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• Behavioral and psychological symptoms of dementia (BPSD) are frequent in residents with dementia • BPSD are detrimental to caregivers' working life and health • Nighttime personalized non-pharmacological therapies (PNPT) are useful to handle BPSD • Perceived health and working life were improved in caregivers from long term care homes which used nighttime PNPT Dementia is frequent in nursing home (NH), affecting between 40 and 50 % of the residents and is associated in 90 % of the cases with behavioral and psychological symptoms (BPSD) which are detrimental to caregivers' working life and perceived health. We compared perceived health and working life between NHs that used or did not use nighttime personalized non-pharmacological therapies (PNPT) to address BPSD. This anonymous survey included 96 caregivers from 25 NHs which used (n = 69) or not (n = 27) nighttime PNPT. Perceived health, nursing and medical care, quality of care and internal motivation were significantly higher, stress symptoms and workload were significantly lower and there was a tendency to enhanced satisfaction with work in caregivers from NHs which used nighttime PNPT. Our present data open a new window on the benefits of PNPT. [ABSTRACT FROM AUTHOR]

This study aimed to determine the associations between adherence to 24-h movement behavior guidelines and self-rated health (SRH) among Japanese adolescents according to their age group. This was a cross-sectional study. Probability proportional sampling data, which were collected from six regions of Okinawa Prefecture, Japan, considering the number of schools, included 2408 fifth-grade students (aged 10–11 years) in 31 elementary schools and 4360 eighth-grade students (aged 13–14 years) in 30 junior high schools. SRH, moderate-to-vigorous physical activity (MVPA), screen time (ST), sleep duration, and confounding factors (sex, weight status, family affluence, parental support, school satisfaction, and school demands) were self-reported. The logistic regression models showed that adherence to ST and sleep recommendations in elementary school students was associated with a high prevalence of good health only, whereas adherence to only MVPA, only sleep, ST and sleep, MVPA and sleep, and all three recommendations were associated with a high prevalence of good health among junior high school students. All combinations that included achievement of the recommended sleep duration were associated with SRH. Achieving 24-h movement behavior guidelines, particularly sleep recommendations, is associated with better perceived health in school-aged children, especially in adolescents. [ABSTRACT FROM AUTHOR]

• Consumers have a higher purchase intention toward imperfect produce when sold by producers compared to professional sellers. • Consumers hold the lay belief that producers (e.g., farmers) provide natural and healthy produce, while professional sellers (e.g., sales clerks) focus more on presale selection. • Utilizing a claim of imperfection can improve the performance of professional sellers when they sell imperfect produce. Although imperfect produce may not differ from regular produce in the dimensions of taste or nutrition, most of consumers unwilling to purchase them, thus, reducing the waste of imperfect produce is crucial for both environmental preservation and food conservation. Through four online experiments in China (covering in total 888 respondents), we provided evidence that consumers are more willing to purchase imperfect produce sold by producers compared to those sold by professional sellers. Pilot study (N = 300) shows that individuals held the lay belief that producers (e.g., farmers) provide natural and healthy produce, while professional sellers (e.g., sales clerks) focus on presale selection. Furthermore, Study 1 (N = 200) found that the sale of imperfect produce by producers elicits a greater purchase intention than that by professional sellers in the context of live streaming shopping. Study 2 (N = 200) then replicated the finding of Study 1 and found that this effect is mediated by the dual mechanism of perceived health and perceived effort in the offline retailing context. Additionally, Study 3 (N = 188) reveals that adding a claim of imperfection causes augments the sales performance of professional sellers in the online shopping context. This finding suggests that adding a claim of imperfection causes can enhance the efficacy of professional sellers in marketing imperfect produce. [ABSTRACT FROM AUTHOR]

• Age ≥65 and dependence are predictors of worse general self-rated health (SRH) 3 months post-stroke. • Motor impairment is a predictor of worse time-comparative SRH 3 months post-stroke. • Being female is a predictor of worse time-comparative SRH 12 months post-stroke. • Dependence is a predictor of worse time-comparative SRH 12 months post-stroke. • Age and motor impairments were the strongest SRH predictors. Self-rated health (SRH) is the perception of an individual regarding their health and an indicator of health status. Identifying predictors of SRH allows the selection of evidence-based interventions that mitigate factors leading to poor SRH and the identification of individuals at risk of worse SRH. To determine the acute predictors of general and time-comparative SRH of individuals with stroke at 3 and 12 months after hospital discharge, considering personal, physical, and mental functions. A prospective study was developed to assess general and time-comparative SRH at 3 and 12 months after hospital discharge according to 2 questions ("In general, how would you say your health is?" and "Compared to a year ago, how would you rate your general health now?"). Potential acute predictors analyzed were personal (age, sex, comorbidities, socioeconomic status, and family arrangement), physical (stroke severity, motor impairment, and independence for basic activities of daily living [ADLs]), and mental (cognitive) functions. Age (adjusted odds ratio [aOR]=2.10) and independence in basic ADLs (aOR=0.29) were significant predictors of SRH at 3 months; at 12 months, no significant predictor was found. Motor impairment (aOR=3.90) was a significant predictor of time-comparative SRH at 3 months; at 12 months, sex (aOR=0.36) and independence in basic ADLs (aOR=0.32) were significant predictors. At 3 months, individuals with stroke who were ≥65 years old and dependent on basic ADLs were more likely to have worse general SRH, while those with higher motor impairments were more likely to have worse time-comparative SRH. At 12 months, women and individuals dependent on basic ADLs were more likely to have worse time-comparative SRH. [ABSTRACT FROM AUTHOR]

Burden of illnesses has been described in the literature using the health-related quality of life (HRQoL) in people with chronic conditions. However, the studies reporting trends of burden are sparse. The aim of this study was to explore the trends of burden of chronic illness from the perspective of HRQoL. This was a secondary analysis of administrative database. Seven data sets of the Canadian Community Health Survey from 2001 to 2014 were obtained for the analysis. Multiple linear and logistic regression models were used on each data set to assess the burden of illness on the Health Utilities Index Mark III (HUI 3), life satisfaction (LS), and perceived health (PH). People with the effect of stroke constantly had low scores on the HUI 3 , LS, and PH. Regression analyses revealed that arthritis, back problem, and mood disorder have greater impact on the HUI 3 score. Effect of stroke, mood disorder, and anxiety disorder stably had the largest negative impact on LS, while chronic obstructive pulmonary disease (COPD), effect of stroke, and cancer had the largest effect on PH. This study identified that arthritis, back pain, mood disorder, effect of stroke, and COPD constantly have high burden on health outcomes compared with other chronic condition over the past decade. • Health-related quality of life (HRQoL) has emerged as an important outcome. • Arthritis, back problem, and mood disorder have greater impact on the HUI3 score. • Stroke had the largest impact on life satisfaction and perceived health. [ABSTRACT FROM AUTHOR]

