Self-perceived Physical Health Research Articles

Impact of race and ethnicity on financial toxicity in patients with genitourinary cancers.

11077 Background: Genitourinary (GU) cancers contribute substantially to the cost of healthcare in the United States (US). While advancements in cancer treatment have improved patient outcomes, disparities in healthcare costs persist, exacerbating the financial burden on vulnerable populations. We sought to investigate the disparities in costs of inpatient hospitalizations among patients with GU cancers in the US. Methods: Eligible adult GU cases from the Medical Expenditure Panel Survey (2019–2021) were included in this study. ICD-10 CM codes were utilized to identify renal cell, prostate, urothelial, testicular, and penile cancers. In addition to the total hospital inpatient (IP) facility expenditure, questions about ability to pay for healthcare were included in the analysis after accounting for the complex survey design and sampling weights. Results: The study included a weighted sample size of 9,061,181 (wt SE = 538,502) GU cases in the US between 2019 and 2021. The mean (95% CI) age of the sample was 71.6 (70.7, 72.5) years. The sample consisted of 7.9% Hispanics, 74.8% non-Hispanic White (NHW), 13.8% non-Hispanic Black (NHB), and 3.5% Asian or other races (NHA). In 2021, NHB participants reported the lowest annual family income of $51742 (18932, 106185), followed by Hispanics with $65233 (24314, 95859), and NHW with 82035 (36298, 158863). A greater proportion of the elderly NHW population was insured compared to NHB and Hispanics (44.9% vs. 32.5% vs. 19.5%), respectively. Of note, NHB patients had worse self-perceived physical and mental health compared to NHW and Hispanics, with 18.1% reporting fair or poor physical and mental health (vs. 8.1% and 14.3%, respectively). NHB participants reported higher rates of familial financial hardship (2019: 10.2% vs. 3.6%; 2020: 6.2% vs. 3.5%; 2021: 7.1% vs. 3.3%) or not being able to afford medical care (2019: 7.2% vs. 2.1%; 2020: 2.5% vs. 0.6%; 2021: 1.9% vs. 1.7%) when compared to NHW. Overall, mean total hospital IP facility expenses were: Hispanics = $2873.30 (1434.49, 4312.12); NHW = $4213.81 (3241.05, 5186.56); and NHB = $5199.99 (2842.93, 7557.05). After accounting for sample weights, gender, family income, age, insurance status, and survey year, Poisson regression analysis showed significant differences between different racial groups. Hispanics were less likely (𝛽=-0.48; p<0.0001), while NHB (𝛽=0.152; p<0.0001) and NHA (𝛽=0.48; p<0.0001) were more likely to spend for an IP hospitalization when compared to NHW (ref.). Conclusions: Our data revealed racial disparities in the costs of inpatient hospitalizations, highlighting potential financial toxicity among patients with GU cancers. Additional investigation is warranted to elucidate factors contributing to these inequities, aiming to optimize cancer management and alleviate financial burdens. Addressing these disparities is crucial to prioritize equitable healthcare access and promote systemic change.

The Impact of Urban Allotment Gardens on Physical and Mental Health in Norway.

In Norway, many communities offer low-rent plots of land on which city dwellers can build summer cottages and grow crops. These allotment gardens serve as recreational escapes from urban life. However, little is known about the impact these gardens have on their members. This study attempts to shed light on today's impact of allotment gardens in a public health setting in Norway. The study was based on 17 semi-structured interviews and 2 in-depth interviews with allotment house owners. Informants were mainly recruited by "snowball sampling". Our data show that maintaining an allotment promotes exercise and provides a positive impact on self-perceived well-being and physical health through outdoor activities. Spending time in the garden contributes to new knowledge and experiences. Owning an allotment garden has provided new knowledge, new skills, new hobbies, and thereby an improvement in lifestyle. The allotment garden has a strong impact on perceived health, well-being, and sense of coherence (SOC) for the individuals. It promotes outdoor activities along with social interaction and can prevent feelings of loneliness and isolation.

Gender Differences Regarding Self-Perceived Physical and Mental Health in Spanish University Sports and Physical Therapy Students after Termination of the COVID-19 Lockdown Period.

