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Since the 1970s, the association between social relationships and health status has been observed using a variety of measures. It is, however, still rare to obtain a dataset that contains detailed information on everyday social networks and that measures social relationships quantitatively for various statistical analyses. In conjunction with the National Social Life, Health, and Aging Project (NSHAP), the Korea Social Life, Health, and Aging Project (KSHAP) is a longitudinal study of health and social factors among older adults in South Korea. Since its inception in 2012, the KSHAP has been an interdisciplinary project involving studies spanning the disciplines of sociology, psychology, psychiatry, medicine, and social work. To date, there are five waves of social network data for village K and one wave for village L. This chapter describes, compares, and discusses the social lives and health of older adults in Korea and the United States by utilizing various social network dimensions and measures of older adults from the KSHAP and NSHAP studies to find common as well as unique pathways in aging in the two countries.
The objective of this paper is to analyse the effects of three different stocking densities on the production, stress and fear parameters of female broilers during a 46-day production period. Chickens were randomly distributed among nine floor pens in groups of 30 broilers with different space allowances for each treatment; namely eight, 20 and 30 chicks m−2. Chicken growth rate was monitored from day eleven to 46 and indicators of stress, including haematocrit, heterophil/lymphocyte ratio and concentrations of plasma corticosterone, as well as tonic immobility, were measured on days 22 and 46. On day 46, the incidence of foot and skin lesions was assessed, and stress was induced to analyse the response of broilers to each stocking density. High stocking densities cause acute stress in broilers; the effects of low and intermediate stocking densities, however, are not so evident, particularly in relation to tonic immobility and response to acute stress.
This study tracked the longstanding effect of childhood adversities on health status over the course of a life. This study used the data from China Health and Retirement Longitudinal Study which was a nationally representative survey and documented the generation who had arrived in the middle- and old-age phase and experienced the difficult time in the early founding of PR China in their childhood. Results shown the significant associations between multiple forms of children adversities (economic distress, child neglect, child abuse, lack of friends, parental mental health problems) and health status in adolescence (from 0.068 to 0.102, p<0.01), and health status in mid and late adulthood, including self-rated general health problems (from 0.039 to 0.061, p<0.01), chronic conditions (from 0.014 to 0.120, p<0.01 except for lack of friends), body aches (from 0.016 to 0.062, p<0.01 except for child neglect), and depression (from 0.047 to 0.112, p<0.01). Meanwhile, results also shown an underlying pathway (i.e., health status in adolescence) linking childhood adversities and health status in mid and late adulthood. Results suggested that the experience of multiple forms of adversities in childhood represented a substantial source of health risk throughout life.
Sexuality, which is an essential part of human life, is an instinct with the potential to cause or be caused by health problems. Although qualitative and quantitative characteristics of sexual life evolves over time, it may continue until the age of eighties.
Objectives
This descriptive-correlational study aimed to analyze the relationship between general health status, quality of life and sexual life among senior people.
Methods
Study was conducted with the participation of 323 (169 female and 154 male) older people at the age of 65+. The participants were clients of the inpatient and outpatient services in a general hospital in Istanbul. General Health Questionnaire, Arizona Sexual Experiences Scale and Quality of Life Scale in Older People were used to collect data via online survey.
Results
The quality of life was better and sexual problems were lower for the participants who had a partner, higher education level, lower age, a regular job, sufficient income, no chronic disease, who defined their relationship as sufficient, frequently engaged in sexual activity and who considered themselves as attractive.
Conclusions
Sexuality in older people changes over time and continues to hold its importance. Researchers should consider the importance of the quality of life on sexual satisfaction in older people.
State Medical Aid is a public health insurance program that allows undocumented immigrants with low financial resources to access health care services for free. However, the low take-up rate of this program might threaten its efficiency. The purpose of this study is therefore to provide the determinants of such a low take-up rate. To this end, we rely on the Premier Pas survey. This is an original representative sample of undocumented immigrants attending places of assistance to vulnerable populations in France. Determinants of State Medical Aid take-up are analyzed through probit and Cox modeling. The results show that only 51% of those who are eligible for the State Medical Aid program are actually covered, and this proportion is higher among women than among men. The length of stay in France is the most important determinant of take-up. It is worth noting that State Medical Aid take-up is not associated with chronic diseases or functional limitations and is negatively associated with poor mental health. There is, therefore, mixed evidence of health selection into the program. Informational barriers and vulnerabilities experienced by undocumented immigrants are likely to explain this low take-up.
This commentary proposes the need for greater normative debate about when, if ever, it is appropriate for insurers to access genetic information of insureds to combat anti-selection.