Few studies have examined the association between financial strain and quality of life outcomes in breast cancer. To examine the association between financial strain and key elements of physical and emotional quality of life among women with breast cancer. Across three geographically diverse samples (census regions: Northeast = 13.2%, Midwest = 26.8%, South = 35.5%, West = 17.4%; international = 7.1%), 309 women with a history of breast cancer completed online surveys including measures of financial strain, depression, anxiety, symptom burden, and perceived health. The third sample (N = 134) also reported financial toxicity that specifically documents financial strain because of medical care costs. Primary analyses assessed the association between financial strain and measures of emotional and physical quality of life. Sensitivity analyses examined associations using the measure of financial toxicity. All analyses were controlled for key covariates. Results showed that 37.5% of women experienced financial strain (Samples 1–3), varying from 12.1% among older, married, and college-educated women to 81.0% among women who were younger, unmarried, and lacked a college education. In addition, 26.1% reported treatment-specific financial toxicity (Sample 3). Financial strain was associated with more severe symptoms of depression (P < 0.001) and anxiety (P < 0.001) and worse physical symptom burden (P < 0.001) and perceived health (P < 0.001). Observed effects were sustained in sensitivity analyses using the financial toxicity measure. The present investigation illustrates the importance of financial strain in breast cancer. Healthcare systems are encouraged to expand interdisciplinary palliative and supportive care services that have the expertise necessary to help financially strained patients navigate the cancer care continuum. [ABSTRACT FROM AUTHOR]

• This study reveals a relationship between job security and organizational commitment, by considering job satisfaction and perceived health. • It highlights the importance of the cross-level boundary condition of internal service climate (ISC) at the organizational level. • The satisfaction effect is more salient in low ISC organizations, while the health effect is only significant in low ISC organizations. The objective of the study is to improve the current understanding of frontline employee perceptions of health by investigating the role of job security and satisfaction. The linkage between perceived health and organizational commitment is also explored. This study further tests the cross-level moderating effect of internal service climate based on a multilevel design. Based on a multilevel study that involved 1251 employees, including both frontline employees and supervisors from 29 casinos, results reveal that the relationship leading from job security and job satisfaction to organizational commitment through perceived health is contingent on organizational-level service climate; and the relationship is more salient for casinos with low-quality internal service climate. Theoretical and managerial implications are presented in the study. [ABSTRACT FROM AUTHOR]

As the population is quickly ageing, strategies for helping elders to maintain and promote good health and well-being are urgently needed. Self-perceived health is a powerful predictor of mortality, physical morbidity, and disability among elderly people. Delivering culturally competent care is necessary for taking care of elders. Self-perceived health is a powerful predictor of mortality, physical morbidity, and disability among elderly people. Spiritual well-being has been found particularly important for older adults' overall health. This descriptive, correlational and predictive study used data that was collected from a convenience sample (N = 150) to examine the effects of spiritual well-being on the relationship between depression and self-perceived health, and to describe spiritual practices commonly used by Taiwanese elders. Findings from this study revealed that spiritual well-being was positively correlated with self-perceived health, negatively associated with depression, and significantly mediated the relationship between depression and self-perceived health. Relaxation and exercise were the most commonly used spiritual practices by Taiwanese elders. Findings from this study support the important role of spiritual well-being in elders' health and add to the body of knowledge about the spiritual practices used by Taiwanese elders. Nurses and health care providers should deliver culturally appropriate spiritual care to enhance spiritual well-being for elders to maintain good health for diverse elder population. • Elders who are depressed were more likely to perceive poor health and lower level of spiritual well-being. • The relationship between depression and self-perceived health among elders is mediated by spiritual well-being. • Taiwanese elders commonly used relaxation and exercise as practices to promote their spiritual well-being. [ABSTRACT FROM AUTHOR]

Psychotic experiences (PEs) are associated with a range of mental and physical disorders, and disability, but little is known about the association between PEs and aspects of health-related quality of life (HRQoL). We aimed to investigate the association between PEs and five HRQoL indicators with various adjustments. Using data from the WHO World Mental Health surveys (n = 33,370 adult respondents from 19 countries), we assessed for PEs and five HRQoL indicators (self-rated physical or mental health, perceived level of stigma (embarrassment and discrimination), and social network burden). Logistic regression models that adjusted for socio-demographic characteristics, 21 DSM-IV mental disorders, and 14 general medical conditions were used to investigate the associations between the variables of interest. We also investigated dose-response relationships between PE-related metrics (number of types and frequency of episodes) and the HRQoL indicators. Those with a history of PEs had increased odds of poor perceived mental (OR = 1.5, 95% CI = 1.2-1.9) and physical health (OR = 1.3, 95% CI = 1.0-1.7) after adjustment for the presence of any mental or general medical conditions. Higher levels of perceived stigma and social network burden were also associated with PEs in the adjusted models. Dose-response associations between PE type and frequency metrics and subjective physical and mental health were non-significant, except those with more PE types had increased odds of reporting higher discrimination (OR = 2.2, 95% CI = 1.3-3.5). Our findings provide novel insights into how those with PEs perceive their health status. [ABSTRACT FROM AUTHOR]

This study focuses on circular migration amongst older Turkish immigrants to investigate two main questions: (1) How do perceived health and available healthcare systems in Turkey and Germany determine the structure of circular migration? (2) How is eldercare shaped by intergenerational conflict and exchange relations amongst older immigrants, their adult children in Germany, and their extended families in Turkey? Through the analysis of 40 in-depth interviews, this study finds that while Turkey offers healthier physical, psychological, and religious options, older circular migrants are more drawn to Germany because they perceive its healthcare system to be superior. Furthermore, contrary to conventional accounts, eldercare has mostly been navigated through intergenerational conflict and exchange relations, instead of family solidarity or traditional filial roles, and these conflicts and exchange principles around eldercare regulate family living arrangements across the two countries. In short, older Turkish immigrants encounter unique challenges in both their home and host countries, which promulgates their circular migration. [ABSTRACT FROM AUTHOR]

Purpose The aim was to classify motives for exercising trying to find sets of related cases that share common motivations, and to relate these latent classes to markers of successful aging. Methods 725 old adult aged 55 to 97 years were sampled in several Spanish towns. Instruments: Successful Aging Inventory (SAI), International Physical Activity Questionnaire (IPAQ), Health Survey SF-8, Satisfaction with Life Scale (SWLS), and motives to practice exercise, were used. Latent Class Analyses (LCAs) were estimated. The classes obtained were compared on markers of successful aging. Results Three latent classes were deemed optimal. Significant differences for several markers of successful aging were found. Conclusion A main conclusion derived from the results is that not all old people do exercise for the same motives, and the class of motives you are in had an impact/relation on markers of successful aging. Motives related to internal rather than external pressures should be promoted in the old age. [ABSTRACT FROM AUTHOR]

In the literature there is a lack of investigation on health inequalities in South America and their differences with respect to those in the developed countries. Since Italy has recorded similar economic trends in recent years and has some similarities with Argentina, we decided to use the Mediterranean country for comparative purposes. Our hypothesis was that, beyond structural differences, health inequalities present similar patterns in these two countries characterized by a capitalist economy. Social groups in advantaged educational and occupational positions exhibit better health than disadvantaged groups. We present some descriptive statistics on the overall situation in the two countries, and we then analyse data stemming from two surveys that collected individual information on social conditions and health statuses (OASD from 2010 to 2015, and “Multiscopo – Health condition and use of health services”, ISTAT 2013). The findings show that Argentina and Italy have different levels of wellbeing, mortality rates, and health services. But relative disparities in health seem very similar, confirming the hypothesis of Marmot (2017) about the general form of health inequalities. Manual and precarious workers (in particular unemployed persons) present systematically worse perceived health with respect to higher social classes. [ABSTRACT FROM AUTHOR]

