Health Risk Factors Research Articles

The effects of childhood trauma on bullying - mental health

Bullying is the systematic abuse of power and is defined as aggressive behavior or intentional harm-doing by peers that is carried out repeatedly and involves an imbalance of power. Being bullied is still often wrongly considered a ‘normal rite of passage’. This review considers the importance of bullying as a major risk factor for poor physical and mental health and reduced adaptation to adult roles, including forming lasting relationships, integrating into work, and being economically independent. Bullying by peers has been mostly ignored by health professionals but should be considered as a significant risk factor and safeguarding issue. In addition, the present relationship between childhood trauma and the risk of bullying, in any of the capacity to either become a target, a bully or both, is explained. The review also considered the differences between direct, relational, and cyberbullying, as well as the effects on both the target, self, and the perpetrator. Particular emphasis is placed on the cumulative response and the possible consequences of bullying in the future, including the emotional state in the form of anxiety, depression, cutting oneself, and thoughts about suicide, but only among those children who face bullying every day. Through emphasizing the intricate processes and the broad impacts of bullying, this paper supports a much-engaged approach towards such issues as: early identification of bullying; the use of school-based prevention methods, and helping the students who have been bullied.

Supporting equitable access to kidney transplant in remote Western Australia using continuous quality improvement.

Despite an epidemic of End-Stage Kidney Disease in the Australian Aboriginal and Torres Strait Islander population, disparities in access to kidney transplantation persist. The journey to successful kidney transplant is long, with an initial suitability assessment required before waitlist-specific activities begin. In an Aboriginal Community Controlled renal service, we aimed to: 1.) Design and implement a continuous quality improvement (CQI) approach to transplant suitability assessment2.) Provide transplant suitability assessments for all patients of the service3.) Describe what temporary contraindications to kidney transplantation should be the focus of health service improvements4.) Explore participant experiences with the suitability assessment process and:5.) Use our findings to inform pre-and post-transplant model of care development within Kimberley Renal Services. Mixed methods design with file review. Transplant suitability assessment results with descriptive analysis, semi-structured interview with thematic analysis. Of completed assessments, 20/66 (30%) had no contraindications and were cleared for workup with median time on dialysis prior to assessment of 2.9 years, 42/66 (64%) had temporary contraindications, and 4/66 (6%) had permanent contraindications. Eighty-five temporary contraindications were identified in 46 individuals: 17/46 had both medical and non-medical contraindications, 5/46 had medical contraindications only, and 24/46 had non-medical contraindications only. The most common temporary contraindications were smoking (23/46), treatment adherence (17/46) and high body mass index (BMI) (11/46). Patients wanted more information on the transplant process, and interviewers noted the importance of providing information in an appropriate way. Patients wanted more support to address modifiable health risk factors to improve their chances of future transplantation. In the first stages of our CQI approach to improving access to kidney transplants for Kimberley Aboriginal people we achieved substantial catch-up in suitability assessments, and a comprehensive summary of factors impacting successful waitlisting. Our results are consistent with, and build upon other work in this space, highlighting the importance of involving Aboriginal staff and patients in education and support for prospective recipients.

Health risk behaviors, depressive symptoms and suicidal ideation among college students: A latent class analysis in middle China.

Previous studies have demonstrated the relationship between health risk behaviors and mental health, but little is discussed among college students. The current study aims to examine clusters of health risk behaviors and their correlation with depressive symptoms and suicidal ideation among Chinese college students. Data was obtained from the 2022 Surveillance for Common Diseases and Health Risk Factors among Students project conducted by the Hubei Province of the Centers for Disease Control and Prevention. Latent class analysis (LCA) was conducted based on health risk behaviors, including diet (breakfast skipping, consumption of sweetened beverages, fast food, milk, soymilk and yogurt), physical activities (physical exercise and sedentary), adverse experiences (verbal violence and emotional neglect), substance use (smoking and drinking), sleep, and unprotected sex behaviors. Mental health was assessed by the depressive symptoms and suicidal ideation. Multivariate logistic regression evaluated the correlation between mental health and health risk behaviors. Among the 6372 Chinese college students, most had sedentary behavior, physical inactivity and unhealthy diet, and > 60 % had more than two health risk behaviors. We further identified four classes of health risk behaviors using LCA. Class 1 (low-risk group, 25.1 %) was unlikely to engage in health-risk behaviors. Class 2 (moderate-risk group, 66.9 %) showed the lowest or second lowest probabilities of most health risk behaviors. Class 3 (High-risk-substance abuse/unprotected sex, 5.2 %) presented the highest probabilities of smoking, drinking, irregular breakfast, unhealthy diet and unprotected sex. Class 4 (High-risk-adverse experiences, 2.8 %) showed the highest probabilities of verbal violence, emotional neglect and insufficient sleep. The high-risk (adverse experiences) class had the highest odds of both depressive symptoms and suicidal ideation, followed by Class 3 and Class 2. Moreover, single-parent and intergenerational families were positively associated with mental health problems in female college students. Due to the cross-sectional study, we cannot identify the changes in different developmental stages. Different intervention strategies should be customized based on clustering patterns of health risk behaviors in the prevention of depression and suicide among college students.

