Self-perceived Health Research Articles

Cross-Sectional Association Between Life Expectancy and Unhealthy Life Years: Proof of Concept Tests of the CroHaM Hypothesis

The recently presented CroHaM hypothesis says (1) that longitudinal health domain-specific expansion and compression effects depend primarily on the health domains’ mortality risk and (2) that these effects exist equivalently in the cross-sectional context, affecting differences in healthy life years (HLY) between populations and subpopulations with different levels of life expectancy (LE). We test this hypothesis by analysing the association between LE and unhealthy life years (ULY) at age 50 for a large number of subpopulations. The analyses are carried out for three health domains which are differently related to mortality: poor self-perceived health and strong activity limitation with comparatively high mortality, and chronic morbidity with comparatively low risk of dying. Data on gender- and subpopulation-specific prevalence of these health conditions are taken from the Actual German Health Study 2012 (GEDA). LEs are estimated with the “Longitudinal Survival Method”, using data of the German Life Expectancy Survey. ULY are estimated with the “Sullivan Method”. Differences in ULY between each subpopulation and the total population and between women and men for each subpopulation are decomposed into the effects caused by differences in health (“health effect”) and mortality (“mortality effect”) with the “Nusselder/Looman Method”. The results confirm the CroHaM hypothesis: we find a positive relationship between LE and ULY only for chronic morbidity, whereas this relationship is negative for poor self-perceived health and strong activity limitation. However, when the mortality effect is controlled for, we find a negative relationship between LE and ULY for all three health domains. The practical relevance of these findings is discussed using the example of the so-called “gender paradox” in health and mortality. We conclude that the CroHaM hypothesis may describe an important determinant of life years spent with and without health impairment, and it may help to better understand and interpret trends and differentials in HLY or ULY based on cross-sectional data. * This article belongs to a special issue on “Levels and Trends of Health Expectancy: Understanding its Measurement and Estimation Sensitivity”.

Self-perceived health status, psychological resilience, and life satisfaction of healthcare workers after 2 years of COVID-19 pandemic

Self-perceived health status, psychological resilience, and life satisfaction of healthcare workers after 2 years of COVID-19 pandemic

Self-perception of oral health, gender and employment among Brazilian population.

Self-perception of oral health is a recognized indicator, based on a single question. Association among oral health and socioeconomic status has been well established, however in Brazil, no results were found on the relation with type of insertion in labor market. The aim of this study was to describe the prevalence of negative self-perception of oral health and associated factors, according to gender among Brazilian workers population, in 2019. The National Health Survey, nationwide household-based survey, carried out in 2019, was used as source of data. Absolute and relative frequencies were calculated to understand the distribution of variables of interest and characterize the sample (n = 54,343). Binary logistic regression was used in the analyses. Odds ratio (OR) was estimated using a 95% confidence interval in bivariate and multivariate analyses. The prevalence of negative self-perception of oral health was 29.3%; in that, 31.0% among men and 27.2% among women. Compared to formal employees, the chance of negative self-perception of oral health among the informal workers was almost 20% higher among men and 13% among women after adjusting for all confounding factors. Unemployed women were 33% more likely to have negative self-perception of oral health. Self-reported unemployment increased the chance of a negative self-perception of oral health among women; however, the same effect was not observed among men. Why is there a difference? The association between informal work and negative SEOH is relevant in the Brazilian context of work deregulation and growth in the number of people without access to formal employment. The results suggested addressing employment conditions in adult oral health promotion actions, with emphasis on gender differences.

Unmet community care needs among older adults in China: an observational study on influencing factors

BackgroundWith the rapidly aging population in China, there is an urgent need to understand and address the community care needs of older adults. This study sought to examine these unmet community care needs of older adults in China and the factors influencing them, with the goal of providing essential groundwork for the development of community care health policies.MethodsThis study used data from the 2018 China Longitudinal Healthy Longevity Survey of 8,870 adults aged 65 years and older. Logistic regression analysis was performed to identify factors related to unmet community care needs.ResultsThe results showed that lower number of children, increased years of schooling, poorer self-perceived economic and health status, residing in an institution rather than living with household members, not having public old-age pensions, and not having activity due to daily living impairments were associated with a higher likelihood of unmet community care needs among older adults.ConclusionsThese findings indicate the necessity for crafting policies that consider the factors affecting unmet community care needs of older adults, including their health vulnerabilities and individual needs. Implementing national initiatives aimed at enhancing the quality of services delivered to older adults is crucial, along with establishing programmes to proactively address their vulnerabilities and individual needs. This study can contribute to the formulation of policy measures aimed at enhancing community care services of older adults in China.

