Health-related quality of life and health risk behaviors among smokers

BACKGROUND: It is well established that smoking has detrimental effects on physical health, but its associations with health-related quality of life (HRQOL) and a variety of health behaviors have not been widely investigated in the U.S. population. METHODS: Data obtained from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing, state-based, random-digit-dialed telephone survey of non-institutionalized persons aged > or =18 years in the United States, Guam, Puerto Rico, and the Virgin Islands, were used in this investigation. The BRFSS monitors the prevalence of key health- and safety-related behaviors and characteristics. In 2001 and 2002 combined, trained interviewers administered HRQOL questions in 23 states and the District of Columbia (n=82,918). This analysis was conducted in 2004. RESULTS: Overall, an estimated 22.4% of adults were current smokers, 24.1% were former smokers, and 53.6% never smoked. Current smokers had significantly poorer HRQOL than those who had never smoked, and were more likely to drink heavily, to binge drink, and to report depressive and anxiety symptoms. Additionally, current smokers were significantly more likely than those who never smoked to be physically inactive, to report frequent sleep impairment, to report frequent pain, and to eat less than five servings of fruits and vegetables per day. CONCLUSIONS: While there are strong positive relationships between smoking and both alcohol consumption and mood disturbance, smoking is also associated with an array of other modifiable risk factors meriting assessment and intervention. In addition to smoking cessation, the increased morbidity and mortality characterizing smokers may potentially be further reduced by improvements in diet, physical activity, and sleep.     

HIV and COPD: impact of risk behaviors and diseases on quality of life

Purpose  

Smoking worsens quality of life among HIV-infected individuals, but it remains unclear if this association is related simply to smoking or to chronic obstructive pulmonary disease (COPD), the end-organ disease caused by smoking.     

Validation of reaction time as a measure of cognitive function and quality of life in healthy subjects and patients

Objective

Malnutrition is a common problem in hospitalized patients and is related to decreased cognitive function and impaired quality of life (QoL). We investigated the validity of reaction time as a simple bedside tool for measuring cognitive function in healthy subjects and patients, and additionally the relationships with QoL and malnutrition in patients.

Methods

Healthy subjects (N = 130) were assessed for simple and complex reaction time and cognitive function (Addenbrooke cognitive examination, ACE). Patients (N = 70) were assessed for simple and complex reaction time, cognitive function (ACE), and QoL (short-form health survey) (N = 40).

Results

Reaction time was related to cognitive function in both healthy subjects and patients. Reaction time was inversely related to the physical component summary of QoL in patients (r= −0.42, P < 0.001). Five of eight QoL scales and the mental component summary of QoL were significantly lower in malnourished patients. Reaction time and ACE were impaired in patients compared to healthy subjects, but not further impaired in malnourished patients.

Conclusion

Simple reaction time test is related to cognitive function in healthy subjects and patients and to QoL in patients. Complex reaction time test is related to more components of cognitive function. Thus, simple and complex reaction time tests could serve as bedside measurements reflecting, respectively, QoL or cognitive function.     

Low discretionary time as a barrier to physical activity and intervention uptake

Objective: To determine whether self-reported discretionary time was associated with physical activity and uptake of a physical activity promotion intervention in a multi-ethnic urban sample. Methods: We examined the association of self-reported discretionary time with hours/week of leisure-time physical activity at baseline and physical activity intervention uptake. Results: Low levels of discretionary time were significantly (P<0.01) associated with fewer hours/week (beta=-0.78, 95%CI=-1.34, -0.22) of physical activity at baseline. Discretionary time was not associated with physical activity intervention uptake. Conclusion: Lack of discretionary time may serve as barrier to physical activity, but its importance on intervention uptake is less clear.     

