Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town,Silte Zone,Southern Nation’s Nationalities and People’s Region,Ethiopia

Background

Mental illnesses worldwide are accompanied by another pandemic, that of stigma and discrimination. Public understanding about mental illnesses and attitudes towards people with mental illness play a paramount role in the prevention and treatment of mental illness and the rehabilitation of people with mental illness.

Objective

To assess community attitude and associated factors towards people with mental illness.

Methods

Community based cross-sectional study was conducted from April 28 to May 28, 2014. Quantitative data were collected through interview from 435 adults selected using simple random sampling. Data were collected using community attitude towards mentally ill (CAMI) tool to assess community attitude towards people with mental illness and associated factors. Multiple linear regression analysis was performed to identify predictors of community attitude towards people with mental illness and the level of significance association was determined by beta with 95% confidence interval and P less than 0.05.

Results

The highest mean score was on social restrictiveness subscale (31.55±5.62). Farmers had more socially restrictive view (β = 0.291, CI [0.09, 0.49]) and have less humanistic view towards mentally ill (β = 0.193, CI [-0.36, -0.03]). Having mental health information had significantly less socially restrictive (β = -0.59, CI [-1.13, -0.05]) and less authoritarian (β = -0.10, CI [-1.11, -0.06]) view towards mentally ill but respondents who are at university or college level reported to be more socially restrictive (β = 0.298, CI [0.059, 0.54]). Respondents whose age is above 48 years old had significantly less view of community mental health ideology (β = -0.59, CI [-1.09, -0.08]).

Conclusion and Recommendation

Residents of Worabe town were highly socially restrictive but less authoritarian. There was high level of negative attitude towards people with mental illness along all the subscales with relative variation indicating a need to develop strategies to change negative attitude attached to mental illness in Worabe town at community level.     

Social Support and Health in Diabetes Patients: An Observational Study in Six European Countries in an Era of Austerity

Introduction

Support from individual social networks, community organizations and neighborhoods is associated with better self-management and health outcomes. This international study examined the relative impact of different types of support on health and health-related behaviors in patients with type 2 diabetes.

Methods

Observational study (using interviews and questionnaires) in a sample of 1,692 type 2 diabetes patients with 5,433 connections from Bulgaria, Greece, Netherlands, Norway, Spain, and the United Kingdom. Outcomes were patient-reported health status (SF-12), physical exercise (RAPA), diet and smoking (SDCSCA). Random coefficient regression models were used to examine linkages with individual networks, community organizations, and neighborhood type (deprived rural, deprived urban, or affluent urban).

Results

Patients had a median of 3 support connections and 34.6% participated in community organizations. Controlled for patients’ age, sex, education, income and comorbidities, large emotional support networks were associated with decrease of non-smoking (OR = 0.87). Large practical support networks were associated with worse physical and mental health (B = -0.46 and -0.27 respectively) and less physical activity (OR = 0.90). Participation in community organizations was associated with better physical and mental health (B = 1.39 and 1.22, respectively) and, in patients with low income, with more physical activity (OR = 1.53).

Discussion

Participation in community organizations was most consistently related to better health status. Many diabetes patients have individual support networks, but this study did not provide evidence to increase their size as a public health strategy. The consistent association between participation in community organizations and health status provides a clear target for interventions and policies.     

Organized Sport Participation Is Associated with Higher Levels of Overall Health-Related Physical Activity in Children (CHAMPS Study-DK)

Introduction

Many children fail to meet international guideline recommendations for health-related activity (≥60 minutes/day of moderate-to-vigorous physical activity [MVPA]), and intervention studies to date have reported negligible effects.

Objective

Explore the associations of organized leisure-time sport participation with overall physical activity levels and health-related physical activity guideline concordance.

Methods

This prospective cohort study was nested in the Childhood Health, Activity, and Motor Performance School Study Denmark. Study participants were a representative sample of 1124 primary school students. Organized leisure-time sport participation was reported via text messaging and physical activity was objectively measured over seven days with accelerometry. Associations between sport participation and physical activity level were explored with multilevel mixed-effects regression models and reported with beta coefficients (b) and adjusted odds ratios (aOR).

