Poor Self-perceived Health Status Research Articles

Associations between depression and diabetic retinopathy in the National Health and Nutrition Examination Survey, 2011 to 2018

Introduction Diabetic retinopathy (DR) is a vision-threatening complication of diabetes mellitus (DM). The relationship between depression and DR is unclear, and prior studies are limited by small sample sizes at single centers. This retrospective, cross-sectional study assessed the prevalence of and associations between depression and DR in the US using the National Health and Nutrition Examination Survey for 2011 to 2018. Methods We collected information on the demographic characteristics, medical conditions, and examination data of NHANES participants with DM. We performed weighted analysis to estimate national prevalence and multivariate analysis to assess the relationship between depression and DR. Results Of the 22,618 participants included, the prevalence of DM and DR were 3146 (13.9%) and 664 (2.9%). The prevalence of depression was 14.2% in DM only and 19.3% in DR (P = 0.006) with greater severity in the DR group (P < 0.001). After adjusting for comorbidities, DR was no longer significantly associated with depression. Depression was not associated with differences in disease management, although participants with depression had poorer self-perceived health status (P < 0.001). Conclusions Depression is more prevalent in individuals with DR than those with DM only. The relationship between depression and DR may be mediated by additional medical comorbidities, but further studies are needed.

Prevalência e fatores associados à violência contra as mulheres rurais: um estudo transversal, Pesquisa Nacional de Saúde, 2019

Abstract The aim of this cross-sectional study was to estimate the prevalence of violence against women living in rural areas, explore associated factors, and characterize cases of violence according to perpetrator, place of occurrence, and frequency. Based on data from the 2019 National Health Survey, using Poisson’s regression we calculated crude and adjusted prevalence ratios for violence committed during the last 12 months against women living in rural areas across Brazil, focusing on the following variables: sociodemographic characteristics, income, social support, and self-reported health status. The prevalence of psychological, physical, and sexual violence was 18%, 4.4%, and 1.5%, respectively. Perpetrators were mainly people known to the victim and violence was mainly committed at home and repeated over time. Prevalence was highest among young women (24.2%), single and divorced women (20% each), women who had complete elementary school till not complete higher education (22% each), women with very poor (34%) and poor (30%) self-perceived health status; and women with a mental health problem (30%). After adjustment, the following variables were retained in the model: women aged 30-39 years and 40-49 years; married women; women with very poor, poor, and fair perceived health; and women diagnosed with a mental health problem.

Prevalence of violence against women living in rural areas and associated factors: a cross-sectional study based on the 2019 National Health Survey.

The aim of this cross-sectional study was to estimate the prevalence of violence against women living in rural areas, explore associated factors, and characterize cases of violence according to perpetrator, place of occurrence, and frequency. Based on data from the 2019 National Health Survey, using Poisson's regression we calculated crude and adjusted prevalence ratios for violence committed during the last 12 months against women living in rural areas across Brazil, focusing on the following variables: sociodemographic characteristics, income, social support, and self-reported health status. The prevalence of psychological, physical, and sexual violence was 18%, 4.4%, and 1.5%, respectively. Perpetrators were mainly people known to the victim and violence was mainly committed at home and repeated over time. Prevalence was highest among young women (24.2%), single and divorced women (20% each), women who had complete elementary school till not complete higher education (22% each), women with very poor (34%) and poor (30%) self-perceived health status; and women with a mental health problem (30%). After adjustment, the following variables were retained in the model: women aged 30-39 years and 40-49 years; married women; women with very poor, poor, and fair perceived health; and women diagnosed with a mental health problem.