To investigate factors associated with anaemia in preschool children.
Design:
A home survey was conducted in 2018. Anaemia in children (capillary blood Hb level < 110 g/l) was the outcome, and socio-economic, demographic and health factors of the mother and child were the independent variables. The measure of association was the prevalence ratio, and its 95 % CI was calculated using Poisson’s regression with robust variance and hierarchical selection of independent variables.
Setting:
Afro-descendants communities living in the state of Alagoas, northeast Brazil.
Participants:
Children aged 6–59 months and their mothers (n 428 pairs).
Results:
The prevalence of child anaemia was 38·1 % (95 % CI 33·5, 42·7). The associated factors with child anaemia were male sex, age < 24 months, larger number of residents at home (> 4), relatively taller mothers (highest tertile) and higher z-score of BMI for age, after further adjustment for wealth index, vitamin A supplementation in the past 6 months and clinical visit in the last 30 d.
Conclusions:
The high prevalence of anaemia observed reveals a relevant public health problem amongst children under five from the quilombola communities of Alagoas. Considering the damage caused to health and multiplicity of risk factors associated with anaemia, the adoption of intersectoral strategies that act on modifiable risk factors and increase vigilance concerning those that are not modifiable becomes urgent.
The key challenges of global health policy are not limited to improving average health status, with a need for greater focus on reducing regional inequalities in health outcomes. This study aimed to assess health inequalities across the major Indian states used data from the Sample Registration System (SRS, 1981–2015), National Family Health Survey (NFHS, 1992–2015) and other Indian government official statistics. Catching-up plots, absolute and conditional β-convergence models, sigma (σ) plots and Kernel Density plots were used to test the Convergence Hypothesis, Dispersion Measure of Mortality (DMM) and the Gini index to measure progress in absolute and relative health inequalities across the major Indian states. The findings from the absolute β-convergence measure showed convergence in life expectancy at birth among the states. The results from the β- and σ-convergences showed convergence replacing divergence post-2000 for child and maternal mortality indicators. Furthermore, the estimates suggested a continued divergence for child underweight, but slow improvements in child full immunization. The trends in inter-state inequality suggest a decline in absolute inequality, but a significant increase or stationary trend in relative health inequality during 1981–2015. The application of different convergence metrics worked as robustness checks in the assessment of the convergence process in the selected health indicators for India over the study period.
To compare exposure to household food insufficiency and the relationship between household food insufficiency and both health status and emergency healthcare utilisation among children with and without special healthcare needs (SHCN).
Design:
Analysing pooled data from the 2016–2017 iterations of the National Survey of Children’s Health, we conducted multivariate logistic regressions on household food insufficiency, health status and emergency healthcare utilisation. We assessed interactions between household food insufficiency and children’s SHCN status in our models of health status and utilisation.
Setting:
United States.
Participants:
Parents of a nationally representative sample of non-institutionalised children (aged 0–17 years).
Results:
Children with SHCN were more likely to experience household food insufficiency (70 v. 56 %), non-excellent health status (67 v. 28 %) and emergency healthcare utilisation (32 v. 18 %) than other children. Household food insufficiency was associated with 37 % (children with SHCN) and 19 % (children without SHCN) reductions in the likelihood of having excellent health. Household food insufficiency was associated with a roughly equal (16–19 %) increase in the likelihood of emergency department utilisation across groups.
Conclusions:
Compared with other children, children with SHCN have an elevated risk of exposure to household food insufficiency and experiencing greater reductions in health status when exposed.
Empirical studies on migration and mental health of migrants are still rare. In Germany they are often characterised by low sample sizes and are limited to certain diseases and geographical areas (old federal states). The comparability of their results is limited. Nonetheless, the assessment of migrants’ health is necessary for adequate medical and psychosocial care for this target group.
Aim
To provide data on mental health of migrants from Poland and from Vietnam in Germany. Methods: We have assessed a random sample of migrants from Poland (n=140) and from Vietnam (n=88) using the Giessen Subjective Complaints List – 24 (GSCL-24) and the Hospital Anxiety and Depression Scale (HADS). Additionally we asked migrants about their knowledge of health care institutions in case of psychosocial problems, their demands and the existing barriers to health care utilisation.
Results
Migrants from Poland and Vietnam have a higher general score of complaints of physical ill-health and higher anxiety and depression values than Germans. Psychosocial and medical institutions are visited less.
Conclusion
Further analytical studies are needed to clarify health differences between these groups. Migrants are a heterogeneous group and only group-specific investigations will clarify associations between countries of origin, health status and use of health care institutions.