Smoking behaviors and perceived risk of injuries in Italy, 2007

OBJECTIVE: Apart from cancer, cardiovascular and respiratory diseases, smoking is associated with an increased risk of accidents and injuries. Many of these can be accounted for by dangerous smoking behaviors such as smoking in bed or while driving. We estimated therefore the prevalence of these hazardous smoking behaviors and the perceived risk of accidents associated with them in Italy. METHODS: Data were derived by a survey on smoking on 3057 subjects, representative of the Italian population aged > or =15 years. Specific questions were included on prevalence and risk perception of smoking while driving or in bed. RESULTS: Of all current smokers (23.5% of the Italian population), 12% reported smoking while in bed, 69% reported smoking while driving a car, and 17% reported smoking while driving a motorcycle. Predictors of smoking while driving were younger age, male sex, and being a heavy smoker. Of the total population, 81% reported that smoking while driving increased the risk of accident, but public perception was lower in men, the young, current smokers, and among the subjects engaging in these behaviors. About 7% of car injuries in Italy could involve a subject who smokes while driving. CONCLUSION: Efforts should be taken, therefore, to disseminate knowledge about the smoking behaviors associated to high risk of injuries.     

Purging behaviors and comorbidity as predictive factors of quality of life in anorexia nervosa

OBJECTIVE: This study examined the predictive factors for the physical and mental summary components (PCS and MCS) of quality of life (SF-36) in patients with anorexia nervosa. METHOD: Forty-seven patients with anorexia nervosa were studied. Assessment comprised psychiatric diagnosis by a clinical structured interview for Axis I disorders (SCID-I) and personality disorders (SCID-II), Clinical Global Impression (CGI), and Quality of Life (SF-36). RESULTS: Anorexia nervosa, restrictive type, was diagnosed in 73.9% of the patients and 51% of the patients presented with comorbidity on Axis I or Axis II or both. The predictive variables for the PCS were poor outcome in previous year, comorbidity on Axes I and II, and female gender. The predictive variables for the MCS were the presence of comorbidity in one or the other of the Axis I or II disorders and purging behaviors. DISCUSSION: The current study suggests the importance of comorbidity and purging behaviors in the quality of life of these patients with anorexia nervosa.     

Dietary variety increases as a function of time and influences diet quality in children

OBJECTIVE: To investigate the changes in dietary variety over time in children and to determine the relationship between dietary variety and diet quality. DESIGN: Dietary data were collected from fourth and fifth grade students for 14 consecutive days by a registered dietitian. SETTING: Colerain School District of Cincinnati, Ohio. PARTICIPANTS: There were 33 children involved in the study. MAIN OUTCOME MEASURES: Two cumulative dietary variety scores were estimated. The first was based on the Food Guide Pyramid groups: grain, fruit, vegetable, dairy, and meat (GFVDM). The second was based on the groups highlighted by the 2000 Dietary Guidelines for variety: grain, fruit, and vegetable (GFV). Diets were analyzed for energy and nutrient content. ANALYSIS: Analysis of variance and Pearson correlation coefficients. RESULTS: Dietary variety increased over time up to 14 days. A significant difference (P <.0001) was found for the cumulative GFVDM and GFV variety scores on days 3, 7, and 14. Positive correlations were found between the GFVDM and GFV variety scores and vitamin C and fiber. CONCLUSIONS AND IMPLICATIONS: This study suggests that a 2-week period is necessary to capture food variety in children. Some associations were found between dietary variety and diet quality. New tools are needed to measure dietary variety in children.     

Explaining differences in perceived health-related quality of life: a study within the Spanish population

Objective

To assess the burden of several determinants on health-related quality of life (HRQOL) and to study its heterogeneity among the different Spanish regions.

Parental monitoring, negotiated unsupervised time, and parental trust: the role of perceived parenting practices in adolescent health risk behaviors.

