Self-reported General Health Status Research Articles

Abstract 814: Bridging the gap: Informal caregivers' access to information on genetic testing for cancer risk

Abstract Introduction: Cancer risk genetic testing (referred to as genetic testing thereafter) benefits patients by allowing them to make informed behavioral and medical decisions to reduce cancer risk and by facilitating surveillance and earlier detection. Informal caregivers, who often serve as primary advocates for those at risk, play a pivotal role in supporting behavioral and medical decisions based on genetic testing information. Assessing caregivers’ knowledge of genetic testing can guide future interventions supporting informed decision-making to ensure that all groups benefit equally from advances in genetic testing. We examined the association between caregiving and knowledge of genetic testing as well as other individual and socioeconomic factors. Methods: Secondary data analysis was conducted using the 2020 Health Information National Trends Survey (HINTS 5 Cycle 4). HINTS is a nationally representative survey of adults in the civilian non-institutionalized US population. Exposure variable was caregiving (yes/no) assessed with the question “Are you currently caring for or making health care decisions for someone with a medical, behavioral, disability, or other condition?”. The outcome variable was genetic testing knowledge (yes/no) assessed with the question “have you heard of high-risk cancer genetic testing - e.g., BRCA 1/2". Weighted, multivariable logistic regression was used to estimate the association between caregiving and genetic testing knowledge adjusting for age, gender, race/ethnicity, marital status, education level, having a regular provider, rural-urban residence, and self-reported general health status. Results: A total of 3,136 participants aged ≥18 were included in the study, of whom 16.4% were caregivers and 35.9% had heard of genetic testing. In the adjusted analysis, there was no statistically significant difference between caregivers and non-caregivers in relation to genetic testing knowledge (P=0.7881). However, respondents who were ≥65 years old (aOR=0.54, 95% CI: 0.40-0.72) were less likely to have heard about genetic testing compared to those aged 18-49, as were respondents who had no regular provider (aOR=0.71, 95% CI: 0.53-0.95) compared to those with a regular provider. Compared to non-Hispanic White respondents, non-Hispanic Black (aOR=0.45, 95% CI: 0.31-0.66) or Hispanic respondents (aOR=0.44, 95% CI: 0.29-0.68) were less likely to have heard about genetic testing. Female respondents (aOR=2.02, 95% CI: 1.55-2.61) were twice as likely to have heard about genetic testing than their male counterparts. Conclusions: We found that about a third of Americans had heard about genetic testing; patients who were younger, female, White, and those who had access to a regular provider were more likely to be aware of testing. Interventions targeting under-resourced caregivers are urgently needed to promote equity in genetic testing and its benefits. Citation Format: Eric Adjei Boakye, Pranali G. Patel, Chaitali S. Dagli, Sarah Wagoner, Mrudula Nair, Nosayaba Osazuwa-Peters, Veronica Bernacchi, Samantha H. Tam. Bridging the gap: Informal caregivers' access to information on genetic testing for cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 814.

Racial and ethnic disparities in self-reported general and mental health status among colorectal cancer survivors: impact of sociodemographic factors and implications for mortality—a SEER-CAHPS study

PurposePatient-reported outcomes are recognized as strong predictors of cancer prognosis. This study examines racial and ethnic differences in self-reported general health status (GHS) and mental health status (MHS) among patients with colorectal cancer (CRC).MethodsA retrospective analysis of Medicare beneficiaries between 1998 and 2011 with non-distant CRC who underwent curative resection and completed a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey within 6–36 months of CRC diagnosis. Analysis included a stepwise logistic regression to examine the relationship between race and ethnicity and fair or poor health status, and a proportional hazards model to determine the mortality risk associated with fair or poor health status.ResultsOf 1867 patients, Non-Hispanic Black (OR 1.56, 95% CI 1.06–2.28) and Hispanic (OR 1.48, 95% CI 1.04–2.11) patients had higher unadjusted odds for fair or poor GHS compared to Non-Hispanic White patients, also Hispanic patients had higher unadjusted odds for fair or poor MHS (OR 1.92, 95% CI 1.23–3.01). These relationships persisted after adjusting for clinical factors but were attenuated after subsequently adjusting for sociodemographic factors. Compared to those reporting good to excellent health status, patients reporting fair or poor GHS or MHS had an increased mortality risk (OR 1.52, 95% CI 1.31–1.76 and OR 1.63, 95% CI 1.34–1.99, respectively).ConclusionRacial and ethnic differences in GHS and MHS reported after CRC diagnosis are mainly driven by sociodemographic factors and reflect a higher risk of mortality. Identifying unmet biopsychosocial needs is necessary to promote equitable care.