Effects of sarcopenic obesity on incident chronic kidney disease and rapid kidney function decline: evidence from the China health and retirement longitudinal study.

Evidence on the effects of sarcopenic obesity (SO) on incident chronic kidney disease (CKD) and rapid kidney function decline (RKFD) in the Chinese population is limited. This study aimed to prospectively examine the associations of SO with incident CKD and RKFD among middle-aged and older Chinese adults. This prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative longitudinal study of Chinese adults aged 45 and older. The analysis included 4201 individuals from the 2011 wave, with renal outcomes ascertained from the 2015 wave. The effects of SO on incident CKD and RKFD were assessed using logistic regression models. Robustness was tested through subgroup and sensitivity analyses. Over four years of follow-up, 228 cases of incident CKD and 213 cases of RKFD were observed. After multivariable adjustment, participants in the "sarcopenic obesity" group showed a 78% increased risk of incident CKD (odds ratio [OR] 1.78, 95% confidence interval [CI] 1.09-2.90) and a 79% increased risk of RKFD (OR 1.79, 95% CI 1.03-3.13), compared to the "nonsarcopenia without obesity" group. Consistent results were observed across subgroups stratified by gender, education level, marital status, geographic area, lifestyle factors, and comorbidities, with no significant interactions detected. In a population-based cohort of middle-aged and older Chinese adults, SO was independently associated with elevated risks of incident CKD and RKFD, without interaction effects. These findings underscore the importance of timely intervention for SO to prevent adverse kidney outcomes. Key message What is already known on this topic? The relationship between sarcopenic obesity (SO) and the risk of chronic kidney disease (CKD) and renal function decline has been established in Korean and Japanese individuals with type 2 diabetes mellitus. However, it is uncertain if these findings apply to other populations, particularly those without diabetes. Additionally, the influence of diabetes on these associations needs further exploration, and the link between SO and rapid kidney function decline (RKFD) remains unestablished. Evidence regarding the effects of SO on incident CKD and RKFD in the Chinese population is limited, highlighting the necessity for this study to fill these gaps in knowledge. What this study adds This study is the first to prospectively explore the association of SO with incident CKD and RKFD in middle-aged and older Chinese adults. We identified SO as a significant risk factor for increased incidence of both CKD and RKFD. These findings expand the understanding of the impact of SO beyond individuals with diabetes mellitus, indicating that SO is a universal risk factor for adverse kidney outcomes in aging populations, irrespective of demographic and health characteristics. How this study might affect research, practice, or policy This study identifies SO as an independent risk factor for incident CKD and RKFD in middle-aged and older Chinese adults. The findings suggest that SO is a modifiable risk factor for kidney health, underscoring the necessity for timely interventions to prevent adverse kidney outcomes. Given the rising prevalence of SO and kidney disease in aging populations worldwide, these results highlight the importance of incorporating SO management into public health and clinical strategies. Questions pending answer What role do specific lifestyle factors (e.g. diet, physical activity) play in mitigating or exacerbating kidney function decline in individuals with SO? Are there genetic markers that predispose individuals with SO to a higher risk of incident CKD and RKFD? What are the underlying molecular mechanisms linking SO to incident CKD and RKFD?