Requirements for energy and particular amino acids (AAs) are known to be influenced by the extent of immune system stimulation. Most studies on this topic use models for immune system stimulation mimicking clinical conditions. Extrapolation to conditions of chronic, low-grade immune system stimulation is difficult. We aimed to quantify differences in maintenance energy requirements and efficiency of energy and protein used for growth (incremental energy and protein efficiency) of pigs kept under low (LSC) or high sanitary conditions (HSC) that were fed either a basal diet or a diet with supplemented AA. Twenty-four groups of six 10-week-old female pigs were kept under either LSC or HSC conditions for 2 weeks and fed a diet supplemented or not with 20% extra methionine, threonine and tryptophan. In week 1, feed was available ad libitum. In week 2, feed supply was restricted to 70% of the realized feed intake (kJ/(kg BW)0.6 per day) in week 1. After week 2, fasting heat production (FHP) was measured. Energy balances and incremental energy and protein efficiencies were measured and analyzed using a GLM. Low sanitary condition increased FHP of pigs by 55 kJ/(kg BW)0.6 per day, regardless of diet. Low sanitary condition did not alter the response of faecal energy output to incremental gross energy (GE) intake, but it reduced the incremental response of metabolizable energy intake (12% units), heat production (6% units) and energy retained as protein (6% units) to GE intake, leaving energy retained as fat unaltered. Incremental protein efficiency was reduced in LSC pigs by 20% units. Incremental efficiencies for energy and protein were not affected by dietary AA supplementation. Chronic, low-grade immune stimulation by LSC treatment increases FHP in pigs. Under such conditions, the incremental efficiency of nitrogen utilization for body protein deposition is reduced, but the incremental efficiency of absorbed energy for energy or fat deposition is unaffected.
European pig production faces economic and environmental challenges. Modelling can help farmers simulate and understand how changes in their management practices affect the efficiency of their production system. We developed an individual-based model of a pig-fattening unit that considers individual variability in performance among pigs, farmers’ feeding practices and animal management and estimates environmental impacts (using life cycle assessment) and economic results of the unit. We previously demonstrated that this model provides reliable estimates of farm performance for different combinations of management practices, pig types and building characteristics. The objectives of this study were to quantify how interactions between feeding practices and animal management influence fattening unit results in healthy or impaired health conditions using the model. A virtual experiment was designed to evaluate effects of interactions between feeding practices, health status of the pig herd and infrastructure constraints on the technical performance, economic results and environmental impacts of the unit. The virtual experiment consisted of 96 scenarios, which combined chosen values of 6 input parameters of the model: batch interval (35 days and 7 days), use or non-use of a buffer room to manage the lightest pigs, feed rationing (ad libitum and restricted) and sequence plans (two-phase (2P), daily-phase (DP)), scale at which the feeding plan is applied (i.e. room, pen and individual) and health status of the pig herd (i.e. healthy v. impaired). Variance analysis was used to test effects of the factors in these 96 scenarios, and multivariate data analyses were used to classify the scenarios. Healthy populations obtained on average higher economic results (e.g. gross margin of 11.20 v. 1.50 €/pig) and lower environmental impacts (e.g. 2.24 v. 2.38 kg CO2-eq/kg pig live weight gain) than the population with impaired health. With 35 days batch interval and DP feeding, populations with impaired health reached gross margin similar to healthy populations with 2P ad libitum feeding and 7 days batch interval. Restricted, DP and individual feeding plans improved the economic and environmental performances of the unit for both health statuses. This study highlighted that health status of the pig herd is the main factor that affects technical, economic and environmental performances of a pig-fattening unit, and that adequate feeding strategies and animal management can compensate, to some extent, the effects of impaired health on environmental impacts but not on gross margin.
In recent decades, concern about rabbit welfare and sustainability has increased. The housing system is a very important factor for animal welfare. However, information about how different available housing types for female rabbits affect their health status is scarce, but this is an important factor for their welfare. Hence, the objective of this study was to evaluate the health status of female rabbits in five common housing systems: three different single-housing systems with distinct available surfaces and heights; a single-housing system with a platform; a collective system. Female rabbits in the collective and platform cages had greater cortisol concentrations in hair than those in the single-housing system with no platform. Haptoglobin concentrations and kit mortality rates during lactation were greater for the collective-cage female rabbits. The collective group had more culled females and more lesions than in the other groups. The main reasons for culling in all the groups were reproduction problems and presence of abscesses, and the collective group of females was the most affected. In conclusion, it appears that keeping females together in collective systems negatively affects their health status and welfare, while single-housing systems imply lower kit mortality rates during lactation and cortisol concentrations, and fewer lesions in female rabbits.