Results

Participants were 53% female, with mean(SD) age = 8.4(1.4) years. Boys were more active than girls (p<0.001), and physical activity levels and guideline concordance decreased with age (p<0.001). Soccer participation at any frequency was associated with greater overall MVPA (b[95% CI] = 0.66[0.20,1.13] to 2.44[1.44,3.44]). Depending on participation frequency, this equates to 5–20 minutes more MVPA on the average day and 3 to 15 fold increased odds of achieving recommended levels of health-related physical activity (aOR[95%CI] = 3.04[1.49,6.19] to 14.49[1.97,106.56]). Similar associations were identified among children playing handball at least twice per week. Relationships with other sports (gymnastics, basketball, volleyball) were inconsistent.

Conclusions

Many children, particularly girls and those in higher grade levels do not adhere to health-related physical activity recommendations. Organized leisure-time sport participation may be a viable strategy to increase overall health-related physical activity levels and international guideline concordance in children.     

Motivation and Barriers for Leisure-Time Physical Activity in Socioeconomically Disadvantaged Women

Introduction

The aim of this study was to examine cross-sectional and longitudinal associations between motivation and barriers for physical activity, and physical activity behavior in women living in socioeconomic disadvantage. This study also examined whether weight control intentions moderate those associations.

Methods

Data from 1664 women aged 18–46 years was collected at baseline and three-year follow-up as part of the Resilience for Eating and Activity Despite Inequality study. In mail-based surveys, women reported sociodemographic and neighborhood environmental characteristics, intrinsic motivation, goals and perceived family barriers to be active, weight control intentions and leisure-time physical activity (assessed through the IPAQ-L). Linear regression models assessed the association of intrinsic motivation, goals and barriers with physical activity at baseline and follow-up, adjusting for environmental characteristics and also physical activity at baseline (for longitudinal analyses), and the moderating effects of weight control intentions were examined.

Results

Intrinsic motivation and, to a lesser extent, appearance and relaxation goals for being physically active were consistently associated with leisure-time physical activity at baseline and follow-up. Perceived family barriers, health, fitness, weight and stress relief goals were associated with leisure-time physical activity only at baseline. Moderated regression analyses revealed that weight control intentions significantly moderated the association between weight goals and leisure-time physical activity at baseline (β = 0.538, 99% CI = 0.057, 0.990) and between intrinsic motivation and leisure-time physical activity at follow-up (β = 0.666, 99% CI = 0.188, 1.145). For women actively trying to control their weight, intrinsic motivation was significantly associated with leisure-time physical activity at follow-up (β = 0.184, 99% CI = 0.097, 0.313).

Conclusions

Results suggest that, especially in women trying to control their weight, intrinsic motivation plays an important role in sustaining physical activity participation over time. Also, weight goals for being physically active seem to play a role regarding short-term physical activity participation in this particular population. Addressing these motivational features may be important when promoting physical activity participation in women living in socioeconomically disadvantaged neighborhoods.     

Where You Live May Make You Old: The Association between Perceived Poor Neighborhood Quality and Leukocyte Telomere Length

Background

Strong evidence supports that living in disadvantaged neighborhoods has direct unfavorable impact on mental and physical health. However, whether it also has direct impact on cellular health is largely unknown. Thus we examined whether neighborhood quality was associated with leukocyte telomere length, an indicator of cellular aging.

Methods

In May 2014, we extracted and analyzed baseline data from the Netherlands Study of Depression and Anxiety (NESDA), a large epidemiological study of individuals age between 18–65 years (n=2902). Telomere length was determined using quantitative polymerase chain reaction. Neighborhood quality was assessed using modified measures of perceived neighborhood disorder, fear of crime, and noise. We used multivariable linear regression models to examine association between perceived neighborhood quality and telomere length with comprehensive adjustment for individual and community characteristics related to socioeconomic and demographic status, urbanization level, mental and physical health, and lifestyle.

Results

Compared to individuals who reported good neighborhood quality, the mean telomere length of those who reported moderate neighborhood quality was approximately 69 base pair shorter (β =-69.33, 95% CI: -119.49, -19.17, p= 0.007), and that of those who reported poor neighborhood quality were 174 base pair shorter (β =-173.80, 95% CI: -298.80, -49.01, p=0.006). For illustrative purposes, one could extrapolate these outcomes to 8.7 and 11.9 years in chronological age, respectively.

Conclusion

We have established an association between perceived neighborhood quality and cellular aging over and above a range of individual attributes. Biological aging processes may be impacted by socioeconomic milieu.     

Factors Affecting Gender Differences in the Association between Health-Related Quality of Life and Metabolic Syndrome Components: Tehran Lipid and Glucose Study

Objective

Using structural equation modeling, this study is one of the first efforts aimed at assessing influential factors causing gender differences in the association between health-related quality of life (HRQoL) and metabolic syndrome.