Socio-economic determinants of alcohol consumption for South Africa

Aims: To examine the socio-economic factors associated with alcohol consumption in South Africa.&#x0D; Design: Cross-sectional study exploring the various socio-economic factors associated with alcohol consumption in South Africa.&#x0D; Setting: South Africans older than 15 years across the country’s nine provinces.&#x0D; Participants: Adult respondents of the drinking status and alcohol intensity questions in Wave 4 of the National Income Dynamics Study (NIDS) (n=28 401).&#x0D; Measures: Alcohol, demographic, emotional, health and neighbourhood variables.&#x0D; Findings: White and Mixed Heritage (referred to as ‘Coloured’ in South Africa) adults were more likely to consume alcohol, while Indian and White adults were less likely to binge drink relative to African adults. Males with a very good self-perceived health were less likely to binge drink while males who resided in neighbourhoods where frequent alcohol and drug abuse was common, were more likely to binge drink. Females who exercised more than three times a week were also more likely to drink and binge drink. Females with a poor self-perceived health status are less likely to binge drink. Adults who smoked were more likely to drink and binge drink relative to non-smoking adults. Accounting for binge drinkers’ household size, average monthly household spending for binge drinkers was low, suggesting that binge drinkers under-reported household alcohol spending. There was evidence of drinking and binge drinking among pregnant women.&#x0D; Conclusions: With respect to binge drinking, race, gender, smoking, neighbourhood, self-perceived health, pregnancy and household alcohol spending warrant further investigation and consideration for possible future alcohol interventions in South Africa.

Increased Salivary IL-1 Beta Level Is Associated with Poor Sleep Quality in University Students.

Poor sleep quality is a major public health concern for all ages. In particular, university students often face stress levels and changes in social life habits that negatively influence their quality of sleep. This could be associated with psychological well-being in terms of anxiety and depressive symptoms, stress levels, and a poor self-perceived health status. The increases in the pro-inflammatory cytokine interleukin 6 (IL-6), IL-1 beta (IL-1β), and tumor necrosis factor alpha (TNFα), in blood have been linked to poor sleep quality in many diseases, but data on salivary cytokine levels in students are missing or are seldom analyzed. In this study we determined the quality of sleep in a sample of university students and the role of psychological assessment and factors affecting sleep (alcohol intake, tobacco, consumption of stimulant drinks, exercise, and body mass index). We also aimed to shed new light on the associations between sleep quality and salivary inflammatory cytokines (IL-1β, IL-6, and TNFα). Sleep quality was measured with the Athens Insomnia Scale (AIS) and Pittsburgh Sleep Quality Index (PSQI). Perceived stress was assessed using Cohen's Perceived Stress Scale (PSS), and the Goldberg Anxiety and Depression Scale (GADS) was used to assess the level of anxiety or depression. Perceived health status was measured with a visual analogue. Saliva samples was taken in the morning and the inflammatory cytokines was measured via enzyme-linked immunoassay. There was a direct and significant association between the salivary IL-1β concentration and AIS score (r = 0.248; p = 0.038, Pearson correlation) and Pittsburgh scale score (r = 0.274; p = 0.022, Pearson correlation). The relationship between IL-1β and AIS controlling for sex, age, and chronic disease, is still significant (r = 0.260; p = 0.033). The relationship between IL-1β and PSQI controlling for the influence of these variables is also significant (r = 0.279; p = 0.022). Salivary IL-1β concentrations were not significantly associated with any of the scores of the other psychological assessments (PSS, anxiety, depression symptoms, or self-perceived health). Salivary TNFα was significantly and inversely associated with self-perceived health (r = -0.259; p = 0.033, Pearson correlation), but the salivary IL-6 concentration was not associated with any of the sleep quality scale or psychological assessment scores. Our results provide a novel relationship between pro-inflammatory cytokine IL-1β in saliva and poor sleep quality. However, the role of inflammation in poor sleep quality requires further study to identify strategies that could lower inflammation and thus, likely improve sleep quality.

Measuring COVID-19 related stress and its associated factors among the parents of school-aged children during the first lockdown in France

