased risk of being depressed, with widows at greater risk than widowers. No association between depression and specific medical conditions was identified.&#x0D; &#x0D; Conclusion: There is a high rate of undetected depression among the elderly attending a local primary health care clinic with widowhood and poor subjective health being strong predictors of mood disorders. The findings warrant replication in bigger samples.&#x0D; &#x0D; (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)&#x0D; &#x0D; S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272250