Methods

A sample of 950 adults, from Tehran Lipid and Glucose Study were recruited for this cross sectional study in 2005–2007. Health-related quality of life was assessed using the Iranian version of SF-36. Metabolic syndrome components (MetSCs) and physical and mental HRQoL were considered as continuous latent constructs explaining the variances of their observed components. Structural equation modeling was performed to examine the association between the constructs of MetSCs and the physical and mental HRQoL within the two gender groups.

Results

Based on the primary hypothesis, MetSCs and HRQoL were fitted in a model. The negative effect of MetSCs on HRQoL was found to be significant only in the physical domain and only in women. The proportion of all the cardio-metabolic risk factors as well as subscales of physical HRQoL that have been explained via the two constructs of MetSCs and HRQoL, respectively, were significantly higher in women. Physical activity in both men (β = 3.19, p<0.05) and women (β = 3.94, p<0.05), age (β = -3.28, p<0.05), education (β = 2.63, p<0.05) only in women and smoking (β = 2.28, p<0.05) just in men, directly affected physical HRQoL. Regarding the mental domain, physical activity (β = 3.37, p<0.05) and marital status (β = 3.44, p<0.05) in women and age (β = 2.01, p<0.05) in men were direct effective factors. Age and education in women as well as smoking in men indirectly affected physical HRQoL via MetSCs.

Conclusion

Gender differences in the association between MetSCs and physical HRQoL could mostly be attributed to the different structures of both MetSCs and physical HRQoL constructs in men and women. Age and smoking are the most important socio-behavioral factors which could affect this gender-specific association in the mental domain.     

Social Capital as a Determinant of Pregnant Mother’s Place of Delivery: Experience from Kongwa District in Central Tanzania

Introduction

Maternal ill health contributes highly to the global burden of diseases in countries South of Sahara including Tanzania. Ensuring that all deliveries take place in health facilities and hence attended by skilled health personnel is one of the strategies advocated by global and national policies, including the Millennium Development Goals (MDGs). However, the number of women delivered by skilled health personnel has remained low in sub Saharan Africa despite of a number of interventions. We sought to determine the role of social capital in facilitating health facility delivery.

Methods

We randomly selected 744 households with children aged less than five years from two randomly selected wards in a rural area in Tanzania. Mothers were enquired about place of delivery of the last child. Social capital was assessed using a modified questionnaire with both structural and cognitive aspects of social capital, administered in face-to-face interviews. Principal Component Analysis (PCA) was used to develop asocial capital index measure. Uni-variate and multivariable regression models were run using STATA 12.

Results

Majority (85.9%) of the mothers reported to have delivered in a health facility during their last birth. Compared to the lowest social capital quintile, delivering in a health facility increased significantly with increase in social capital level: low (Adjusted Odds Ratio (AOR) = 2.9; Confidence Interval (CI): 1.4–6.1, p = 0.004); moderate (AOR = 5.5, CI: 2.3–13.3, p-value<0.001); high (AOR = 4.7; CI: 1.9–11.6, p-value<0.001) and highest (AOR = 5.6, CI: 2.4–13.4, p-value<0.001) and χ²-test for the trend was significant (χ² = 17.21, p<0.001).

Conclusion

Overall, social capital seems to play an important role in enhancing health facility delivery that may lead to improved maternal and child health. Concerted efforts should focus on promoting and supporting effective social capital and in particular cognitive social capital.     

Time Out-of-Home and Cognitive,Physical, and Emotional Wellbeing of Older Adults: A Longitudinal Mixed Effects Model

Background

Time out-of-home has been linked with numerous health outcomes, including cognitive decline, poor physical ability and low emotional state. Comprehensive characterization of this important health metric would potentially enable objective monitoring of key health outcomes. The objective of this study is to determine the relationship between time out-of-home and cognitive status, physical ability and emotional state.