The COVID-19 pandemic was an unprecedented situation that raised concerns about the physical and mental health of adolescents. Several surveys demonstrated that post-lockdown, women reported more complaints and lower perceived quality of life compared to men. The aim of this study was to analyze gender differences in self-reported physical and mental health immediately after the second lock-down restrictions (July 2020 to December 2020) were suspended and physical exercise classes resumed after a break of several months. This was achieved using a comparative cross-sectional survey of over-18-year-old students from the faculties of Sports Science and Physical Therapy at the University of Cadiz (UCA) in Spain. Quality of life was assessed using two types of questionnaires. The first covered quality of nutrition (PREDIMED), and the second assessed emotional impact (SF12). Physical activity level was estimated using the International Physical Activity Questionnaire (IPAQ). Of the 166 participants in this study, about two-thirds were men. Men had a better perception of their overall health quality than women. In addition, men had significantly fewer limitations in performing activities of daily living than their female counterparts. In contrast, female university students had better coping strategies, that is, they were better able to handle the problems of daily life and did so with more composure, attention, and concentration. These findings highlight the differences in post-release recovery between men and women and can be used to develop programs to promote better living standards and services to reduce gender disparities, which can ultimately improve quality of life.

Relationships between employment status with self-perceived mental and physical health in Canada.

The annual cost of mental illnesses in Canada is estimated to be $50 billion. Research from other countries have suggested that employment status is associated with mental and physical health. Within the Canadian context, there is a dearth of research on the relationship between employment and mental health. To explore the relationships between age, gender, income, and employment status on mental and physical health. The 2021 Canadian Digital Health Survey dataset was used for this study. Data records, which included responses for the questions on age, gender, income, employment status, mental, and physical health, were used in the analysis. Ordinal logistics regression was applied to investigate the associations that may exist between mental and physical health with the various sociodemographic factors. Descriptive statistics were also provided for the data. The total sample size included in the analysis was 10,630. When compared to respondents who had full-time employment, those who were unemployed were more likely to have lower self-perceived mental health (OR: 1.91; 95% CI: 1.55-2.34). Retired respondents were less likely to have worse mental health than respondents who were employed full-time (OR: 0.78; 95% CI: 0.68-0.90). Self-perceived physical health was more likely to be lower for those who were unemployed (OR: 1.74; 95% CI: 1.41-2.14) or retired (OR: 1.28; 95% CI: 1.12-1.48) when compared to respondents employed full-time. The likelihood of worsening mental and physical health was also found to be associated with age, gender, and income. Our findings support the evidence that different factors contribute to worsening mental and physical health. Full-time employment may confer some protective effects or attributes leading to an increased likelihood of having improved mental health compared to those who are unemployed. Understanding the complex relationships on how various factors impact mental health will help better inform policymakers, clinicians, and other stakeholders on how to allocate its limited resources.

THE ROLE OF TRUST FOR DEMOGRAPHIC VARIABILITY IN VACCINE HESITANCY AND BEHAVIORS AMONG OLDER ADULTS

Abstract Because of increased risks of infectious disease, understanding older adults’ decisions related to trust and reception of vaccines is important. This study examines the associations between demographic characteristics, vaccine hesitancy, compliance, and the potential mediating role of uncertainty of who to trust. Seven hundred and thirty-nine older adults in North Dakota, oversampled from rural and lower vaccinated regions, completed a mailed survey about vaccine beliefs and behaviors. Participants reported demographic characteristics (age, gender, years of education, rurality, political ideology, and self-perceived physical health) and answered a 7-item scale of vaccine hesitancy. Vaccination behaviors were measured with an assessment of overall vaccine compliance, as well as measures of uptake for influenza, shingles, pneumonia, and SARS-CoV-2 immunizations. Uncertainty who to trust was assessed with the single-item “I am not sure who to trust when it comes to information about vaccines”, which was rated from Strongly Agree (4) to Strongly Disagree (1) and used as a mediator. Bootstrapping analyses indicated uncertainty of who to trust partially or fully mediated associations of rurality, education level, and political leaning with vaccine hesitancy. Further, trust partially or fully mediated associations of education level, health, and political leaning with vaccine behaviors; however, trust did not account for the association between vaccine hesitancy and behaviors. Findings highlight demographic variations in older adults’ vaccine beliefs and behaviors that may be partially explained due to uncertainty who to trust, indicating that practitioners should implement education and trust-building interventions, especially with rural-dwelling, conservative-leaning, and lower-educated older adults.

