Health behaviours and wellbeing of health workers amidst the COVID-19 pandemic

The coronavirus disease 2019(COVID-19)pandemic has led to heightened levels of anxiety and stress levels towards the health threats posed by the SARS-CoV-2 virus.At least 10%of those infected were health workers.In addition,a large proportion of infected cases and deaths were possibly due to SARS-CoV-2 infections acquired in hospitals or long-term care facilities.Health workers,especially those working on the frontline play a crucial role in controlling and preventing the COVID-19 pandemic.Previous studies reported that health workers were exposed to severe emotional stress(i.e.,burnout,depression and anxiety symptoms)during the outbreaks of infectious diseases including severe acute respiratory syndrome(SARS),Ebola and Middle East respiratory syndrome(MERS).It is therefore important to be aware that prolonged exposure to moderate-to severe stress can have negative health consequences and reduce the work performance of health workers.Therefore,some immediate measures should be taken by the health care institutions and relevant health authorities to ensure that Chinese health workers are better supported in caring for large number of COVID-19 patients.Future studies should examine the health status and work efficiency of health workers working in high stress environment amidst the COVID-19 pandemic or other disasters.

Family function and health behaviours of stroke survivors

Purpose:To investigate health behaviours and family function in stroke survivors,and evaluate the relationships among them.Methods:Patients who were diagnosed with stroke before and went back to neurology clinic between August 2011 and February 2012 in a tertiary hospital in Guangzhou,China were recruited for this study.Patients that were discharged and living at home for at least two months were asked to complete Family Assessment Device(FAD)and Health Promoting Lifestyle Profile,version II(HPLP-II)questionnaires.Individual items were scored between 1 and 4 points,and survey scores were compared and analysed using Pearson's correlations.Results:The mean overall FAD family function score was 2.18±0.25 points,with lower scores observed for problem solving and role function factors,and higher scores for communication,affection involvement,and behaviour control.The mean overall HPLP-II health behaviour score was 2.27±0.36 points,with the highest score for the nutrition factor,and the lowest score for the exercise factor.The total score of family function negatively correlated with health behaviours(r?0.535,p<0.01).Conclusions:Family function and health behaviours in stroke survivors are related,and need further improvement.Healthcare workers should pay close attention to patients'family function and health behaviours and find the reasons which may be influence their level.

Healthcare needs and access in a sample of Chinese young adults in Vancouver, British Columbia: A qualitative analysis

Objectives: Immigrants of Chinese ethnicity and young people (between 18 and 30 years of age) are known to access health services less frequently and may be at greater risk for experiencing unmet health needs. The purpose of this study was to examine the health beliefs, health behaviors, primary care access, and perceived unmet healthcare needs of Chinese young adults.Methods: Semi-structured in-depth interviews were carried out with eight Chinese young adults in Vancouver, Canada. Results: A content analysis revealed that these Chinese young adults experienced unmet healthcare needs, did not have a primary care provider, and did not access preventive services. Cultural factors such as strong family ties, filial piety, and the practice of Traditional Chinese Medicine influenced their health behaviors and healthcare access patterns. Conclusion: Chinese young adults share similar issues with other young adults in relation to not having a primary care provider and accessing preventive care but their health beliefs and practices make their needs for care unique from other young adults.

Predictors of health-promoting behaviour among older adults with hypertension in Indonesia

Objectives:This study aimed to determine the predictors of health-promoting behaviour among older adults with hypertension in Bengkulu City,Bengkulu,Indonesia.Methods:A cross-sectional study was conducted in 333 older adults with hypertension,who were selected using multistage sampling method.Data were obtained by face-to-face interview with structured questionnaires.The questionnaires used in this study included the Health-Promoting Lifestyle Profile II(HPLP II),Hypertension Knowledge-Level Scale(HK-LS),Self-Rated Abilities for Health Practices Scale(SRAHP),Barriers to Health-promoting Behaviour Scales(BAS),Benefits to Health-Promoting Behaviour Scales(BES),Multidimensional Scale of Perceived Social Support(MSPSS)and Situational Influences Questionnaire(SIQ).Data were analysed by using multiple linear regressions.Results:The mean and standard deviation(Mean±SD)of each questionnaire were as follows:HPLP II,2.55±0.19;HK-LS,11.83±3.00;SRAHP,2.00±5.87;BAS,27.89±2.70;BES,34.29±2.29;MSPSS,60.35±8.12;and SIQ,47.71±6.66.According to the multiple linear regression model,36.9% of the variation in health-promoting behaviour among older adults with hypertension can be explained by six variables,namely,education,knowledge,self-efficacy,perceived barriers,social support and situational influences(adjusted R^(2)=0.369).Conclusions:High and good-quality education will increase the level of health-promoting behaviour,whereas barriers,such as expense and time requirement,can decrease it.Situational influences and support from family and friends can also influence the older adult's attempts to change their health behaviour.Increased self-efficacy will clearly result in improved health-promoting behaviour of older adults with hypertension.