Health Risk Factors, Microbiological Quality of “Choukouya” (Braised Meats) Sold in the Districts of the City of Man

Health Risk Factors, Microbiological Quality of “Choukouya” (Braised Meats) Sold in the Districts of the City of Man

Addressing cardiovascular health risk factors in American Indian/Alaska Native Children: A narrative review

Background Cardiovascular disease (CVD) is common in American Indian/Alaska Native (AI/AN) adults and represents the leading cause of mortality. Risk factors for CVD in AI/AN adults are well-described, and a growing body of evidence reports the inequitable prevalence of factors associated with the development of CVD in AI/AN children, including obesity, physical inactivity, and diabetes mellitus (DM). Objective This article organizes and summarizes the evidence describing CVD risk factors in AI/AN children, discusses the social drivers of health impacting these risks, and highlights several programs that have demonstrated effectiveness in improving AI/AN child health. Results Fortunately, multiple community- and Tribal-based programs have aimed to mitigate the impact of obesity, diabetes, and physical activity in AI/AN youth, given that nascent CVD begins in the pediatric years. These efforts include screening, lifestyle choices, including diet and exercise, and, importantly, culturally relevant programming to promote cardiovascular health in AI/AN children. Discussion Though at a disproportionate risk for CVD based on biological and social drivers of health, AI/AN children are being prioritized by their communities, and there are many ongoing efforts to support their cardiovascular health. However, further investigation and investment is warranted to protect this population and address ongoing disparities in AI/AN CVD.

Prevalence of and risk factors for osteoporosis and fragility fracture in adults with cerebral palsy: A systematic review.

To systematically review the prevalence and incidence of osteoporosis, osteopenia, low bone mass, and fragility fracture in adults with cerebral palsy (CP), and identify the risk factors for osteoporosis and fracture. A systematic literature search was performed in the MEDLINE, PubMed, CINAHL, AMED, Cochrane Reviews, EMBASE, and EBM database reviews from inception until May 2024. Search terms covered a combination of keywords for CP, fracture, osteoporosis, incidence and prevalence, and risk factors. Participants were adults with CP aged 18 years and older. JBI critical appraisal instruments were used to assess quality and risk of bias. Seventeen of 303 studies met the eligibility criteria to assess the prevalence and incidence of osteoporosis and fracture, and 16 of 663 studies to assess risk factors. Osteoporosis prevalence was 5% in a general adult population with CP, increasing to 43% in those attending outpatient clinics. Osteoporosis incidence reported in one study was 2.85 per 1000 person years. Prevalence of fragility fracture was 5.5% overall but up to 38% in outpatient settings. Risk factors for osteoporosis and fracture included mobility status, nutritional status, and anticonvulsant use. Low bone density and fracture is common in adults with CP with reduced mobility. The main risk factors for poor bone health are related to reduced mobility, nutrition, and anticonvulsant use.

Risk factor clusters for non-communicable diseases in adolescents in Eastern Cape, South Africa

Background: The increasing prevalence of non-communicable diseases (NCDs) among adolescents in South Africa is a growing public health concern.Aim: To examine the clustering of NCD risk factors, with a focus on gender, socio-economic status (SES) and perceived stress among adolescents.Setting: The study involved adolescents from eight schools in Buffalo City Metropolitan Municipality and Amatole district, Eastern Cape.Methods: A stratified random sample of 266 adolescents (aged 12 years–18 years) was assessed for anthropometric, physiological, and perceived stress measures. Data included body mass index (BMI), blood pressure (BP), cholesterol, glucose levels, and perceived stress (via the Perceived Stress Scale). Analysis involved descriptive statistics, Chi-square tests, t-tests, and k-means clustering.Results: Females (n = 155) showed a higher prevalence of NCD risk factors, with 80.2% classified as overweight or obese compared to 19.8% of males, and 77.2% had elevated cholesterol versus 22.8% of males. Perceived stress was higher in affluent schools (59.8%) despite fewer metabolic risks. K-means analysis identified four health profiles with significant SES and health differences (p 0.001). Cluster 1 (high SES) showed elevated BP, BMI, and stress, while Clusters 2–4 (low SES) varied in risks, with Cluster 4 showing the highest BP and metabolic risks despite low stress.Conclusion: These results highlight unique health profiles and risk factors across socio- economic contexts, with female adolescents from lower socio-economic backgrounds facing greater metabolic risks.Contribution: This Study provides original insights into the interplay between gender, SES and perceived stress in shaping NCD risk among South African adolescents.

Air quality and the risk of acute atrial fibrillation (EP-PARTICLES study): A nationwide study in Poland.