Methods and Findings

Participants included 85 independent older adults, age 65–96 years (M = 86.36; SD = 6.79) who lived alone, from the Intelligent Systems for Assessing Aging Changes (ISAAC) and the ORCATECH Life Laboratory cohorts. Factors hypothesized to affect time out-of-home were assessed on three different temporal levels: yearly (cognitive status, loneliness, clinical walking speed), weekly (pain and mood) or daily (time out-of-home, in-home walking speed, weather, and season). Subject characteristics including age, race, and gender were assessed at baseline. Total daily time out-of-home in hours was assessed objectively and unobtrusively for up to one year using an in-home activity sensor platform. A longitudinal tobit mixed effects regression model was used to relate daily time out-of-home to cognitive status, physical ability and emotional state. More hours spend outside the home was associated with better cognitive function as assessed using the Clinical Dementia Rating (CDR) Scale, where higher scores indicate lower cognitive function (β _CDR = -1.69, p<0.001). More hours outside the home was also associated with superior physical ability (β _Pain = -0.123, p<0.001) and improved emotional state (β _Lonely = -0.046, p<0.001; β _{Low mood} = -0.520, p<0.001). Weather, season, and weekday also affected the daily time out-of-home.

Conclusions

These results suggest that objective longitudinal monitoring of time out-of-home may enable unobtrusive assessment of cognitive, physical and emotional state. In addition, these results indicate that the factors affecting out-of-home behavior are complex, with factors such as living environment, weather and season significantly affecting time out-of-home. Studies investigating the relationship between time out-of-home and health outcomes may be optimized by taking into account the environment and life factors presented here.     

Impact of Individual-Level Social Capital on Quality of Life among AIDS Patients in China

Background

With growing recognition of the social determinants of health, social capital is an increasingly important construct in international health. However, the application of social capital discourse in response to HIV infection remains preliminary. The aim of this study was to assess the impact of social capital on quality of life (QoL) among adult patients with acquired immune deficiency syndrome (AIDS).

Methods

A convenient sample of 283 patients receiving antiretroviral treatment (ART) was investigated in Anhui province, China. QoL data were collected using the Medical Outcomes Study HIV Survey (MOS-HIV) questionnaire. Social capital was measured using a self-developed questionnaire. Logistic regression models were used to explore associations between social capital and QoL.

Results

The study sample had a mean physical health summary (PHS) score of 50.13±9.90 and a mean mental health summary (MHS) score of 41.64±11.68. Cronbach''s α coefficients of the five multi-item scales of social capital ranged from 0.44 to 0.79. When other variables were controlled for, lower individual levels of reciprocity and trust were associated with a greater likelihood of having a poor PHS score (odds ratio [OR] = 2.02) or PHS score (OR = 6.90). Additionally, the factors of social support and social networks and ties were associated positively with MHS score (OR = 2.30, OR = 4.17, respectively).

Conclusions

This is the first report to explore the effects of social capital on QoL of AIDS patients in China. The results indicate that social capital is a promising avenue for developing strategies to improve the QoL of AIDS patients in China, suggesting that the contribution of social capital should be fully exploited, especially with enhancement of QoL through social participation. Social capital development policy may be worthy of consideration.     

Early Childhood Development and Schooling Attainment: Longitudinal Evidence from British,Finnish and Philippine Birth Cohorts

Background

While recent literature has highlighted the importance of early childhood development for later life outcomes, comparatively little is known regarding the relative importance of early physical and cognitive development in predicting educational attainment cross-culturally.

Methods

We used prospective data from three birth cohorts: the Northern Finland Birth Cohort of 1986 (NFBC1986), the 1970 British Cohort Study (BCS1970), and the Cebu Longitudinal Health and Nutrition Survey of 1983 (CLHNS) to assess the association of height-for-age z-score (HAZ) and cognitive development measured prior to age 8 with schooling attainment. Multivariate linear regression models were used to estimate baseline and adjusted associations.

Results

Both physical and cognitive development were highly predictive of adult educational attainment conditional on parental characteristics. The largest positive associations between physical development and schooling were found in the CLHNS (β = 0.53, 95%-CI: [0.32, 0.74]) with substantially smaller associations in the BCS1970 (β = 0.10, 95% CI [0.04, 0.16]) and the NFBC1986 (β = 0.06, 95% CI [-0.05, 0.16]). Strong associations between cognitive development and educational attainment were found for all three cohorts (NFBC1986: β = 0.22, 95%-CI: [0.12, 0.31], BCS1970: β = 0.58, 95%-CI: [0.52, 0.64], CLHNS: β = 1.08, 95%-CI: [0.88, 1.27]). Models jointly estimating educational associations of physical and cognitive development demonstrated weaker associations for physical development and minimal changes for cognitive development.

Conclusion

The results indicate that although physical and cognitive early development are both important predictors of educational attainment, cognitive development appears to play a particularly important role. The large degree of heterogeneity in the observed effect sizes suggest that the importance of early life physical growth and cognitive development is highly dependent on socioeconomic and institutional contexts.     

