Self-perceived General Health Research Articles

Central Sensitization in Patients with Chronic Pain Secondary to Carpal Tunnel Syndrome and Determinants.

Central sensitization (CS) is commonly seen in chronic pain disorders, including neuropathic pain. However, there exist inconsistencies concerning the presence of CS in chronic pain secondary to carpal tunnel syndrome (CTS). CS and neuropathic pain manifestations in CTS remain not well established. Therefore, this study aims to investigate the CS and pain profiles in patients with CTS and to explore the potential determinants associated with CS. Patients with suspected CTS symptoms lasting 3 months or above and healthy controls were enrolled. History, physical examinations, and nerve conduction studies were employed to confirm the diagnosis and severity of median nerve dysfunction. The central sensitization inventory (CSI) was used to screen CS. Other outcomes included neuropathic pain, CTS-specific symptom severity and functions, emotion, and health-related quality of life. Between-group comparisons were conducted in terms of the CS presence. Logistic regression analysis was performed to identify determinants associated with CS. Over 60% of participants with CTS were found with clinical CS, significantly higher than that in the control group. More than 70% of the CTS participants were identified to have possible or very likely neuropathic pain components. In addition, one-fourth of CTS cases had depression or anxiety. Anxiety was associated with an increased risk of developing CS in CTS (adjusted OR=1.31, 95% CI 1.08-1.59), whereas higher self-perceived general health rating was negatively associated with the presence of CS (adjusted OR=0.92, 95% CI 0.88-0.97) in the multivariate adjusted regression model. CS is prevalent in patients with CTS. Predominant neuropathic pain characteristics were uncovered in CTS patients as well as comorbid psychological distress. Significant association was found between anxiety and CS presence. Self-perceived general health was inversely related to CS. Further research is warranted to explore the mechanisms of anxiety and central pain processing in painful entrapment neuropathy.

“I feel healthy, I don’t need to go”: Analysis of the cancer screening barrier

Abstract Background Cancer screening is an essential tool for reducing cancer mortality. However, screening hesitancy is still a quite common issue in many countries. In this study, we focus on one of the most commonly declared reasons for breast and cervical screening non-attendance among Czech women, which is ‘feeling healthy’. Methods We use a mixed-methods approach to investigate the ‘feeling healthy’ barrier, trying to connect three data sources. First, we use a representative sample of Czech women to find the most common reasons for screening non-attendance. Second, we used semi-structured interviews with 10 women to investigate the barriers to screening more deeply. Third, we analyse the data from the European Health Interview Survey (EHIS) 2019, trying to confirm some of the previous findings, using the self-perceived general health variable as a proxy for ‘feeling healthy’. Results ‘Not experiencing any symptoms’ was the most common reason for cervical (36.7% of non-attendees) and the second most common reason for breast screening (29.2%) non-attendance. Women in the semi-structured interviews talked about that they felt healthy and thus did not feel the urge to attend screening. This feeling was often related to living a healthy life in the form of eating healthy, having enough exercise, not smoking or not drinking. EHIS data show that women with ‘good’ and ‘fair’ self-perceived health compared to those with ‘very good’ health had higher chances of attending both cervical (OR = 1.67, 95%CI 1.32-2.13 and OR = 1.34, 95%CI 1.03-1.74) and breast screening (OR = 2.14, 95%CI 1.76-2.61 and OR = 1.44, 95%CI 1.14-1.82; all models controlled for age and education). Conclusions ‘Feeling healthy’ can lead women to believe they do not need to attend cancer screening. Measures should be taken to improve health literacy and cancer awareness to dispel misconceptions about cancer symptoms and encourage women to prioritise screening. Key messages • One of the most common resaons of screening non-attandance is ‘feeling healthy’. • Women with ‘good’ and ‘fair’ self-perceived health compared to those with ‘very good’ health had higher chances of attending both cervical and breast screening.

Effects of ozone therapy on anxiety and depression in patients with refractory symptoms of severe diseases: a pilot study.

