Poor Self-perceived Health Research Articles

Informal Employment, Working Conditions, and Self-Perceived Health in 3098 Peruvian Urban Workers.

Peru has one of the highest informal employment rates in Latin America (73%). Previous studies have shown a higher prevalence of poor self-perceived health (P-SPH) in informal than in formal workers. The aim of this study was to analyze the role of working conditions in the association between informality and SPH in an urban working population in Peru. We conducted a cross-sectional study based on 3098 workers participating in the working conditions survey of Peru 2017. The prevalence of P-SPH and exposure to poor working conditions were calculated separately for formal and informal employment and were stratified by sex. Poisson regression models were used to assess the association between P-SPH and informal employment, with crude and adjusted prevalence ratios (PR) for working conditions. Informal employment affected 76% of women and 66% of men. Informal workers reported higher exposition to poor working conditions than formal workers and reported worse SPH. Informal workers had a higher risk of P-SPH than formal workers: PR 1.38 [95% CI: 1.16–1.64] in women and PR 1.27 [95% CI: 1.08–1.49] in men. Adjustment by working conditions weakened the association in both sexes. In women, this association was only partially explained by worse working conditions; PR 1.23 [95% CI: 1.04–1.46]. Although some of the negative effect of informal employment on workers´ health can be explained by the characteristics of informality per se, such as poverty, a substantial part of this effect can be explained by poor working conditions.

Burnout Syndrome and Related Factors in Mexican Police Workforces.

Burnout (BO) is a response to prolonged exposure to work-related stressors characterized by emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). The police working environment includes continued critical life-threatening situations, violence, and injuries, among other related factors putting them at high risk of distress. The objective of this study was to evaluate the association between Burnout Syndrome and sociodemographic, occupational, and health factors in Mexican police officers. We applied the Maslach Burnout Inventory Human Services Survey (MBI-HSS) to 351 active members of the Mexican police workforce. In addition, a specific questionnaire identified the presence of chronic degenerative diseases, hypertension, diabetes, digestive diseases, self-perception of food quality, and hours of sleep. Furthermore, 23.36% of police workforces presented high levels of burnout; 44.16% of police were highly emotionally exhausted, 49.29% had lost empathy with people, and 41.03% presented low personal achievement. Moreover, the worst levels of the syndrome were present in people with a poor self-perceived health status, poor perception of diet quality, without regular mealtimes, bad sleep habits, and elevated Body Mass Index. Data suggest that in Mexican police officers, BO is dimensionally different from all other groups previously studied (DP > EE > PA).

Impacto del confinamiento por la COVID-19 en la salud autopercibida en Chile según género

ObjectiveTo analyse the social factors associated with self-perceived health during the COVID-19 lockdown in the Chilean resident population according to gender perspective. MethodCross-sectional study conducted during the COVID-19 lockdown between May 17 and August 17, 2020 with an online survey. Self-perceived health was analysed in the population aged 18 years or older in relation to social variables. Multivariate logistic regression models were constructed to assess the association between independent variables with self-perceived health, through adjusted odds ratio (aOR). Analyses were stratified by sex (M: men; W: women). Results5981 persons were analysed (women: 63.9%). 29.6% of women and 19.2% of men reported poor self-perceived health. In women it worsens with increasing age. Worse self-perceived health was mainly associated with lack of social support (ORa M: 2.05; ORa W: 2.34), concern about living together at home (ORa M: 1.66; ORa W: 1.38), perceived inadequate housing conditions (ORa M: 1.89; ORa W: 2.63), and disagreement with government measures (ORa M: 2.80; ORa W: 1.82). In women, it was also associated with informal work or being inactive in the labour market (ORa: 2.11). In men worse self-perceived health was associated with being self-employed (ORa: 1.65; confidence interval [CI]: 1.11–2.45) and has secondary education (ORa: 2.81; CI: 1.32–5.98). ConclusionsThe social impact of lockdown in self-perceived health is related to gender, age, care work, and socioeconomic conditions, as well as, by disagreement with the measures implemented to manage the pandemic.