Prevalence of early and late onset of chronic diseases and multimorbidity and its association with physical, mental and functional health among older Indian adults

BackgroundIdentifying people with early and late onset of chronic conditions might help target the subpopulations that are more vulnerable to negative mental, physical and functional health outcomes. The current study aimed to examine the association of early and late onset of chronic single and multiple morbidities with self-perceived physical and mental health, functional limitations and physical inactivity among older Indian adults.MethodsCross-sectional study was conducted using data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017–2018). The total sample size for the present study was 31,386 older adults age 60 years or older. Multivariable binary logistic regression analysis was used to establish the association between the outcomes (poor perceived physical/mental health, functional difficulty and physical inactivity) and explanatory variables (early [ = < 50 years of age] and late [> 50 years]) onset of chronic illnesses such as hypertension, diabetes, heart attack, heart disease, stroke, cancer, lung disease, arthritis, osteoporosis and psychiatric disease).ResultsOverall, 24.21% of the sample population had poor self-perceived physical health, whereas 8.67% of participants had poor self-perceived mental health. The prevalence of difficulty in ADL, difficulty in IADL, and physical inactivity was 23.77%, 48.36%, and 68.9%, respectively. Odds of poor perceived mental health were higher for the respondents with early as well as late onset of hypertension, stroke, and arthritis; while individuals with late onset of diabetes, and heart disease had higher odds of poor perceived mental health than those without chronic disease. Individuals with early onset of single morbidity were more likely to report ADL difficulty (adjusted odds ratio [AOR]: 1.33, confidence interval [CI]: 1.06–1.67); while those with late onset of single (AOR: 1.34, CI: 1.17–1.53) and multimorbidity (AOR: 1.91, CI: 1.63–2.24) were more likely to report ADL difficulty compared with individuals without morbidity. Individuals with early as well as late-onset of multimorbidity had more than two times higher odds of reporting poor physical health, poor mental health and IADL difficulty compared with individuals without chronic disease.ConclusionsThe present study revealed that early and/or late onset of chronic single and/or multiple morbidities significantly predicted poor self-perceived physical and mental health, functional limitations and physical inactivity among older Indian adults. The findings further suggest that late onset of chronic diseases such as cancer and stroke and multi-morbidity had stronger associations with physical inactivity that may help identify high risk groups for screening and support.

Nurse Resiliency and Health in Practicing Nurses Before and During COVID-19.

The aim of this study was to compare the degree of resilience and self-perceived physical and mental health in nurses before and during the COVID-19 pandemic. Work-related stress among nurses is recognized as an antecedent of burnout, which in turn impacts resiliency and well-being. The work of nursing has long been noted as stressful. Although nurse resilience and perceived well-being have been shown to decrease during a period of usual stress (constant and chronic), the impact and significance of prolonged stress on nurse resilience and well-being illuminates throughout the literature. Replicating a cross-sectional prepandemic study, nurses were resurveyed in 2020 during the COVID-19 pandemic. In both studies, the Connor-Davidson Resilience Scale and PROMIS Global Health was used to measure respondent's: 1) resilience level; 2) physical health status; and 3) mental health status, respectively. Independent 2-sample t tests were performed to compare the pre-and-post score differences in the 3 outcomes. To identify characteristics that were associated with the pre-and-post differences, comparison analyses were also performed within each level of the respondents' characteristic variables. A higher proportion of postsurvey respondents reported working more than 8 hours of overtime per week, had thoughts of quitting their current job, and thought their workload was too much compared with the presurvey respondents. Generally, the postgroup resilience scores and self-perceived physical and mental scores were statistically significantly lower compared with the pregroup scores, but those differences were only observed in certain subgroups defined by respondents' characteristics. Self-perceived physical and mental health are significantly associated with the degree of resilience and worsened during the COVID-19 pandemic, especially in younger and older nurse cohorts. Engaged nurse leaders are key to implement interventions that build resilience and perceived well-being during periods of usual and prolonged stress.