Effects of aircraft noise exposure on self-reported health through aircraft noise annoyance: Causal mediation analysis in the DEBATS longitudinal study in France.

Previous studies reported an association between transportation noise and self-reported health status (SRHS). They also suggested a mediating role of noise annoyance using conventional statistical methods. These methods are subject to bias in longitudinal studies with time-dependent exposure, mediator and confounding factors. This study aims to investigate the mediating role of aircraft noise annoyance in the effect of aircraft noise on SRHS using a causal inference approach to address time-dependent variables issues. We used data from 881 participants in all three visits in the DEBATS longitudinal study conducted around three French airports. Participants over 18 years of age reported their self-perceived health status, aircraft noise annoyance, and noise sensitivity by completing a questionnaire at three visits in 2013, 2015 and 2017. Noise maps were used to estimate aircraft noise levels outside their homes. Marginal structural models with inverse probability weighting were used to estimate the total effect of aircraft noise levels on SRHS and its decomposition into direct and indirect effect through aircraft noise annoyance. This study showed a deleterious effect of aircraft noise on SRHS. The odds ratio (OR) corresponding to the total effect and comparing the highest aircraft noise category (≥60 dBA) to the reference category (<50 dBA) was significant (ORpoor/fair_SHRS = 1.25 (95%CI: 1.06 to 2.08)). It also showed no direct effect of aircraft noise levels on SRHS, but an indirect effect through annoyance. This indirect effect increased as aircraft noise levels increased, with a statistically significant OR when comparing the highest noise category (≥60 dBA) to the lowest (<50 dBA) (ORpoor/fair_SHRS = 1.16 (95%CI: 1.03 to 1.52)). Nearly 66% of aircraft noise's effect on SRHS was mediated by aircraft noise annoyance. This study supports the deleterious causal effect of aircraft noise on SRHS. The results highlight the important mediating role of aircraft noise annoyance in the causal pathway from exposure to aircraft noise to poor/fair SRHS.

Comparing Sarcopenia Definitions and Muscle Power Reduction: Associations with Health Outcomes in Spanish Community-Dwelling Older Adults.

Objectives: To analyze the associations between the different operational definitions of sarcopenia published in the last decade and reduced muscle power with a set of adverse health-related outcomes, such as comorbidities, depression, polypharmacy, self-perceived health, educational attainment, socioeconomic status, falls, and hospitalizations in Spanish community-dwelling older adults. Methods: A total of 686 community-dwelling older adults (median age: 72; women: 59.2%; physically active: 84%) were included in this cross-sectional analysis (ClinicalTrials.gov: NCT05148351). Sarcopenia was assessed using the FNIH, EWGSOP2, AWGS, and SDOC algorithms. Reduced muscle power was defined as the lowest sex-specific tertile and measured during the rising phase of the sit-to-stand test using a validated mobile application. Unadjusted and adjusted logistic regressions by potential confounders were performed to identify the association between sarcopenia and reduced muscle power with health-related outcomes. Results: Sarcopenia prevalence was 3.4%, 3.8%, 12.4%, and 21.3% according to the SDOC, FNIH, EWGSOP2, and AWGS, respectively. Among these definitions, moderate and large associations with health-related outcomes were observed for EWGSOP2 and SDOC, respectively, but few associations were found for FNIH and AWGS criteria. Reduced muscle power was associated more frequently and moderately with health-related outcomes compared to sarcopenia definitions. These associations remained constant after adjusting for confounders. Conclusions: The prevalence and impact of sarcopenia varied depending on the definitions used. Among the sarcopenia definitions, the SDOC exhibited the strongest associations, while reduced muscle power was the variable most frequently associated with health-related outcomes compared to any of the four sarcopenia definitions in well-functioning and physically active community-dwelling older adults.

