1,060 research outputs found
Current state of psychosocial epidemiology: Where are we? What are the next steps?
No full textThe ultimate aim of epidemiological science is to improve population health by generating information that facilitates evidence-based guidelines and policies. As outlined in the chapters of this textbook, epidemiological research has already linked a number of psychosocial factors to health outcomes, including social networks, job stress, emotions, religious service attendance and personality types. Although researchers have explored the nature of the observed associations by assessing temporal relationships, the strength of the risk factor–disease link, biological plausibility and modifiability, crucially, for most psychosocial risk factors, causality remains elusive and their value as targets for disease prevention remains unclear. In this chapter, we identify opportunities to improve progress in this field. Three suggestions are made: large-scale collaborative research (‘big data’), precision phenotyping and interventional approaches
Psychosocial epidemiology: key concepts and methods
No full textIn this introductory chapter of The Routledge International Handbook of Psychosocial Epidemiology, we describe the concepts and methods used in the study of psychosocial factors, health and disease, including study designs to obtain robust information and minimise bias. In addition, we discuss the various strategies as well as the challenges of translating evidence into population health improvement. As living standards have improved, absolute deprivation in the material sense (e.g. lacking food and shelter for survival) has receded, at least in high-income countries. Regulatory standards also protect populations from the threat of pollution, contaminated food, and workplace physical hazards. In western societies, risk and protective factors for health are therefore becoming increasingly psychosocial in nature rather than physical. It is within this milieu that psychosocial epidemiology, a discipline linking psychological, social and medical sciences, has flourished. Opportunities for such research are now better than ever before. Assessment of psychosocial factors, such as social relations, life stresses and mood, has become easier with the development of digital survey technology and improved availability of information on social environments, both of which can be linked to individual medical records. The advent of electronic health records and wearable devices provides researchers with a practical way to monitor a person’s health over time and to identify those who are at risk of developing chronic conditions. We contend that psychosocial epidemiology is a growing scientific discipline, both in terms of discovery (i.e. as a study of disease causation and mechanisms) and delivery (as a study of cost-effective interventions)
Association between low functional health literacy and mortality in older adults: longitudinal cohort study
No full textObjective: To investigate the association between low functional health literacy (ability to read and understand basic health related information) and mortality in older adults.Design: Population based longitudinal cohort study based on a stratified random sample of households.Setting: England.Participants: 7857 adults aged 52 or more who participated in the second wave (2004-5) of the English Longitudinal Study of Ageing and survived more than 12 months after interview. Participants completed a brief four item test of functional health literacy, which assessed understanding of written instructions for taking an aspirin tablet.Main outcome measure: Time to death, based on all cause mortality through October 2009.Results: Health literacy was categorised as high (maximum score, 67.2%), medium (one error, 20.3%), or low (more than one error, 12.5%). During follow-up (mean 5.3 years) 621 deaths occurred: 321 (6.1%) in the high health literacy category, 143 (9.0%) in the medium category, and 157 (16.0%) in the low category. After adjusting for personal characteristics, socioeconomic position, baseline health, and health behaviours, the hazard ratio for all cause mortality for participants with low health literacy was 1.40 (95% confidence interval 1.15 to 1.72) and with medium health literacy was 1.15 (0.94 to 1.41) compared with participants with high health literacy. Further adjustment for cognitive ability reduced the hazard ratio for low health literacy to 1.26 (1.02 to 1.55).Conclusions: A third of older adults in England have difficulties reading and understanding basic health related written information. Poorer understanding is associated with higher mortality. The limited health literacy capabilities within this population have implications for the design and delivery of health related services for older adults in England
Influences of early shift work on the diurnal cortisol rhythm, mood and sleep: within-subject variation in male airline pilots
No full textWe aimed to investigate how early and late work shifts influenced the diurnal cortisol rhythm using a within-subjects study design. Participants were 30 healthy male non-smoking pilots, mean age 39.4, employed by a short-haul airline. The standard rotating shift pattern consisted of 5 early shifts (starting before 0600 h), followed by 3 rest days, 5 late shifts (starting after 1200 h) and 4 rest days. Pilots sampled saliva and completed subjective mood ratings in a logbook 6 times over the day on two consecutive early shift days, two late days and two rest days. Sampling was scheduled at waking, waking+30 m, waking+2.5 h, waking+8 h, waking+12 h and bedtime. Waking time, sleep duration, sleep quality and working hours were also recorded. Cortisol responses were analysed with repeated measures analysis of variance with shift condition (early, late, rest) and sample time (1-6) as within-subject factors. Early shifts were associated with a higher cortisol increase in response to awakening (CAR(i)), a greater total cortisol output over the day (AUC(G)) and a slower rate of decline over the day than late shifts or rest days. Early shifts were also associated with shorter sleep duration but co-varying for sleep duration did not alter the effects of shift on the cortisol rhythm. Both types of work shift were associated with more stress, tiredness and lower happiness than rest days, but statistical adjustment for mood ratings did not alter the findings. Early shift days were associated with significantly higher levels of circulating cortisol during waking hours than late shifts or rest days.<br/