Social Capital as Protection Against the Mental Health Impact of the COVID-19 Pandemic.

The corona pandemic has a huge impact on the mental wellbeing of the Dutch population. Based on a large-scale panel survey (N = 22,696) on the social impact of COVID-19, this article firstly examines which social groups are most susceptible to the mental health consequences of the pandemic. Secondly, we examine whether social capital provides protection against this impact. We find that the mental health impact of COVID-19 is considerable and that it increased over the course of 2020. Women, young people, respondents with low incomes and/or poor self-perceived health, experience relatively more fear and stress due to the pandemic. We do not find a difference between respondents with or without a migration background. Social capital (received support, trust in people and in institutions) has the expected effect: the more support and trust, the less fear and stress. There is a mediation effect. Older people, respondents with high incomes and/or good health experience less fear and stress, partly because they have more social capital. This is different for females. They would experience even more fear and stress, compared to men, were it not for the fact that they have more social capital. Hence we conclude that social capital indeed provides some protection against the negative mental health consequences of COVID-19.

Self-Reported Menstrual Alterations During the COVID-19 Syndemic in Spain: A Cross-Sectional Study.

IntroductionAvailable evidence suggests that there might be an association between the stressors experienced during the COVID-19 syndemic and changes in menstrual patterns. The aim of this study was to assess self-reported menstrual alterations during the COVID-19 syndemic among women and people who menstruate aged 18–55 in Spain.Materials and MethodsA cross-sectional online survey-based study was conducted (March–July 2021). Descriptive statistics were calculated and multivariate logistic regression models were constructed. This study was conducted as part of the “Equity and Menstrual Health in Spain” research project.ResultsAmong participants (N=17,455), 39.4% reported menstrual alterations since the start of the syndemic. Participants self-reporting long COVID-19 presented higher odds of menstrual alterations (aOR: 1.34, 95% CI, 1.15-1.57). In participants with no history of COVID-19, the risk for self-reported menstrual alterations was significantly higher based on employment situation, among participants experiencing financial issues (eg, financial issues always/many times <12 months: aOR: 1.68, 95% CI, 1.48–1.90), poorer self-perceived health (eg, poor: aOR: 2.00, 95% CI, 1.31–3.07), and those diagnosed with polycystic ovary syndrome (aOR: 1.13, 95% CI, 1.02–1.26). Among participants with a self-reported COVID-19 diagnosis, factors that significantly increased the odds for menstrual alterations were experiencing financial strains (eg, financial issues always/many times <12 months: aOR: 1.53, 95% CI, 1.09–2.14), poorer self-perceived health (eg, poor: aOR: 3.09, 95% CI, 1.01–9.52). Overall, factors that decreased the odds of reporting menstrual alterations included age >25, being a carer, not having a gynecological condition and using hormonal contraception.Discussion and conclusionsFindings suggest an impact of the COVID-19 syndemic on menstrual patterns. Social inequities in reporting menstrual alterations were identified. While the risk of reporting menstrual alterations was higher among participants with long COVID-19, evidence is not conclusive. Further research on menstrual health in the context of COVID-19 is needed, also to inform policy and practice.

Multiple Logistic Regression Analysis of Smartphone Use in University Students.

Problematic smartphone use (PSU) is an expanded public health heed that requires more study to clarify the influence elements of different populations. The aim of this study was to investigate the relationship between smartphone use, and sleep quality, self-perceived health, and exercise participation in university students. A total of 1,575 Taiwanese undergraduate students from 7 universities participated in the study. Three questionnaires were completed by the study individuals. The results show the overall PSU rate was 11.8%. Average smartphone users were more likely to feel in good health, better sleep quality and less unsatisfactory exercise participation than those who were problematic smartphone users. Multiple logistic regression analysis indicated that PSU, low weekly exercise frequency, and poor sleep quality were significant indicators of poor self-perceived health. We concluded that both low physical activity and PSU did have negative impacts on self-perceived health and sleep quality for undergraduate students.