Illness perception and cardiovascular health behaviour among persons with ischemic heart disease in Indonesia

Objective:A study was conducted to explore the level of illness perception,the level of cardiovascular health behaviour and the relationship between illness perception and cardiovascular health behaviour among persons with ischemic heart disease(IHD)in a community setting.Method:The participants comprised 235 persons with IHD.The instruments used were as follows:1)Demographic Data and Health Information,2)The Brief Illness Perception Questionnaire(Brief IPQ),3)The Open-ended Questionnaire(OEQ),and 4)The Modified Cardiac Health Behaviour Scale(MCHBS).Findings from the OEQ are used to assess in-depth illness perception and to extend the information obtained from the Brief IPQ.The design of the study was descriptive correlational.The data were analysed using descriptive statistics to present the demographic data and health information.Inferential statistics was used to resolve the relationship between illness perception and cardiovascular health behaviour by using Pearson's Product Moment Correlation.Result:The mean score of illness perception was at a moderate level(M=43.65,SD=3.93),whereas the mean score of cardiovascular health behaviour was at a high level(M=80.29,SD=5.42).A significant positive relationship existed between illness perception and cardiovascular health behaviour among persons with IHD(r=0.38,P<0.01).Conclusion:Persons with higher illness perception showed a positive correlation with higher cardiovascular health behaviour at a significant level of 0.01.Results provided important information for nurses to develop an intervention program to promoting appropriate illness perception and cardiovascular health behaviour among persons with IHD.

Wearable activity trackers and health awareness: Nursing implications

Purpose:Wearable devices are commonly used to measure physical activity.However,it remains unclear the effect of wearing these devices on health awareness.Our aim was to provide evidence related to wearing physical activity trackers and health awareness.Methods:A quantitative comparison study design was used comparing participants who wore physical activity tracking devices(n=108)and those who did not(n=112).A paper-based Physical Health Knowledge survey designed for the purpose of this research was used for data collection in 2018.Results:A difference between participants who wore physical activity tracking devices and those that did not was identified in relation to activity levels and physical health awareness.Wearable devices are suggested as an opportunity for nurses to engage people in physical activity with the potential to improve their health awareness.Conclusions:Nurses are well placed in the healthcare landscape to work with patients who own an activity tracker device concerning increasing activity self-monitoring.This information the patient has from the device can also form the basis of health discussions between nurses and the people in their care.

Widening the perspectives of fracture prevention in osteoporosis by identifying subgroups based upon psychological aspects and health behaviour

The potential importance of psychological aspects in relation to risk factors for fractures and preventing unhealth behaviour has rarely been investigated in the field of osteoporosis. This study explores some psychological aspects and health behaviour of people detected to have osteoporosis at the time of a forearm fracture. Moreover, it aims at revealing subgroups within this population with clinical relevance for managing secondary prevention actions. Data collection was based on questionnaires and physical tests. Eighty-five individual were analysed. The results confirm earlier research on a similar population having relatively good self-reported health behaviour. The individuals reported high quality of life, high amount of physical activity and low alcohol intake. A majority reported good osteoporosis knowledge, a high sense of coherence (mean = 74) and high activity-specific balance confidence (mean = 81). Furthermore, hierarchical cluster analysis indicated a typology of two subgroups where 75% matched a health-resilient group while 25% matched a health-vulnerable group. The vulnerable group had a significantly lower sense of coherence SOC (p = 0.02) and activity-specific balance confidence, ABC (p = 0.001). This pattern was confirmed from behavioural aspects but only regarding one traditional risk factor namely the history of fractures. The health-vulnerable group achieved a significantly weaker physical profile, less reported time spent outdoors and lower quality of life. The differences found between the subgroups indicate that this typology, as a complement to models based upon relative risk like FRAX, can be relevant for widening perspectives in future research and clinical practice of fracture prevention in osteoporosis.