Health Behaviours As a Mechanism in the Prospective Relation between Workplace Reciprocity and Absenteeism: A Bridge too Far ?

Background

The persistent lack of evidence on causal mechanisms between social capital and health threatens the credibility of the social capital—health association. The present study aims to address this ongoing problem by investigating whether health behaviours (i.e. smoking, alcohol consumption, and physical activity) mediate the prospective relation between workplace reciprocity and future sickness absence.

Methods

A cohort of 24,402 Belgian employees was followed up during 12 months for sickness absence. Workplace reciprocity was measured with four indicators—colleague help, colleague interest, supervisor help, and supervisor concern. Three types of multilevel mediation models were applied.

Results

Overall, workplace reciprocity negatively related to high sickness absence (≥ 10 days) mainly independently from health behaviours. Uniquely, colleague interest positively related to smoking (OR = 1.058, 95% CI = 1.019, 1.098) and smoking in turn, positively related to sickness absence (OR = 1.074, 95% CI = 1.047, 1.101). No behavioural pathways could be identified between company-level reciprocity and sickness absence, and company-level health-related behaviours did not mediate the relation between company-level reciprocity and individual sickness absence.

Conclusions

These results suggest that both social capital and health behaviours are relevant for employee health, but health behaviours seem not to be the underlying explanatory mechanism between workplace reciprocity and health.     

Relationship among Medical Student Resilience,Educational Environment and Quality of Life

Context

Resilience is a capacity to face and overcome adversities, with personal transformation and growth. In medical education, it is critical to understand the determinants of a positive, developmental reaction in the face of stressful, emotionally demanding situations. We studied the association among resilience, quality of life (QoL) and educational environment perceptions in medical students.

Methods

We evaluated data from a random sample of 1,350 medical students from 22 Brazilian medical schools. Information from participants included the Wagnild and Young’s resilience scale (RS-14), the Dundee Ready Educational Environment Measure (DREEM), the World Health Organization Quality of Life questionnaire – short form (WHOQOL-BREF), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI).

Results

Full multiple linear regression models were adjusted for sex, age, year of medical course, presence of a BDI score ≥ 14 and STAI state or anxiety scores ≥ 50. Compared to those with very high resilience levels, individuals with very low resilience had worse QoL, measured by overall (β=-0.89; 95% confidence interval =-1.21 to -0.56) and medical-school related (β=-0.85; 95%CI=-1.25 to -0.45) QoL scores, environment (β=-6.48; 95%CI=-10.01 to -2.95), psychological (β=-22.89; 95%CI=-25.70 to -20.07), social relationships (β=-14.28; 95%CI=-19.07 to -9.49), and physical health (β=-10.74; 95%CI=-14.07 to -7.42) WHOQOL-BREF domain scores. They also had a worse educational environment perception, measured by global DREEM score (β=-31.42; 95%CI=-37.86 to -24.98), learning (β=-7.32; 95%CI=-9.23 to -5.41), teachers (β=-5.37; 95%CI=-7.16 to -3.58), academic self-perception (β=-7.33; 95%CI=-8.53 to -6.12), atmosphere (β=-8.29; 95%CI=-10.13 to -6.44) and social self-perception (β=-3.12; 95%CI=-4.11 to -2.12) DREEM domain scores. We also observed a dose-response pattern across resilience level groups for most measurements.

Conclusions

Medical students with higher resilience levels had a better quality of life and a better perception of educational environment. Developing resilience may become an important strategy to minimize emotional distress and enhance medical training.     

Health-Related Quality of Life of Latin-American Immigrants and Spanish-Born Attended in Spanish Primary Health Care: Socio-Demographic and Psychosocial Factors

Background

This study compares the health-related quality of life of Spanish-born and Latin American-born individuals settled in Spain. Socio-demographic and psychosocial factors associated with health-related quality of life are analyzed.

Methods

A cross-sectional Primary Health Care multi center-based study of Latin American-born (n = 691) and Spanish-born (n = 903) outpatients from 15 Primary Health Care Centers (Madrid, Spain). The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess health-related quality of life. Socio-demographic, psychosocial, and specific migration data were also collected.