Air pollution remains the single largest environmental health risk factor, while atrial fibrillation (AF) is the most prevalent arrhythmia globally. The study aimed to investigate the relationship between short-term exposure to air pollution and acute AF admissions. Individual data on AF hospitalization in the years 2011-2020 were collected from the National Health Fund in Poland (ICD-10: I48.XX). To obtain high-resolution data on air pollution we applied a modelling method using the GEM-AQ model. Associations between air pollution exposure and acute AF admissions were estimated using generalized additive models with Poisson regression. Over the analysed period, we recorded 252,566 acute admissions due to AF. Each 10 µg/m3 increment of PM2.5 and NO2 concentration, 1 µg/m3 of SO2 and 10 ng/m3 of benzo(a)pyrene (BaP) concentration on the day of exposure resulted in 1.13% (0.70%-1.55%), 1.65% (1.05%-2.26%), 0.11% (0.01%-0.21%), and 0.3% (0.04%-0.55%) increases in acute AF admissions, respectively. The estimates are larger for women and older people. Stronger associations between PM2.5 and BaP concentrations and AF admissions in poorly urbanized areas were noted. Areas with high gross domestic product levels were more affected by the increase in NO2 concentrations, resulting in a 0.2% (1.001-1.003) increase in AF admissions. Exposure-response functions show steeper slopes of the pollutant-outcome associations in the lower ranges of exposures, far below World Health Organization (WHO) air quality guideline norms. For the zero-emission scenario, we estimate avoidable AF admissions - 5,873 for PM2.5 (95% CI 3,679 to 8,047) and 3,295 for NO2 (2,108-4,477). Air pollution acts as a triggering factor and can be associated with acute AF hospitalisations. PM2.5 and NO2 have an impact on AF even at concentrations levels below WHO air quality guideline norms.

Breaking the Sick Workers Conundrum: An Analytical Study on the US Autoworkers Physical and Mental Health Risks

Autoworkers suffer from a higher mortality rate of cancer and heart diseases compared to the public due to long-term exposure to workplace hazards and mental stress. A comparative literature review was conducted to show the influence of health-risk factors among autoworkers; a qualitative study of nine in-person interviews with autoworkers in Michigan was designed for better comprehension of their decisions regarding health risks at work. This study revealed that financial stress and mistrust towards corporations and the government play significant roles in workers acceptance of working in hazardous environments; together, these factors contribute to peoples reluctance towards using proper personal protective equipment and other means of safety practices. The author believes that a public financial aid program for autoworkers and training programs for corporate management on communication and empathy will reinvigorate the auto-manufacturing industry with a healthier and more productive labor force.

Mental health risk in human services work across Europe: the predictive role of employment in various sectors

BackgroundHuman services occupations are highly exposed to mental health risks, thus psychosocial risk management is critical to assure healthy and safe working conditions, promote mental health and commitment, and prevent fluctuation of employees. However, still little is known about prominent psychosocial risk factors in various human services work.ObjectivesTo identify prominent psychosocial risk factors of mental health in human services occupations and to explore their individual and organizational correlates in 19 European countries.MethodsCross-sectional survey using data from the European Union's Labor Force Survey among 379,759 active employees in 19 European countries. First, a descriptive analysis was carried out to establish the prevalence of mental health risk factors. Then sociodemographic correlates of occupational mental health risk factors were assessed by means of Pearson's chi-squared test. Finally, correlations were explored between perceived psychosocial risk factors and human vs. non-human services occupations, as well as contextual variables by applying multilevel logistic and multinomial regression analyses.ResultsThe prevalence of mental health risk was 45.1%. Work overload (19.9%), dealing with difficult clients (10.2%), and job insecurity (5.8%) were the most prevalent mental health risk factors among European employees. We identified significant differences in the prevalence of mental health risks and specific mental health risk factors among employees according to sex, age, and educational attainment. The prevalence of mental health risks was significantly higher among women (47.0%, man: 43.3%), workers aged 35–50 years (47.5%, >50: 44.4%, <35: 42.3%), and those with the higher level of education (51.9%, secondary with diploma: 42.6%, elementary: 36.2%). Employees working in healthcare in Northern Europe were most likely to be exposed to mental health risks (AME = 0.717). Working in healthcare in Northern Europe was the strongest predictor of reporting work overload (AME = 0.381). Working in social care in Central and Eastern Europe was the strongest predictor of reporting dealing with difficult clients (AME = 0.303) as the most prevalent mental health risk factor.ConclusionUnderstanding the impact of employment in specific human services occupations on mental health and its specific occupational stressors are vital to improve mental health and safety at work and maintain high quality services.