Is environmental regulation conducive to the reduction of residents’ health costs? – evidence from the Chinese Family Panel Survey

BackgroundIn response to environmental degradation and the associated health challenges, the Chinese government has implemented a comprehensive array of environmental protection measures. Given the health enhancement objective of environmental protection measures and the considerable costs involved in the implementation process, evaluating whether environmental regulation is beneficial to reducing the health costs of the population is of great significance for enhancing environmental governance efficiency and social welfare. The data from the Chinese Family Panel Survey (CFPS) is applied to examine the effect of environmental regulation on the reduction of residents’ health costs from a microscopic perspective.ResultsThe results indicate that for a 1% increase in total investment in environmental governance, residents’ health costs will decrease by 0.189%. The examination of the causal pathway suggests that implementing environmental regulation can diminish residents’ health costs through improving air quality and residents’ health status. Concurrently, there exist significant heterogeneities in the role of environmental regulation in reducing residents’ health costs. The effect of environmental regulation is more pronounced for the young, males, and individuals with better self-perceived health. Furthermore, the outcome of environmental regulation exhibits greater efficacy in urban areas compared to rural areas. Lastly, market-incentive environmental regulation in reducing health costs is more effective than command-controlled regulation.ConclusionsEnhancing the intensity of environmental regulation contributes to decreasing residents’ health costs. The findings can provide policy reference for implementing environmental governance and achieving tangible enhancements in individuals' life quality.

Demographic and socioeconomic disparity in knowledge, attitude, and practice towards tuberculosis in Northwest, China: evidence from multilevel model study

BackgroundTuberculosis (TB) remains a serious global public health problem in China. The right knowledge, attitude, and practice (KAP) towards TB are indispensable to appropriate healthcare-seeking behaviors and treatment services timely. However, there are few studies that addressed the KAP towards TB in high-risk and under-developing regions in China. This study aims to evaluate the KAP towards TB in Ningxia Northwest, China, and identify factors that influence it. The findings can guide future health education and promotion interventions.MethodsA stratified multistage random sampling method was used to conduct a face-to-face questionnaire survey with 33 items for selected residents. The composite score of Knowledge, Attitudes, and Practices (KAP) was divided into two groups, which are poor (scores below the average) and good (scores above the average). A two-level logistic model with a random intercept equation accounted for the similarity of residents within communities to examine the association between individual-level KAP and demographic and socioeconomic factors.ResultsA total of 2,341 residents were recruited, the mean age was 50, and 41.2% were female. The percentages of residents who were total awareness of TB knowledge and had positive attitudes and behavior toward TB were 51.9%, 75.3%, and 76.2%, respectively. The two-level logistic model demonstrated that residents with a high annual family income, urban living, primary school education or higher, occupation of teacher or doctor, a very good self-perceived status, medical insurance, knowing DOTS, and family members or friends with TB history had better knowledge of TB (P < 0.05). Residents living in urban areas, with junior and senior high school education, a very good self-perceived status, health insurance, knowing DOTS, and family members or friends with TB history had positive attitude of TB (P < 0.05). Residents living in urban areas, a primary school education or higher, occupation of teacher, doctor and workers, a very good self-perceived status, medical insurance, knowing DOTS, and family members or friends with TB history had positive practice of TB (P < 0.05).ConclusionsFavorable demographic (higher education levels, teachers or doctors) and socioeconomic (high income, living in urban area) factors are associated to better knowledge, attitudes and practices toward TB in Northwest China. Interventions to improve KAP at the community level are required to speed up the TB reduction rate, which may benefit to ensure the End TB Strategy will be achieved.

Trajectories of social class and adult self-perceived oral health.