Sociodemographic and health factors associated with the risk of financial catastrophe when informal care for patients with haematological neoplasms is replaced by formal care

BackgroundCancer is one of the diseases with the highest incidence and mortality in the world, and one that requires greater care (formal and informal). At present, the traditional informal caregiver is disappearing. The objective is to analyse the sociodemographic and health factors associated with the possible catastrophic financial effect on households of replacing informal care by formal care for patients with blood cancer, during the different stages of treatment in Spain.MethodsA total of 139 patients with haematological neoplasm who underwent stem cell transplantation completed a longitudinal questionnaire during each of three treatment phases. Of this population, 88.49% received informal care. The households were classified into those where the replacement of informal care with formal care would impose a financial burden exceeding 40% of equivalent household income, versus those who would not suffer this consequence. Three logistic regression models (one for each treatment phase) were estimated and the corresponding marginal effects determined.ResultsThe factors associated with a higher probability of financial catastrophe were married marital status, low education level, fair to very poor self-perceived health status, the diagnosis of leukaemia in the pre-transplant and first-year post-transplant phases and of multiple myeloma disease in the final post-transplant phase.ConclusionsThese findings reveal the need to design social policies to meet the care needs of patients with blood cancer which at present are covered by informal care. Given the foreseeable elimination of this option, these families must be protected from the financial burden incurred from the use of privately-contracted assistance.

Radiotherapy-Related Fatigue Associated Impairments in Lung Cancer Survivors during COVID-19 Voluntary Isolation.

The main objective of this study was to investigate the impairments presented after COVID-19 voluntary isolation by lung cancer survivors that experienced radiotherapy-related fatigue. In this observational study, data were collected after COVID-19 voluntary isolation. Patients were divided into two groups according to their fatigue severity reported with the Fatigue Severity Scale. Health status was assessed by the EuroQol-5D, anxiety and depression by the Hospital Anxiety and Depression Scale, and disability by the World Health Organization Disability Assessment Schedule 2.0. A total of 120 patients were included in the study. Patients with severe fatigue obtained higher impairment results compared to patients without severe fatigue, with significant differences in all the variables (p < 0.05). Lung cancer survivors who experienced severe radiotherapy-related fatigue presented higher impairments after COVID-19 voluntary isolation than lung cancer patients who did not experience severe radiotherapy-related fatigue, and showed high levels of anxiety, depression and disability, and a poor self-perceived health status.

Association between Rheumatoid Arthritis and Poor Self-Perceived Oral Health in Korean Adults.

Background and objective: Rheumatoid arthritis (RA) and oral health problems have been reported as specific disease units; however, this study was conducted to evaluate the association between RA and comprehensive oral health status. Therefore, this study aimed to assess the association between RA and oral health using self-perceived oral health (SPOH) variables that can determine the oral health status in Korean adults using representative national data. Methods: Data from 40,186 selected participants were collected from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2007 and 2018. The prevalence relative risk (PRR) was estimated using Poisson regression analysis to obtain the risk ratio of the SPOH according to RA. Results: The risk of SPOH depending on the RA status was statistically significant (odds ratio [OR] = 1.108, 95% confidence interval [CI] 1.005–1.222). In addition, the risk of SPOH depending on the RA status was higher in the group with diabetes mellitus (DM) (OR = 1.205, 95% CI 0.966–1.503) than in the group without DM (OR = 1.088, 95% CI 0.976–1.214). Conclusions: In this study, a significant association was identified between RA and SPOH. Oral health experts should identify the factors affecting the oral health of patients with RA and provide correct oral health care; however, additional research is needed.

Caregiving and Caregiver Health 1 Year into the COVID-19 Pandemic (CUIDAR-SE Study): A Gender Analysis.