Health Related Quality of Life after Total Knee Replacement in Osteoarthritis Patients

Background: Total knee replacement is a widely recognized and successful surgical intervention for patients suffering from knee osteoarthritis, aiming to alleviate pain and improve function and quality of life. This procedure has been increasingly recommended due to its high success rate in enhancing patient satisfaction and functional capacity. Objective: The primary goal of this study was to assess the health-related quality of life (HRQoL) in patients after undergoing total knee replacement for osteoarthritis. Method: This cross-sectional study involved 80 patients (47 females and 33 males) who had undergone knee arthroplasty. Data collection was facilitated using the SF-12 and WOMAC questionnaires at Horizon and General Hospital. Subsequent data analysis was performed using SPSS. Results: The study's results highlighted a mean total score of 35.7 (SD = 6.32335), with scores ranging from a minimum of 23.00 to a maximum of 54.00. These scores represent a moderate variance in patient outcomes. The self-reported general health status revealed that 39.0% of patients rated their health as 'Good', followed by 26.8% as 'Very Good', and 18.3% as 'Fair'. In terms of physical activity limitations, 18.3% of patients reported being 'Limited a Lot' in moderate physical activities, while 40.2% reported limitations in work or other activities. Conclusion: The study concluded that total knee replacement significantly improves health-related quality of life in patients with osteoarthritis, as indicated by the wide range of scores. Most patients reported positive outcomes, with a majority indicating good or very good general health status post-surgery.

Self-reported health and coping strategies of Ukrainian female refugees in the Czech Republic

ABSTRACT The main aim of the study was to investigate the coping strategies and their association with self-reported general health/psychological status in Ukrainian female refugees’ sample (N = 919) in the Czech Republic. The BRIEF-COPE inventory was employed to investigate coping strategies. Binomial logistic regression analysis was performed to investigate the association between self-reported general health status and self-reported psychological status with coping strategies adjusted by socio-demographics. The findings showed that within problem-focused coping strategies, planning what to do and taking action to try to make the stressful situation better has been found the most frequently used. Among the emotion-focused coping, more often used strategies connected with accepting the situation and learning to live in new circumstances. On side of avoidance coping strategies, only strategies to work or to do other activities ‘to take their minds off things’ were used more often. Further, outcomes revealed that ineffective coping strategies of self-blame and behavioral disengagement were associated with poorly reported general health/psychological status, and effective coping strategy was positively associated with better-reported psychological status. The research outcomes could be useful for the policymakers to help Ukrainian female refugees to better adapt to the country and avoid worsening physical and mental health statuses.

Predictors of self-reported general health status in people experiencing homelessness with serious mental illness.

The growing homeless population in the U.S.A. is disproportionately impacted by poor mental and physical health status, including a higher incidence of acute and chronic health problems, increased hospitalizations, and premature mortality compared to the general population. This study examined the association between demographic, social, and clinical factors and perceptions of general health status among the homeless population during admission to an integrated behavioral health treatment program. The study sample included 331 adults experiencing homelessness with a serious mental illness or co-occurring disorder. Participants were enrolled in services at a day program for unsheltered homeless adults, a residential substance use treatment program for males experiencing homelessness, a psychiatric step-down respite program for those experiencing homelessness following psychiatric hospitalization, permanent supportive housing for formerly chronically homeless adults, a faith-based food distribution program, and homeless encampment sites in a large urban area. Participants were interviewed using The Substance Abuse and Mental Health Services Administration's National Outcome Measures tool and a validated health-related quality of life measurement tool, SF-36. Data were examined using in elastic net regression. The study found seven factors to be particularly strong predictors of SF-36 general health scores.Male gender, "other" sexual identity, stimulant use, and Asian race were all associated with better perceptions of health status, while transgender status, inhalant use, and number of times arrested were associated with poorer perceptions. This study suggests targeted areas for health screening within the homeless population; however, more studies are necessary to demonstrate generalizability of the results.