To determine the effect of social mobility on self-perceived oral health (SPOH) by: (i)characterizing patterns of social mobility from birth to adulthood and (ii)assessing their influence on SPOH among British adults. A secondary data analysis of the 1970 British Cohort Study. Data were collected at birth and at 5, 10, 16, 26, 30, 34, 38, 42 and 46 years of age. Social class (SC) was indicated by parental SC from birth to age 16 and own SC from ages 26 to 42. At age 46, SPOH was measured using a single question. Sex, ethnicity, country and residence area were included as potential confounders. Latent class growth analysis (LCGA) was used to identify trajectories of exposure to non-manual SC over time, instead of predetermined categories. LCGA identified four social mobility patterns: stable high, stable low, upwardly mobile and downwardly mobile; the time for the change in SC happening between 16 and 26 years. A total of 9657 participants were included. In the crude model, stable high had lower odds (OR: 0.67, 95% CI: 0.59-0.76), while downward mobility and stable low had higher odds (OR: 1.36, 95% CI: 1.15-1.61 and OR: 1.57, 95% CI: 1.40-1.77) of poor SPOH than upward mobility. These results were corroborated in the fully adjusted model; being female and living in rural areas was also associated with lower odds (OR: 0.64, 95% CI: 0.59-0.71 and OR: 0.90, 95%CI: 0.80-1.00) of poor SPOH. Social mobility significantly affects SPOH in British adults. Those in non-manual SC have better SPOH than those in manual SC. When compared to upward mobility, downwardly mobile individuals report bad SPOH more frequently, evidencing that current SC influences oral health in a slightly greater measure than early years SC.

Sociodigital Determinants of eHealth Literacy and Related Impact on Health Outcomes and eHealth Use in Korean Older Adults: Community-Based Cross-Sectional Survey.

eHealth literacy is an essential skill for pursuing electronic health information, particularly for older people whose health needs increase with age. South Korea is now at the intersection of a rapidly digitalizing society and an increasingly aged population. eHealth literacy enables older people to maximize the effective use of emerging digital technology for their health and quality of life. Understanding the eHealth literacy of Korean older adults is critical to eliminating the gray digital divide and inequity in health information access. This study aims to investigate factors influencing eHealth literacy in older Korean adults and its impact on health outcomes and eHealth use. This was a cross-sectional survey. Community-dwelling older adults 65 years and older in 2 urban cities in South Korea were included. eHealth literacy was measured by the eHealth Literacy Scale. Ordinal logistic regression was used to analyze factors associated with eHealth literacy and multivariate ANOVA for the impact of eHealth literacy on health outcomes and eHealth use. In total, 434 participants were analyzed. A total of 22.3% (97/434) of participants had high eHealth literacy skills. Increasing age, higher monthly income, and time spent on the internet were significantly associated with eHealth literacy (P<.001), and social media users were 3.97 times (adjusted odds ratio 3.97, 95% CI 1.02-15.43; P=.04) more likely to have higher skill. Higher eHealth literacy was associated with better self-perceived health and frequent use of digital technologies for accessing health and care services (P<.001). Disparity in socioeconomic status and engagement on the internet and social media can result in different levels of eHealth literacy skills, which can have consequential impacts on health outcomes and eHealth use. Tailored eHealth interventions, grounded on the social and digital determinants of eHealth literacy, could facilitate eHealth information access among older adults and foster a digitally inclusive healthy aging community.

Oral health self-perception, maximum bite force and masticatory efficiency in patients with overdentures with different attachment systems-A crossover study.

The literature is unclear about how the different attachment systems for overdentures impact the maximum bite force, the masticatory efficiency and how this impact in the oral health self-perception in patients. To evaluate the effect of two attachment systems (O-ring and Locator) for mandibular overdenture using single implant on quality of life, maximum bite force (BF) and masticatory efficiency (ME). Twenty-eight completely edentulous denture wearers with a mandibular symphysis implant were randomly selected and allocated into two groups in a crossover study, considering O-ring and Locator attachment types. The quality of life and self-perception of oral health were assessed using the Oral Health Impact Profile (OHIP-Edent) and Geriatric Index of Determination of Oral Health (GOHAI) questionnaires, respectively. BF was measured using a gnathodynamometer and ME by chewing silicone cubes and almonds in different numbers of cycles. There was no difference between the attachment systems about self-perceived oral health and impact on quality of life (p > .05). The O-ring-type system obtained a significantly higher BF than the locator-type system (p = .04). Regardless of the food chewed, no statistically significant difference was observed with the type of attachment (p > .05). The ME was directly proportional to the masticatory cycles only for almonds (p < .01). Locator and O-ring inserts had a similar impact on patients' quality of life, self-perception of oral health and ME. Additionally, the O-ring system exhibited superior properties in the BF.

Subjective risk factors of severe pain at discharge from the emergency department.