Patients with refractory symptoms of severe diseases frequently experience anxiety, depression, and an altered health-related quality of life (HRQOL). Some publications have described the beneficial effect of ozone therapy on several symptoms of this kind of patient. The aim of this study was to preliminarily evaluate, in patients treated because of refractory symptoms of cancer treatment and advanced nononcologic diseases, if ozone therapy has an additional impact on self-reported anxiety and depression. Before and after ozone treatment, we assessed (i) anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS); (ii) the HRQOL (according to the EQ-5D-5L questionnaire), which includes a dimension on anxiety and depression and a visual analog scale (VAS) measuring self-perceived general health. Before ozone therapy, 56% of patients were on anxiolytic and/or antidepressant treatment. Before and after ozone therapy, the anxiety and depression HADS subscales (i) significantly correlated with the anxiety/depression dimension of the EQ-5D-5L questionnaire and (ii) inversely correlated with the health status as measured by the VAS. After ozone therapy, we found a significant improvement in anxiety and depression measured by both the (i) HADS subscales and (ii) EQ-5D-5L questionnaire. The addition of ozone therapy for patients with refractory symptoms of cancer treatment and advanced chronic nononcologic diseases can decrease anxiety and depression severity levels. Additional, more focused studies are ongoing to provide the needed explanatory information for this finding.

Predicting self-perceived general health status using machine learning: an external exposome study

BackgroundSelf-perceived general health (SPGH) is a general health indicator commonly used in epidemiological research and is associated with a wide range of exposures from different domains. However, most studies on SPGH only investigated a limited set of exposures and did not take the entire external exposome into account. We aimed to develop predictive models for SPGH based on exposome datasets using machine learning techniques and identify the most important predictors of poor SPGH status.MethodsRandom forest (RF) was used on two datasets based on personal characteristics from the 2012 and 2016 editions of the Dutch national health survey, enriched with environmental and neighborhood characteristics. Model performance was determined using the area under the curve (AUC) score. The most important predictors were identified using a variable importance procedure and individual effects of exposures using partial dependence and accumulated local effect plots. The final 2012 dataset contained information on 199,840 individuals and 81 variables, whereas the final 2016 dataset had 244,557 individuals with 91 variables.ResultsOur RF models had overall good predictive performance (2012: AUC = 0.864 (CI: 0.852–0.876); 2016: AUC = 0.890 (CI: 0.883–0.896)) and the most important predictors were “Control of own life”, “Physical activity”, “Loneliness” and “Making ends meet”. Subjects who felt insufficiently in control of their own life, scored high on the De Jong-Gierveld loneliness scale or had difficulty in making ends meet were more likely to have poor SPGH status, whereas increased physical activity per week reduced the probability of poor SPGH. We observed associations between some neighborhood and environmental characteristics, but these variables did not contribute to the overall predictive strength of the models.ConclusionsThis study identified that within an external exposome dataset, the most important predictors for SPGH status are related to mental wellbeing, physical exercise, loneliness, and financial status.

Social determinants of inadequate prenatal care utilization in sheltered homeless mothers in the Greater Paris area in France.

Sheltered homeless families suffer from deleterious living conditions such as housing instability (i.e., moving from one shelter to another) that could be an additional barrier to healthcare utilization. Few studies have specifically examined perinatal health in homeless mothers and their utilization of prenatal healthcare. This study aimed to identify social determinants such as living conditions (i.e., housing instability) associated with inadequate prenatal care utilization (PCU) in sheltered homeless mothers in the Greater Paris area in France. The homeless children and families cross-sectional survey [ENFAMS: (Enfants et familles sans logement)] was performed on a random representative sample of homeless families living in shelters in the greater Paris area in 2013. Following French guidelines, PCU was deemed inadequate if one or more of the following criteria was met: attending fewer than 50% of recommended prenatal visits, PCU initiation after the first trimester of pregnancy, and fewer than three ultrasounds during the entire pregnancy. Families were interviewed in 17 languages by trained peer interviewers in face-to-face interviews. Structural equation modeling was used to identify factors associated with inadequate PCU and to estimate correlations between them. This study analyzed data on 121 homeless sheltered mothers who had at least one child less than one year old. They were socially disadvantaged and most were born outside France. One in five (19.3%) had inadequate PCU. Associated factors were socio-demographic characteristics (young age, primiparous), health status (dissatisfaction with self-perceived general health), and living conditions (housing instability in the second and third trimesters). It is essential to reduce housing instability to help sheltered mothers to benefit from social, territorial and medical support and healthcare utilization. Housing stability for pregnant sheltered homeless mothers should be a priority to ensure better PCU and guarantee the newborn's health as much as possible.