PURPOSE: To compare two different parenting practices (parental monitoring and negotiated unsupervised time) and perceived parental trust in the reporting of health risk behaviors among adolescents. METHODS: Data were derived from 692 adolescents in 9th and 10th grades (x = 15.7 years) enrolled in health education classes in six urban high schools. Students completed a self-administered paper-based survey that assessed adolescents' perceptions of the degree to which their parents monitor their whereabouts, are permitted to negotiate unsupervised time with their friends and trust them to make decisions. Using gender-specific multivariate logistic regression analyses, we examined the relative importance of parental monitoring, negotiated unsupervised time with peers, and parental trust in predicting reported sexual activity, sex-related protective actions (e.g., condom use, carrying protection) and substance use (alcohol, tobacco, and marijuana). RESULTS: For males and females, increased negotiated unsupervised time was strongly associated with increased risk behavior (e.g., sexual activity, alcohol and marijuana use) but also sex-related protective actions. In males, high parental monitoring was associated with less alcohol use and consistent condom use. Parental monitoring had no affect on female behavior. Perceived parental trust served as a protective factor against sexual activity, tobacco, and marijuana use in females, and alcohol use in males. CONCLUSIONS: Although monitoring is an important practice for parents of older adolescents, managing their behavior through negotiation of unsupervised time may have mixed results leading to increased experimentation with sexuality and substances, but perhaps in a more responsible way. Trust established between an adolescent female and her parents continues to be a strong deterrent for risky behaviors but appears to have little effect on behaviors of adolescent males.     

Health-related quality of life and health-promoting behaviors in black men

This study examined the health-related quality of life and health-promoting behaviors in a convenience sample of low-income black men. Almost three-fourths reported their overall health as good or better. However, the mean number of recent (that is, past 30 days) mentally unhealthy days was 13.12, and more than half reported frequent (> or =14) mentally unhealthy days. There were strong correlations between mentally unhealthy days and various health-promoting behaviors. The contrast between participants' overall health and mental health is disconcerting. Implications for social work practice with low-income black men to improve health promotion are discussed.     

Health-risk behaviors and quality of life among young men

Purpose

To examine the associations between substance use and other health-risk behaviors and quality of life (QOL) among young men.

Methods

The analytical sample consisted of 5,306 young Swiss men who participated in the Cohort Study on Substance Use Risk Factors. Associations between seven distinct self-reported health-risk behaviors (risky single-occasion drinking; volume drinking; cigarette smoking; cannabis use; use of any other illicit drugs; sexual intercourse without a condom; low physical activity) were assessed via chi-square analysis. Logistic regression analyses were conducted to study the associations between each particular health-risk behavior and either physical or mental QOL (assessed with the SF-12v2) while adjusting for socio-demographic variables and the presence of all other health-risk behaviors.

Results

Most health-risk behaviors co-occurred. However, low physical activity was not or negatively related to other health-risk behaviors. Almost all health-risk behaviors were associated with a greater likelihood of compromised QOL. However, sexual intercourse without a condom (not associated with both physical and mental QOL) and frequent risky single-occasion drinking (not related to mental QOL after adjusting for the presence of other health-risk behaviors; positively associated with physical QOL) differed from this pattern.

Conclusions

Health-risk behaviors are mostly associated with compromised QOL. However, sexual intercourse without a condom and frequent risky single-occasion drinking differ from this pattern and are therefore possibly particularly difficult to change relative to other health-risk behaviors.     

医院服务质量、购买风险对患者消费行为影响的实证研究

提出了一个包含医护人员服务质量、购买风险、患者预期的服务质量、顾客预期的消费价值等变量的综合的顾客行为意向概念模型，并提出了6条假设。在4家医院对患者进行问卷调查以检验该模型。研究结果表明6条假设均获得支持。     

Modeling explicitly and mechanistically median lethal concentration as a function of time for risk assessment

A mechanistic model that explains how toxic effects depend on the duration of exposure has been developed. Derived from the dynamic energy budget (DEB)tox model, it expresses the hazard rate as a function of the toxic concentration in the organism. Using linear approximations in accordance with the general simplifications made in DEBtox, the concentration that induces x% of lethality (LCx) and in particular the lethal concentration 50% (LC50) are expressed explicitly as functions of time. Only three parameters are required: an asymptotic effect concentration, a time constant, and an effect velocity. More sophisticated (but still analytic) models are possible, describing more complex toxicity patterns such as an increase of sensitivity with time or, conversely, an adaptation. These models can be fitted to the common and widespread LC50 endpoints available from the literature for various aquatic species and chemicals. The interpretation of the values assigned to the parameters will help explain the toxicity processes and standardize toxicity values from different sources for comparisons.     