To examine the risk factors for severe pain upon discharge from the emergency department, assuming appropriate pharmacological treatment of pain, in order to improve pain relief in emergency departments and reduce the risk of potential chronic pain. An analytic study was conducted utilizing data from a multicenter randomized controlled trial to evaluate patients' experiences upon admission and discharge from the emergency department (ED). Severe pain was defined by a score of six on a numerical rating scale of zero to ten. Stress and negative emotions (including anger, fear, sadness, and regret) were evaluated using numerical rating scales, respectively ranging from 0 to 10 and 1 to 5. The risk factors of severe pain at discharge (SPD) from ED were calculated using logistic regression considering patient characteristics evaluated at their admission to the ED. From the 1240 patients analyzed, 22.2% had SPD from the ED. Each increase of one point in the intensity of acute pain and anger was significantly associated with a higher risk of SPD from ED. In addition, woman, negative self-perceived health, and age under 65years, are other significant factors associated with SPD from the ED. In addition to acute pain on admission, this study highlights new factors to consider when managing pain in emergency care, such as anger, and self-perceived health. Addressing these aspects can help reduce the likelihood of developing SPD from the ED, which in turn could potentially lead to the onset of chronic pain in future. SOFTER IV Project clinical identification number: NCT04916678.

On the Motivations for Purchasing Long-Term Care Insurance: Protecting Bequest and Unreliability of Family Care

Family considerations are known to influence the decision to buy long-term care (LTC) insurance. This paper uses a Swiss survey to identify the characteristics of individuals willing to purchase LTC insurance, either to protect their children’s bequest or because they cannot rely on family for care. First, it shows that the presence or absence of children plays an important role in the two motivations for buying LTC insurance. Second, it shows that individuals from the French-speaking part of Switzerland and those with lower self-perceived health are more likely to buy LTC insurance because of the unreliability of family care. On the other hand, individuals with higher self-perceived health and those with a right and center political orientation are more likely to buy LTC insurance for reasons of bequest protection. The results provide insights into designing more targeted strategies to promote LTC insurance.

The BigMove Intervention for People With Physical and Mental Health Conditions: A First Evaluation of Self-Perceived Health, Quality of Life, Coping and Mental and Social Functioning.

The BigMove intervention aims to improve the functioning and quality of life of people with physical and mental health conditions via an integrated care approach. This pilot study evaluates the impact of the intervention on self-perceived health (SPH), quality of life (QoL), active coping behaviour, and mental and social functioning. Data were analysed from N = 457 participants who had been referred to the intervention by their general practitioner (mean age 48.98 years; 76% female). Three patient-reported and one clinician-rated measures were used: SPH, QoL (MANSA), active coping behaviour (UPCC-ACT), mental and social functioning (HoNOS). Pre- and post-intervention measurements (from 2011 to 2018) were compared using paired-samples t-tests. Due to missing data, analyses were conducted with 205-257 participants per completed outcome. Associations with age and sex were assessed using repeated-measures ANOVA. Clinically relevant change was evaluated with the Edwards-Nunnally index and standard error of measurement (SEM) scores. Post-intervention, there were statistically significant improvements for all outcomes (p < 0.0001) with moderate to large effect sizes (d = 0.41 to 1.02). The observed changes in outcomes can be considered as clinically relevant improvements. This pilot study provides preliminary evidence that the intervention has positive effects on SPH, QoL, active coping behaviour, and mental and social functioning.

Assessment of treatment needs, barriers, and self-perception regarding oral health among female university students: a cross-sectional study

BackgroundThe study aimed to compare the self-perceived oral health status measured through a self-administered questionnaire with clinically determined oral health status measured by decayed-missing-filled teeth (DMFT) and community periodontal index of treatment need (CPITN) indices in university going females. In addition, access barriers to treatment related to oral healthcare were also determined.MethodsA 3-month analytical cross-sectional study was designed for consenting university going females (aged 18–22 years) in Islamabad, Pakistan. The self-perceived oral health was recorded through a questionnaire requesting information regarding socio-demographics, self-perception of oral health, frequency of dental visits and barriers to seeking oral health. Seven independent examiners performed intraoral clinical examination and assessed the oral health status using globally standardized oral health assessment indices (DMFT and CPITN).ResultsA total of 400 students were included in the final sample. The study revealed a significant disparity between self-perceived oral health and clinical assessment. Although perceived oral health was considered “good” by 80.0% of the respondents, clinical examination revealed moderate DMFT scores (mean 2.95 ± 1.41) and periodontal disease requiring treatment in 89.5% of the individuals. The most common barriers in seeking dental care were lack of knowledge, dental phobia, affordability issue and false self-perception.ConclusionThe present study demonstrated a notable discrepancy between self-perception of oral health and clinically assessed oral health. These results emphasize the importance of focused educational programs and community outreach programs, especially directed towards this demographic. Prioritizing such initiatives will help individuals to recognize their actual oral health condition thus encouraging positive oral health behaviors and outcomes.