Psoriatic Arthritis Quality of Life Questionnaire: results of translation, cultural adaptation and validation in Russian language

Psoriatic arthritis (PsA) is a chronic progressive disease from the pondyloarthritis group of diseases. In recent years, there has been a significant increase in the incidence of PsA and cases of its severe course, with significant influence on the quality of life (QoL) of patients and early disability. Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL) is the first quality of life questionnaire designed specifically for PsA that has not been previously validated in Russia.Objective: to translate the original PsAQoL questionnaire into Russian and evaluate the psychometric properties of the Russian version.Material and methods. The original PsAQoL was translated into Russian using two translational panels. In all, 12 local residents were included in the translation stage of the study. The external and logical validity of the questionnaire was assessed. Further, Russian-speaking patients with an established diagnosis of PsA (n=10) tested the questionnaire. A separate cohort of patients with PsA (n=50) was enrolled in a postal test retest study on 2 occasions, 2 weeks apart. Clinical data and the Medical Outcomes Study-Short Form (SF-36) questionnaire were used to assess convergent validity.Results and discussion. The Russian version of PsAQoL was relevant, clear, and easy to complete (6.1 minutes on average). PsAQoL had high internal consistency (Cronbach's á=0.87) and excellent retest validity (r>0.85). PsAQoL scores correlated most strongly with the SF-36 General Health Scale (r=-0.68, p<0.01). PsAQoL score did not depend on sex and age (p>0.05). The PsAQoL could distinguish between groups of patients defined by self-reported general health status and self-reported severity of PsA.Conclusion. The Russian version of PsAQoL proved to be understandable and easy to complete, as well as a reliable and valid tool for assessing the quality of life of patients with PsA.

Effect of a Remotely Delivered Self-directed Behavioral Intervention on Body Weight and Physical Health Status Among Adults With Obesity

The effectiveness of remotely delivered, self-directed, weight loss programs in routine clinical practice is largely unknown. To test whether a self-directed, remotely administered behavioral lifestyle intervention improves weight and self-reported general health status compared with usual care. In this randomized clinical trial, 511 adults with a body mass index (BMI) of 30 or more and less than 45 (based on electronic health record [EHR] weight and height), were enrolled from 30 Veterans Health Administration (VHA) sites between February 15, 2018, and December 18, 2018 (final follow-up February 18, 2021). Participants were randomly assigned to the intervention group (n = 254) or the control group (n = 257). Both received usual care. Participants randomized to the intervention received Diabetes Prevention Program-based self-directed videos, handouts, and coaching messages via an online platform or US mail for 12 months. Coprimary outcomes were weight measured in primary care and recorded in the EHR and self-reported general health status using the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12) physical component score (PCS; higher scores are better [range, 0-100]) at the 12-month follow-up. The between-group minimal clinically important differences are 3 kg for weight and 5 points for the SF-12 PCS. Linear mixed models used weights and SF-12 PCS measured at either time point, with participants analyzed according to randomization assignment. Statistical significance for each coprimary outcome was based on a 2-sided α level of .025. Among 511 participants randomized (mean age, 57.4 [SD, 13.9] years; 231 female [45%]), 429 (84.0%) had EHR-based weights and 410 (80.2%) had SF-12 PCS data at 12 months. The unadjusted mean weight at 12 months declined from 102.7 kg to 99.8 kg in the intervention group compared with 101.9 kg to 101.0 kg in the control group (adjusted between-group mean difference, -1.93 [97.5% CI, -3.24 to -0.61]; P = .001). At 12 months, the unadjusted mean SF-12 PCS scores declined from 44.8 to 44.3 among intervention participants compared with 44.5 to 43.2 among control participants (adjusted between-group mean difference, intervention minus control, 0.69 [97.5% CI, -1.11 to 2.49]; P = .39). Cardiovascular events represented the highest percentage of serious adverse events, accounting for 25% of events in the intervention group and 35% in the control group. Among adults with obesity, a remotely delivered self-directed, behavioral lifestyle intervention, compared with usual care, resulted in statistically significantly greater weight loss at 12 months, although the difference was not clinically important. There was no significant difference in self-reported general physical health status at 12 months. ClinicalTrials.gov Identifier: NCT03260140.