Results

Compared to Spanish-born participants, Latin American-born participants reported higher health-related quality of life in the physical functioning and vitality dimensions. Across the entire sample, Latin American-born participants, younger participants, men and those with high social support reported significantly higher levels of physical health. Men with higher social support and a higher income reported significantly higher mental health. When stratified by gender, data show that for men physical health was only positively associated with younger age. For women, in addition to age, social support and marital status were significantly related. Both men and women with higher social support and income had significantly better mental health. Finally, for immigrants, the physical and mental health components of health-related quality of life were not found to be significantly associated with any of the pre-migration factors or conditions of migration. Only the variable “exposure to political violence” was significantly associated with the mental health component (p = 0.014).

Conclusions

The key factors to understanding HRQoL among Latin American-born immigrants settled in Spain are age, sex and social support. Therefore, strategies to maintain optimal health outcomes in these immigrant communities should include public policies on social inclusion in the host society and focus on improving social support networks in order to foster and maintain the health and HRQoL of this group.     

Physical Activity Levels and Domains Assessed by Accelerometry in German Adolescents from GINIplus and LISAplus

Background

Physical activity (PA) is a well-known and underused protective factor for numerous health outcomes, and interventions are hampered by lack of objective data. We combined accelerometers with diaries to estimate the contributions to total activity from different domains throughout the day and week in adolescents.

Methods

Accelerometric and diary data from 1403 adolescents (45% male, mean age 15.6 ± 0.5 years) were combined to evaluate daily levels and domains of sedentary, light, and moderate-to-vigorous activity (MVPA) during a typical week. Freedson’s cutoff points were applied to determine levels of activity. Total activity was broken down into school physical education (PE), school outside PE, transportation to school, sport, and other time.

Results

About 2/3 of adolescents’ time was spent sedentary, 1/3 in light activity, and about 5% in MVPA. Boys and girls averaged 46 (SD 22) and 38 (23) minutes MVPA per day. Adolescents were most active during leisure sport, spending about 30% of it in MVPA, followed by PE (about 20%) transport to school (14%) and either school class time or other time (3%). PE provided 5% of total MVPA, while leisure sport provided 16% and transportation to school 8%. School was the most sedentary part of the day with over 75% of time outside PE spent sedentary.

Conclusions

These German adolescents were typical of Europeans in showing low levels of physical activity, with significant contributions from leisure sport, transportation and school PE. Leisure sport was the most active part of the day, and participation did not vary significantly by sex, study center (region of Germany) or BMI. Transportation to school was frequent and thus accounted for a significant fraction of total MVPA. This indicates that even in a population with good access to dedicated sporting activities, frequent active transportation can add significantly to total MVPA.     

How Possibly Do Leisure and Social Activities Impact Mental Health of Middle-Aged Adults in Japan?: An Evidence from a National Longitudinal Survey

Objectives

This study aimed to investigate longitudinal relations between leisure and social activities and mental health status, considering the presence or absence of other persons in the activity as an additional variable, among middle-aged adults in Japan. This study used nationally representative data in Japan with a five-year follow-up period.

Methods

This study focused on 16,642 middle-aged adults, age 50–59 at baseline, from a population-based, six-year panel survey conducted by the Japanese Ministry of Health, Labour and Welfare. To investigate the relations between two leisure activities (‘hobbies or cultural activities’ and ‘exercise or sports’) and four social activities (‘community events’, ‘support for children’, ‘support for elderly individuals’ and ‘other social activities’) at baseline and mental health status at follow-up, multiple logistic regression analysis was used. We also used multiple logistic regression analysis to investigate the association between ways of participating in these activities (‘by oneself’, ‘with others’, or ‘both’ (both ‘by oneself’ and ‘with others’)) at baseline and mental health status at follow-up.

Results

Involvement in both leisure activity categories, but not in social activities, was significantly and positively related to mental health status in both men and women.Furthermore, in men, both ‘hobbies or cultural activities’ and ‘exercise or sports’ were significantly related to mental health status only when conducted ‘with others’. In women, the effects of ‘hobbies or cultural activities’ on mental health status were no differences regardless of the ways of participating, while the result of ‘exercise or sports’ was same as that in men.

Conclusions

Leisure activities appear to benefit mental health status among this age group, whereas specific social activities do not. Moreover, participation in leisure activities would be effective especially if others are present. These findings should be useful for preventing the deterioration of mental health status in middle-aged adults in Japan.     

Effect of Dietary Patterns on Muscle Strength and Physical Performance in the Very Old: Findings from the Newcastle 85+ Study

Background

Healthy diet has been associated with better muscle strength and physical performance in cross-sectional studies of older adults but the effect of dietary patterns (DP) on subsequent decline, particularly in the very old (aged 85+), has not been determined.