Association between air temperature and self-perceived health status in Southern Germany: Results from KORA FIT study

BackgroundShort-term exposure to low and high air temperatures can cause serious harmful effects on human health. Existing literature has mostly focused on associations of ambient air temperature with mortality and the need for health care in population-level studies. Studies that have considered self-perceived health status as an outcome when examining the effects of air temperature on health are scarce. In this study, we explored the short-term association of daily mean air temperature with various measures of self-perceived health status. MethodsThis cross-sectional analysis is based on the Cooperative Health Research in the Region of Augsburg (KORA) FIT study conducted in 2018/2019 and included participants from the Augsburg region of Southern Germany. Health-related quality of life (HRQOL) was evaluated by using the 5-level EuroQol Five Dimension (EQ-5D-5L) questionnaire, including the EuroQol visual analog scale (EQ-VAS). Self-rated health (SRH) and comparative self-rated health (CSRH) were each assessed using a single question. Daily mean air temperature data was estimated using a spatiotemporal model and assigned to participants' home addresses at a resolution of 1 × 1 km. Regression models with a Distributed Lag Non-linear Modeling (DLNM) approach were used to investigate the associations between daily mean air temperature and self-perceived health measures. ResultsWe found no association of heat or cold with the HRQOL, SRH or CSRH. Nevertheless, there was a significant protective association of low air temperature with the EQ-5D-5L dimension “usual activities.” ConclusionThere was no evidence of daily mean air temperature adversely affecting participants' self-perceived health status.

Impact of dental caries and Self-perceived oral health on daily lives of children and mothers in rural Egypt: a household survey

BackgroundThe present study assessed the impact of oral health on the daily lives of children and mothers living in a rural area in Northwestern Egypt.MethodsA cross-sectional household survey including children between 6 and 12 years old and their mothers was conducted in rural Egypt, 2019–2020. Data were collected using clinical examination and interview-based questionnaires of children and mothers. Three binary logistic regression models were used to assess the relationship between the dependent variables (oral health impact (yes, no) on avoiding smiling, chewing problems, and missing school (children) and avoiding social events (mothers)), and the explanatory variables: oral health (clinically-assessed caries experience and self-reported oral health) controlling for sociodemographic profile (child age and sex, mother’s education), daily toothbrushing and village of residence.ResultsA total of 211 households with 355 children and 211 mothers were included (91.5% response rate). About 54% of the children were girls, mean (SD) age = 8.7 (2.05) years and 82.3% did not brush their teeth daily. Mother’s mean (SD) age was 31.70 (5.45) years. Because of dental problems, 31.3% of children reported chewing difficulties, 31% avoided smiling compared to 76.3% and 43.6% of mothers. Also, 30.4% of children missed school and 76.8% of mothers reported reduced participation in social activities. In children, the number of decayed anterior teeth was associated with significantly higher odds of avoiding smiling (AOR = 1.22, 95%CI: 1.03, 1.44). In mothers, a greater number of posterior missing teeth was associated with significantly higher odds of chewing difficulties (AOR = 1.21, 95%CI: 1.01, 1.45), and a greater number of all missing teeth was associated with significantly higher odds of reduced participation in social events (AOR = 1.30, 95%CI: 1.30, 1.57). Good/ very good reported oral health in children and mothers was associated with lower odds of avoiding smiling and chewing problems (p < 0.05).ConclusionDecayed anterior teeth in children have a negative impact on smiling whereas missing teeth in mothers affect the ability to chew food and socialize. The psychological, functional, and social impacts of caries in this rural setting needs to be mitigated by improving oral health literacy and access to care.

Assessment of Health-Related Quality of Life and Its Determinants in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study.