Effect of Fictive Kinship Interactions on the Physical Health and Psychological Well-Being of Older Adults: A Randomized Controlled Trial of Shared Site Intergenerational Programs in China

ABSTRACT This randomized controlled trial examined the effects of fictive kin interaction on the physical health and psychological well-being of older adults living in a shared site nursing home in China. The results revealed that depression levels significantly decreased and self-efficacy and flourishing levels significantly increased among the participants who engaged in additional one-to-one pair activities with kindergartners, with the effect size ranging from medium to large. The research findings indicated that one-to-one fictive kinship interactions between older adults and young children can promote the self-perceived physical health and psychological well-being of older adults in a Chinese context.

Perceived mental and physical health in patients with common cancers: A study using the PROMIS framework in All of Us database.

10619 Background: The self-perception of one's mental and physical health (MH and PH) is of utmost importance for individuals diagnosed with cancer. This study focuses on the assessment of self-perceived mental and physical health (MH and PH) in individuals diagnosed with cancer. The Patient-Reported Outcomes Measurement Information System (PROMIS) framework is used to measure health outcomes, with PROMIS-PH measuring physical well-being and PROMIS-MH measuring mental health status. The study aims to evaluate self-reported mental and physical health of individuals with common cancers in the All of Us database, which includes over 414,000 participants in the US who have completed PROMIS-PH and PROMIS-MH surveys. Methods: We included participants from All of Us dataset version 6, which includes survey data collected between May 6, 2018 and January 1, 2022 who had available electronic health records data (N = 258,188). From the survey data, we calculated PROMIS-PH and PROMIS-MH score in participants with diagnosis code (ICD9/ICD10) of any cancers (N = 36377), breast (N = 5172), prostate (N = 5234), colon (N = 2366), and lung cancer (N = 2338). The study compared scores each cancer groups using Wilcoxon rank sum test, with a significance level of P &lt; 0.05. Analysis was performed in the web-based platform Jupyter Notebook using programming language R. Results: The study calculated PROMIS-MH and PROMIS-PH scores based on two questions, with response options valued from 1 to 5. The higher the score, the higher the level of perceived mental and physical health. Results showed that the mean PROMIS-MH score for all cancers was 7.38, with the highest score of 7.67 in prostate cancer and the lowest score of 7.10 in lung cancer. The mean PROMIS-PH score for all cancers was 7.31, with the highest score of 7.62 in prostate cancer and the lowest score of 6.71 in lung cancer. Prostate cancer group showed the highest PROMIS-PH and PROMIS-MH scores among the four cancer groups (P &lt; 0.05), while participants with lung cancer reported the lowest PROMIS-PH and PROMIS-MH scores (P &lt; 0.05). Additionally, breast cancer had higher PROMIS-MH and PROMIS-PH scores compared to all cancers (P &lt; 0.05), while lung cancer had lower PROMIS-MH and PROMIS-PH scores (P &lt; 0.05). There was no significant difference in PROMIS-MH score between all cancers and colon cancer. Conclusions: These results suggest that individuals with lung cancer may have a lower level of perceived mental and physical health compared to those with other cancers. Further research is needed to understand the underlying causes of these differences and to evaluate the effectiveness of interventions aimed at improving the well-being of individuals with cancer.