Perceptions of Oral Health and Quality of Life among Parents in Kuwait.

To determine the self-perceived oral health and general health as well as the oral health-related quality of life (OHRQoL) among parents in Kuwait. This cross-sectional study was conducted among parents visiting the School Oral Health Programme (SOHP) clinics in all the governorates in Kuwait. Being a parent and able to read and understand the Arabic language was the inclusion criterion. A convenience sample of parents (n = 2357) were enrolled in this study, which was conducted using a self-administered questionnaire in Arabic. The questionnaire included previously validated questions and also questions designed for this study. The parents completed and returned the questionnaire while waiting for their children in the waiting area of the SOHP clinic. The mean age of the parents was 38.3 ± 7.3 years. The majority (75.2%) of the participants perceived their oral health 'excellent', 'very good' or 'good' and 76.4% also rated their general health as 'excellent', 'very good' or 'good'. Overall, higher levels of perceived oral health were reported more frequently by younger participants, females, Kuwaitis, and those who had higher levels of education (p < 0.001). Most of the participants (72.3%) were satisfied with their oral health, (91.0%) enjoyed eating their food and (79.0%) liked their smile. Perceived difficulty in chewing food was stated by only 21.0%, and very few (5.0%) had speech difficulties. Almost half (45.0%) mentioned that they had never had any dental and/or gum problems that affected their daily activities during the past 6 months, nor did such problems influence their social activities. Nearly two-thirds (61.0%) stated that they never had any difficulty in conversation, and half (49.0%) did not report any disturbance in their sleep. Cronbach's alpha (0.89) showed a high degree of internal consistency between different OHRQoL responses. Most of the parents were satisfied with their oral health, which had an impact on their quality of life.

Motivational readiness for physical activity and health literacy: results of a cross-sectional survey of the adult population in Germany

BackgroundHealth literacy, defined as the knowledge, motivation, and competences to use health information to improve health and well-being, is associated with regular physical activity. However, there is limited evidence on whether health literacy is also related to the motivational readiness for physical activity in a general population. The aim of this study was to investigate whether motivational readiness for leisure-time physical activity is associated with health literacy.MethodsAnalyses were based on data of 21,895 adults from the cross-sectional German Health Update and European Health Interview Survey 2014/2015 (GEDA 2014/2015-EHIS). Motivational readiness for leisure-time physical activity was assessed with stages of change for physical activity with a set of validated items. It was then classified, according to an established algorithm, into five stages: precontemplation, contemplation, preparation, action, and maintenance. Health literacy was measured with the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and categorised as low, medium, and high. For bivariate and multinomial logistic regression analyses, the stages were categorised in three phases as: (1) no intention (precontemplation), (2) planning (contemplation or preparation), and (3) in activity (action or maintenance). The models were adjusted for sex, age, education, health consciousness, self-efficacy, and self-perceived general health status.ResultsHigh compared to low health literacy was associated with a 1.65-times (95% CI = 1.39–1.96) greater probability of being in activity than planning. High compared to low health literacy was associated with a reduced risk of having no intention to change physical activity behaviour (relative risk ratio, RRR = 0.84, 95% CI = 0.75–0.95). The associations persisted after adjusting for covariates.ConclusionHigh health literacy was positively associated with more advanced phases of motivational readiness for leisure-time physical activity. Therefore, taking health literacy into account in interventions to promote motivational readiness for leisure-time physical activity could be a useful approach.