Background Type 2 diabetes mellitus is a complex metabolic disorder associated with several complications that determine the quality of life of the patients. Health-related quality of life (HRQoL) is a measurable outcome of the self-perception of a patient's health which is affected due to age, lifestyle changes, medication, and treatment modalities. This study was undertaken to understand the impact of individual parameters of age, medication type and duration, diabetes-associated complications, and levels of glycated hemoglobin (HbA1c) on the quality of life (QoL) of the patient. Methodology This single-center prospective, cross-sectional study was conducted at the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India. Participants were recruited from the Outpatient Department of General Medicine, IGIMS.HRQoL was measured using a validated and reliable EuroQol 5-dimensions 5-levels (EQ-5D-5L) questionnaire developed by the EuroQol Research Foundation, along with the EuroQol-Visual Analogue Scale (EQ-VAS). The eligibility criteria included adult diabetic patients above 18 years of age with complete medical records, who had been treated at the outpatient department for a minimum of three months and could be interviewed. Results The results from this study show that 46% of the patients belonged to the age group of 45-65 years. The quality of health index scores and EQ-VAS scores significantly correlated withage (p-values: 1.11 e-4 and 3.09 e-5; <0.05). Of the subjects,66.4%, 6.7%, and 26.8% were under oral hypoglycaemic agents (OHA), insulin, and both insulin with OHA medications respectively. HbA1C levels werestatistically significantly correlated with mobility, self-care, usual activities, pain or discomfort, and anxiety or depression (p-value 0.032; <0.05), along with self-perception of the patient's health (p-value 0.00026; <0.05).Also, the perception of having slight problems in mobility, self-care, usual activities, pain or discomfort, and anxiety or depression was similar irrespective of gender (EQ-5D-5L score for males: 9.47 and females: 9.3). Despite suffering from diabetes-associated chronic complications, 60.5% of the subjects perceived their overall health to be good as indicated by the scores. Conclusion The self-perception of HRQoL concerning mobility, self-care, usual activities, pain or discomfort, and anxiety or depression was correlated with age, duration of anti-diabetic medication, and HbA1C level. Good mobility, self-care, and performing usual activities reduce anxiety or depression as opposed to age, pain, and discomfort. However, the subjects in this study cohort perceived overall good health in themselves in terms of EQ-VAS and 5D-5L scores, indicating effective diabetic care and management options available to them.

The reciprocal relationship between prosocial behaviour and self-perceived physical health: The role of positive affect and openness to experience.

The present study used a cross-lagged design to explore the bidirectional relationship between adolescents' prosocial behaviour and self-perceived physical health and to explore the mediating role of positive affect and the moderating role of openness to experience. A total of 1525 middle school students (Mage = 12.41, 47% male) in northern China were surveyed for 3 years. The results showed the following: (1) prosocial behaviour at T1 positively predicted self-perceived physical health at T3; and vice versa; and (2) this observed relation between prosocial behaviour and self-perceived physical health was explained by positive affect; (3) the mediating role of positive affect on the path from prosocial behaviour at T1 to self-perceived physical health at T3 was observed only among adolescents with high openness traits. This finding verified the protective effect of prosocial behaviour on the healthy development of the actor.

Impact of a Primary School Health Promotion Programme on Adolescents' Health Behaviour and Well-Being.

Schools can play a key role in promoting health among adolescents, and Hungarian legislation gives them sufficient space to do so. In our study, we examined the impact of a multiyear school health promotion programme on pupils' health behaviour and well-being. We carried out our investigation in an intervention and a control primary school in Hungary. All 5th and 7th grade pupils were invited to participate in the questionnaire-based survey between 2017 and 2021. The effect of the intervention was quantified using univariate and multivariate logistic regression analyses. Our results show that for those behaviours where pupils' personal choices had a greater influence (unhealthy eating, smoking, screen time), the health promotion programme was more effective. For those behaviours where family background and parental influence were more pronounced (healthy eating, physical activity), the intervention had less impact. Self-perceived health was better in the 7th-grade intervention group. Our findings are in line with the conclusion of systematic reviews that more intensive, longer-term, multi-behavioural school health promotion programmes can be effective in promoting positive behaviour. To be more effective, it would be worth using a well-structured curriculum, well-developed teaching materials, and greater involvement of teachers, parents, and various local organisations.