Facial skin texture and colour play an important role in observers' judgments of apparent health and have been linked to aspects of physiological health, including fitness, immunity and fertility. However, most studies have focused on Caucasian populations. Here, we report two studies that investigate the contribution of skin texture and colour to the apparent health of Malaysian Chinese faces. In Study 1, homogenous skin texture, as measured by wavelet analysis, was found to positively predict ratings of apparent health of Asian faces. In study 2, homogenous skin texture and increased skin yellowness positively predicted rated health of Malaysian Chinese faces. This finding suggests that skin condition serves as an important cue for subjective judgements of health in Malaysian Chinese faces. [ABSTRACT FROM AUTHOR]

Exposure to ethnic discrimination has been conceptualized as a sociocultural stressor that is associated with lower self-rated health. However, this association remains understudied among Hispanics and less is known about constructs that may mitigate the effects of ethnic discrimination on self-rated health. Accordingly, this study aimed to (a) examine the association between ethnic discrimination and self-rated health among Hispanic emerging adults (ages 18–25), and (b) examine the extent to which self-esteem and resilience may moderate this association. A convenience sample of 200 Hispanic emerging adults from Arizona (n = 99) and Florida (n = 101) was recruited to complete a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Results indicate that higher ethnic discrimination was associated with lower self-rated health. Moderation analyses indicated that self-esteem functioned as a moderator that weakened the association between ethnic discrimination and self-rated health; however, resilience did not function similarly as a moderator. This study adds to the limited literature on ethnic discrimination and self-rated health among Hispanics and highlights that psychological factors, such as enhancing self-esteem, may help buffer the adverse effects of ethnic discrimination on health outcomes. [ABSTRACT FROM AUTHOR]

Background: Individuals who use illicit drugs are at heightened risk for HIV and/or Hepatitis C Virus (HCV). Despite the medical consequences of drinking for drug-using individuals with these infections, many do drink. In other studies, how individuals perceive their health relates to their engagement in risk behaviors such as drinking. However, among drug-using individuals with HIV and HCV, whether perceived health relates to drinking is unknown.Objective: We examine the association between perceived health and drinking among drug-using individuals with HIV and/or HCV.Methods: In a large, cross-sectional study, we utilized samples of individuals with HIV (n=476), HCV (n=1145), and HIV/HCV co-infection (n=180), recruited from drug treatment centers from 2005 to 2013. In each sample, we investigated the relationship between perceived health and drinking, using ordinal logistic regressions. We present uncontrolled models as well as models controlled for demographic characteristics.Results: Among samples of drug using individuals with HIV and with HCV, poorer perceived health was associated with risky drinking only when demographic characteristics were taken into account (Adjusted Odds Ratios: 1.32 [1.05, 1.67] and 1.16 [1.00, 1.34], respectively). In the smaller HIV/HCV co-infected sample, the association of similar magnitude was not significant (AOR=1.32 [0.90, 1.93]).Conclusions: Drug using patients with HIV or HCV with poor perceived health are more likely to drink heavily, which can further damage health. However, when demographics are not accounted for, these effects can be masked. Patients' reports of poor health should remind providers to assess for health risk behaviors, particularly heavy drinking. [ABSTRACT FROM AUTHOR]

Objectives (i) To analyze if general cognitive performance, perceived health and depression are predictors of Subjective Memory Complaints (SMC) contrasting their effect sizes; (ii) to analyze the relationship between SMC and objective memory by comparing a test that measures memory in daily life and a classical test of associated pairs; (iii) to examine if different subgroups, formed according to the MFE score, might have different behaviors regarding the studied variables. Methods Sample: 3921 community-dwelling people (mean age 70.41 ± 4.70) without cognitive impairment. Consecutive non-probabilistic recruitment. Assessment: Mini Cognitive Exam (MCE), daily memory Rivermead Behavioural Memory Test (RBMT), Paired Associates Learning (PAL), Geriatric Depression Scale (GDS), Nottingham Health Profile (NHP). Dependent variable: Memory Failures Everyday Questionnaire (MFE). Results Two different dimensions to explain SMC were found: One subjective (MFE, GDS, NHP) and other objective (RBMT, PAL, MCE), the first more strongly associated with SMC. SMC predictors were NHP, GDS, RBMT and PAL, in this order according to effect size. Considering MFE scores we subdivided the sample into three groups (low, medium, higher scores): low MFE group was associated with GDS; medium, with GDS, NPH and RBMT, and higher, with age as well. Effect size for every variable tended to grow as the MFE score was higher. Conclusion SMC were associated with both health profile and depressive symptoms and, in a lesser degree, with memory and overall cognitive performance. In people with fewer SMC, these are only associated with depressive symptomatology. More SMC are associated with depression, poor health perception and lower memory. [ABSTRACT FROM AUTHOR]

The ability to savor positive life events is associated with higher emotional well-being; however, few studies have examined savoring ability in older adults. The present study used a longitudinal design to examine changes in perceived savoring abilities and associations with perceived health in older adulthood. Older adults ( N = 131) reported on beliefs about savoring and perceived health at baseline and 2 1/2 years later. Perceived anticipation (savoring the future) and reminiscing (savoring the past) abilities declined from baseline to follow-up. Better perceived health at baseline predicted greater perceived reminiscing and anticipation abilities at follow-up. Greater perceived ability to savor the present moment at baseline predicted better perceived health at follow-up. Aging and poorer health focus older adults' thoughts on present-moment pleasures, which may benefit health, but may also lead to reductions in perceived anticipation and reminiscing abilities. [ABSTRACT FROM AUTHOR]

Objective: War captivity may affect spouses of former-prisoners-of-war (ex-POWs) in many ways, including posttraumatic stress symptoms (PTSS) and somatic difficulties manifested in negative perceived health. This is generally known as secondary traumatization. Theory suggests that development of secondary traumatization occurs through the relationship with the primary trauma survivor Figley (1986) , thus implying that the ability to keep balanced emotional distance in the relationship may play a pivotal role. Notwithstanding, the contribution of self-differentiation to secondary somatic disturbances remains largely uninvestigated. The current study fills this gap.Methods: Ex-POWs' wives (n=143) and control former-combatants' wives (n=102), were assessed prospectively 30 (T1) and 38 (T2) years after the 1973 Yom Kippur War. Self-differentiation and PTSS were assessed at both time-points, while perceived health measures were assessed at T2.Results: Wives of ex-POWs endorsed higher PTSS, lower self-differentiation and negative perceived health, compared to control wives. Indirect exposure to war captivity was related to low self-differentiation and elevated PTSS, which predicted negative perceived health. Furthermore, self-differentiation characterized by fusion-with-others fully mediated the relation between indirect exposure to war captivity and perceived health, beyond the effects of PTSS as a mechanism.Conclusion: Results suggest that tendencies towards fusion-with-others within the marital relationship, act as a risk factor not only for psychological distress but also for somatic distress among secondary trauma survivors. Hence, clinical interventions may seek to improve indirect trauma survivor's self-differentiation capacities, thus potentially facilitating the prevention of secondary somatic distress. [ABSTRACT FROM AUTHOR]