Reaction to political and socioeconomic transition and self-perceived health status in the adult population of Gjilan region, Kosovo

Aim: The objective of our study was to assess the association of reaction to political and socioeconomic transition with self-perceived general health status in adult men and women in a region of Kosovo, a post-war country in the Western Balkans which has proclaimed independence in 2008.&#x0D; Methods: This was a cross-sectional study carried out in Gjilan region of Kosovo in 2014, including a representative sample of 867 primary health care users aged ≥35 years (419 men aged 54.3±10.9 years and 448 women aged 54.0±10.1 years; overall response rate: 87%). Reaction to political and socioeconomic aspects of transition was assessed by a three-item scale (trichotomized in the analysis into positive attitude, intermediate attitude, and negative attitude towards transition), which was previously used in the neighbouring Albania. Self-reported health status was measured on a 5-point scale which was dichotomized in the analysis into “good” vs. “poor” health. Demographic and socioeconomic data were also collected. Binary logistic regression was used to assess the association of reaction to transition with self-rated health status.&#x0D; Results: In crude/unadjusted models, negative attitude to transition was a “strong” predictor of poor self-perceived health (OR=2.5, 95%CI=1.7-3.8). Upon multivariable adjustment for all the demographic factors and socioeconomic characteristics, the association was attenuated and was only borderline statistically significant (OR=1.6, 95%CI=1.0-2.6, P=0.07).&#x0D; Conclusion: Our findings indicate an important association between reaction to transition and self-perceived health status in the adult population of the newly independent Kosovo. Policymakers and decision-makers in post-war countries such as Kosovo should be aware of the health effects of attitudes towards political and socioeconomic aspects of transition, which is seemingly an important psychosocial factor.

Correlation Analysis between Self-perceived Oral Health and Self-perceived General Health among Adults in China.

To analyse the correlation between self-perceived oral health (SPOH) and selfperceived general health (SPGH) and the influencing factors. In this study, we collected sociodemographic information and details about SPOH and SPGH status for Chinese adults (≥ 18 years), and a total of 2233 people were included. The data were analysed using SPSS software (IBM, Armonk, NY, USA) with a chi-square test and binary logistic regression. In total, 43.4% of adults' self-perceived oral health was at a "good" level and 57.9% of adults' self-perceived general health was at a "good" level. The SPOH was correlated with SPGH (r = 0.593, P < 0.001). Good SPOH was associated with younger age, no dentures, no smoking, brushing teeth twice or more a day, periodontal health, no malocclusion and decayed, missing and filled teeth (DMFT) ≤ 12. Good SPGH was associated with younger age, higher educational level, no dentures, no smoking, brushing teeth twice or more a day, periodontal health, no malocclusion and DMFT ≤ 12. SPOH and SPGH are correlated with each other, and greater attention should be paid to oral health to promote general health.

Health associations with meeting the new Canadian 24-Hour Movement Guidelines recommendations according to body mass index classes in Canadian adults.