Objective

We investigated the association between previously established DP and decline in muscle strength and physical performance in the very old.

Design

791 participants (61.8% women) from the Newcastle 85+ Study were followed-up for change in hand grip strength (HGS) and Timed Up-and Go (TUG) test over 5 years (four waves 1.5 years apart). Mixed models were used to determine the effects of DP on muscle strength and physical performance in the entire cohort and separately by sex.

Results

Previously we have established three DP that varied in intake of red meats, potato, gravy and butter and differed with key health and social factors. HGS declined linearly by 1.59 kg_F in men and 1.08 kg_F in women (both p<0.001), and TUG slowed by 0.13 log₁₀-transformed seconds (log₁₀-s) in men and 0.11 log₁₀-s in women per wave after adjusting for important covariates (both p<0.001), and also showed a nonlinear change (p<0.001). Men in DP1 (‘High Red Meat’) had worse overall HGS (β = -1.70, p = 0.05), but men in DP3 (‘High Butter’) had a steeper decline (β = -0.63, p = 0.05) than men in DP2 (‘Low Meat’). Men in DP1 and women in DP3 also had overall slower TUG than those in DP2 (β = 0.08, p = 0.001 and β = 0.06, p = 0.01, respectively), but similar rate of decline after adjusting for sociodemographic, lifestyle, health, and functioning factors. The results for HGS and TUG were not affected by participants’ cognitive status.

Conclusions

DP high in red meats, potato and gravy (DP1), or butter (DP3) may adversely affect muscle strength and physical performance in later life, independently of important covariates and cognitive status.     

Association between Physical Activity and Teacher-Reported Academic Performance among Fifth-Graders in Shanghai: A Quantile Regression

Introduction

A growing body of literature reveals the causal pathways between physical activity and brain function, indicating that increasing physical activity among children could improve rather than undermine their scholastic performance. However, past studies of physical activity and scholastic performance among students often relied on parent-reported grade information, and did not explore whether the association varied among different levels of scholastic performance. Our study among fifth-grade students in Shanghai sought to determine the association between regular physical activity and teacher-reported academic performance scores (APS), with special attention to the differential associational patterns across different strata of scholastic performance.

Method

A total of 2,225 students were chosen through a stratified random sampling, and a complete sample of 1470 observations were used for analysis. We used a quantile regression analysis to explore whether the association between physical activity and teacher-reported APS differs by distribution of APS.

Results

Minimal-intensity physical activity such as walking was positively associated with academic performance scores (β = 0.13, SE = 0.04). The magnitude of the association tends to be larger at the lower end of the APS distribution (β = 0.24, SE = 0.08) than in the higher end of the distribution (β = 0.00, SE = 0.07).

Conclusion

Based upon teacher-reported student academic performance, there is no evidence that spending time on frequent physical activity would undermine student’s APS. Those students who are below the average in their academic performance could be worse off in academic performance if they give up minimal-intensity physical activity. Therefore, cutting physical activity time in schools could hurt the scholastic performance among those students who were already at higher risk for dropping out due to inadequate APS.     

Relationship of the Perceived Social and Physical Environment with Mental Health-Related Quality of Life in Middle-Aged and Older Adults: Mediating Effects of Physical Activity

Background

Mental health conditions are among the leading non-fatal diseases in middle-aged and older adults in Australia. Proximal and distal social environmental factors and physical environmental factors have been associated with mental health, but the underlying mechanisms explaining these associations remain unclear. The study objective was to examine the contribution of different types of physical activity in mediating the relationship of social and physical environmental factors with mental health-related quality of life in middle-aged and older adults.

Methods

Baseline data from the Wellbeing, Eating and Exercise for a Long Life (WELL) study were used. WELL is a prospective cohort study, conducted in Victoria, Australia. Baseline data collection took place in 2010. In total, 3,965 middle-aged and older adults (55–65 years, 47.4% males) completed the SF-36 Health Survey, the International Physical Activity Questionnaire, and a questionnaire on socio-demographic, social and physical environmental attributes. Mediation analyses were conducted using the MacKinnon product-of-coefficients test.

Results

Personal safety, the neighbourhood physical activity environment, social support for physical activity from family or friends, and neighbourhood social cohesion were positively associated with mental health-related quality of life. Active transportation and leisure-time physical activity mediated 32.9% of the association between social support for physical activity from family or friends and mental health-related quality of life. These physical activity behaviours also mediated 11.0%, 3.4% and 2.3% respectively, of the relationship between the neighbourhood physical activity environment, personal safety and neighbourhood social cohesion and mental health-related quality of life.