Self-medication and its typology in Chinese elderly population: A cross-sectional study.

This paper aims to evaluate the prevalence of self-medication and its associated factors among the Chinese elderly. Also, according to whether the elderly communicate with doctors (no matter before or after self-medication), we aimed to categorize self-medication and explore the associated factors. It was a cross-sectional study. Data were derived from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). According to whether communicate with doctors or not, self-medication was reclassified as "self-medicate and NOT communicating with a doctor," and "self-medicate and communicate with a doctor." A binary logistic regression was used to identify which elderly were more likely to self-medicate, and a multinomial logistic regression was applied to explore the associated influencing factors of self-medication classifications. A total of 17,445 individuals aged ≥45 years were enrolled. The prevalence of self-medication was 58.60%. Self-medication was strongly associated with sex, education level, pension, self-reported general health status, chronic illness, satisfaction with local medical services, and three province-level socioeconomic welfare variables. About 19.64% of self-medication populations had communicated with a doctor. Higher education level and younger age were significantly associated with a higher probability of "self-medication and communication with a doctor." The prevalence of self-medication among the Chinese elderly is increasing over the year. Health education on appropriate medication use targeting elder adults with low education levels is highly recommended. The typology of self-medication and its factors are new research entry points and could be meaningful for future studies.

Social isolation and health among family caregivers of older adults: Less community participation may indicate poor self-reported health.

Social isolation is associated with adverse health outcomes in the general older adult population, but little is known about indicators of social isolation in family caregiver populations. This cross-sectional study examined the prevalence of social isolation in the 2015 National Survey of Caregiving. Using the Convoy Model of social relations, a life-course social support framework, we also examined associations between social isolation and caregiver self-reported health. Using multiple ordinal logistic regression models, we examined social isolation - operationalised with a five-item summative measure and, alternatively, with each social isolation item - as a predictor of self-reported general health status. On the dichotomised summative measure, 24.74% (n=2,175) were more isolated. Younger caregivers were more isolated (M=56.77 years, SE=0.76) compared with those who were not (M=60.86 years, SE=0.41). Self-reported general health was as follows: 4.93% poor; 15.67% fair; 25.62% good; 34.81% very good and 18.97% excellent. Less social isolation was associated with higher odds of better self-reported health (Adjusted odds ratio [AOR]=1.19; CI=1.05-1.35). Of the individual social isolation indicators, only a lack of community participation was associated with higher odds of worse self-reported health (AOR =1.57; CI=1.25-1.97). Social isolation and particularly community participation were associated with caregiver health status. It may be necessary for healthcare providers to consider these factors in caregiver health assessments. Future research is recommended to understand the consequences of various social isolation indicators in diverse samples including younger caregivers.

Cannabidiol use and perceptions in France: a national survey

BackgroundCannabidiol (CBD), a safe, non-intoxicating cannabis component, is growing in popularity in Europe and worldwide. However, CBD EU regulation is blurry, and consequent labelling and product quality issues may have implications for public health. There is therefore a need to assess the prevalence and perceived harmfulness of CBD use in EU countries, as well as to characterise CBD users. We aimed to do so in the French population.MethodsIn December 2021, an online survey was conducted in a sample respecting the French adult population structure for key demographic variables. Sociodemographic, behavioural and CBD perception data were collected. Three separate regressions were performed to identify correlates of i) having heard of CBD, ii) using CBD, iii) perceived harmfulness of CBD. A hierarchical classification was also performed to identify profiles of CBD users.ResultsThe study sample comprised 1969 adults, of whom 69.2% had heard of CBD and 10.1% used it. Less than half (46.8%) of the former considered it harmful. Having heard of CBD was associated with younger age, being born in France, tobacco use, and cannabis use. CBD use was associated with younger age, tobacco use, cannabis use, poor self-reported general health status, and positive perception of alternative medicines. Cluster analysis revealed four different CBD user profiles based on socio-demographics and behavioural characteristics.ConclusionTen percent of the adults in this French study used CBD, and several user profiles emerged. Our results indirectly advocate clearer European CBD regulations to ensure safe and high-quality products.