Pesticide safety among farmworkers: perceived risk and perceived control as factors reflecting environmental justice

Farmworkers in the United States constitute a population at risk for serious environmental and occupational illness and injury as well as health disparities typically associated with poverty. Pesticides are a major source of occupational injury and illness to which farmworkers are exposed. Efforts to provide safety training for farmworkers have not been fully evaluated. Based on the Health Belief Model, this analysis examines how safety information affects perceived pesticide safety risk and control among farmworkers and how perceived risk and control affect farmworker knowledge and safety behavior. Data are based on interviews conducted in 1999 with 293 farmworkers in eastern North Carolina as part of the Preventing Agricultural Chemical Exposure in North Carolina Farmworkers' Project. Perceived pesticide risk and perceived pesticide control scales were developed from interview items. Analysis of the items and scales showed that farmworkers had fairly high levels of perceived risk from pesticides and perceived control of pesticide safety. Receiving information about pesticide safety (e.g., warning signs) reduced perceived risk and increased perceived control. Pesticide exposure knowledge was strongly related to perceived risk. However, perceived risk had a limited relationship to safety knowledge and was not related to safety behavior. Perceived control was not related to pesticide exposure knowledge, but was strongly related to safety knowledge and safety behavior. A key tenet of environmental justice is that communities must have control over their environment. These results argue that for pesticide safety education to be effective, it must address issues of farmworker control in implementing workplace pesticide safety.     

The association of physical activity,sleep, and screen time with mental health in Canadian adolescents during the COVID-19 pandemic: A longitudinal isotemporal substitution analysis

BackgroundThe impact of COVID-19 on adolescent mental health is a global concern. Increased screen time and reduced physical activity due to the lockdown measures have been linked to detrimental mental health outcomes; however, the literature remains limited by cross-sectional and retrospective designs, and consideration of behaviours in isolation. Prospective evidence is necessary to examine whether moderate-to-vigorous physical activity (MVPA), sleep and screen time influenced changes in mental health.MethodAnalyses used data from a prospective cohort study of secondary school students in Canada with baseline data from the 2018–2019 school year and linked follow-up data from online surveys completed during the initial COVID-19 outbreak (May–July 2020). Multilevel linear regression models were used to evaluate the within- and between-person isotemporal substitution effects of sleep, MVPA and screen time behaviours on depression, anxiety, subjective well-being, and trait emotional dysregulation.ResultsLinked longitudinal data from 2645 students attending 44 schools were available. Between-person effects indicated that individuals who engaged in more MVPA and sleep while minimizing screen time had lower depression scores, less severe emotional dysregulation, and better subjective well-being. While controlling for between-person effects, within-person year-on-year change suggests those who increased screen time while decreasing either MVPA or sleep experienced mental health decline on all outcomes.ConclusionMVPA and sleep were associated with youth mental health during the early COVID-19 lockdown. Increasing MVPA and sleep (or at least mitigating the increase of screen time) compared to the prior year was associated with better mental health during the early pandemic. A limitation to consider is that the screen time measure represents a combination of screen behaviours, and effects of replacing screen time may have varied if distinctions were made.     

Health-related quality of life and perceived health status of Turkish population

Quality of Life Research - This study was conducted to assess the health-related quality of life (HRQOL) and perceived health status of the Turkish population. The data came from a nationwide...     