Objective: Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical visit.Methods: Primary care physician-patient interactions (297 patients across 100 physicians) were rated for the physician's humility and the effectiveness of the physician-patient communication. Additionally, patients reported their overall health and physicians and patients reported their satisfaction with the interaction.Results: Within-physician fluctuations in physician humility and self-reported patient health positively predicted one another, and mean-level differences in physician humility predicted effective physician-patient communication, even when controlling for the patient's and physician's satisfaction with the visit and the physician's frustration with the patient.Conclusions: The results suggest that humble, rather than paternalistic or arrogant, physicians are most effective at working with their patients.Practice Implications: Interventions to improve physician humility may promote better communication between health care providers and patients, and, in turn, better patient outcomes. [ABSTRACT FROM AUTHOR]

According to the income inequality hypothesis, income inequality is associated with poorer health. One important proposed mechanism for this effect is reduced trust. In this study, we argue that income inequality during a person's formative years (i.e., around age 16) may have lasting consequences for trust and health. Multilevel analyses of data from the combined World Values Survey and European Values Study that were collected between 1981 and 2014 support our prediction and show that income inequality is associated with ill health in young adults, in part because it reduces their social trust. The negative consequences of income inequality remain stable for a substantial period of life but eventually fade away and have no effect after age 36. [ABSTRACT FROM AUTHOR]

The psychological impact of incarceration vary from individual to individual and most people first entering prison experience severe stress. Our objective was to describe the characteristics of detainees arrested for the first time and who had medical examination during custody. The study sample included 200 detainees arrested for the first time in 2012 and examined for the second time before May 31, 2013, 200 detainees arrested for the first time in 2012 and who had not a second examination by May 31, 2013, and a control group of 200 individuals who had been arrested before. Collected data related to persons' characteristics, the course of detention, alleged assaults and traumatic injuries. In our sample, victimization was the most frequent motivation for requesting a medical examination and affected 31–46% of patients who requested the examination. The medical examination was less frequently requested by the detainee at the first detention than at subsequent detentions (35% and 31% vs. 51%, P < 0.001). Unremarkable psychic states were found in most cases in all groups. Detainees expressed a good or very good opinion on custody in 40–51% of cases. In 75–89% of cases, detainees were considered to be unconditionally fit for detention. The present findings suggest only minor differences between clinical features of individuals arrested for the first time and their clinical status when they were arrested for the second time. The systematic collection of more detailed description of the detainees’ psychic state could be relevant at the time of medical examinations in police cells. [ABSTRACT FROM AUTHOR]

Objective To explore how patient activation, i.e. patients’ perceived knowledge, skills and self-confidence to manage their health and healthcare, develops within chronically ill individuals over time, and to estimate the impact of self-rated health on this development. Methods Linear regression analyses and structural equation modeling were conducted using longitudinal data from 751 people with chronic disease(s). Patient activation was assessed by the patient activation measure; self-rated health was assessed by the SF-36 general health scale. Results Mean patient activation score at baseline was 60.6, and 18 months later 56.5. Baseline self-rated health had a positive, indirect effect on patient activation at 18 months. In addition, the change in self-rated health over one year (from baseline) was a significant predictor of patients’ activation scores. Conclusion Patient activation is not a stable characteristic of people who have been chronically ill for years. Within individuals both increases and decreases occur, but at group level patient activation slightly decreases over time. This may (partly) be due to the deterioration of health that many people with chronic illness experience in course of time. Practice implications Clinical practitioners should assess the activation level of chronically ill patients regularly, especially when changes in health occur. [ABSTRACT FROM AUTHOR]

Objectives Health behaviours including diet, smoking, alcohol consumption, and physical activity, predict health risks at the population level. We explored health behaviours, barriers to healthy eating and self-rated health among individuals of retirement age. Study design 82 men and 124 women participated in an observational, cross-sectional online survey. Main outcome measures A 14-item Mediterranean diet score (MDPS), perceived barriers to healthy eating (PBHE), self-reported smoking, physical activity habits, and current and prior perceived health status (PHS) were assessed. A health behaviours score (HBS) including smoking, physical activity, body mass index (BMI) and MDPS was created to evaluate associations with PHS. Two-step cluster analysis identified natural groups based on PBHE. Analysis of variance was used to evaluate between group comparisons. Results PBHE number was associated with BMI ( r = 0.28, P < 0.001), age ( r = −0.19; P = 0.006), and MDPS ( r = −0.31; P < 0.001). PHBE cluster analysis produced three clusters. Cluster-1 members (busy lifestyle) were significantly younger (57 years), more overweight (28 kg/m 2 ), scored lower on MDPS (4.7) and reported more PBHE (7). Cluster-3 members (no characteristic PBHE) were leaner (25 kg/m 2 ), reported the lowest number of PBHE (2), and scored higher on HBS (2.7) and MDPS (6.2). Those in PHS categories, bad/fair, good, and very good, reported mean HBS of 2.0, 2.4 and 3.0, respectively ( P < 0.001). Compared with the previous year, no significant associations between PHS and HBS were observed. Conclusions PBHE clusters were associated with BMI, MDPS and PHS and could be a useful tool to tailor interventions for those of peri-retirement age. [ABSTRACT FROM AUTHOR]

Owing to the inconclusive findings of research regarding the health benefits of pet ownership, we compared perceived health, stress, life satisfaction, happiness, and psychosomatic symptoms in dog owners and non–dog owners. As an attempt to overcome some earlier methodological issues, the sample consisted of 602 individuals from Mexico aged ≥18 years (377 dog owners and 225 non–dog owners). These 2 groups were equivalent in age, gender, educational level, marital status, employment, parental status, and the presence of chronic illness. The results indicated that, compared to non–dog owners, the dog owners' scores were significantly lower for psychosomatic symptoms and stress and were higher for general health, vitality, emotional role, absence of bodily pain, social functioning, and mental health. No significant difference between groups was found for life satisfaction, happiness, physical functioning, or physical role. Group differences might occur because individuals who perceive themselves to be healthier also choose to have a pet; nevertheless, 273 (72.6%) had owned a pet during the previous 5 years, and 86 (22.8% of the overall sample) reported that they had always owned dogs. In conclusion, the dog owners perceived themselves as healthier—but not happier—than non–dog owners. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Acquiring close peer relationships is an important developmental task in adolescence. This task may be particularly demanding for adolescents with congenital heart disease (CHD), who face disease-specific challenges putting them at risk for social isolation and loneliness. This study compared cross-sectional levels of loneliness in adolescents with and without CHD; examined the longitudinal course of loneliness and identified different developmental trajectory classes in adolescents with CHD; and investigated to what extent these trajectory classes are accompanied by differences in depressive symptoms and perceived health. Methods: A total of 429 adolescents with simple to complex CHD participated in the present longitudinal study consisting of three measurement waves with 9-month intervals (M age = 15.75 years at T1; 53.4% boys). The control sample at time 1 (T1) consisted of 403 adolescents who were matched in terms of age and sex. Results: Patients and controls did not differ in loneliness levels at T1. In adolescents with CHD, latent class growth analysis identified five trajectory classes (i.e., chronically high, high decreasing, moderate stable, low increasing, and stable low), which were meaningfully distinguished on depressive symptoms and several domains of perceived health. In general, adolescents in the chronically high loneliness trajectory reported the most depressive symptoms and the poorest perceived health, whereas adolescents in the low stable trajectory reported the opposite pattern. Conclusions: Findings demonstrate that chronic feelings of loneliness are associated with worsened perceived health in adolescents with CHD. Intervention programs targeting patients' adjustment should be sensitive to the presence of such feelings. [Copyright &y& Elsevier]