Health behaviours in older cancer survivors in the English Longitudinal Study of Ageing
No full textObjectivesTo assess health behaviours in cancer survivors in a population-based sample of older adults in the United Kingdom (UK).MethodsData were from wave 1 of the English Longitudinal Study of Ageing. Prevalence of smoking, alcohol consumption and physical activity was compared in cancer survivors and those with no cancer diagnosis. Associations between health behaviours and quality of life (QoL) and depressive symptoms were compared in both groups.ResultsThere were 716 (6.2%) cancer survivors in the sample. Cancer survivors were more likely to be former smokers (p < 0.001) and less likely to do moderate or vigorous physical activity (p < 0.05) than those with no cancer diagnosis. Physical activity was associated with better QoL and lower depressive symptoms, and smoking with poorer QoL and higher depressive symptoms, in both groups.DiscussionLevels of health behaviours among cancer survivors in the UK are suboptimal. Effective strategies to promote healthy lifestyles are needed in this vulnerable population
Health behaviours and quality of life in colorectal cancer survivors
No full textPurpose As cancer survival rates improve, there is growing interest in the role of lifestyle in longer-term health and quality of life (QoL). This study examined the prevalence of health-related behaviours, and the associations between health behaviours and QoL, in colorectal cancer survivors.Methods Patients diagnosed with colorectal cancer within the last 5 years identified from five London (UK) hospitals (N = 495) completed a survey that included measures of fruit and vegetable (F&V) intake, physical activity, smoking status and alcohol consumption. The EORTC-QLQ-C30 questionnaire was used to index QoL.Results The majority of respondents were overweight/obese (58%), not physically active (<5 bouts of moderate activity per week; 82%) and ate fewer than five portions of F&V a day (57%). Few were smokers (6%) or heavy drinkers (weekly alcohol units >21 for men and >14 for women; 8%). Physical activity showed the strongest association with functional QoL and was also associated with lower fatigue, pain and insomnia (P < 0.05). F&V intake was associated with higher global QoL and physical, role and cognitive function (P < 0.05). Using a total health behaviour score (calculated by assigning one point for each of the following behaviours: not smoking, consuming ?5 portions of F&V a day, being physically active and having moderate alcohol consumption), there was a linear relationship with global QoL, physical function and fatigue (P < 0.05).Conclusion A high proportion of colorectal cancer survivors in the UK have suboptimal health behaviours, and this is associated with poorer QoL
Attitudes to cardiovascular health promotion among GPs and practice nurses
No full textBackground. Cardiovascular health promotion is an important element of national health strategy, but doubts have been raised about current methods, and attitudes among general practice staff are ambivalent. Objectives. We aimed to assess attitudes to cardiovascular health promotion, opinions about efficacy and perceptions of skills in lifestyle counselling in GPs and nurses from the same practices. Method. A questionnaire survey of 107 GPs and 58 practice nurses from 19 group practices (100% response rate). Results. Practice nurses were seen to have the main responsibility for cardiovascular health promotion. Although attitudes to health promotion were generally positive, lack of training in lifestyle counselling was perceived to be a problem. Few responders believed that they were very influential in helping people change their lifestyles. Beliefs about the effectiveness of lifestyle counselling were mixed, with cigarette smoking, physical inactivity and obesity being seen as difficult to change. Beliefs in the effectiveness of lifestyle counselling were associated with positive attitudes towards health promotion and greater confidence in training. No association between personal health behaviour and attitudes towards health promotion were observed. Conclusions. It is recognized that health promotion involves more than the provision of simple information and advice, but GPs and practice nurses lack confidence in lifestyle counselling skills. The attitudes of health professionals are crucial to the implementation of prevention strategies and require regular review
Objectively assessed sedentary time and type 2 diabetes mellitus: a case-control study.
No full textThere is some evidence to suggest detrimental, linear associations between objectively assessed sedentary time and various metabolic risk factors [1, 2], although it remains unclear if these associations are independent of moderate to vigorous physical activity [3, 4]. The effects of sedentary behaviour on health might be more apparent in clinical populations and the elderly, although the majority of research in this area has been conducted in healthy participants, which might partly explain inconsistencies in the findings. Thus, translation into specific clinical populations is needed. If a reduction in risk of type 2 diabetes mellitus can be achieved by rectifying the imbalance between sitting time and light-intensity (‘lifestyle’) activity, this would have important implications for early intervention and treatment. The aim of this study was to compare objectively assessed levels of sedentary and physical activity in type 2 diabetic patients and age matched healthy controls
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