Health-related quality of life, health risk behaviors, and disability among adults with pain-related activity difficulty

OBJECTIVES: We examined the association between pain-related activity difficulty (PRAD) in the past 30 days and health-related quality of life, health behaviors, disability indices, and major health impairments in the general US population. METHODS: We obtained data from 18 states in the 2002 Behavioral Risk Factor Surveillance System, an ongoing, cross-sectional, state-based, random-digit-dialed telephone survey of noninstitutionalized adults aged 18 years or older. RESULTS: Nearly one quarter of people in the 18 states and the District of Columbia reported at least 1 day of PRAD in the past 30 days. PRAD was associated with obesity, smoking, physical inactivity, impaired general health, infrequent vitality, and frequent occurrences of physical distress, mental distress, depressive symptoms, sleep insufficiency, and anxiety symptoms. Moreover, a general dose-response relationship was noted between increased days of PRAD and increased prevalence of impaired health-related quality of life, disability indices, and health risk behaviors. CONCLUSION: Pain negatively influences various domains of health, not only among clinical populations, but also in the general community, suggesting a critical need for the dissemination of targeted interventions to enhance recognition and treatment of pain among adult community-dwellers.     

Gender and perceived quality of life: research with professors from the health area

The rapid process of change in the global economy in recent years and the organization of labor have influenced gender relations in the teaching profession. These transformations have been disadvantageous for women, leaving them in a situation of occupational overload. The scope of this study was to analyze the working conditions of female teachers in higher education in the health education area in the city of Vitória, State Espírito Santo, and their implications on health and quality of life. This is qualitative research into data gathered from interviews upon which Bardin content analysis was also employed. This technique revealed three categories: leisure, rest and health; sense of loss of social and family interaction; and perceived quality of life. The results show that insufficient leisure time may lead to sleep disturbances predisposing the individual to psychic illness; overwork; significant alterations in labor organization compromising social and family interaction with repercussions on health and quality of life. The work performed by female professors in the health area contributes to the onset of illness, with pejorative effects on their family, love, social, environmental and professional lives, with consequent loss of quality of life.     

Replacing sedentary time with physical activity: effects on health-related quality of life in older Japanese adults

Background

The isotemporal substitution (IS) approach can be used to assess the effect of replacing one activity with the equal duration of another activity on relevant outcomes. This study examined the associations of objectively assessed sedentary behavior (SB) and physical activity (PA) with health-related quality of life (HRQOL) in older Japanese adults, using the IS approach.

Methods

Participants were 287 older Japanese adults (aged 65–84?years) who wore accelerometers for at least 7 days. We calculated the average daily time spent in SB (≤1.5 METs); light-intensity PA (LPA: >?1.5 to <?3.0 METs); and moderate- to vigorous-intensity PA (MVPA: ≥3.0 METs) per day. HRQOL was assessed using the Medical Outcomes Survey Short Form-8 questionnaire.

Results

The IS models showed replacing SB or LPA with MVPA to be significantly associated with better physical component summary scores. Replacing SB with MVPA was marginally associated with better mental component summary scores.

Conclusion

These findings indicate that replacing SB with the same amount of MVPA may contribute to better physical HRQOL in older adults.

     

Predictors of quality of life in women: hormone therapy self-efficacy and health-promoting behaviors.

Osteoporosis and coronary heart diseases (CHD) are two major health problems that affect postmenopausal women. The literature emphasizes that prevention of osteoporosis and/or CHD through the practices of health-promoting behaviors and hormone therapy usage can improve quality of life (QOL) for women. The purpose of this study was to examine the impact of health-promoting behaviors and hormone therapy self-efficacy on QOL. The sample contained 210 women between the ages of 45 and 84 years of age, who completed three instruments developed specifically for this study. The majority of the participants perceived moderate satisfaction with their life as a whole, performed many health-promoting behaviors, and perceived slight confidence in their ability to continue hormone therapy. Among current users of hormones, hormone therapy self-efficacy beliefs explained 31% of the variance in QOL. Among non-users of hormones, health-promoting behaviors explained 7% of the variance in QOL. In the entire sample, health-promoting behaviors explained 10% of the variance in QOL. There were significant differences between current users of hormones and non-users of hormones in QOL and in health-promoting behaviors. The study has implications for intervention and for future research.