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Background: The life expectancy of patients with congenital heart disease (CHD) has increased substantially. Health care should meet their needs through enhancing psychological functioning, quality of life, and perceived health. A possible determinant of these variables is sense of coherence (SOC). The interplay between SOC and outcome variables is not thoroughly scrutinized yet. Objective: To examine the direction of relationships between SOC and domains of perceived health in adolescents with CHD. Design: A longitudinal, observational study with two measurement points and a time lag of nine months. Setting: The pediatric and congenital cardiology department of a university hospital in Belgium. Participants: Adolescents with CHD (n = 429 at time 1) were recruited from the hospital's database. At time 1, mean age was 15.8 years, 53.4% were boys, and most adolescents had a moderately complex heart defect (47.6%). Methods: Participants filled out the 13-item SOC questionnaire and the PedsQL scale at both time points. Cross-lagged path analysis using structural equation modeling was conducted, controlling for age, sex, educational level, disease complexity, and prior heart surgery for CHD. Results: SOC at time 1 positively predicted all domains of generic perceived health (physical, emotional, social, and school functioning) and three out of five domains of disease-specific perceived health (symptoms, physical appearance, and cognitive problems) at time 2. Conversely, better school functioning and less cognitive problems at time 1 positively predicted SOC at time 2. Conclusions: Evidence was obtained for reciprocal pathways between SOC and the domains of perceived health, although the predominant direction of effects was found to be from SOC to perceived health. Hence, improving SOC has the potential to enhance future perceived health of adolescents with CHD. [ABSTRACT FROM AUTHOR]

Background: Insomnia is highly prevalent and impairing but also highly comorbid with other chronic physical/mental disorders. Population-based research has yet to differentiate the role impairments uniquely associated with insomnia per se from those due to comorbidity. Methods: A representative sample of 6791 adult subscribers to a large national US commercial health plan was surveyed by telephone about sleep and health. Twenty-one conditions previously found to be comorbid with insomnia were assessed with medical/pharmacy claims data and validated self-report scales. The Brief Insomnia Questionnaire, a fully structured, clinically validated scale, generated insomnia diagnoses according to inclusion criteria of DSM-IV-TR, ICD-10, and Research Diagnostic Criteria/International Classification of Sleep Disorders: Diagnostic and Coding Manual, Second Edition. The World Health Organization Disability Assessment Schedule-II assessed number of days in the past 30 when health problems prevented respondents from conducting their usual daily activities. Regression analyses estimated associations of insomnia with days-out-of-role controlling comorbidity. Results: Insomnia was significantly associated with days-out-of-role (.90 days/month) in a gross model. The association was reduced when controls were introduced for comorbidity (.42 days/month). This net association did not vary with number or type of comorbid conditions but was confined to respondents 35+ years of age. Insomnia was one of the most important conditions studied not only at the individual level, where it was associated with among the largest mean days-out-of-role, but also at the aggregate level, where it was associated with 13.6% of all days-out-of-role. Conclusions: Insomnia has a strong net association with days-out-of-role that does not vary as a function of comorbidity. [ABSTRACT FROM AUTHOR]

Summary: Objective: Self-rated health is a strong independent predictor of mortality after accounting for objective health status, behavioral risk factors, and sociodemographic characteristics. However, mechanisms underlying this association are largely unexplained. Inflammation has been associated with increased risk of morbidity and mortality in the elderly. The current study aimed to: (1) examine associations between self-rated health and serum inflammatory markers in older adults; (2) examine the relative strength of these associations for self-rated health versus self-rated change in recent health; (3) examine components of self-rated health that may underlie the association between inflammation and global self-rated health. Methods: Self-rated health, as measured by the RAND health survey, and serum interleukin (IL)-6 and C-reactive protein (CRP) were assessed among 250 generally healthy older adults (185 women, 65 men; average age=63.8±13.7 years). Results: A series of linear regression analyses demonstrated that poorer self-rated health was significantly associated with higher IL-6 and CRP. These relationships remained after controlling for age, body mass index, gender, and objective health conditions. These associations also remained after controlling for depressive symptoms, neuroticism, perceived change in health over the past year, and health behaviors (smoking, sleep quality, and physical activity). Analyses of RAND component measures demonstrated that poorer physical functioning was significantly associated with IL-6; the relationship between global self-rated health and both IL-6 and CRP remained after accounting for perceived physical functioning. Conclusions: Poorer self-rated health is associated with elevated serum inflammatory markers among generally healthy older adults. The relationship of self-rated health with inflammatory markers is not secondary to depressive symptoms, neuroticism, or recent changes in perceived health. Subjective ratings of health provide important clinical information regarding inflammatory status, beyond traditional objective risk factors, even among generally healthy individuals. [Copyright &y& Elsevier]

Abstract: Background: A number of studies of elderly depression have examined the association between depression and its related factors; however, they did not observe how the development of related factors influenced elderly depression over time. This study aims to understand the rising trajectory of depressive symptoms found in elderly male and female, and whether the causation of depression due to related factors would be heterogeneous between male and female over a decade from 1993 to 2003. Method: This study uses the data from the “Survey of Health and Living Status of the Elderly in Taiwan”. A total of 1017 elderly Taiwanese, aged 60 and over, completed four survey modules. The latent growth curve model and general growth mixture model were used to identify the trajectories of depression symptoms, and to assess their related factors in the elderly male and female in Taiwan during the 10year survey study. Result: The results showed that a rising trajectory of depressive symptoms came about for both Taiwan elderly male and female over ten years. We also found that in the trajectories of depressive symptoms between elderly male and female across four waves of data, the results were heterogeneous. The trajectory of depressive symptoms in males was affected by perceived health and disability; the trajectory of depressive symptoms in females was influenced by disability and social support. Conclusion: These findings demonstrated that the final depressive symptoms of the elderly would differ from the elderly with developmentally different depressive related factors. The findings also highlighted the developmental trajectories of depressive symptom in terms of their related factors in the elderly. [Copyright &y& Elsevier]

Abstract: Background: Population-based study of a random sample of 50-year-old men and women in Gothenburg, Sweden. Objective: To examine the determinants of perceived health and the differences between 50-year-old men and women. Methods: Men and women born in 1953 were examined between 2003 and 2004. Participation rate was 60% among the men and 67% among the women. Questionnaires were used, including one on perceived health that was ranked on a 7-point scale from 1 (excellent) to 7 (very poor). The participants'' medical histories were obtained through a questionnaire, and risk factors were measured. Results: Women generally perceived their health as poorer than men. Women experienced more symptoms than men, and most symptoms were more prevalent among women than men. Poor perceived health was strongly related to number of symptoms. In multivariable analyses 5 factors were related to perceived health in both men and women: working full or part time (women OR [odds ratio] = 0.3, men OR = 0.3) and physical activity (women OR = 0.6, men OR = 0.6) had a positive effect, whereas a low level of social activities (women OR = 1.9, men OR = 1.7), still feeling tired after normal hours of sleep (women OR = 4.5, men OR = 4.0), and feeling burned out during the past 12 months (women OR = 2.3, men OR = 3.0) had a negative effect on perceived health. Conclusions: Women perceive their health as “worse” in comparison with men. Perceived health is a multifaceted condition related to social circumstances, physical activity, various symptoms, and tiredness after normal hours of sleep both in women and men. [Copyright &y& Elsevier]