Moderate Beer Consumption Is Associated with Good Physical and Mental Health Status and Increased Social Support

There is little large-scale evidence on the effect of alcoholic beer consumption on physical, mental and, above all, socio-emotional health. Here, we conducted a secondary data analysis of the 2012 and 2017 National Health Surveys with 33,185 individuals aged 18 years and older to assess beer consumption in relation to self-perceived health, functional limitations, mental health, and social support. Logistic regression models assessed the association of alcohol consumption (abstainers, ex-drinkers, occasional drinkers, moderate beer drinkers, and heavy beer drinkers) with self-perceived health (poor or good), limitations of type (none, physical, mental, or both) and intensity (none, mild, or severe), mental health (poor, average, or good) and social support (poor, average, or good). Analyses were adjusted for sex, age, occupational social class, educational level, place of residence, survey, part-time physical activity, dietary information, smoking, and body mass index. Compared to abstainers, occasional and moderate beer drinkers were associated with better mental and self-perceived health and social support, and were less likely to report mild or severe physical limitations. In contrast, former drinkers were associated with worse indicators of self-perceived health, physical health, mental health, and social support than abstainers. Alcoholic beer consumption showed a J-shaped relationship with self-perceived, physical, mental, and social-emotional health, with better values at moderate levels.

Cold Housing in Central Mexico: Environmental Dissatisfaction and Underheating Lowers Self-Perceived Health in Central Mexico

Despite being perceived as a warm country, winters in the Central Mexican Plateau frequently reach temperatures below zero Celsius. Prolonged exposures to low temperatures resulting in heart and respiratory morbidities are estimated to be responsible for 50% of the reported illness in the plateau, attributable primarily to the design of homes ill-suited to extreme temperatures. Consequently, there is a growing need to ensure that dwellings provide adequate indoor thermal conditions in the region. Hence, on-site sensors were used to collect temperature and relative humidity data every five minutes in 26 living rooms in the Plateau for 11 months. From these data, a subsample was determined, resulting in dwelling-level thermal comfort and health surveys on 15 homes. Computer simulations were used to investigate whether the building itself could provide thermal comfort under different retrofitting scenarios. Multiple linear regression relating the Predicted Percentage Dissatisfaction (PPD) index to self-perceived health was undertaken. Both monitored and simulated results were matched against our underheating model, finding that 92% of the homes had cold indoor environments, some even during summer. High PPD and intense levels of underheating were positive predictors of higher self-reported health problems. More self-reported health problems were correlated with both lower life satisfaction and self-worth, and with subjects’ use of more adaptive strategies against environmental dissatisfaction. Dynamic computer simulations suggested that indoor thermal environments could be improved by enforcing the non-utilised standard NOM-ENER-020, which recommends the addition of insulation on walls and roofs. These findings suggest that the cold environments within homes of the plateau influence the self-perceived physical and mental health of its population. Hence, the application of adequate measures, such as retrofitting homes with stronger standards than the existing NOM-ENER-020 are needed in place.

False Atrial Fibrillation Alerts from Smartwatches are Associated with Decreased Perceived Physical Well-being and Confidence in Chronic Symptoms Management.

Wrist-based wearables have been FDA approved for AF detection. However, the health behavior impact of false AF alerts from wearables on older patients at high risk for AF are not known. In this work, we analyzed data from the Pulsewatch (NCT03761394) study, which randomized patients (≥50 years) with history of stroke or transient ischemic attack to wear a patch monitor and a smartwatch linked to a smartphone running the Pulsewatch application vs to only the cardiac patch monitor over 14 days. At baseline and 14 days, participants completed validated instruments to assess for anxiety, patient activation, perceived mental and physical health, chronic symptom management self-efficacy, and medicine adherence. We employed linear regression to examine associations between false AF alerts with change in patient-reported outcomes. Receipt of false AF alerts was related to a dose-dependent decline in self-perceived physical health and levels of disease self-management. We developed a novel convolutional denoising autoencoder (CDA) to remove motion and noise artifacts in photoplethysmography (PPG) segments to optimize AF detection, which substantially reduced the number of false alerts. A promising approach to avoid negative impact of false alerts is to employ artificial intelligence driven algorithms to improve accuracy.

Predictors of second COVID-19 booster dose or new COVID-19 vaccine hesitancy among nurses: A cross-sectional study.