BackgroundThe COVID-19 pandemic placed important challenges on parents, as they had to meet various demands during lockdown, including childcare, work and homeschooling. Therefore, the current study aimed to investigate perceived stress levels among the parents of school-aged children and explore their association with sociodemographic, environmental and psychological factors during lockdown.MethodsA cross-sectional study was conducted among the parents of school-aged children ages 8 to 18, who lived in the Grand Est region of France during the first wave of the pandemic. An online survey collected sociodemographic data, living and working conditions, and exposure to COVID-19 as well as parent’s levels of perceived stress (PSS-10), self-perceived health status (SF-12), social support (MSPSS) and resilience (BRS). Multivariable logistic regression models were conducted to evaluate the association between moderate to severe perceived stress and various factors.ResultsIn total, 734 parents were included. The results indicated that 47% were experiencing moderate stress and 7.2% were experiencing severe stress. Factors most strongly associated with risk of moderate to severe levels of stress were lower levels of parental resilience (OR = 3.8, 95% CI: 2.2–6.6) and poor self-perceived mental health status (OR = 7.3, 95% CI: 5.0–10.8). The following risk factors were also identified: female sex; being in the age range of 35–44; difficulties isolating and contracting COVID-19, which involved hospitalization and separation or isolation from family. The support of friends (OR = 0.8, 95% CI: 0.7–1.0) and family (OR = 0.5, 95% CI: 0.3–0.8) were protective factors.ConclusionsThese findings suggest that supportive and preventive programs should focus on the improvement of resilience and mental health management to promote parents’ wellbeing. Research has to focus both on individuals’ inner potential for increasing resilience and the environmental resources to be activated. Building and boosting resilience among parents could serve as a protective factor against negative outcomes for them and their families.

The effect of COVID-19 pandemic on depression and suicidal ideation in Korean community dwelling elderly

IntroductionThe impacts of the coronavirus disease of 2019 (COVID-19) pandemic on mental health have been relatively severe.ObjectivesThis study examined the influence of the COVID-19 especially on depression and suicidal ideation in community-dwelling elderly in Korea.MethodsData were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea). A total of 2,423 elderlies were recruited from 22 counties in Jeollanam-do between April and October 2021. We used self-reported questionnaires, including sociodemographic factors, COVID-19 related stress, suicidal ideation, Geriatric Depression Scale-Short Form Korean Version (GDS-SF). Logistic regression was performed to examine the factors on depression and suicidal ideationResultsOf the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, the worry of COVID-19 infection and restriction of daily activity due to COVID-19 pandemic were significantly associated with depression. Male sex, poor perceived health status, disability in house chores and depressive symptom are risk factors for suicidal ideation.Image:Image 2:Image 3:ConclusionsThese findings showed that increased risk factor for depression and suicidal ideation in community dwelling elderly during COVID-19 pandemic. We confirmed that feelings of isolation and negative perception of health were risk factors on depression in community dwelling elderly in the context of the COVID –19 pandemic. Also male, poor self-perceived health status, difficulty of independent living and worry and depression are increased the risk of suicidal ideation among the elderly.Disclosure of InterestNone Declared

Prevalence Of Depression And Associated Factors Among Elderly Population In A Rural Area Of Kozhikode District, North Kerala.

Background: Old age is often accompanied by frailty and diseases including neuropsychiatric disorders. Demen-tia and depression are the most common neuropsychiatric disorders among the elderly. Kerala has the maximum proportion of elderly in its population and successful identification of the elderly at risk is important for early in-tervention. The purpose of the study is to estimate the prevalence of depression and associated factors among the elderly population. Methods: A cross-sectional study was conducted among 320 elderlies from July 2018 to July 2019.The preva-lence of depression was estimated using GDS-15. Socio-demographic factors, self- perceived health status, mor-bidity profile, falls and related factors, religious practices, independence in activities of daily living, and other so-cial factors associated with depression were assessed. Results: 38.1% of the elderly were depressed. Majority had mild depression (23.4%) and 3.1% were severely depressed. Having no formal education, low socioeconomic status, not living with a spouse, no role in decision -making, average or poor self-perceived health status, past surgical history, and fear of falls were found to be inde-pendent predictors of depression. Conclusion: The prevalence of depression was high among elderly. Screening for depression in the elderly should be incorporated in already available programs along with appropriate health care measures.