Conclusions

If these results are replicated in future longitudinal studies, tailored interventions to improve mental health-related quality of life in middle-aged and older adults should use a combined strategy, focusing on increasing physical activity as well as social and physical environmental attributes.     

Associations of Sedentary Behaviour,Physical Activity,Blood Pressure and Anthropometric Measures with Cardiorespiratory Fitness in Children with Cerebral Palsy

Background

Children with cerebral palsy (CP) have poor cardiorespiratory fitness in comparison to their peers with typical development, which may be due to low levels of physical activity. Poor cardiorespiratory fitness may contribute to increased cardiometabolic risk.

Purpose

The aim of this study was to determine the association between sedentary behaviour, physical activity and cardiorespiratory fitness in children with CP. An objective was to determine the association between cardiorespiratory fitness, anthropometric measures and blood pressure in children with CP.

Methods

This study included 55 ambulatory children with CP [mean (SD) age 11.3 (0.2) yr, range 6-17 yr; Gross Motor Function Classification System (GMFCS) levels I and II]. Anthropometric measures (BMI, waist circumference and waist-height ratio) and blood pressure were taken. Cardiorespiratory fitness was measured using a 10 m shuttle run test. Children were classified as low, middle and high fitness according to level achieved on the test using reference curves. Physical activity was measured by accelerometry over 7 days. In addition to total activity, time in sedentary behaviour and light, moderate, vigorous, and sustained moderate-to-vigorous activity (≥10 min bouts) were calculated.

Results

Multiple regression analyses revealed that vigorous activity (β = 0.339, p<0.01), sustained moderate-to-vigorous activity (β = 0.250, p<0.05) and total activity (β = 0.238, p<0.05) were associated with level achieved on the shuttle run test after adjustment for age, sex and GMFCS level. Children with high fitness spent more time in vigorous activity than children with middle fitness (p<0.05). Shuttle run test level was negatively associated with BMI (r² = -0.451, p<0.01), waist circumference (r² = -0.560, p<0.001), waist-height ratio (r² = -0.560, p<0.001) and systolic blood pressure (r² = -0.306, p<0.05) after adjustment for age, sex and GMFCS level.

Conclusions

Participation in physical activity, particularly at a vigorous intensity, is associated with high cardiorespiratory fitness in children with CP. Low cardiorespiratory fitness is associated with increased cardiometabolic risk.     

Construct Validity of the SF-12v2 for the Homeless Population with Mental Illness: An Instrument to Measure Self-Reported Mental and Physical Health

Background

Self-reported health measures are important indicators used by clinicians and researchers for the evaluation of health interventions, outcome assessment of clinical studies, and identification of health needs to improve resource allocation. However, the application of self-reported health measures relies on developing reliable and valid instruments that are suitable across diverse populations. The main objective of this study is to evaluate the construct validity of the SF-12v.2, an instrument for measuring self-rated physical and mental health, for homeless adults with mental illness. Various interventions have been aimed at improving the health of homeless people with mental illness, and the development of valid instruments to evaluate these interventions is imperative.

Study Design

We measured self-rated mental and physical health from a quota sample of 575 homeless people with mental illness using the SF-12v2, EQ-5D, Colorado Symptoms Index, and physical/mental health visual analogue scales. We examined the construct validity of the SF-12v2 through confirmatory factor analyses (CFA), and using ANOVA/correlation analyses to compare the SF-12v2 to the other instruments to ascertain discriminant/convergent validity.

Results

Our CFA showed that the measurement properties of the original SF-12v2 model had a mediocre fit with our empirical data (χ² = 193.6, df = 43, p < .0001, CFI = 0.85, NFI = 0.83, RMSEA = 0.08). We demonstrate that changes based on theoretical rationale and previous studies can significantly improve the model, achieving an excellent fit in our final model (χ² = 160.6, df = 48, p < .0001, CFI = 0.95, NFI = 0.95, RMSEA = 0.06). Our CFA results suggest that an alternative scoring method based on the new model may optimize health status measurement of a homeless population. Despite these issues, convergent and discriminant validity of the SF-12v2 (scored based on the original model) was supported through multiple comparisons with other instruments.

Conclusion

Our study demonstrates for the first time that the SF-12v2 is generally appropriate as a measure of physical and mental health status for a homeless population with mental illness.