Data on meeting the Canadian 24-Hour Movement Guidelines for adults (24-H Guidelines) and associations with health indicators by body mass index (BMI) class are needed to support public health surveillance. The aim of this study was to describe the proportion of Canadian adults meeting individual and various combinations of the 24-H Guidelines by BMI class and their association with health indicators. Data from the cross-sectional Canadian Health Measures Survey cycles 1 to 4 (2007 to 2015, n = 10,515 adults aged 18 to 79 years) were used. Daily time spent in moderate-to-vigorous physical activity (MVPA) and sedentary behaviour were assessed using accelerometry. Sleep duration, recreational screen time, chronic conditions, sociodemographic characteristics, and general and mental health were self-reported. The BMI, waist circumference, blood pressure and aerobic fitness were directly measured. Respondents were classified as meeting the 24-H Guidelines when: • the MVPA was 150 minutes per week or more; • sedentary time was nine hours or less per day; • recreational screen time was three hours or less per day; • sleep duration was seven to nine hours per day for individuals aged 18 to 64 years or seven to eight hours per day for individuals aged 65 years and older. Significantly fewer adults with overweight (6.1%) or class I (4.3%) and class II or III (3.9%) obesity met all three 24-H Guidelines compared with those with normal weight (9.5%). Meeting all three or two recommendations of the 24-H Guidelines was generally associated with a lower waist circumference, higher aerobic physical fitness and self-perceived general health regardless of BMI class. Canadian adults living with overweight and obesity are less likely to meet the 24-H Guidelines. Most of the benefits associated with meeting the 24-H Guidelines are observed regardless of BMI status.

Distinct care trajectories among persons living with arthritic conditions: A two-year state sequence analysis.

Developing solutions to optimize care trajectories (CareTs) requires examining patient journeys through the health care system. This study aimed to describe CareTs among people living with arthritis and evaluate their association with self-reported health outcomes. Analyses were conducted using the TorSaDE Cohort (n = 102,148), which connects the 2007 to 2016 Canadian Community Health Surveys (CCHS) with Quebec administrative databases (longitudinal claims). CareTs of participants living with arthritis according to CCHS (n = 16,631), over the two years before CCHS completion, were clustered using state sequence analysis (months as a time unit). CareT group membership was then put in association with self-reported outcomes (pain intensity and interference, self-perceived general and mental health). The analysis revealed five CareT groups characterized predominantly by: (1) arthritis-related visits to a specialist (n = 2,756; 16.6%), (2) arthritis-related emergency department visits (n = 2,928; 17.6%), (3) very high all-cause health care utilization and arthritis-related hospitalizations (n = 1,570; 9.4%), (4) arthritis-related medical visits to general practitioners and specialists (n = 2,708; 16.3%), (5) low all-cause health care utilization (n = 6,669; 40.1%). Multivariable results revealed that CareT group membership was associated with higher levels of pain interference (CareT group #3 vs. #5: OR: 1.4, 95%CI: 1.1-1.8) and fair/poor self-perceived general health (CareT group #1 vs. #5: OR: 1.551, 95%CI: 1.319-1.824; #2 vs. #5: OR: 1.244, 95%CI: 1.062-1.457; #3 vs. #5: OR: 1.771, 95%CI: 1.451-2.162; #4 vs. #5: OR: 1.481, 95%CI: 1.265-1.735). Sate sequence analysis is an innovative method of studying CareTs and valuable for making evidence-based decisions taking into account inter- and intra-individual variability.

Quality of Life and Related Factors in Specialists on Pediatric Dentistry and the like Graduated from a Public University: A Mixed Methods Approach.

This study aims to analyze the factors associated with the quality of life (QOL) in pediatric dentistry specialists and the like, graduated in a public university between 1972 and 2018. A mixed study (explanatory sequential design) was conducted. Firstly, a cross-sectional survey (n = 62, 51% women) was carried out and complemented with three focus groups (FGs) and four semi-structured interviews (SIs). Descriptive statistics, bivariate analyzes and non-parametric correlation were calculated. A multivariate linear regression was carried out to establish the factors associated with QOL. In FGs, the concept of QOL and the factors that influence it was investigated, by following a qualitative content analysis and later the information was triangulated. The median QOL scores surpass 62 points. The multivariate analysis showed that the factors exerted the greatest influence negatively (decreases the QOL score) were: having an independent or service provision contract (p < 0.05), low social support (p < 0.001), job dissatisfaction (p < 0.01), poor mental health (p < 0.01), self-perceived poor general health (p < 0.01). The information from the FGs and interviews allow to establish three categories of analysis: (1) QOL and health: multiple facets, determinants, and dimensions; (2) encounters and disagreements between the postgraduate curricular training proposal and the labor and social field of the specialist; (3) an itinerant clinical specialization. The QOL of participants is considered good in general terms and is conditioned by subjective factors, the social environment, and the conditions of their professional work.