Abstract: Aim: This study sought to assess the association between metabolic syndrome (MS) and health-related quality of life (HRQOL) in the general population. Methods: We analyzed data for 4463 adults, aged 30 years or older, from the Korea National Health and Nutrition Examination Survey 2005. “EuroQol 5D”, which measures two dimensions, the EuroQol 5D index score (EQ-5D) and the EuroQol visual analogue scale (EQ-VAS), was used to evaluate HRQOL. Results: Mean scores for the EQ-5D in both sexes and EQ-VAS in women decreased with increasing number of MS components, and women''s means for both scores were significantly lower than men''s. In individual domains of HRQOL, men with more MS components tended to have higher odds ratios for decreased self-care, and women had decreased mobility, according to the EQ-5D. In men, high blood pressure led to decreased EQ-5D, and in women, abdominal obesity and high blood pressure did so. Additionally, we found that taking medication had an impact on decreased HRQOL, especially in subjects with impaired fasting glucose. Conclusions: HRQOL was negatively associated with the number of MS components and it was decreased by taking hypoglycemic medications. This association differed by gender. [Copyright &y& Elsevier]

Abstract: Background: Complementary and alternative medicine (CAM) is described as a set of healthcare and medical practices not currently part of conventional western medicine. In this study, we aimed to investigate the frequency, type and factors associated with the use of CAM in Parkinson’s disease (PD) patients at a neurological outpatient clinic. Method: All PD patients at the outpatient clinic (N = 421) received a postal questionnaire covering ten types of CAM plus an open alternative labelled ‘other type’, their possible effect, and socio-demographic, health and disease-related factors. Results: 325/403 (81%) eligible patients responded comprising 172 men and 153 women, median age 74 years for both genders. CAM use was reported by (M/F) 51/59 patients (30/39%); 31/33 patients (18/22%) taking CAM drugs and 48/57 (28/37%) using CAM methods with acupuncture having the highest frequency. Significant differences between CAM users and non-users were found with regard to educational level, perceived health and levodopa load. More females than males used CAM, but the difference was not significant. The majority of CAM users perceived ‘No improvement‘ or ‘Some improvement’. Twenty percent of users reported that they had spent the equivalent of 50 € on CAM during the last 6 months. Conclusion: CAM use is rather common among PD outpatients, with one in three having experience of CAM practices. Badly-perceived health and higher education were factors significantly associated with CAM utilization. A trend for more female CAM users was also seen. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the relationship between subjective well-being, functional independence and lowerlimb performance (muscle strength, gait velocity and balance) among elderly people undergoing outpatient follow-up, stratified by sex and age groups. Methods: We evaluated 125 elderly people, aged 60 years and over, who received care at a geriatric outpatient clinic. The instruments used were: 1) Functional Independence Measure (FIM) to evaluate functional dependence; 2) Short Physical Performance Battery (SPPB) to measure physical performance; and 3) Subjective Well-Being (SWB) with questions about health and satisfaction with life. Results: A convenience sample was used, with predominance of females (who had greater functional impairment). The Spearman correlation coefficients for subjective well-being and the performance tests varied from -0.16 to 0.31 for men and -0.09 to 0.29 for women, therefore there were no differences between the sexes. However, the older participants had a higher level of satisfaction than the younger participants. Perceived health was also more satisfactory among the older participants, however comparative perceived health was better among the elderly participants with moderate to good physical performance. Conclusion: The results suggest that older individuals have greater satisfaction with life and better perceived health. Moreover, good physical performance was an important variable for better perceived health when compared to other people. [ABSTRACT FROM AUTHOR]

Abstract: Numerous empirical studies, largely conducted in Western societies, have linked social capital to health outcomes. However, few studies thus far have been conducted in northeastern Asian countries, particularly Japan. Therefore, whether social capital is a determinant of health in Japanese society remains unclear. This study attempted to provide new evidence for the impact of social capital on health in Japan by analyzing original survey data with two different statistical models. In total, 1910 subjects were randomly selected from 210 enumeration districts (EDs) considered in the 2000 population census. In the present study, after excluding missing data on the outcome and predictor variables, we conducted an analysis of 1157 individuals nested within 206 EDs. Ecological and multilevel regression analyses were performed to examine the association between social capital and health, measured by the General Health (GH) perception item (a subcategory of Short Form 36 (SF-36)), and to estimate the impact of aggregated indicators of social capital on health. We developed an original Japanese version of three social capital items (perceived helpfulness, kindness, and greeting) based on previous studies and expert opinions and prepared a social cohesion index that integrated these three social capital items. The ecological model, after adjusting for sociodemographic factors, revealed that perceived helpfulness and greeting, along with the social cohesion index, were observed to have statistically significant associations with GH. The multilevel model, after adjusting for individual social capital perceptions, indicated that the two aggregated indicators of community social capital (kindness and greeting), along with the social cohesion index, showed a statistically significant association with GH. These results showed the existence of a contextual effect of social capital on health outcomes, although individual differences in social capital perceptions in Japan were considered. [Copyright &y& Elsevier]

Abstract: The aims of this research were to describe Finnish adolescents'' different motives for digital game playing, and to examine relations between digital game playing and parent–child communication, school performance, sleeping habits, and perceived health. A questionnaire was used to assess a nationwide postal sample of 12–18-year-old Finns (6761 respondents, response rate 69%) in winter 2003. Among respondents, 4085 adolescents played digital games and answered questions on digital game motives. Two main motives emerged: instrumental (learn new things and procedures, have a common topic for conversation, use and develop game playing skills, experience different roles/worlds) and ritualized (pastime, entertainment; recover, relax; escape everyday life, forget worries). The importance of all motives increased for participants with longer playing times. Instrumental motives were more important to boys and younger respondents. They were associated with earlier bedtime, worse perceived health, better mother communication, and better school grades, but only among boys. The importance of ritualized motives increased with age and was related to better school performance, worse sleeping habits, and worse perceived health in both sexes. Digital games seem to have the same basic functions as media in serving adolescents'' mood management and stimulation seeking. Among boys, gaming is part of the male socio-cultural communication context. [Copyright &y& Elsevier]

• Lower quality of life, perceived health, and well-being during than pre-lockdown. • No difference between the two lockdown periods. • Quality of life linked to physical activity, happiness, and energy. • Perceived health linked to exercise, medical condition, isolation, and memory. • Well-being linked to isolation, energy, and age. . The concept of lockdown in relation to COVID-19 is thought to have an indirect impact on the quality of life and well-being of the elderly due to its consequences on the physical, psychological, and cognitive health of individuals. However, previous published studies on this subject are limited in terms of methodological approach used, including the absence of pre-confinement status and the type of experimental design, which is often cross-sectional. The present study proposes a longitudinal design with pre-confinement measures. It assesses changes in quality of life, perceived health, and well-being by comparing the period before lockdown (T1 = December 2019), three months after the start of the first lockdown (T2 = June 2020), and during the second lockdown (T3 = January 2021) due to COVID-19.. This study is conducted with a group of 72 healthy elderly persons. They completed an electronic (online) survey assessing personal factors, activities, and participation as well as responding to the EuroQol-5D and Warwick-Edinburgh Mental Well-being Scale.. A decrease in quality of life, perceived health and well-being was observed between T1 and T2 and between T1 and T3, but no difference was reported between the two lockdown periods. The variables associated with these changes included energy level, level of happiness, physical activity, change in medical condition, memory difficulties, level of perceived isolation and age.. This study will help to target variables that may have a deleterious effect on older adults for consideration in future confinement settings and for preventive purposes. [ABSTRACT FROM AUTHOR]