Understanding factors related to poor quality of life (QoL) and self-rated health (SRH) in clinical high-risk (CHR) for psychosis is important for both research and clinical applications. We investigated the associations of both constructs with CHR symptoms, axis-I disorders, and sociodemographic variables in a community sample.
Methods:
In total, 2683 (baseline) and 829 (3-year follow-up) individuals of the Swiss Canton of Bern (age-at-baseline: 16–40 years) were interviewed by telephone regarding CHR symptoms, using the Schizophrenia Proneness Instrument for basic symptoms, the Structured Interview for Psychosis-Risk Syndromes for ultra-high risk (UHR) symptoms, the Mini-International Neuropsychiatric Interview for current axis-I disorders, the Brief Multidimensional Life Satisfaction Scale for QoL, and the 3-level EQ-5D for SRH.
Results:
In cross-sectional structural equation modelling, lower SRH was exclusively significantly associated with higher age, male gender, lower education, and somatoform disorders. Poor QoL was exclusively associated only with eating disorders. In addition, both strongly interrelated constructs were each associated with affective, and anxiety disorders, UHR and, more strongly, basic symptoms. Prospectively, lower SRH was predicted by lower education and anxiety disorders at baseline, while poorer QoL was predicted by affective disorders at baseline.
Conclusions:
When present, CHR, in particular basic symptoms are already distressful for individuals of the community and associated with poorer subjective QoL and health. Therefore, the symptoms are clinically relevant by themselves, even when criteria for a CHR state are not fulfilled. Yet, unlike affective and anxiety disorders, CHR symptoms seem to have no long-term influence on QoL and SRH.
This study investigated health-related quality of life outcomes for children with cochlear implants in India using the Glasgow Children's Benefit Inventory questionnaire. Cochlear implantation is associated with improved language outcomes. Some studies show this gives higher quality of life after implantation. Previous research demonstrates that India presents unique circumstances that impact perspectives regarding cochlear implantation.
Method
Children (aged under 18 years) who had undergone cochlear implantation were recruited from Vani Pradan Kendra, an organisation for individuals with hearing loss based in Bangalore, India. Demographic data including age, sex, duration of hearing loss and age at implant were collected, and the children's parents or caregivers completed the Glasgow Children's Benefit Inventory questionnaire.
Results
Sixty-nine children (mean age: 8.0 ± 3.89 years) were recruited, and all reported improved quality of life after cochlear implantation. There was no effect of age, gender or education on reported benefits. However, a younger age at implant and longer experience with an implant were associated with greater quality of life improvements.
Conclusion
Cochlear implantation leads to improved quality of life, with greater improvements associated with earlier implantation. This supports early intervention in children with profound hearing loss.
We conducted a study to describe food profile, health status and stroke risk factors in the population of the Aeolian Islands.
Design
Self-administrated questionnaires regarding eating habits, health status and stroke risk factors were obtained from a sample of the general Aeolian population. We analysed the difference from common healthy eating habits indicated by the Italian Institute of Nutrition.
Setting
Current evidence finds the Mediterranean diet is a protective factor for cardio- and cerebrovascular diseases. The Aeolian Islands are an interesting study setting because of their peculiarity in the epidemiology of cerebrovascular and neurodegenerative diseases.
Participants
Individuals (n 586; age range 15–93 years; mean 52 (sd 18) years) living in the Aeolian Islands.
Results
We found low fish consumption in 13·3% and vitamin intake deficiency in 5·8% of participants. A marked excess of saturated fats was observed in 71·0% of participants. Sodium excess was reported almost in half of participants (49·0%). Eating habits were characterized by high consumption of fruits and vegetables, consistent use of olive oil and scanty use of cured meat. Health status as evaluated by the General Health Questionnaire was characterized by ‘normal distress’ level in the majority of participants.
Conclusions
Study findings show the eating habits and health status of the Aeolian people in an interesting setting of low incidence of cerebrovascular disease. This nutrition regimen has been proved to be protective against cerebrovascular disease. Nutrition is likely to contribute to the low incidence of stroke in this population.