Gender Differences in Health Self-Perception in Older Adults in Primary Health Care in Brazil

Abstract The men-to-women ratio shows that women outnumber men, and aging-related aspects signal differences between older men and older women, confirming gender-based differences in aging. Our study aimed to foster discussion on gender and its consequences for health, considering the perceived and self-reported health of older people attending primary health care facilities. We carried out a quantitative descriptive cross-sectional study in the city of Fortaleza, Ceará, Northeastern Brazil, with people aged 60 or older who were individually interviewed using a questionnaire addressing sociodemographic data (age, gender, marital status, income, education), systemic health (self-reported diseases), oral health and perceived general health (ipresent and past year health status). Participants were 821 older people whose age ranged from 60 to 100 years, with a mean of 69.7 years. There was a predominance of women (n=580; 70.6%). Participants presented low levels of education and income. Women were 1.3 times more likely to present systemic diseases and 1.5 times more likely to use medications compared with men. Women were more edentulous and presented more soft tissue problems than men. There were no differences in self-perceived general health and past year health status among the participants. The participants’ self-reported health status revealed women are at an increased risk of getting sick, thus demonstrating gender-based inequalities in health among older adults. Public health policies need to improve people's access to primary care, especially in disadvantaged socioeconomic classes. Strategies should include financial support for health, retirement and social security policies to diminish gender-based inequalities in health.

Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up.

BackgroundMetabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors.ObjectiveTo assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial.DesignProspective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55–75 years old) with overweight or obesity at baseline.MethodsThe desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: ≥0.0 kg (T1, n = 1,638); 0.0 to −4.0 kg (T2, n = 1,903); ≤−4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed physical activity. The Framingham equation assessed cardiovascular risks. The changes in the severity of MetS were also assessed. The Beck Depression Inventory assessed depressive symptoms and the SF-36 assessed health-related quality of life. Data were analyzed using general linear models.ResultsBMI decreased at T2 and T3 (T1: 0.3, T2: −0.7, T3: −1.9). The most significant improvement in diet quality was observed at T3. Cardiovascular risk decreased at T2 and T3. Mean reductions in MetS severity score were: −0.02 at T1, −0.39 at T2 and −0.78 at T3. The perception of physical health increases in successive tertiles.ConclusionsIn older adults with MetS, more ambitious desired weight loss goals were associated with improvements in diet, cardiovascular health and perceived physical health during the first year of a healthy lifestyle intervention programme. Weight dissatisfaction needs to be considered by health professionals.Clinical trial registrationhttp://www.isrctn.com/ISRCTN89898870, identifier 89898870.

P-311 Comparing the impact of endometriosis vs. fibroids on women’s psychological and physical health, and sexual function: a case-control study