The COVID-19 pandemic has highlighted the importance of informal care and shown that women continue to shoulder the brunt of responsibilities in this area. In this study, we analyzed differences in caregiving and self-perceived health in a group of informal male and female caregivers 1 year into the COVID-19 pandemic. We performed a cross-sectional survey of 261 informal caregivers (165 women and 96 men) in two regions of Spain using computer-assisted telephone interviewing between February and April 2021. We performed descriptive, bivariate, and multivariate analyses to calculate the odds of poor self-perceived health according to different caregiver, care recipient, and caregiving characteristics. We also analyzed the perceived effects of the pandemic on caregiving, caregiver health, and other aspects of life. Compared with male caregivers, female caregivers were more likely to experience increases in caregiving intensity and burden and a decline in self-perceived health as a result of the pandemic. Men providing high-intensity care, however, also reported deteriorated health. Men experienced fewer reductions in informal support, a factor that exerted a protective health effect. Women, by contrast, experienced a reduction in all support systems and in this case, a third-level education exerted a protective effect. Our results provide key insights that should be taken into account to design gender-based interventions aimed at supporting already stretched and burdened caregivers. A greater sharing of responsibilities and more resources are needed.

A survey on self-medication for the prevention or treatment of COVID-19 and distrust in healthcare of veterans in a primary care setting in the United States.

The SARS-CoV-2 (COVID-19) pandemic brought the public overwhelming and conflicting information. Rates of trust in healthcare professionals have been declining among laypersons over the past five decades. In this setting, we sought to evaluate the use of medications, both with or without a prescription, to prevent and treat SARS-CoV-2 as well as trust in healthcare among patients in a primary care clinic. We surveyed 150 veterans in primary care clinic waiting rooms at a large southwestern tertiary care Veterans Affairs hospital. This survey was performed in March-November 2021. The survey asked about respondents' demographics, use of medications, nutritional supplements, and other remedies for the prevention and treatment of COVID-19, perceived access to care using Agency for Healthcare Research and Quality (AHRQ) Consumer Assessment of Healthcare Providers and System (CAHPS), overall health status, and barriers to medical appointments in the last 12 months. Distrust was measured using the Revised Health Care Distrust scale. We used univariate and multivariate linear regression analyses to study predictors of distrust to healthcare. Forty-two (28%) of 150 respondents reported taking an agent for the prevention of COVID-19, while 4% reported storing antibiotics for the treatment of COVID-19, if diagnosed. Medications were obtained from medical providers, US stores or markets, the Internet, home stockpiles, and other countries. Medications with potentially harmful effects taken for the prevention and treatment of COVID-19 included hydroxychloroquine, pseudoephedrine, and antibiotics. Among those surveyed, the mean (SD) on the health system distrust score was 2.2 (0.6) on a scale of 1-5, with 5 indicating higher distrust. Younger age, self-reported poor health, lack of a regular physician, and self-reported poor access to care were independently associated with distrust in healthcare. Self-medication to prevent COVID-19 infection with unproven therapies was common among respondents, as was some level of distrust in the healthcare system. Access to care was one of the modifiable factors associated with distrust. Future studies may explore whether improving trust may moderate self-treatment behavior and storage of potentially harmful medications. Self-Medication Habits and Trust in Healthcare Among Patients in a Primary Care Setting in the United States The public has received information from many different sources on COVID-19. Trust in healthcare leadership has also been impacted. We studied self-medication habits to prevent or treat COVID-19 among a group of primary care patients in a large hospital system in the Southwest United States. We also explored these patients' trust in their healthcare system.We asked people waiting in primary care clinic waiting rooms whether they had taken any medications, nutritional supplements, or other remedies to prevent or treat COVID-19. We also asked people whether they stored medications in the event that they were diagnosed with COVID. The survey explored patients' trust in the healthcare system through a validated trust survey tool. The survey also assessed basic demographic information, health literacy, access to care, and self-reported health status. These survey answers were analyzed to see whether there was an association between trust in healthcare and other factors including self-medication habits, access to care, demographics, or perceived health.This study found that over 25% of the 150 people surveyed had taken a medication, nutritional supplement, or remedy in an attempt to prevent COVID. We found that some people were taking potentially harmful medications, including hydroxychloroquine, pseudoephedrine, and antibiotics. We found that patients' distrust score was 2.2 on a scale of 1-5 (5 is associated with higher distrust). Self-medication for the prevention or treatment of COVID was not associated with distrust; however, younger age, self-perceived lack of access to healthcare, self-perceived poor overall health, and not having a regular doctor were predictors for lower trust. This information provides a basis to further study self-medication habits as well as ways to improve trust in the healthcare system.