Adding Insult to Injury: The Impact of Musculoskeletal Pain on Fishermen’s Sleep Patterns

ABSTRACT Objectives Commercial fishing is one of the most dangerous industries in the United States, and although injuries have been a prominent focus for research, some health and safety risk factors such as sleep are understudied. In this paper, data from a multi-modal research study of sleep patterns, lifestyle factors, occupational exposures, medical histories, and health assessments in four U.S. fisheries are used to explore the connections between pain and sleep. Methods A mixture of randomized cluster sampling, study promotions, and dockside recruitment was utilized to gather a sufficient number of fishermen in the Alaska Salmon, Oregon Dungeness Crab, Massachusetts Scallop, and Massachusetts Lobster fisheries for the study. Fishermen were surveyed about sleep patterns, occupational exposures, and lifestyle factors. Surveyed fishermen were provided with free comprehensive health assessments by occupational health nurses and physicians or Advanced Practice Providers. Data were collected in REDCap and downloaded into SAS for analysis using a variety of analytic methods. Results A total of 262 surveys and 162 physical examinations were completed with captains and crew members in the four fisheries targeted for study. The average self-reported consecutive hours of sleep for fisheries workers that spend several days at sea (i.e. Crab, Scallop, and Salmon fisheries) were roughly 3.5 to 4.0 h in a 24-h period. Of particular note, the majority of fishermen, regardless of fishery, suffered from back pain, and roughly 40% of fishermen noted pain and discomfort significantly impede their ability to sleep. Conclusions This study underscores the connections between musculoskeletal pain and sleep, providing yet further impetus for preventing musculoskeletal injuries among fishermen. Given the ties between existing sleep debt in the industry and the health and safety risks posed by repeated exposure to insufficient sleep, this study highlights the need for the prevention of these injuries and potentially better treatment options for fishermen who suffer from musculoskeletal disorders.

Prediction of oral diseases in care dependent older people

BackgroundA large number of older people depend on others for help with their daily personal care, including oral health care. Nursing home and elder-care staff often face challenges identifying older people, who are exposed to or at an increased risk of oral diseases. Thus, the aim of this study was to identify risk factors that non-dental care staff can use to identify older people at risk of oral diseases and poor oral hygiene.MethodsIn this cross-sectional study, the oral health and risk factors for poor oral health were determined for 217 care dependent older people living in two nursing homes and a rehabilitation centre or receiving home care in two Danish municipalities. The outcome variables for oral disease i.e. caries, periodontitis, and gingivitis, and oral hygiene, i.e. plaque and calculus, were assessed using standardised oral examinations. Risk factors for oral diseases and poor oral hygiene were assessed based on a questionnaire concerning (1) background information, (2) health status, (3) social support, (4) oral health behaviours, and (5) self-reported oral health. The associations between oral health and risk factors were investigated using logistic regression analyses.ResultsIn general, older people with different living arrangements had quite similarly distributed risk factors. The oral examinations showed that 54.5% had oral diseases, and 14.8% had poor oral hygiene. Not seeing a dentist regularly was significantly associated with having oral diseases (Odds Ratio, 2.87; CI, 1.53–5.39) and poor oral hygiene (OR, 4.50; CI, 1.83–11.05). A significant association was found between the presence of an oral disease and adversely affected quality of life (OR, 2.65; CI, 1.42–4.95), especially due to challenges eating (OR, 3.76; CI, 1.64–8.60) and/or smiling and showing teeth (OR, 3.64; CI, 1.27–10.42). A significant association was also found between poor oral hygiene and taking psychotropic drugs (OR, 2.61; CI, 1.08–6.30).ConclusionQuestions regarding the use of the dental care system and oral health problems could be used by nondental care staff in conversations with older people to determine their risk of oral diseases and poor oral hygiene.

