青少年健康相关危险行为的类型及与心理健康的关系:基于潜在剖面分析的结果

目的:探讨青少年健康相关危险行为的类型,在性别上的差异,及其与心理健康水平的关系。方法:采用潜在剖面分析方法对2734名中学生的健康危险行为进行分析。结果:①青少年的健康危险行为分为三个潜在类别:高危组、边缘组和低危组,比例分别为:2.9%、16.4%、80.7%。②与低危组相比,女生更不容易进入高危组,且达到统计显著(OR=-0.95,P<0.01);与低危组相比,女生更不容易进入边缘组,且达到统计显著(OR=-0.56,P<0.01)。③除了人际和谐维度,生活幸福、乐于学习、情绪稳定、考试镇定和心理健康总分在低危组上均显著高于边缘组和高危组;同时,边缘组得分也显著高于高危组。结论:青少年健康危险行为分为三类;高危组、边缘组和低危组,且在性别和心理健康水平上表现出差异。     

Balance ability and cognitive impairment influence sustained walking in an assisted living facility

Purpose of studyThe purpose of this study was to determine the influence of cognitive impairment (CI),¹ gait quality, and balance ability on walking distance and speed in an assisted living facility.Materials and methodsThis was a longitudinal cohort study of institutionalized older adults (N = 26; 555 observations) followed for up to 8 months. Hierarchical linear modeling statistical techniques were used to examine the effects of gait quality and balance ability (using the Tinetti Gait and Balance Test) and cognitive status (using the Montreal Cognitive Assessment) on walking activity (distance, sustained distance, sustained speed). The latter were measured objectively and continuously by a real-time locating system (RTLS).ResultsA one-point increase in balance ability was associated with an 8% increase in sustained walking distance (p = 0.03) and a 4% increase in sustained gait speed (p = 0.00). Gait quality was associated with decreased sustained gait speed (p = 0.03). Residents with moderate (ERR = 2.34;p = 0.01) or severe CI (trend with an ERR = 1.62; p = 0.06) had longer sustained walking distances at slower speeds when compared to residents with no CI.ConclusionsAfter accounting for cognitive status, it was balance ability, not gait quality, that was a determinant of sustained walking distances and speeds. Therefore, balance interventions for older adults in assisted living may enable sustained walking activity. Given that CI was associated with more sustained walking, limiting sustained walking in the form of wandering behavior, especially for those with balance impairments, may prevent adverse events, including fall-related injury.     

Assessing the Relationship Between Mental Distress and Tobacco Use in Post-Katrina and Rita Louisiana

Background: The relationship between mental health status and smoking is complicated and often confounded by bi-directionality, yet most research on this relationship assumes exogeneity. Objectives: The goal of this article is to implement an instrumental variable approach to (1) test the exogeneity assumption and (2) report on the association between mental health status and smoking post-disaster. Methods: This analysis utilizes the 2006 and 2007 Louisiana Behavioral Risk Factor Surveillance Survey to examine the link between mental distress and smoking in areas affected by Hurricanes Katrina and Rita. Residence in a hurricane-affected parish (county) was used as an instrumental variable for mental distress. Results: Just over 22% of the sample resided in a hurricane-affected parish. Residents of hurricane-affected parishes were significantly more likely to report occasional and frequent mental distress. Residence in a hurricane-affected parish was not significantly associated with smoking status. With residence established as a salient instrumental variable for mental distress, the exogeneity assumption was tested and confirmed in this sample. A dose-response relationship existed between mental distress and smoking, with smoking prevalence increasing directly (and non-linearly) with mental distress. Conclusions: In this sample, the relationship between mental distress and smoking status was exogenous and followed a dose-response relationship, suggesting that the disasters did not result in an uptake of smoking initiation, but that the higher amounts of mental distress may lead to increased use among smokers. The findings suggest that tobacco control programs should devise unique strategies to address mentally distressed populations.