Falls among Elderly in a Rural Community: Incidence and Determinants

Background: Falls are one of the emerging public health issues and a barrier for active aging. There is a scarcity of studieson incidence of falls among elderly population which provide information on real burden from rural part of India. Hence,the study was undertaken to find out the incidence of falls and determinants among elderly population.Materials and Methods: A prospective cohort study was carried out by involving 260 elderlies in a primary health centrearea of Bengaluru by using simple random sampling technique over a period of one year. Data was collected regarding,socio-personal characteristics, substance use, co-morbidities and self-perceived health status using interview method andassessment of housing conditions was also undertaken. House visit was conducted to explain the purpose of the studyand to distribute falls dairy. Telephonic interview was undertaken to collect history of falls and related information oncein three months and at the end of one-year elderly were revisited to confirm the falls. All the data was analysed using Epiinfo 7.2.2.1.Results: The incidence of falls among elderly was 48.2%. The socio-personal characteristics such as age group ≥70 years(p&lt;0.001), low/medium standard of living index (SLI) (p=0.03), poor/average self-perceived health status (p=0.001),provision of separate living room (p=0.0006) and location of bathroom and toilet outside the house (p=0.04) wereassociated with falls.Conclusion: The incidence of falls among elderly was more compared to previous studies and associated with advancedage, poor income, poor self-perceived health status, living alone in separate room and location of bathroom and toiletoutside the house.

Financial Difficulties Correlate With Mental Health Among Bangladeshi Residents Amid COVID-19 Pandemic: Findings From a Cross-Sectional Survey.

Background: The COVID-19 pandemic is a global threat which has challenged mental resilience and impacted the psychological well-being of people across all age groups globally. The present study aimed to investigate how financial difficulties during the pandemic correlate with mental health among residents of Bangladesh.Methods: A cross-sectional survey was conducted on 4,020 residents from different parts of Bangladesh between July and September 2020, during a period of elevated risk of COVID-19 infection. A self-reported online questionnaire comprising socio-demographic, financial difficulties and psychometric measures (to assess depression, anxiety and stress) was used to gather information from participants. Multivariable logistic regression analysis was performed to determine the factors associated with mental health consequences.Results: The prevalence of depression, anxiety, and stress in the sample were 71.1%, 62.3%, and 56.7%, respectively. Levels of depression, anxiety, and stress were significantly higher among participants who reported female sex, being unmarried, smaller families, higher monthly family income, poor self-perceived health status, living near people who had been infected by COVID-19, probability of decreased income, food scarcity (both during the pandemic and in the future) and the possibility of unemployment. However, due to the nature of the cross-sectional study performed with a convenience sampling method, the causal relationship between variables cannot be justified.Conclusions: After several months of the COVID-19 pandemic in Bangladesh, more than half of the respondents rated their mental health concerns as moderate to severe. The findings highlight the contributing factors of poor mental health which warrant the creation of interventions that address the economic, financial and mental health impacts of the pandemic.

Association Between Household Income and Self-Perceived Health Status and Poor Mental and Physical Health Among Cancer Survivors.