Global prevalence and gender inequalities in at least 60 min of self-reported moderate-to-vigorous physical activity 1 or more days per week:An analysis with 707,616 adolescents

Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For instance,from a population-level point of view,increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels.Also,including a more sensitive cut-point of≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice.Thus,the current study aims to estimate the prevalence of≥60 min of MVPA≥1 days per week among adolescents globally,and to describe any relevant gender inequalities.Methods:We used representative datasets from 146 countries/territories collected between 2003 and 2019.MVPA was self-reported.Participants were grouped into younger(≤14 years old)and older(>14 years old)adolescents.Crude Poisson regression models were used to identify the relative differences in≥60 min of MVPA≥1 days per week between boys and girls,and random-effects meta-analysis models were used to identify the pooled estimates.Analyses were stratified by country and region.Results:Approximately 80%of both younger and older adolescents reported≥60 min of MVPA≥1 days per week.This prevalence was≥94%in Europe and Central Asia and North America,while the estimates for the other regions were<77%.The prevalence of≥60 min of MVPA≥1 days per week was higher among boys than girls,with the largest differences occurring among the oldest adolescents(Prevalence ratio_(≤14y)=1.04(95%confidence interval(95%CI)):1.03-1.04)vs.Prevalence ratio_(>14y)=1.09(95%CI:1.08-1.10)).Conclusion:Approximately 8 out of 10 adolescents reported accumulating≥60 min of MVPA≥1 days per week,with notable differences between regions.Gender differences were observed in several countries,especially among the oldest adolescents.Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve≥60 min of MVPA≥1 days per week and reducing gender inequalities.

Better understanding of c-reactive protein and leukocytes in psychiatric inpatients with affective disorders:A biopsychosocial approach

BACKGROUND Affective disorders(AD)have been linked to inflammatory processes,although the underlying mechanisms of this relationship are still not fully elucidated.It is hypothesized that demographic,somatic,lifestyle,and personality variables predict inflammatory parameters in AD.AIM To identify biopsychosocial factors contributing to inflammation in AD measured with two parameters,C-reactive protein(CRP)and leukocytes.METHODS This observational study investigated 186 hospital inpatients diagnosed with AD using demographic parameters,serum inflammatory markers,somatic variables,psychological questionnaires,and lifestyle parameters.Hierarchical regression analyses were used to predict inflammatory markers from demographic,somatic,lifestyle,and personality variables.RESULTS Analyses showed that 33.8%of the variance of CRP was explained by body mass index and other somatic medication(e.g.anti-diabetics),age and education,and age of affective disorder diagnosis.For leukocytes,20.1%of the variance was explained by smoking,diet,metabolic syndrome(MetS),and anti-inflammatory medication(e.g.non-steroidal anti-inflammatory drugs).Other psychiatric or behavioural variables did not reach significance.CONCLUSION Metabolic components seem important,with mounting evidence for a metabolic affective disorder subtype.Lifestyle modifications and psychoeducation should be employed to prevent or treat MetS in AD.

Exploring Challenges in Developing a Smart and Effective Assistive System for Improving the Experience of the Elderly Drivers

As the overall population ages, driving-related accidents and injuries, associated with elderly drivers, have risen. Existing research about elderly drivers mainly focuses on factual data collection and analysis, indicating the elderly＇s growing fatal accident rates and their different behaviours compared to younger drivers. However, few research has focused on design-led practical solutions to mitigate the elderly＇s growing fatal accidents, by consid- ering their usability and body conditions, afflicting the elderly, such as decreased vision, hearing, and reaction times. In this paper, first, current worldwide situations on growing fatal accident rates for elderly drivers is reviewed and the key impact factors are identified and discussed with regarding to usability and design trend in the automotive technology for elderly. Second, existing smart vehicle technology-based solutions to promote safe driving are explored and their pros and cons are discussed and anal- ysed. Most of solutions are not created by people with driving difficulties, which are caused by health problems most commonly afflicting the elderly. Thirdly, diverse design-led research activities are taken, such as a survey, observation, and interviews to gain new understanding of what kinds of driving problems elderly drivers have and demonstrate how new system concepts could be developed for the elderly＇s benefits. Finally, it is found that the elderly＇s low vision and late reaction are main factors causing their driving difficulties. Based on this finding, usable vehicle system design ideas have been proposed, by utilising facial expression sensing technology as a solution. The proposed solutions would ensure reducing both the elderly＇s driving problems and high fatal accident rates and provide a more enjoyable driving environment for the elderly population.