Abstract Study question What is the impact of endometriosis vs. fibroids on women’s psychological and physical health, and sexual function? Summary answer Endometriosis and fibroids are associated with worse self-perceived health status and with a greater percentage of sexual dysfunction compared with the control group. What is known already Endometriosis and fibroids are two benign gynaecological conditions that affect a significant percentage of women globally. The negative impact of endometriosis on women’s psychological health, quality of life, and sexuality has been widely demonstrated. On the other hand, the body of evidence on the impact of fibroids on women’s life is smaller and with contrasting results. Recent research has demonstrated that uterine fibroids may lead to stress and poor sexual satisfaction, with a disability score similar to that of heart disease, diabetes mellitus, or breast cancer. Thus far, systematic comparisons between fibroids and endometriosis have not been addressed. Study design, size, duration This case-control study was conducted in an Italian gynaecological clinic between March 2019 and July 2021. Sample size was determined using the software G* Power. We calculated that 252 participants were necessary to compare 3 groups using univariate analysis of variance, with a medium effect size (Cohen’s f = .25), α = .05, and power = .95. Considering that the anticipated percentage of missing data was 20%, the final required sample size was 303 participants. Participants/materials, setting, methods The study involved three groups of patients: women with diagnosed endometriosis or uterine fibroids, and women without a history of endometriosis and without fibroids (101 women in each group). All the participants completed the Hospital Anxiety and Depression Scale (HADS), the 12 item Short-Form survey (SF-12), and the Female Sexual Function Index (FSFI). A researcher made questionnaire was used to collect sociodemographic and medical information (e.g., endometriosis- and fibroid-related symptoms). Main results and the role of chance Controlling for age, there were no significant group differences with regards to psychological health (P = .575). However, either women with endometriosis (P &amp;lt; .001) or fibroids (P = .003) reported poorer self-perceived general health status (SF-12 item 1) than women in the control group. A greater percentage of women with sexual dysfunction (FSFI total score &amp;lt; 26.55) was found in the two clinical groups, and especially in the endometriosis group (65%, vs 54% in the fibroids group and 44% in the control condition; χ2 = 8.392, P = .015). Specifically, women with endometriosis (P &amp;lt; .001) and women with fibroids (P = .039) reported lower desire than control participants. In addition, women with endometriosis experienced greater pain than women in the control group (P = .001). No statistically significant differences were found between the two clinical groups. Limitations, reasons for caution Most of the data included in these analyses were collected during the pandemic, which has been significantly affecting people’s psychological health, and especially women’s emotional wellbeing. For this reason, the absence of significant group differences in the HADS score should be interpreted with caution. Wider implications of the findings Endometriosis overall is clearly associated with sexual dysfunction, but the relation between uterine fibroids and sexual function requires further investigation, especially with regards to the effects of specific factors such as number, size and location. In general, sexual function should be routinely assessed in women diagnosed with any gynaecological condition. Trial registration number Not applicable.

Income-related inequality and decomposition of edentulism among aged people in China

BackgroundThe aim of this study was to assess the income-related inequality of edentulism among the aged in China and identify the contributing factors.MethodsA secondary analysis of data from the 4th National Oral Health Epidemiology Survey in China was conducted, and 65–74 years old were selected for the analysis of income-related inequality of edentulism. The concentration curve, Concentration index (CI) and Erreygers-corrected concentration index (EI) were used to represent inequality and its degree qualitatively and quantitatively, respectively. A decomposition method based on probit model was employed to determine the contributors of inequality, including demographic factors, income status, oral health-related knowledge, attitude and practices and self-perceived general health status.ResultsIn China, aged people with edentulism were concentrated in the poor. The CI was − 0.2337 (95% CIs: − 0.3503, − 0.1170). The EI was − 0.0413 (95% CIs: − 0.0619, − 0.0207). The decomposition results showed that income (75.02%) and oral health-related knowledge, attitude and practices (15.52%) were the main contributors to the inequality.ConclusionThis study showed that pro-poor inequality among the elderly with edentulism existed in China. Corresponding policies against the contributors could be considered to promote the health equality of the elders.

Association between self-reported dental fear and exposure to violence among adolescents-A population-based study.

The etiology of dental fear (DF) is multifactorial and involves other contributing factors than dental traumatic experiences. To study, among adolescents, associations between DF and exposure to child physical abuse (CPA), intimate partner violence (IPV), and bullying. We extracted data from a population-based survey of 4977 adolescents who were 15-17years old in 2017. The questionnaire queried socioeconomic background factors, DF, self-perceived oral health, general health, and exposure to child abuse. To estimate associations between DF and exposure to child abuse, we used multivariate logistic regression analysis. Overall, 8.2% reported DF, girls (10.5%) reported DF significantly more often than boys (5%), and adolescents not identifying themselves as girl or boy reported the highest prevalence of DF (25.5%; p<.001). 15.3% had been exposed to child physical abuse; 11.1%, to IPV; and 11.2%, to bullying. Experiences of IPV and bullying, but not physical abuse, were statistically significantly associated with DF. The odds of developing DF for adolescents exposed to any type of violence was 1.9 times the odds for adolescents with no exposure to child abuse. Exposure to violence is associated with dental fear in adolescents.