883-P: Associations of State Earned Income Tax Credits with Self-Reported Health Status among U.S. Adults with Diabetes, 2000–2016

Persons with low socioeconomic status are disproportionately affected by diabetes and among people with diabetes, those with lower incomes tend to have poorer health status than those with higher incomes. Few studies have examined whether policies to improve the financial status of low-income populations can improve health outcomes among people with diabetes. Using data on state earned income tax credit (EITC) policies from the National Bureau of Economic Research and self-reported health status from the 2000-2016 Behavioral Risk Factor Surveillance System (BRFSS) , we examined the association of state EITC with poor health status among United States (US) adults with self-reported diagnosed diabetes. Poor overall health was defined as self-reported general health status of “fair” or “poor” in BRFSS. Poor mental and physical health were defined as having at least 14 self-reported days in poor mental or poor physical health in the past 30 days, respectively. State EITC was defined as the state’s EITC amount as a percentage of the federal EITC. We used weighted logistic regression to model the effect of EITC variation across states and over years and calculated the marginal effects of state EITC on health status, controlling for poverty, race, education, unemployment, state gross domestic product (GDP) , state Medicaid expansion, and state minimum wage policy. Poisson regression models were conducted as a sensitivity analysis. A 10-percentage point increase in the state EITC was associated with a 3% lower rate of poor mental health status (-2,759 per 100,000, 95% CI = -5,494, -25) . The associations of the state EITC with physical health and overall health status were not statistically significant. The results were robust to choice of model based on the sensitivity analysis. Policies that increase income retained may help to improve self-reported mental health status of US adults with diabetes. Disclosure S.Tang: None. Y.Chen: None. D.B.Rolka: None. G.Imperatore: None. C.S.Holliday: None. P.Zhang: None.

AB0574 PREDICTOR FACTORS IN EMPOWERMENT OF PATIENTS WITH PRIMARY SJOGREN SYNDROME IN THE FRAME OF VALUE BASED HEALTH CARE

BackgroundPatient empowerment is a key component in developing awareness of the disease in patient-centred care in the setting of chronic disease management.ObjectivesThis study aimed to evaluate predictive factors in the empowerment of patients with Sjögren’s Syndrome (pSS), while examining patients reported outcome measures (PROMs) in the setting of value-based health care.MethodsIn this cross-sectional study, 169 patients with pSS (F/M: 162/7; mean age: 52.94±12.20 years) were included. Data was collected from the clinical examination, major salivary gland ultrasonography (SGUS) and a structured questionnaire regarding utilisation of health services and PROMs regarding Oral Health Impact Profile-14 (OHIP-14), Hospital Anxiety and Depression Scale (HADS; HADS-Anxiety and HADS-Depression) and Self-reported General Health Status (100-m VAS; 0: very poor vs 10: very good). Both stimulated (S-SFRs) and unstimulated salivary flow rates (U-SFRs) of patients were measured as ml/min. Patients with hyposalivation were grouped as according to U-SFR (≤0.1 ml/min). Furthermore, Outcome Measures from Rheumatology ultrasonography (OMERACT US) scores (from 0: normal to 3 points: severe inhomogeneity) were collected to evaluate glandular involvement of patients. After initial statistical analyses was carried out, mediation analysis was performed to evaluate the associations.ResultsThe rate of patients with hyposalivation was found as 45% and most (85.7%) had elevated SGUS scores (≥2 points). In addition, self-reported oral health problems were common in the study group (from 23.8% to 53.4%). Among this cohort, the patients suffered from Burning oral sensation (27 %) had poor scores in OHIP-14 (29.81±14.48 vs 20.22±12.43), HADS-Depression (10.07±4.49 vs 6.65±4.20) and Self-reported general health status (45.43±17.95 vs 55.56±22.43) compared to those without Burning oral sensation (p=0.006, p=0.019, p=0.018, respectively). Furthermore, significant correlations were observed between OHIP-14 score and HADS-A score (r: 0.4 p: 0.004) and HADS-D scores (r: 0.58 p=0.000). Utilising mediation analysis, the HADS-Depression score was directly mediated by the presence of Burning oral sensation (p=0.0005) and indirectly mediated by OHIP-14 score (p=0.0360). In this group, the interval from the last dental visit was mean: 19 months. Interestingly, 60% preferred to relate their oral discomfort during visits (3 times a year), to rheumatologists.ConclusionBetter health outcomes could be achieved by reducing oral discomfort, increasing dental visits, improvement of oral health related quality of life and managing depression by a multidisciplinary team with dentists and psychiatrists in patient-centred care. Since these factors have a significant effect on patients’ daily life, treatment plans are needed to provide patient empowerment by using suitable strategies in the frame of value-based health care.Disclosure of InterestsNone declared