To assess the levels of second COVID-19 booster dose/new COVID-19 vaccine hesitancy among nurses and explore the potential predictors of vaccine hesitancy. COVID-19 full vaccination seems to be highly effective against highly contagious variants of SARS-CoV-2. Healthcare workers are at high-risk group since they have experienced high levels of COVID-19-associated morbidity and mortality. An on-line cross-sectional study was carried out in Greece in May 2022, using a self-administered questionnaire. The study population included nurses in healthcare services who were fully vaccinated against COVID-19 at the time of study. We considered socio-demographic characteristics, COVID-19-related variables, and attitudes toward COVID-19 vaccination and pandemic as potential predictors of vaccine hesitancy. We applied the STROBE checklist in our study. Among 795 nurses, 30.9% were hesitant toward a second booster dose or a new COVID-19 vaccine. Independent predictors of hesitancy included lower educational level, absence of a chronic condition, good/very good self-perceived physical health, lack of flu vaccination during 2021, front-line nurses that provided healthcare to COVID-19 patients, nurses that had not been diagnosed with COVID-19 and nurses that had at least one relative/friend that has died from COVID-19. Moreover, increased compliance with hygiene measures, increased fear of a second booster dose/new COVID-19 vaccine and decreased trust in COVID-19 vaccination were associated with increased hesitancy. Our study shows that a significant percentage of nurses are hesitant toward a second booster dose/new COVID-19 vaccine. This initial hesitancy could be a barrier to efforts to control the COVID-19 pandemic. Nurses' role during the COVID-19 pandemic is essential since they are the front-line healthcare workers empowering the public with their passion and empathy. There is a need to communicate COVID-19 vaccine science in a way that is accessible to nurses in order to decrease COVID-19 vaccine hesitancy. No patient or public contribution.

Attitudes toward COVID-19 Pandemic among Fully Vaccinated Individuals: Evidence from Greece Two Years after the Pandemic.

Considering the major effects of COVID-19 pandemic on health, social, economic, and political dimensions of all countries, positive attitudes toward COVID-19 pandemic are essential to control the pandemic. In our study, we investigated attitudes toward COVID-19 pandemic among fully COVID-19 vaccinated individuals two years after the pandemic and we identified predictors of attitudes. We conducted an on-line cross-sectional study with 815 fully COVID-19 vaccinated individuals in Greece during May 2022. A self-administered and valid questionnaire was disseminated through social media platforms. We measured socio-demographic variables and COVID-19-related variables as potential predictors of attitudes toward COVID-19 pandemic. The outcome variable was attitudes toward COVID-19 pandemic (compliance with hygiene measures, trust in COVID-19 vaccination, fear of COVID-19, and information regarding the COVID-19 pandemic and vaccination). We found a very high level of compliance with hygiene measures, a high level of trust and information about the COVID-19 pandemic and vaccination, and a moderate level of fear of COVID-19. Also, we identified that females, participants with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis adhered more in hygiene measures. Trust in COVID-19 vaccination was higher among females, older participants, those with a higher educational level, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis. Moreover, females, older participants, those with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, those that received a flu vaccine in previous season, and those without a previous COVID-19 diagnosis experienced more fear of COVID-19. Finally, level of information regarding COVID-19 pandemic and vaccination was higher for participants with a higher educational level, those without a chronic disease, those with a better self-perceived physical health, and those that received a flu vaccine in previous season. Understanding predictors of attitudes toward COVID-19 pandemic among fully vaccinated individuals is crucial for developing appropriate public health campaigns in the future. Vaccination should be accompanied by positive attitudes in order to decrease the frequency of negative outcomes of COVID-19, such as hospitalization, complications and mortality.

Predictors of Willingness of the General Public to Receive a Second COVID-19 Booster Dose or a New COVID-19 Vaccine: A Cross-Sectional Study in Greece.

Given the concerns of waning immunity from the primary COVID-19 vaccines and the first booster dose, we conducted an online cross-sectional study in May 2022 to investigate willingness to receive a second COVID-19 booster dose or a new COVID-19 vaccine and its associated factors. Overall, 62% of the participants were willing to be vaccinated, 25.8% were unsure, and 12.3% were unwilling to be vaccinated. The main reasons against accepting a second COVID-19 booster dose/new COVID-19 vaccine were concerns about the side effects and the effectiveness and the opinion that further vaccination is unnecessary. Males, younger individuals, participants without a previous COVID-19 diagnosis, and those with good/very good self-perceived physical health were significantly more frequently willing to receive a second COVID-19 booster dose or a new COVID-19 vaccine. Additionally, increased fear of the COVID-19, increased trust in COVID-19 vaccinations, and decreased fear of a second booster dose or a new COVID-19 vaccine was associated with increased willingness. Our results show some hesitancy and unwillingness toward further COVID-19 vaccination and indicate that the fear of COVID-19 and trust in COVID-19 vaccination affects public opinion.