Background: Health-related quality of life (HRQoL) is multidimensional and is composed of, at a minimum, self-perceived health status, physical functioning, and psychological well-being. HRQoL measures reflect the extent of disability and dysfunction associated with a chronic disease such as cancer. The objective of this study is to examine factors associated with HRQoL among cancer survivors.Methods: Data from the 2009 Behavioral Risk Factor Surveillance System survey was used to examine factors associated with HRQoL among participants who reported having ever been diagnosed with cancer. Four questions associated with HRQoL included self-perceived health status, number of bad physical health days, and number of bad mental health days per month. Least square regression and logistic regression models, adjusted for confounding variables, were used for an ordinal and dichotomous [5 (bad) vs. 1–4 (excellent, very good, good, fair)] scale of HRQoL, respectively.Results: Fifty nine thousand one hundred seventy three participants reported having ever been diagnosed with cancer. Adjusted mean self-perceived health status (5-point scale) among survivors of thyroid, colon, lung, cervical, breast, prostate, and ovarian cancer was 3.83 (0.05), 4.02 (0.04), 4.36 (0.06), 3.77 (0.03), 3.88 (0.03), 3.78 (0.04), and 3.96 (0.05), respectively. After adjusting for confounders, a positive dose-response effect was observed between income range and all three HRQoL measures across all seven cancer sites. Income was consistently and inversely associated with a higher chance for reporting poorer HRQoL [OR: 0.64, 95% CI: 0.57–0.71], [OR: 0.63, 95% CI: 0.48–0.82], [OR: 0.67, 95% CI: 0.56–0.80], [OR: 0.69, 95% CI: 0.56–0.86], [OR: 0.55, 95% CI: 0.49–0.62], [OR:0.55, 95% CI: 0.44–0.69], [OR: 0.75, 95% CI: 0.62–0.91] among those with thyroid, colon, lung, cervical, breast, prostate, and ovarian cancer, respectively.Discussion: This study found that income range was associated with HRQoL among cancer survivors. It is plausible that financial resources may lessen the overall burden of cancer survivors, which could improve health-related quality of life among cancer survivors.

Self-perceived health status among adults with obesity in Quebec: a cluster analysis

PurposePeople with obesity are a highly heterogeneous group. Characterizing this heterogeneity may help to improve public health by offering adapted interventions and treatments to more homogeneous sub-groups among obese patients. This research aims to (1) identify distinct clusters of people with obesity based on demographic, behavioural, and clinical factors in the province of Quebec (Canada) and (2) assess the association of these clusters with selfperceived health. MethodsWe conducted a sex specific cluster analysis (multiple correspondence analysis and hierarchical clustering) of adults with body mass index (BMI) ≥ 30 kg/m2 from the 2015–2016 Canadian Community Health Survey in Quebec. Clusters were based on demographic, clinical, and behavioural characteristics. The clusters were tested for association with poor selfperceived health using logistic regression. ResultsThree clusters of individuals with obesity were identified. These were (1) young individuals, (2) people with higher levels of depression and anxiety, and (3) older adults with high comorbidity. Those with high levels of depression and anxiety (9% of men vs. 13% of women) were associated with the poorest selfperceived health. ConclusionsPeople with obesity in Quebec can be categorized into three clusters based on demographic, clinical, and behavioural characteristics. The findings of this study draw attention to the need to examine the coexistence of obesity with depression and anxiety, particularly as it relates to selfperceived health.

Informal employment and poor self-perceived health in Latin America and the Caribbean: a gender-based comparison between countries and welfare states in a pooled analysis of 176,786 workers