• Socio-demographic factors affect self-rated health restoration in campus green spaces. • Frequency and duration of use positively affect students' self-rated restoration. • Companionship is significant to the felt health benefits of campus green spaces. There is increasing awareness of the benefits of campus green space in promoting student's health. However, information on how campus green spaces benefit students' health is insufficient or limited to guide the planning or management process. As a result, the present study collected 897 valid responses to examine the differences in campus green space usage patterns among students with varying individual characteristics and to assess the interrelationships between students' socio-demographic characteristics, perceived naturalness, patterns of use, and self-rated restoration and health using a structural equation model. The findings indicated that there were gender disparities in the presence of companions and frequency of use of campus green space, as well as discipline differences in companion presence. Additionally, gender, age, and discipline had distinct associations with perceived naturalness, patterns of use and self-rated restoration and health. Perceived naturalness positively contribute to patterns of use and self-rated restoration and health, while the frequency of use positively contributed to self-rated restoration and health. Moreover, students' perceived health can be improved in part through the mediating effect of the self-rated restoration. The study findings demonstrated how campus green spaces benefit students' health and provided valuable information for campus green space managers and designers. Therefore, we propose that presenting diverse natural elements, manipulating them in natural forms, providing feelings of wildness or friendliness, and eatablishing vast, high-quality, and diverse green spaces to promote students' health. [ABSTRACT FROM AUTHOR]

Abstract: Background: Self-rated health has been shown to be a significant predictor of mortality. However, there is limited knowledge on what factors contribute to the global perception of self-rated health in patients with chronic obstructive pulmonary disease (COPD). Objective: To describe the associations between physical and psychological symptoms, physical and mental health functioning, and perceptions of mastery with concurrent and longitudinal global self-rated health (GSRH) in patients with COPD and to determine if gender modifies these relationships. Design: Cross-sectional analysis of data from a longitudinal clinical trial. Setting: University medical center in the United States. Participants: 115 patients with moderate to severe COPD. Methods: GSRH was measured using one question from the Medical Outcomes Study, SF-36 which states, “In general, would you say your health is: excellent, very good, good, fair, or poor”. Physical and psychological symptoms were measured with the Shortness of Breath Questionnaire, Chronic Respiratory Questionnaire (CRQ), and Center for Epidemiologic Studies Depression Scale (CESD); the SF-36 was used to measure physical and mental health functioning; mastery was measured by a sub-scale of the CRQ. The BODE index, a multidimensional disease severity grading system, was also included. Stepwise logistic regression analyses were performed. Results: In cross-sectional analyses, only disease severity as measured by the BODE index was associated with GSRH [odds ratio, 1.52; 95% confidence interval, CI (1.08, 2.15)]. Stratified analyses by gender showed that the association between the BODE index and the GSRH held up for men, but not for women. Higher perception of symptom control was associated with positive health ratings in women. Subjects with less fatigue at baseline had a lower risk of reporting poor health 12 months later [OR 0.84; 95% CI (0.72, 0.98)]. Conclusions: For patients with COPD, ratings of global health were mostly influenced by measures that reflect their physical state, e.g. disease severity and fatigue. While additional work is needed to better understand gender differences in factors that contribute to GSRH, therapeutic nursing interventions might place greater focus on symptom management if the goal is to improve patients’ perceptions of their global health. [Copyright &y& Elsevier]

Abstract: Background: The occurrence of workplace violence is rather frequent within the nursing profession, with well-known consequences on the psychological health of victims. Objectives: This study is aimed at assessing the relationships between relevant individual, organizational, and psychosocial factors, and the frequency of several types of workplace violence; the direct as well as the interactive impact of violence and psychosocial factors on organizational commitment and perceived health. Design: Questionnaire-based cross-sectional and longitudinal survey designs were employed for the two study objectives, respectively. Setting: Five hundred and sixty-five healthcare institutions from eight European countries participated in the Nurses’ Early Exit Study. Participants: The 34,107 participants were nursing staff holding different qualifications. The response rate was 55.1% in the cross-sectional part and 40.5% in the follow-up phase. At baseline, the respondents were mostly female (89.3%), in the age group 30–44 years (52.9%), registered or specialized nurses (67.0%), working mainly in medico-surgical wards (36.3%), and employed full-time (72.8%). Methods: In the cross-sectional analysis, the relationship between the predictor variables and frequency of violence was assessed by means of a hierarchical multiple linear regression. In the longitudinal analysis, main direct and interactive effects of violence and psychosocial factors on perceived health and organizational commitment were assessed by means of hierarchical multiple linear regression analyses with interaction terms. Results: Higher levels of adverse work-related factors were significantly associated with higher frequency of the distinguished types of violence. Significant interactions were found between psychosocial factors and violence only in predicting organizational commitment, even if effect sizes were very low. No interactions were observed for perceived health. The prevalence of the distinguished types of violence varied across the participating countries according to the presence of adverse work- and non-work-related factors. Conclusions: These findings suggest the necessity of interventions both over working conditions conducive to violence and violent behaviours themselves. [Copyright &y& Elsevier]

Abstract: This study investigates the relation of five chronic cardiovascular diseases and diabetes mellitus (DM) to perceived health, and the moderating effects of sex and age. In a community-based cross-sectional telephone survey in Hong Kong, 7730 Chinese aged 25–74 were interviewed in 1994–1996. The odds ratio for poor perceived health associated with each condition was calculated adjusting for age, sex and education. Subjects free from the six conditions were treated as the comparison group. Hypertension, angina, DM, coronary heart disease (CHD) and stroke were significantly associated with poor perceived health. The odds ratio of poor perceived health was significantly greater in men than in women for having more than one condition among DM, CHD and stroke (p=0.02), and insignificantly greater for stroke, CHD and angina. The odds ratios were significantly greater in the young (25–39) versus the old (60–74) for DM (p=0.008) in men and women combined, and for having either DM, CHD or stroke in men (p=0.02). These findings suggest that the relation of DM, CHD and stroke with poor perceived health tends to be stronger in men and younger adults. These findings have implications for health care workers and home carers who need to appreciate that the same condition may have a different perceived impact on persons of different sex and age, and be sensitive to their varying needs. [Copyright &y& Elsevier]

Abstract: Patients with psychosis have been found to suffer from physical illnesses more commonly than the general population. In this report, self-reported physical ill health and its correlates among subjects with and without vulnerability to psychosis in a sample of first-degree relatives, help-seekers and controls were investigated. Perceived physical health was statistically significantly poorer among subjects with minor symptoms on the Structured Interview for Prodromal Symptoms and those vulnerable to psychosis than among those without symptoms measured by 13 somatoform symptom sum scores of the Symptom Checklist-90. Those at current risk of psychosis had a significantly higher mean sum score on the 13 somatic items (mean=21.1) than others (mean=9.6). Having physical symptoms or a self-reported physician-diagnosed illness was significantly associated with vulnerability to psychosis (odds ratio=3.05). The subjects with a mood disorder (odds ratio=4.33) had significantly more commonly physician-diagnosed illnesses than those who had no diagnosis or any other diagnosis. Physical ill health seems to be common among those vulnerable to psychosis. [Copyright &y& Elsevier]