Prevalence of Insomnia and its Associated Factors among Geriatric Population in an Urban Locality of Bengaluru, Karnataka, India- A Cross-sectional Study

Introduction: Insomnia is a major public health concern among the aged population due to its impact on quality of life and raises an economic burden to the family and community. However, in the Indian scenario, the lack of information from communitybased studies, stresses the need to assess the prevalence and factors associated with insomnia. Aim: To find out the prevalence of insomnia and its associated factors, among aged population in an urban locality of Bengaluru, Karnataka, India. Materials and Methods: This cross-sectional study was conducted in the urban field practise area of a Medical College in Bengaluru, Karnataka, India, with 880 elderly subjects, from October 2016 to March 2017. Using Probability Proportional to Size (PPS), study subjects were surveyed in eight urban localities under Urban Health Training Centre. Insomnia was assessed by using {Difficulty in Maintaining Sleep (DSM)-IV-TR} diagnostic criteria. Variables associated with insomnia such as socio-personal characteristics and financial status was also assessed. The data was analysed using Chi-square test. Results: The mean age of study subjects was 67.5±3.4 years and 455 (51.7%) were females and 425 (48.3%) were males. The prevalence of insomnia among aged population was 571 (64.9%) and prevalence of insomnia was more among females (p&lt;0.001), Hindu by religion (p=0.001), unemployed (p&lt;0.001), single (p&lt;0.001), those with poor Self-Perceived Health (SPH) status (p&lt;0.001), chronic diseases (p&lt;0.001), history of stressful life events (p&lt;0.001), with financial dependency (p&lt;0.001) and social assistance (p&lt;0.001). Conclusion: The present study revealed high prevalence of insomnia and female, Hindu religion, unemployment, single, poor SPH status, presence of chronic diseases, history of stressful life events, presence of financial dependency and social assistance found to be significantly associated with insomnia.

Association between Neighbourhood Deprivation Trajectories and Self-Perceived Health: Analysis of a Linked Survey and Health Administrative Data.

Life course exposure to neighbourhood deprivation may have a previously unstudied relationship with health disparities. This study examined the association between neighbourhood deprivation trajectories (NDTs) and poor reported self-perceived health (SPH) among Quebec's adult population. Data of 45,990 adults with complete residential address histories from the Care-Trajectories-Enriched Data cohort, which links Canadian Community Health Survey respondents to health administrative data, were used. Accordingly, participants were categorised into nine NDTs (T1 (Privileged Stable)-T9 (Deprived Stable)). Using multivariate logistic regression, the association between trajectory groups and poor SPH was estimated. Of the participants, 10.3% (95% confidence interval [CI]: 9.9-10.8) had poor SPH status. This proportion varied considerably across NDTs: From 6.4% (95% CI: 5.7-7.2) for Privileged Stable (most advantaged) to 16.4% (95% CI: 15.0-17.8) for Deprived Stable (most disadvantaged) trajectories. After adjustment, the likelihood of reporting poor SPH was significantly higher among participants assigned to a Deprived Upward (odds ratio [OR]: 1.77; 95% CI: 1.48-2.12), Average Downward (OR: 1.75; CI: 1.08-2.84) or Deprived trajectory (OR: 1.81; CI: 1.45-2.86), compared to the Privileged trajectory. Long-term exposure to neighbourhood deprivation may be a risk factor for poor SPH. Thus, NDT measures should be considered when selecting a target population for public-health-related interventions.

Gender differences in psychosocial function and self-reported health status in late-diagnosed autistic adults: results from the FACE-ASD national cohort.

While adult outcome in autism spectrum disorder (ASD) is generally measured using socially valued roles, it could also be understood in terms of aspects related to health status - an approach that could inform on potential gender differences. We investigated gender differences in two aspects of outcome related to health-status, i.e. general functioning and self-perceived health status, and co-occurring health conditions in a large multi-center sample of autistic adults. Three hundred and eighty-three participants were consecutively recruited from the FondaMental Advanced Centers of Expertise for ASD cohort (a French network of seven expert centers) between 2013 and 2020. Evaluation included a medical interview, standardized scales for autism diagnosis, clinical and functional outcomes, self-perceived health status and verbal ability. Psychosocial function was measured using the Global Assessment of Functioning scale. While autistic women in this study were more likely than men to have socially valued roles, female gender was associated with poorer physical and mental health (e.g. a 7-fold risk for having three or more co-occurring physical health conditions) and a poorer self-perceived health status. Psychosocial function was negatively associated with depression and impairment in social communication. Half of the sample had multiple co-occurring health conditions but more than 70% reported that their visit at the Expert Center was their first contact with mental health services. To improve objective and subjective aspects of health outcome, gender differences and a wide range of co-occurring health conditions should be taken into account when designing healthcare provision for autistic adults.

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).

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.

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.

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.