BackgroundMore than half of the working population in Latin American and Caribbean (LAC) countries is engaged in informal employment. The few previous studies indicate that this employment condition could have negative consequences for workers’ health. The aim of the present study was to estimate the association between self-perceived health and informality in LAC countries according to gender and welfare state type.MethodsThe cross-sectional study based on different working conditions and health national surveys was carried out in 13 LAC countries between 2012 and 2018. A sample of 176,786 workers was selected from these surveys. The association between health and informality was estimated using Poisson regression. Finally, a random effects meta-analysis was carried out by country. All results were stratified by sex and type of welfare state (statalist or familialist).ResultsInformal workers reported significantly worse health than formal workers, for both women (1.28 [95% CI 1.14-1.43]) and men (1.30 [1.12-1.50]). This difference was broader and more significant in countries with statalist welfare state regimes, among both women (1.40 [1.22-1.60]) and men (1.51 [1.30-1.74]), than in familialist regime countries (1.19 [1.03-1.38] and 1.24 [1.03-1.49], respectively).ConclusionsThis study provides strong evidence of the association between informal employment and worker health. Welfare states appear to have a modifying effect on this association. The transition from the informal to the formal labour market in LAC is essential to improving the health of the population.

Prevalence and predictors of different patterns of hypertension among adults aged 20\u201360 years in rural communities of Southeast Nigeria: a cross-sectional study

BackgroundHypertension, a major cardiovascular disease risk factor exists several years without symptoms. Few data exist on prevalence and predictors of hypertension among apparently healthy Nigerian adults. This makes it difficult for policy-makers to concentrate efforts to control emerging health burden of the disease. This study assessed prevalence and predictors of isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) and combined systolic and diastolic hypertension (CSDH).MethodsCross-sectional survey design was employed in the study of 517 adult participants (20–60 years) in a rural setting. Selection of the respondents was through multistage sampling which involved systematic, proportionate and simple random sampling. Data on socio-demographic characteristics, blood pressure, height, weight, and waist circumference were collected. Frequencies, T-test, analysis of variance and Chi square were used in statistical analysis. Bivariate and multivariate logistic regressions were used to evaluate variables associated with different patterns of hypertension with significance accepted at P < 0.05. Frequencies, percentages, crude and adjusted odd ratios were reported. Statistical Product and Service Solutions version 21.0 was used in statistical analysis.ResultsISH (10.6%), IDH (18.2%) and CSDH (37.8%) were observed among the participants. ISH was less likely among 20–29 year-olds (adjusted odds ratio (aOR) = 0.35, 95% confidence interval (C.I.) = 0.13–0.94), 30–39 year-olds (aOR = 0.30, 95% C.I. = 0.11–0.82) and those with abdominal obesity (aOR = 0.12, 95% C.I. = 0.03–0.56). Participants who perceived their health status as good (aOR = 3.80, 95% C.I. = 1.29–11.18) and excellent (aOR = 5.28, 95% C.I. = 1.54–18.07) were respectively 3.80 and 5.28 times more likely to have ISH. Those with secondary education had significantly higher likelihood for IDH (aOR = 2.05, 95% = 1.02–4.14) whereas self-perceived poor health status (aOR = 0.24, 95% C.I. = 0.09–0.65), absence of obesity (aOR = 0.10, 95% C.I. = 0.01–0.81) and general obesity (aOR = 0.35, 95% C.I. = 0.17–0.72) were associated with reduced risk for IDH. Secondary (aOR = 0.60, 95% C.I. = 0.36–0.99) and tertiary (aOR = 0.49, 95% C.I. = 0.28–0.85) education were associated with reduced risk for CSDH but combined obesity (aOR = 4.39, 95% C.I. = 2.25–8.58) increased the risk for CSDH by 4.ConclusionISH, IDH and CSDH were problems among the adults with age, obesity, self-perception of good/excellent health status and low education level as significant predictors. Health and nutrition education to prevent comorbidities and cerebrovascular accidents are recommended.

Common and different characteristics among combinations of physical frailty and sarcopenia in community-dwelling older adults: The Korean Frailty and Aging Cohort Study.