Mental and physical health among the French population before and during the first and second COVID-19 lockdowns: Latent class trajectory analyses using longitudinal data

BackgroundThe French government issued national COVID-19-related confinement and stay-at-home orders depending on different epidemic levels in a bid to stem the coronavirus pandemic and its resurgence. The long-term impact of lockdown measures on the general population may vary. We aimed to identify and characterize self-reported mental and physical health trajectories in the French population from pre-lockdown to the first and second COVID-19 lockdowns and to identify factors associated with health status variation patterns. MethodsWe did a secondary analysis of the MAVIE cohort in France. Volunteers of this national cohort were recruited between November 2014 and December 2019, and information was collected at recruitment (pre-lockdown), April–May 2020 (the first lockdown), and October–December 2020 (the second lockdown). Latent class mixed models were built to identify distinct anxiety (as measured by GAD-7) and depressive (as measured by PHQ-9) symptoms, and self-perceived mental and physical health trajectories. Factors associated with status variation were identified by logistic or multinomial regression. ResultsA total of 613 participants with data in all three data collection waves were included. Respondents spent almost half as much time on traditional media, websites and social media during the second lockdown as during the first. Mean anxiety scores were 1.96, 2.37 and 2.82 at pre-lockdown, and the first and second lockdowns, respectively. Mean depressive scores were 3.12, 3.36 and 3.95, respectively. Latent class mixed models fitted two and three distinct trajectory classes respectively for anxiety symptoms (‘no pre-pandemic anxiety, slightly increase’, 58.9%; ‘consistently fair’, 41.1%) and depressive symptoms (‘consistently very low’, 34.6%; ‘consistently low’, 56.1%; ‘increasing and clinically significant at the second lockdown’, 9.3%), and four classes for self-perceived mental and physical health. Females were more likely to belong to trajectories of the most vulnerable one as regard to the symptoms of anxiety and depression, and self-perceived mental and physical health. The younger participants were also more vulnerable to anxiety symptoms and those with a clinical diagnosis or a positive COVID-19 test for the participant or relatives were more likely to belong to vulnerable trajectories for depressive symptoms and self-perceived mental health. ConclusionA continuing increase in the mean scores of anxiety and depression symptoms was observed throughout the two lockdown periods in France. Further analyses revealed distinct patterns with a small fraction of volunteers experiencing worsening mental and physical health symptoms. This vulnerable small part of the population requires targeted support.

Health-related quality of life in young adults born small for gestational age: a prospective cohort study

BackgroundIndividuals born small for gestational age (SGA) have an increased risk of several adverse health outcomes, but their health-related quality of life (HRQoL) across young adulthood has yet to be studied. The main aim of this study was to investigate if being born SGA at term is associated with poor HRQoL at 32 years of age. A second aim was to explore longitudinal changes in HRQoL from age 20 to 32 years.MethodsIn the prospective NTNU Low Birth Weight in a Lifetime Perspective study, 56 participants born SGA and 68 non-SGA control participants completed the Short Form 36 Health Survey (SF-36) at age 32 years to assess HRQoL. The SF-36 was also administrated at age 20 and 28 years. Longitudinal changes in the eight SF-36 domains and the two component summaries from 20 to 32 years were analyzed by linear mixed models. In total, 82 adults born SGA and 98 controls participated at least once and were included in the longitudinal analyses.ResultsAt age 32 years the participants born SGA scored 14.8 (95% CI 4.7 to 25.3) points lower in the SF-36 role-physical domain compared with the control group, i.e. more problems with work or other daily activities due to physical health problems. The longitudinal analyses showed significant group differences from 20 to 32 years in the role-emotional domain, and in the physical and mental component summaries. Among participants born SGA, the physical component summary decreased from age 20 to 28 years (-3.2, 95% CI -5.0 to -1.8), while the mental component summary (6.0, 95% CI 2.9 to 8.6) and role-emotional domain score (19.3, 95% CI 9.9 to 30.3) increased, but there were no further changes from 28 to 32 years. There were no longitudinal changes in the control group from 20 to 32 years.ConclusionOverall, individuals born SGA at term reported similar HRQoL at age 32 years compared with non-SGA controls. Self-perceived mental health improved during young adulthood among individuals born SGA, while self-perceived physical health deteriorated. The latter findings warrant further investigation.