The Kalyani cohort created in 2010 by the National Institute of Biomedical Genomics, West Bengal, India, is designed to serve as a platform for conducting prospective basic and translational studies on epidemiology and genomics of health and disease-related parameters, particularly of non-communicable diseases (NCDs). The overall goal is to assess behavioural, biological, genetic, social and environmental factors and obtain necessary evidence for effective health improvement. Collected baseline data comprise 15727 individuals, >14 years of age from seven municipal wards in the Kalyani and Gayeshpur regions. Data are being collected on demographics, current health status, medical history and health-related behaviours. Blood samples were also collected from a subset of individuals (n = 5132) and analysed for estimation of known markers of NCDs. DNA has been extracted from blood samples and stored for future use. Important baseline findings include a high prevalence of diabetes, dyslipidemias and hypothyroidism. Prevalence estimates for these disorders obtained from self-reported data are significantly lower, indicating that participants are unaware of their health problems. The identification of ‘at risk’ individuals will allow formation of sub-cohorts for further investigations of epidemiological and genetic risk factors for NCDs. Access to the resource, including data and blood samples, created by this study will be provided to other researchers.
This study examines the associations between subjective memory complaints (SMC) and health variables: multimorbidity, presence of certain diseases, health perceived state, difficulties seeing and hearing, pain, and use of medications and health services. Furthermore, we aim to identify risk groups based on multimorbidity and calculate the effect size for each of these relationships.
Methods:
Cross-sectional epidemiological study using a face-to-face interview with a structured questionnaire. Sample size: 1,342 people aged 65 years and older taken from a random sample of the census tracts. SMC were studied using questions regarding memory complaints.
Results:
Multimorbidity and polypharmacy are associated with SMC, so are impaired vision and hearing. SMC are more frequently present in people who use health services more intensively and exhibit reduced functional activity as a result of diseases. With respect to specific diseases, only cerebrovascular accidents and chronic constipation were associated with SMC. In regression analysis, predictors of SMC were vision and hearing impairment, poor self-perceived health, pain, and general practitioner visits. However, the effect size of these factors is low. The variables that indicate risk groups are number of diseases, reduced functional activity, hearing impairment, and poor self-perceived health.
Conclusions:
Memory complaints are a heterogeneous phenomenon. Our results confirm that multimorbidity, polypharmacy, greater use of health services, pain, and poor self-perceived health are associated with SMC. We identified two risk groups with a high percentage of complaints and a healthy group with a low percentage. Detecting these factors and these risk and healthy groups is useful in achieving proper patients management.
Studies on whether the co-occurrence of psychotic experiences (PEs) and depression confers a more pronounced decrement in health status and function compared with depression alone are scarce in the general adult population.
Method
Data on 195 479 adults aged ⩾18 years from the World Health Survey were analysed. Using the World Mental Health Survey version of the Composite International Diagnostic Interview (CIDI), depression in the past 12 months was categorized into four groups: depressive episode, brief depressive episode, subsyndromal depression, and no depression. Past 12-month psychotic symptoms were assessed using four questions on positive symptoms from the CIDI. Health status across seven domains (cognition, interpersonal activities, sleep/energy, self-care, mobility, pain/discomfort, vision) and interviewer-rated presence of a mental health problem were assessed. Multivariable logistic and linear regression analyses were performed to assess the associations.
Results
When compared with those with no depression, individuals with depression had higher odds of reporting at least one PE, and this was seen across all levels of depression severity: subsyndromal depression [odds ratio (OR) 2.38, 95% confidence interval (CI) 2.02–2.81], brief depressive episode (OR 3.84, 95% CI 3.31–4.46) and depressive episode (OR 3.75, 95% CI 3.24–4.33). Having coexisting PEs and depression was associated with a higher risk for observable illness behavior and a significant decline in health status in the cognition, interpersonal activities and sleep/energy domains, compared with those with depression alone.
Conclusions
This coexistence of depression and PEs is associated with more severe social, cognitive and sleep disturbances, and more outwardly apparent illness behavior. Detecting this co-occurrence may be important for treatment planning.
To determine if there is gender or laterality predilection in patients with semicircular canal dehiscence syndrome.
Methods:
A multi-institutional chart review was performed to identify patients diagnosed with semicircular canal dehiscence between 2000 and 2015. A systematic literature search was conducted using PubMed to further identify patients with semicircular canal dehiscence. Age, gender and laterality data were collected. Statistical analysis was performed to evaluate for gender or laterality preponderance.
Results:
A total of 682 patients with semicircular canal dehiscence were identified by literature and chart review. Mean age of diagnosis was 49.75 years (standard deviation = 15.33). Semicircular canal dehiscence was associated with a statistically significant female predominance (chi-square = 7.185, p = 0.007); the female-to-male ratio was 1.2 to 1. Left-sided semicircular canal dehiscence was most common, followed by right-sided then bilateral (chi-square = 23.457, p < 0.001).
Conclusion:
Semicircular canal dehiscence syndrome is most commonly left-sided and exhibits a female predominance. This may be secondary to morphological cerebral hemisphere asymmetries in both sexes and a predilection of women to seek more medical care than men.