Physical frailty and sarcopenia are geriatric syndromes associated with adverse health outcomes. However, the common and different conditions associated with physical frailty and sarcopenia remain unclear. This study aimed to compare the clinical characteristics of older adults with physical frailty and sarcopenia. This cross-sectional study analyzed 2028 community-dwelling older adults, aged 70-84 years (mean age 75.9 ± 4.0 years; 50.1% men). Physical frailty was defined using the Fried frailty phenotype, whereas sarcopenia was defined using the Asian Working Group for Sarcopenia 2014 and 2019 criteria. The prevalence of physical frailty was 5.5%, whereas that of sarcopenia, using the Asian Working Group for Sarcopenia 2014 and 2019, was 9.1% and 17.5%, respectively. The concordance of physical frailty with sarcopenia was higher in the Asian Working Group for Sarcopenia 2019 criteria than in 2014. Frail-only participants had a higher incidence of disability, cognitive dysfunction, poor self-perceived health, and depressive symptoms than the sarcopenic-only participants. Frail-and-sarcopenic participants showed a lower body mass index (≥23 kg/m2 ) than frail-only participants. Furthermore, in frail-and-sarcopenic participants, recurrent falls (16.9% vs 5.5%) were higher than in the neither-frail-nor-sarcopenic participants; falls with fracture (11.5% vs 1.7%) and fear of falling (59.0% vs 36.7%) were higher in frail-and-sarcopenic participants than in sarcopenic-only participants. This study showed significant differences between physical frailty and sarcopenia among community-dwelling older adults. Older adults with physical frailty and sarcopenia were more likely to have higher fall-related outcomes than the others. Geriatr Gerontol Int 2022; 22: 42-49.

Challenges Faced by Emergency Physicians in China: An Observation From the Perspective of Burnout

Background: Burnout is considered a global problem, particularly in the emergency health sector; however, no large-sample cross-sectional study has assessed the prevalence of burnout among emergency physicians and its associated factors.Methods: A nationally representative cross-sectional survey of 15,243 emergency physicians was conducted in 31 provinces across China between July and September 2019. Multiple linear regression analysis was performed to identify correlates of burnout.Results: The participants' mean scores were 25.8 (SD = 15.9) on the emotional exhaustion (EE) subscale, 8.1 (SD = 7.9) on the depersonalization (DP) subscale, and 26.80 (SD = 12.5) on the personal accomplishment (PA) subscale, indicating a pattern of moderate EE, moderate DP, and high PA. The results of the large-sample survey found that 14.9% of emergency physicians had a high level of burnout in China, with 46.8% scoring high for EE, 24.1% scoring high for DP, and 60.5% having a high risk of low PA. Having poor self-perceived health status and sleep quality, working in developed regions and governmental hospitals, having an intermediate professional title, experiencing depression, performing shift work and experiencing workplace violence made emergency physicians more likely to experience occupational burnout.Conclusion: Positive measures should be taken to reduce the burnout of emergency physicians and improve their work enthusiasm to maintain the quality of emergency medical services.

Low back pain prevalence and associated factors in nurses from Brazilian primary health units.

Primary health unit (PHU) nursing work is different when compared to hospital environment. Although low back pain (LBP) literature presents studies conducted in hospital nursing personnel, there is a lack of studies in PHU nurses. This study aimed to measure the prevalence of LBP in PHU nursing personnel in the city of Pelotas, Brazil. Sociodemographic (age, gender, number of children, skin color, income and marital status), occupational (PHU type, formal education, professional experience, weekly workload, extra work activity, workload perception), nutritional (BMI), health (self-perceived health, smoking, sleep quality and minor psychiatric disorders, PHU physical structure perception) and behavioral (leisure-time physical activity) characteristics were assessed. LBP was defined as pain or discomfort between the last rib and gluteal fold. Poisson regression was used to evaluate the relationship among LBP and covariates. LBP prevalence was 65.2%. Chronic (12 weeks) and acute (7 days) LBP prevalence were 22.4%and 53.4%, respectively. LBP was associated with obesity (PR 1.39 95%CI 1.01-1.92) and poor self-perceived health (PR 2.77 95%CI 1.32-5.80). Prevalence of LBP in PHU nursing personnel is high and similar to hospital nurses. Individual characteristics such as body mass and health perception were associated with LBP.