Psychological distress prior to surgery is related to symptom burden and health status in lung cancer survivors

PurposePatients with lung cancer experience a variety of distressing symptoms which could adversely affect quality of life. The aim of this study was to determine whether psychological distress prior to surgery is associated to health status and symptom burden in lung cancer survivors.MethodsA longitudinal observational study with 1‐year follow‐up was carried out. Health status was measured by the WHO Disability Assessment Scale (WHO-DAS 2.0), the Euroqol-5 dimensions (EQ-5D) and the Pittsburgh Sleep Quality Index (PSQI). Symptoms severity included dyspnoea (Multidimensional Profile of Dyspnoea); pain (Brief Pain Inventory); fatigue (Fatigue Severity Scale); and cough (Leicester Cough Questionnaire).ResultsOne hundred seventy-four lung cancer patients were included. Patients in the group with psychological distress presented a worse self-perceived health status, functionality and sleep quality. The group with psychological distress also presented higher dyspnoea, fatigue and pain.ConclusionPatients with psychological distress prior surgery present with a greater symptom burden and a poorer self-perceived health status, lower functionality and sleep quality, than patients without distress 1 year after the lung resection.

Financial Strain and Health Status Among European Workers: Gender and Welfare State Inequalities.

Objectives: Although in-work poverty has been increasing, in Europe policy about poverty and social exclusion tends to focus on labor market participation, independently of the level of remuneration and the quality of work, and studies about financial strain among workers, as well as on its relationship with health status, are still scarce. The objectives of this study were: (1) to compare the prevalence of financial strain among workers among different welfare state typologies, and (2) to examine whether the relationship between financial strain and health status differs by welfare state regime. For both objectives we examined whether there were gender differences.Methods: We conducted a cross-sectional study using data from the 6th European Working Conditions Survey of 2015 and selected a subsample of all employees from the EU28 aged 16–64 years (13,156 men and 13,225 women).Results: There were large differences in the prevalence of financial strain between welfare state typologies, which were not explained by individual factors. Additionally, differences across welfare regimes were greater among women. Nordic countries had the lowest prevalence (12.1% among men and 12.3% among women) whereas Southern European countries had the highest (49.5% among men and 47.9% among women). In both sexes and in all welfare state typologies, financial strain was associated with poor self-perceived health status and poor psychological well-being. Whereas, Southern European countries had the highest prevalence of financial strain, the magnitude of the association with health status was smaller than in other country typologies.Conclusion: In Europe, policies are needed to address the specific structural factors leading to financial strain as well as its relationship with health status among workers.

Demographic and lifestyle risk factors of dry eye disease subtypes: A cross-sectional study

PurposeTo evaluate demographic and lifestyle factors associated with aqueous deficient and evaporative dry eye disease. MethodsA total of 1125 general public visitors (707 females, mean ± SD age, 33 ± 21, range 5–90 years) at the Royal Society Summer Science Exhibition were recruited in a cross-sectional study. A demographic and lifestyle factor questionnaire was administered, and dry eye symptomology (DEQ-5 score), ocular surface characteristics (conjunctival hyperaemia, and infrared meibography), and tear film parameters (tear meniscus height, non-invasive breakup time, and lipid layer grade) were evaluated for the left eye of each participant within a single session. The diagnostic criteria for dry eye disease subtypes were adapted from the rapid non-invasive dry eye assessment algorithm. ResultsOverall, 428 (38%) participants fulfilled the diagnostic criteria for dry eye disease, 161 (14%) with aqueous deficient dry eye disease, and 339 (30%) with evaporative dry eye disease. Multivariate logistic regression demonstrated that advancing age, female sex, reduced sleep duration, higher psychological stress, and poorer self-perceived health status were independently associated with aqueous deficient dry eye disease (all p < 0.05). Significant risk factors for evaporative dry eye disease included advancing age, East and South Asian ethnicity, contact lens wear, increased digital device screen exposure, higher psychological stress, and poorer self-perceived health status (all p < 0.05). ConclusionsBoth subtypes of dry eye disease were associated with several unique and shared demographic and lifestyle factors. The findings of this study could inform future research design investigating the utility of targeted screening and risk factor modification for the prevention and management of dry eye disease.