Cultural drivers and health-seeking behaviours that impact on the transmission of pig-associated zoonoses in Lao People’s Democratic Republic

Pig rearing is an important income source in the Lao People’s Democratic Republic(PDR),with many smallholder farmers using traditional free-range pig production systems.Despite the potentially significant health risks posed by pig production regarding pig-associated zoonoses,information on the sociocultural drivers of these zoonoses is significantly lacking.This review summarises the existing sociocultural knowledge on eight pig-associated zoonoses suspected to be endemic in Southeast Asia:brucellosis,Q fever(Coxiella burnetii),trichinellosis,hepatitis E virus,leptospirosis,Japanese encephalitis,Streptococcus suis and Taenia solium taeniasis-cysticercosis.It summarises current knowledge on these diseases grouped according to their clinical manifestations in humans to highlight the propensity for underreporting.A literature search was conducted across multiple databases for publications from 1990 to the present day related to the eight pig-associated zoonoses and the risk and impact connected with them,with Lao PDR as a case study.Many of these pig-associated zoonoses have similar presentations and are often diagnosed as clinical syndromes.Misdiagnosis and underreporting are,therefore,substantial and emphasise the need for more robust diagnostics and appropriate surveillance systems.While some reports exist in other countries in the region,information is significantly lacking in Lao PDR with existing information coming mainly from the capital,Vientiane.The disease burden imposed by these zoonoses is not only characterised by morbidity and mortality,but directly impacts on livelihoods through income reduction and production losses,and indirectly through treatment costs and lost work opportunities.Other factors crucial to understanding and controlling these diseases are the influence of ethnicity and culture on food-consumption practices,pig rearing and slaughter practices,hygiene and sanitation,health-seeking behaviours and,therefore,risk factors for disease transmission.Published information on the knowledge,attitudes and beliefs of people regarding pig zoonoses and their risk factors is also extremely limited in Lao PDR and the broader Southeast Asian region.The need for more transdisciplinary research,using a One Health approach,in order to understand the underlining social determinants of health and their impacts on health-seeking behaviours,disease transmission and,ultimately,disease reporting,cannot be more emphasized.

Coastal Accessibility and Availability for Physical Activity: A Cross-Sectional Assessment in New Zealand Adults

Background: This study aimed to examine cross-sectional relationships between objective measures of the built environment (neighborhood walkability and access to and availability of public open spaces including the coast) with self-reported physical activity in adults residing in Auckland, New Zealand. Methods: A telephone survey captured self-reported physical activity and socio-demographic information from adult residents from randomly selected households. Robust approaches were employed to deriving and “ground-truthing” objective built environment measures around individual addresses. Multivariable binary logistic regression models were used to examine the associations between environmental factors and being classified as accumulating sufficient physical activity or otherwise. Results: A total of 1986 participants agreed to participate. Compared with those with no coastal access points within an 800 m street network buffer of their residence, those with 1 - 2 access points were 1.45 times more likely to be classified as sufficiently active (95% CI 1.08, 1.94, p = 0.05). Compared with individuals with no coastal settings within their neighborhood buffer, those with at least two coastal settings in their neighborhood were significantly more likely to be sufficiently active (p = 0.03). Conclusion: Access to, and availability of, coastal places were important associates of accumulating sufficient activity for health in this population.

Factors associated with changes in physical activity and sedentary behaviour during one year among university-based young adults

The purpose of this study was to identify correlates of changes in physical activity(PA)and sedentary behaviour(SB)among university-based young adults in Bangladesh.Data were from a 1-year prospective study with 2 assessment points(baseline n=573,20.7±1.35 years,45%female;retention rate 69%,analytical sample=395).Participants completed a self-administered written survey on PA,SB,health and lifestyle be-haviours,and sociodemographics.Changes in PA were categorised as:negligible(±<60 min/week),>60 min/week decrease,or>60 min/week increase.Changes in SB were categorised as negligible(±<120 min/week),>120 min/week decrease,and>120 min/week increase.Multinomial logistic regression analysis was used to identify the correlates.About quarters(72%)of participants had insufficient PA at both assessment points.Of those who were sufficiently active at Wave 1,5%became insufficiently active at Wave 2.One quarter of par-ticipants(23%)had high SB at Wave 1 and Wave 2.Of those who had low SB at Wave 1,16%had high SB at Wave 2.Being male[OR=2.04(95%CI:1.06–3.93)],baseline phone time of>2 h/day[OR=3.14(95%CI:1.04–7.04)]and not participating in organised sports at baseline[OR=2.56(95%CI:1.24–5.29)]were associated with a decrease in PA by>60 min/week.Participants who frequently experienced stress at baseline had higher odds of increasing SB by>120 min/day[OR=1.83(95%CI:1.04–3.23)].SB is more variable than PA over 1 year in university-based young adults in Bangladesh.Males,those with high phone time,those not engaging with organised sports,and those with frequent stress may change to a more inactive lifestyle.