Relationship Between Spirituality, Religiosity, and General Life Satisfaction Among Canadians Living with Neurological Conditions in New Brunswick and Manitoba.

This study assessed the association between religion and spirituality on general life satisfaction among a sample of community-dwelling Canadians with neurological conditions. The data represented responses from two provinces that participated in the national Canadian Community Health Survey-Annual Component (CCHS-2011). A weighted subsample (n = 4562) of respondents with neurological conditions from the provinces of New Brunswick and Manitoba was used. Multivariate logistic regression fitted the models using STATA version 14. Spiritual coping, self-perceived general, and mental health were found to be predictors of greater life satisfaction and quality of life. It may be beneficial to incorporate spiritualandreligious needs in the circle of care for those living in the community with neurological conditions.

Subjektivna procena zdravstvenog statusa i broj dana na bolovanju kod ljudi koji boluju od astme i hronične opstruktivne bolesti pluća

Introduction/Aim: There is a lack of studies focusing on the comparison of health-related quality of life (HRQOL) between people with asthma and people with chronic obstructive pulmonary disease (COPD). The purpose of this study was to examine and compare self-reported health status in people who have asthma and people who have COPD. Methods: Data were collected from adult participants who came to primary health care institutions using a general questionnaire to examine their health status and the Serbian version of the HRQOL-14. The propensity score method was used to match people with asthma and COPD on age, gender, education level and adherence to therapy. Results: A total of 1,954 patients (47% men, 53% women) were included in the study. The average age of patients with asthma was 49.4±15.5, whereas the patients with COPD were older - 59.5±12.4. In both groups, 60% of the participants reported their health status as poor. No difference was found between patients with asthma and patients with COPD in terms of self-perceived general health status and the number of sick days. Patients with asthma and COPD reported the greatest number of days with sleep disorders, followed by days with symptoms of anxiety and depressive symptoms and the least number of days with having pain. Conclusion: These data indicate the need to improve sleep patterns in people with asthma and COPD. These data could be used to further examine specific features of sleep among people with asthma and COPD.

Assessment of the fear of COVID-19 and its impact on lung cancer screening participation among the Korean general population.

BackgroundWe aimed to assess the fear of COVID-19 and how much it affected the behaviors of the general population towards cancer screening.MethodsThe Korean National Cancer Screening Survey is an annual population-based, cross-sectional survey to investigate cancer screening rates of five major malignancies. We extracted data on 3,557 cancer-free respondents aged ≥40 years in 2020, including sociodemographic characteristics, comorbidities, family history of cancer, self-perceived general health status, attitudes towards screening, and fear of COVID-19 compared with lung cancer. We collected information on health check-ups participation including cancer screening with or without schedule during the pandemic and analyzed the participation rate according to the degree of fear of COVID-19.ResultsAmong 3,557 respondents, 1,066 (29.97%) people were more worried by COVID-19 than by lung cancer. 2,392 (67.25%) did not participate in health check-ups, of which 573 (24.0%) had a schedule for health check-ups but did not receive. We observed a significant increase (P<0.05) in the proportion of non-participation with schedule when the fear of COVID-19 exceeds lung cancer. In multivariate logistic analysis, the respondents with more fear of COVID-19 compared with lung cancer showed decreased likelihood of attendance in health check-ups (OR, 0.84; 95% CI: 0.71–0.98).ConclusionsA considerable proportion of the general population perceived more fear of COVID-19 than lung cancer, which significantly hampered their engagement in regular medical check-ups including cancer screening. This finding highlights the need for providing appropriate information to the target population of lung cancer screening to minimize disruption in cancer prevention activities.