Temporal trends in self-reported general and mental health status among colorectal cancer patients: racial/ethnic disparities in a population-based analysis.

Patient-reported outcomes are essential to patient-centered cancer care. We sought to determine the relationships between colorectal cancer (CRC) diagnosis and trends in self-reported general health status (GHS) and mental health status (MHS) among racial/ethnic groups. We used population-based Surveillance, Epidemiology, and End Results (SEER)-Consumer Assessment of Healthcare Providers and Systems (CAHPS) data to identify CRC patients diagnosed from 1996 to 2011 who reported GHS and/or MHS on a CAHPS survey within 6years before or after diagnosis and were 65 or older at survey completion. Multivariable logistic regression assessed relationships of patient race/ethnicity and CRC diagnosis with the odds of reporting fair or poor GHS or MHS. Five thousand five hundred forty-five patients reported GHS and/or MHS within 6years before CRC diagnosis and 4,604 reported GHS and/or MHS within 6years after diagnosis. 80.9% were non-Hispanic white (NHW), 7.1% were non-Hispanic black (NHB), 6.7% were Hispanic, and 5.3% were non-Hispanic Asian. Being diagnosed with CRC was associated with increased odds of reporting fair or poor GHS (OR = 1.55, 95% CI = 1.40-1.72) and MHS (OR = 1.33, 95% CI = 1.13-1.58). For GHS, this trend held for all race/ethnicities except NHBs, and for MHS, this trend held for NHWs and Hispanics only. CRC diagnosis is an important driver of increased likelihood of fair and poor GHS and MHS, but the relationship is complicated by effect modification by race/ethnicity. Efforts to further understand the race/ethnicity-specific relationships between CRC diagnosis and declines in GHS and MHS are necessary to promote equitable care for all patients.

Olfaction and Physical Functioning in Older Adults: A Longitudinal Study.

Poor olfaction is associated with worse functional performance in older adults, but longitudinal evidence is lacking. We investigated poor olfaction in relation to longitudinal changes in physical functioning among community-dwelling older adults. The analysis included 2 319 participants from the Health, Aging and Body Composition study (aged 71-82 years, 47.9% men, and 37.3% Blacks) who completed the Brief Smell Identification Test in 1999-2000. Olfaction was defined as good (test score 11-12), moderate (9-10), or poor (0-8). Physical functioning was assessed up to 4 times over 8 years, using the Short Physical Performance Battery (SPPB) and the Health Aging and Body Composition Physical Performance Battery (HABCPPB). We conducted joint model analyses and reported the differences in annual declines across olfaction groups. During the follow-up, compared to those with good olfaction, older adults with poor olfaction had greater annual declines in both the SPPB score (-0.137, 95% CI: -0.186, -0.088) and all its subscales: standing balance (-0.068, 95% CI: -0.091, -0.044), chair stand (-0.046, 95% CI: -0.070, -0.022), and gait speed (-0.022, 95% CI: -0.042, -0.001). A similar observation was made for the HABCPPB score (difference in annual decline: -0.032, 95% CI: -0.042, -0.021). These findings are robust and cannot be explained by measured confounding from demographics, lifestyle factors, and chronic diseases or by potential biases due to death and loss of follow-up. Similar associations were observed across subgroups of sex, race, and self-reported general health status. This study provides the first epidemiological evidence that poor olfaction predicts a faster decline in physical functioning. Future studies should investigate potential mechanisms.

Oral Health and Psychosocial Predictors of Quality of Life and General Well-Being among Adolescents in Lesotho, Southern Africa.