NYHA class and cardiopulmonary exercise capacity impact self-rated health-related quality of life in young adults after arterial switch operation for transposition of the great arteries

BackgroundEvaluating the impact of subjective physical activity status and cardiopulmonary exercise capacity on physical and mental health-related quality of life (QOL) in young adults after neonatal arterial switch operation for transposition of the great arteries. MethodsIn a prospective reassessment study, 92 young adults (age 22.8 ​± ​2.6 ​y) underwent standardized evaluation of health-related QOL (SF-36), NYHA status and cardiopulmonary exercise performance (CPET). ResultsPeak oxygen uptake was 33.1 ​± ​7.1 ​ml/kg/min corresponding to 84.5 ​± ​15.5% of predicted, according to the borderline subnormal range. 65% were classified as normal or borderline, 35% as impaired. 88% were NYHA class I and 12% class II, 45% exercised regularly. Despite average or even elevated mean scores for the QOL domains, more patients reported significantly poorer results, indicated by increased percentages below −2 SD for physical (5.6%), social (7.8%) and emotional role functioning (8.8%). Significant correlations existed between physical health domains and objective exercise performance (r ​= ​0.23 to 0.34, p ​= ​0.001 to 0.032) as well as NYHA class (r ​= ​0.33 to 0.46, p ​< ​0.001 to 0.002). Mental health domains were also significantly correlated with NYHA class (r ​= ​0.22 to 0.41, p ​≤ ​0.001 to 0.04) and peak oxygen uptake. ConclusionsDespite good results on average, young adults with TGA after ASO are at elevated risk for a reduced QOL. Objective exercise capacity and NYHA class are significant indicators for self-perceived physical and mental health. Applications of QOL measurement should be part of routine clinical follow up in this patient group.

Infant Carrying in the United States: A Survey of Current Practices, Physical and Mental Health Benefits, and Challenges of Babywearing

Background: Parents carry their infants, toddlers, and young children every day. An ergonomic aid to carry (ie, babywearing) has been used for generations by caregivers of young children worldwide. While the benefits of close physical contact for infants are well documented, little is known on how this additional load impacts the health of the caregiver. Objective: An understanding of how babies are carried during their early years, especially how this behavior affects the musculoskeletal and mental health of the caregiver, is the first step to understanding this dynamic and is the objective of this research. Study Design: Cross-sectional observational study. Methods: A survey was designed to provide insight into current practices in the United States and the self-perceived physical and mental health benefits or challenges to babywearing. Results: A total of 3758 babywearing enthusiasts with a high level of experience and frequent babywearing responded. Respondents reported babywearing to allow for multitasking (97%) and for bonding/attachment (87%). Increased babywearing frequency was associated with improvements in fatigue, insomnia, and interest in sex among caregivers. Most respondents had experienced back pain (82%). Urinary incontinence and pelvic organ prolapse appear more prevalent than other research reports, although strong relationships were not found with babywearing. Finally, respondents had mild symptoms of stress, anxiety, and depression. Surprisingly, no relationships were identified between mental health scales and babywearing frequency or experience. Conclusions: Taken together, this data provides a better understanding of physical and mental health of caregivers in the United States, especially as they relate to babywearing. See the Video, Supplemental Digital Content A (available at: https://links.lww.com/JWHPT/A72).

Hostility mediates the relations between self-perceived physical health status and cost-inflicting mate retention.

Hostility mediates the relations between self-perceived physical health status and cost-inflicting mate retention.