Integrating primary care in a specialized forensic psychiatric setting: predictors of program adherence

AimThis study investigates patient adherence to an integrated primary care intervention within medium secure forensic psychiatric services.MethodsUsing a prospective cohort design, we evaluated the implementation of a 1-year integrated primary care intervention across seven medium secure wards in the Central Denmark Region. Using descriptive statistics, baseline data were analyzed to compare completers and non-completers, with a focus on somatic health indicators and preexisting attitudes toward primary care services.ResultsOf the 75 patients included in the intervention, almost 40% did not complete it. Baseline data demonstrated a high burden of health risk factors, with 75% of patients being daily smokers and 58% meeting the criteria for metabolic syndrome. Negative preexisting perceptions of primary care services were particularly prevalent among non-completers (42%). Those who completed the intervention had a greater illness burden (p = 0.02) and tended to have more favorable attitudes toward primary care, although this was not statistically significant. Notably, over 30% of eligible inpatients either declined or were deemed unable to participate in the intervention.ConclusionsHigh rates of health risk factors were identified, highlighting the sensibility of integrating primary care services in forensic psychiatric settings. Such integration may represent a necessary standard of care, aligning Denmark with international practices. The high rates of non-adherence underscore the serious issue of negative preexisting perceptions of primary care. The results emphasize the need to strengthen relationships between forensic psychiatric patients and primary care services, both within and beyond forensic settings.

Interventions by Cardiovascular Drugs Against Aircraft Noise-Induced Cardiovascular Oxidative Stress and Damage.

Noise pollution is a known health risk factor and evidence for cardiovascular diseases associated with traffic noise is growing. At least 20% of the European Union's population lives in noise-polluted areas with exposure levels exceeding the recommended limits of the World Health Organization, which is considered unhealthy by the European Environment Agency. This results in the annual loss of 1.6 million healthy life years. Here, we investigated the protective effects of cardiovascular drug interventions against aircraft noise-mediated cardiovascular complications such as elevated oxidative stress or endothelial dysfunction. Using our established mouse exposure model, we applied mean sound pressure levels of 72 dB(A) for 4 d. C57BL/6 mice were treated with the beta-blocker propranolol (15 mg/kg/d s.c. for 5 d) or the alpha-blocker phenoxybenzamine (1.5 mg/kg/d s.c. for 5 d) and noise-exposed for the last 4 d of the drug administration. Short-term noise exposure caused hypertension (measured by tail-cuff blood pressure monitoring) and impaired endothelial function (measured by isometric tension recording in the aorta and video microscopy in cerebral arterioles in response to acetylcholine). Noise also increased markers of oxidative stress and inflammation. Treatment of mice with propranolol and phenoxybenzamine prevented endothelial and microvascular dysfunction, which was supported by a decrease in markers of inflammation and oxidative stress in heart tissue and the brain. Amelioration of noise-induced hypertension (systolic blood pressure) was not observed, whereas pulse pressure was lowered by trend. This study provides a novel perspective mitigating the adverse effects of noise pollution, especially in vulnerable groups with medication, a rationale for further pharmacological human studies.

Topical review: sleep regulation as a novel target for treating preschool-aged children with attention-deficit/hyperactivity disorder symptoms.

Elevated attention-deficit/hyperactivity disorder (ADHD) symptoms in preschoolers are a risk factor for poorer psychiatric health, cognitive deficits, and social and academic impairment across the lifespan. The first-line treatment for these preschoolers, behavioral parent training (BPT), reduces children's disruptive behaviors and parenting stress, yet its impact on core ADHD symptoms is inconsistent. Early interventions targeting biological mechanisms linked to core ADHD pathophysiology are critically needed. This topical review explores sleep dysregulation as a potential key target for early intervention for ADHD symptoms among preschoolers. Sleep dysregulation is common in school-aged children with ADHD, and treating sleep improves core ADHD symptoms in older children. Cross-sectional and prospective research with preschoolers offers compelling evidence that sleep dysregulation and ADHD symptoms are closely linked over the course of early development. BPT and behavioral sleep medicine (BSM) interventions share an underlying theoretical framework and could be streamlined to target sleep in addition to daytime behaviors. Novel early interventions targeting underlying biological mechanisms linked to core ADHD pathophysiology are critically needed to improve the trajectories of ADHD symptoms, comorbidity, and functional deficits for preschoolers with elevated ADHD symptoms. Sleep regulation is a promising mechanistic treatment target for this population, and future interventions may draw from the shared behavioral principles of BPT and BSM to target behaviors across the 24-hr period and employ scalable formats to optimize the number of families who can benefit from parent-based interventions targeting ADHD symptoms and sleep in early development.

Identifying Patients at Risk for Cardiometabolic and Chronic Diseases by Using the Exercise Vital Sign to Screen for Physical Inactivity.