Background: Adolescents’ quality of life is reported to be significantly associated with physical and social wellbeing. Although adolescents are 30% of the Southern African population, no previous studies have focused on this group in relation to oral health and quality of life. Methods: A 40-item survey and clinical oral examinations were conducted in public schools in Maseru from 10 to 25 August 2016. Simple, bivariate, and multivariate regressions were used to evaluate the associations of oral health and psychosocial factors with self-reported general health status and quality of life. Results: A total of 526 participants, aged 12–19 years old, responded to the survey and participated in the clinical examinations. The majority reported a good (good/very good/excellent) quality of life (84%) and general health (81%). Bivariate results showed that self-reported general health in this population was significantly influenced by age. The presence of toothache and sensitivity in the adolescents were significantly associated with poor (fair/poor) self-reported general health and were found to be the best predictors for self-general health and quality of life. Conclusions: The absence of dental conditions such as toothache and tooth sensitivity can lead to a better perception of general health and Quality of Life in adolescents.

Self-Perceived Health and Chronic Conditions Among Users of Supplements With and Without Botanical Ingredients: Findings from the 2009–2014 National Health and Nutrition Examination Survey

The objective of this research was to investigate associations among self-reported health status, chronic conditions, and use of dietary supplements containing botanicals and describe reasons for use among U.S. adult supplement users. This was a cross-sectional analysis using data from the 2009–2014 National Health and Nutrition Examination Survey (NHANES). Supplement information was collected with a 30-day recall interview. Self-reported general health status and doctor-informed diagnoses of chronic conditions were assessed using a health status questionnaire. We used weighted multivariate logistic regressions to assess associations between supplement use and perceived health and number of chronic conditions. Participants were 16,958 non-institutionalized U.S. adults aged 20 years and older. Adults with excellent or very good self-perceived health were more likely to use botanical supplements than adults with good perceived health (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.28–1.74). Adults with three or more chronic conditions were more likely to report using botanical supplements than adults with no chronic conditions (aOR, 1.49; 95% CI, 1.13–1.69). The most frequently reported reasons for both non-botanical and botanical supplements use were “personal choice or influenced by advertisements or word of mouth,” “improve health,” and “specific health conditions” (93.3%, 84.2%, and 64.7%, respectively). While perceptions of health are more positive among adults using botanical supplements, chronic conditions and reasons for botanical supplements use related to personal choice, improving health, or addressing specific conditions were more likely. Differentiating botanical supplements from other complementary and integrative therapies may be useful for facilitating a deeper understanding of the reasons.

Do knowledge about sodium, health status by self-report, and having hypertension predict sodium consumption behaviors among Southern California hospital employees?

Little is known about factors that shape sodium consumption behaviors among hospital employees targeted by recent federally funded, sodium-related policy, systems, and environmental change interventions. To address this gap in health promotion practice, we assessed the influence of sodium-related knowledge and attitudes, and health status by self-report on the sodium consumption behaviors of hospital employees targeted by the Los Angeles County Sodium Reduction Initiative. Cross-sectional surveys were administered to 1,213 hospital employees at four Southern California hospitals between 2016 and 2018. Logistic regression models examined the associations between five key sodium consumption behaviors and independent variables of interest (i.e., knowledge and attitudes about sodium, self-reported general health status, and self-reported lifetime hypertension diagnosis), controlling for covariates (i.e., sociodemographic characteristics, body mass index, the type of hospital from which participants were recruited, and the median household income in the hospital's zip code). 1,213 hospital employees completed the survey (completion rate = 50%). The belief that salt intake is harmful was associated with four of five sodium consumption behaviors, while adequate sodium intake knowledge and self-reported "good health" were associated with three of the behaviors. Hypertension diagnosis was associated with only one. Understanding sodium consumption behaviors among healthcare workers can help hospitals improve their employees' health through the promotion of healthier food environments in the workplace and changes in institutional practices.