Abstract: Visiting favourite natural settings may serve as a resource for regulating negative feelings and coping with perceived stress. The authors investigated the association between perceived health, the selection and experiential qualities of favourite places in four residential areas; 211 respondents (average age 40 years) responded to the questionnaire. Respondents with a certain amount of health complaints, such as headaches, chest or stomach pains, and faintness or dizziness, were more likely to select natural favourite places than those with few complaints. Respondents with health complaints benefited more in emotional terms from their visits to the favourite place although they did not visit their places more frequently than others. The change toward positive feelings was associated in particular with natural favourite places and relaxing in them. The results give impetus to research on the self-regulation of mood and neighbourhood context in health. [Copyright &y& Elsevier]

Abstract: Background: Sense of coherence (SOC) and perceived health (PH) have been seen as predictors of the outcome of vocational rehabilitation (VR) and as influencing the probability of disability pension (DP). We aimed to relate SOC and PH to outcome of VR with a focus on gender differences. Methods: A total of 372 patients (174 men and 198 women) with long-standing musculoskeletal disorders underwent VR. Data were obtained through questionnaires to patients and from subjects’ records and computer files at the National Social Insurance Office. Results: Three years after the VR process had ended, men who received DP had significantly lower SOC scores than those who did not receive DP (125 vs. 146; p <0.05). For women there was no difference. Both men and women who received DP significantly more often had a PH score above the mean (p ≤0.05), indicating bad health. Conclusions: Women who received DP had a higher SOC than men who received DP. The gender difference might be related to a societal recognition of musculoskeletal disorder among women, leading to a more generous acceptance of DP. The income disparity between men and women with lower income for women is probably also of importance. SOC might be a factor of value in predicting the rehabilitation process. [Copyright &y& Elsevier]

Background: Socioeconomic inequalities in health in the Baltic countries are possibly increasing due to concomitant pressures. This study compared time trends from 1994 to 2004 in the pattern and magnitude of educational inequalities in health in Estonia, Latvia, Lithuania and Finland. Methods: The data were gathered from cross-sectional postal surveys of the Finbalt project, conducted every second year since 1994 on adult populations (aged 20-64 years) in Estonia (n = 9049), Latvia (n = 7685), Lithuania (n = 11 634) and Finland (n = 18821). Three self-reported health indicators were used: (i) less than good perceived health, (ii) diagnosed diseases, and (iii) symptoms. Results: The existing educational inequalities in health in three Baltic countries and Finland remained generally stable over time from 1994 to 2004. Also, the overall prevalence of all three health indicators was generally stable, but in the Baltic countries improvement in perceived health was mainly found among the better educated men and women. Diagnosed diseases increased in the Baltic countries, except Lithuania, where diseases decreased among the better-educated women. Symptoms increased among the better-educated Estonian and Finnish women. Conclusions: The period from 1994 to 2004 of relative stabilization since the worst conditions of the social transition has not been followed by notable changes in self reported health, and this appears to be the situation across all educational groups in the Baltic countries. While health inequalities did not markedly change, substantial inequalities do remain, and there were indications of favourable developments main[y among the better-educated respondents. The factors contributing towards increasing health inequalities may only be visible in the future. [ABSTRACT FROM AUTHOR]

Summary: Twenty-six healthy adults age 20–58 (Mean 31.8) participated in six weeks of either astanga yoga or hatha yoga class. Significant improvements at follow-up were noted for all participants in diastolic blood pressure, upper body and trunk dynamic muscular strength and endurance, flexibility, perceived stress, and health perception. The improvements differed for each group when compared to baseline assessments. The astanga yoga group had decreased diastolic blood pressure and perceived stress, and increased upper body and trunk dynamic muscular strength and endurance, flexibility, and health perception. Improvements for the hatha yoga group were significant only for trunk dynamic muscular strength and endurance, and flexibility. The findings suggest that the fitness benefits of yoga practice differ by style. [Copyright &y& Elsevier]

During the last two decades, quality of life (QOL) has been perceived as an innovative indicator of patients’ self-perceived health status, allowing integration of a qualitative approach in medical decision-making. This is evident from the number of publications related to this topic: during the three decades between 1973 and 2002, 1124 papers dealing with QOL in asthma were cited in Medline, 85% having been published during the last 15 years and 65% during the last 5 years. A number of reasons can be given for the interest in this subject: the limitations of traditional indicators of health outcomes, the evolution of the relationship between patients and physicians, the rationalisation of health care expenditures, the increasing importance of health care interventions, and also the desire to keep up with the fashion. The medical community at large has been trying to define QOL, how to measure it, looking at the available instruments and how to use them; this is also true for allergy. Of the 1124 publications cited above, only 41 (3.5%) were written in French. We point out that QOL is a measurable concept, that it is based on a subjective approach and that it has numerous applications. Nevertheless, for a wider use in France, especially in allergy, decision makers must make it a key issue before clinicians are going to understand QOL and make full use of questionnaires used to measure it. [Copyright &y& Elsevier]

The awareness of illness in schizophrenia has a new lease of interest, in particular with the techniques of « insight therapy », striving to increase the level of patient’s insight. However, little is known about links between this level of insight and its impact on the quality of life. In this work, we investigated, in 21 schizophrenic patients, the influence of insight on quality of life, taking into account confounding socio-demographic and clinical factors. The level of insight is appreciated using the Markova&grave; and Berrios Insight Scale and the G12 item of the Positive and Negative Symptoms Scale (PANSS). The patient’s subjective quality of life is evaluated by the self-reported questionnaire S–QoL. No correlation was found between level of insight and socio-demographic and clinical factors. By contrast, a significant negative correlation between subjective evaluation of quality of life and level of insight is found. All S–QoL domains were concerned, in particular the « self-esteem » one. These results must be discussed in relation to psycho-educational treatment needs. [Copyright &y& Elsevier]

This study examines how socioeconomic inequalities in perceived health were reproduced as a cohort of adult men became 10 years older, and focuses especially on the role of social causation and health-selective mobility. A two-wave panel data set collected by the Nord-Trøndelag Health Study (HUNT), Norway, is used, and the study is based on a sample of 9189 men aged 25–49 at baseline. Systematic socioeconomic inequalities in perceived health were observed both at baseline and 10 years later when the sample was aged 35–59. Measured as age-adjusted percentage differences, inequalities in perceived health widened during the study period, both among those who were continuously employed and between the employed and non-employed. The pattern of health inequalities was transformed as a result of numerous changes in perceived health and considerable social mobility during the study period. Compared to higher white collar, changes in perceived health during the study period were more negative among medium-level and manual occupations, and even more negative among the non-employed. Mobility between occupational classes among those employed at both observation points was not selective for health, but transitions into and out of employment were strongly health-selective. It is argued that the transformation of the health inequality pattern among those continuously employed was solely due to social causation, i.e., to more negative changes in perceived health among medium/manual occupations than among the white collar. The wider difference in perceived health between the employed and non-employed was, however, primarily a result of health-selective mobility into and out of the non-employed category. [Copyright &y& Elsevier]