Physical inactivity is a major health risk factor for multiple chronic diseases and early death. Despite evidence supporting diet and physical activity behavioral counseling interventions, physical inactivity is rarely measured or managed in primary care. A need exists to fully explore and demonstrate the value of screening patients for physical inactivity. This study aimed to 1) compare health profiles of patients screened for inactivity versus patients not screened for inactivity, and 2) compare health profiles of inactive, insufficiently active, and active patients as measured by the Exercise Vital Sign screener. The study sample comprised adult patients attending a well visit from November 1, 2017, through December 1, 2022, at a large midwestern university hospital. We extracted data from electronic medical records on exercise behavior reported by patients using the Exercise Vital Sign (EVS) questionnaire. We extracted data on demographics characteristics, resting pulse, encounters, and disease diagnoses from PCORnet Common Data Model (version 6.1). We used the Elixhauser Comorbidity Index to determine disease burden. We compared patients with complete and valid EVS values (n =7,261) with patients not screened for inactivity (n = 33,445). We conducted further comparisons between screened patients reporting 0 minutes (inactive), 1 to 149 minutes (insufficiently active), or ≥150 minutes (active) minutes per week of moderate-vigorous physical activity. Patients screened for inactivity had significantly lower rates of several comorbid conditions, including obesity (P < .001), diabetes (P < .001), and hypertension (P < .001) when compared with unscreened patients. Compared with insufficiently active and inactive patients, active patients had a lower risk of 19 inactivity-related comorbid conditions including obesity (P < .001), depression (P < .001), hypertension (P < .001), diabetes (P < .001), and valvular disease (P < .001). These findings suggest inactive and insufficiently active patients are at increased risk for multiple inactivity-related chronic conditions. These findings further support existing recommendations that inactive patients receive or be referred to evidence-based lifestyle behavioral counseling programs.

Youth at Work: Exploring the Relationship Between Social Status, a History of Child Labour, and Health

BackgroundDespite positive post-pandemic changes, youth are still employed in work environments and conditions that threaten their health. AimTo evaluate individual, family, and work-related factors associated with physical and mental health, and the relationship between health, social status, and child labour among young apprentices. DesignA cross-sectional study. MethodsThe study involved 417 young workers between December 2023 and April 2024. Data were gathered using the Social Status Index Form, Brief Symptom Inventory, physical examinations, and analyzed through IPWRA, hierarchical regression, and decision tree analysis. ResultsBeing male, having five or more siblings, and having a father with low education were significant predictors of a history of child labour. After adjusting for objective social status, key risk factors for young workers' physical health included being female, having poor mental health, having a lowly educated mother, and working long hours. Approximately one-quarter of the variability in young workers' mental health could be attributed to factors related to low family status, such as the mother's employment, a history of child labor, having a sibling not in formal education, low subjective social status, working in the service sector, and being in an inappropriate working environment. ConclusionLow family social status, a history of child labor, and unsafe working conditions emerge as key shared predictors of both physical and mental health risks. In line with the decent work goal, macro-level policies aimed at improving social status and regulating working conditions are essential to supporting youth in the workforce.

In our own words: Using participatory dialogue to reflect on the mental health experiences of autistic students in university

The mental health of autistic university students is a key issue to address, evidenced by increased prevalence of mental health issues within the autistic community and growing numbers of autistic university students. Autistic students experiencing mental health issues have the lowest retention and progression rates of any disability group. This research took a novel approach, with seven co-authors and members of the participatory group (all current/recent students) identifying 10 themes reflecting their mental health experiences at university through reflective discussions, enabling autistic people to lead research and address power imbalances inherent in autism research. They presented these themes at a webinar, attended by over 200 staff from UK universities, providing a platform for autistic students to influence practice. Ten themes identified in line with experiences of the triggers and risk factors for mental health at university were; Routine, living independently, reasonable adjustments, group work, sensory issues, attendance and a range of learning options, disclosing diagnosis, social issues, burnout and seeing the bigger picture. We discussed the support that we found to be useful and developed recommendations for universities to support the positive well-being of autistic students. We outline the need for universities to co-produce services and support with autistic students.

Mental health problems and risk factors of refugee children exposed to the 2023 earthquakes in Turkey

Mental health problems and risk factors of refugee children exposed to the 2023 earthquakes in Turkey