Aircraft Noise Levels, Annoyance and General Health of Residents of Communities contiguous to a Major Airport in Lagos State

The purpose of this study was to investigate the relationship between the aircraft noise exposure, annoyance reactions and health status of the residents living within the vicinity of the Murtala Muhammed International Airport (MMA) in Lagos state, Nigeria. Aircraft noise monitoring was conducted in five locations within the vicinity (0-5Km) of MMA, and a sixth distant location (14km away). Levels of aircraft noise for all five locations within the vicinity of the airport exceeded the EPA Victoria threshold of 75 dB LAmax for the residential area (outdoor). A survey on annoyance induced by aircraft noise exposure and general health status was conducted on 450 local residents in the study locations using the International Commission on Biological Effect of Noise question and a single question that has been applied in Dutch national health care surveys since 1983 on self-reported general health status respectively. Percentage of residents within the vicinity of MMA that were highly annoyed (%HA) exceeded 15% guideline limit stipulated by Federal Interagency Committee on Urban Noise while 14.5% reported poor health status. There was a significant association between the annoyance reactions and aircraft noise levels in the study locations while the association between self-reported health status and aircraft noise levels was not significant. Taken together, the residents within the vicinity of the airport are exposed to aircraft noise levels above permissible limit which may be associated with high annoyance reaction but may not be associated with poor health rating. Evidence-based aircraft noise related policies by government are advocated.

A prediction tool for vitamin D deficiency in New Zealand adults.

This study aims to develop a model for predicting vitamin D deficiency in New Zealand adults using easily accessible clinical characteristics. Data were derived from the Vitamin D Assessment (ViDA) study dataset. Included participants in the main analysis were aged 50-84 years and resided in Auckland, New Zealand. The dataset was split into a discovery dataset in which the prediction model was developed (n = 2036) and a validation dataset in which it was tested (n = 2037). The prediction model was developed using clinical characteristics in a logistic regression analysis with deseasonalised serum 25OHD (DS-25OHD) as the dependent variable. DS-25OHD < 40 nmol/L was found in 8.2% of European participants, 18.8% of Māori participants, 23.1% of Pacific participants and 52.2% of South Asian participants. Predictors for DS-25OHD < 40 nmol/L in the European sub-cohort included increasing age, female sex, higher body mass index, current smoking, no alcohol intake, lower self-reported general health status, lower physical activity hours, lower outdoor hours and no use of vitamin D-containing supplementation. The area under the curve in the discovery dataset was 0.73, and in the validation dataset was 0.71. Of those with a prediction score ≥ 10 (total risk score range 0-21.5), the sensitivity and specificity for predicting vitamin D deficiency was 0.90 and 0.41, respectively. Non-European ethnicity is an important risk factor for vitamin D deficiency. Our vitamin D deficiency prediction model performed well and demonstrates its potential as a tool that can be integrated into clinical practice for the prediction of vitamin D deficiency.

Dental and Medical Service Utilisation in a German Population - Findings of the LIFE-Adult-Study.

This study investigated utilisation behaviour of the dentist compared to general practitioners (GP) and medical specialists in a German cohort under consideration of risk indicators for irregular dental attendance. Analysis of the results of the population-based LIFE-Adult-Study (Leipzig, Germany) was performed. A total of 2231 participants of the LIFE-Adult-Study were randomly selected to complete the relevant questionnaire, considering medical attendance behaviour. Associations of self-reported medical conditions, including dentaland medical attendance, sociodemographic factors, as well as self-reported general health status and oral health complaints were determined. Of the 2231 participants who were included in the analysis, 14.2% reported not to have visited the dentist during the preceding 12 months. There could be shown a more selective utilisation behaviour towards medical services in smokers, men, low socioeconomic status and depression. Women were more likely to attend the dentist than men (OR = 1.8, CI = 1.4-2.3). Smoking (OR = 0.7, CI = 0.6-1.0), low socioeconomic status (OR = 0.6, CI = 0.4-0.8) and depression (OR = 0.6, CI = 0.4-0.9) were related to less dental attendance. Additionally, persons who do not visit the dentist regularly showed less attendance of the GP as well as medical specialists (p <0.05). Depression could be shown to be an additional risk factor for unfavourable utilisation behaviour towards the dentist. The results showed differences in dental and medical attendance, depending on different patient-related factors. Focusing attention towards high-risk groups might improve dental as well as medical utilisation behaviour, and therefore health status as well.