Associations of university student life challenges with mental health and self-rated health

Background Mental health problems are highly prevalent among university students. Stress due to student life challenges may be a risk factor for poorer health. This study investigates to what extent student life challenges and changes therein are associated with mental health and self-rated health. Methods In a longitudinal study with 568 Italian university students mental health was assessed using the Mental Health Inventory-5 (MHI-5) and self-rated health with a single item from the Short Form 36 Health Survey (SF36) (score ranges: 0-100) at baseline and at six months follow-up. Student life challenges were investigated using six subscales (score ranges: 1-4) of the Higher Education Stress Inventory (HESI). A between-within linear regression model was used to investigate whether a higher exposure to life challenges was associated with poorer health (between individuals) and whether changes in student life challenges were associated with changes in health (within individuals). Results Higher exposure to student life challenges was associated with poorer mental health (b ranging from -5.3 to -10.3) and self-rated health (b ranging from -3.1 to -9.6). An increase in student life challenges within individuals was associated with poorer mental health and self-rated health, in particular for high workload (b up to -5.9), faculty shortcomings (b up to -5.7), and unsupportive climate (b up to -5.6). Discussion Exposure to student life challenges and changes therein are associated with university students' health. Our findings suggest that student life challenges may be a target for interventions to improve mental health and self-rated health among university students. Key messages Mental health and self-rated health differ between students and change within-them. Higher exposure to student life challenges is associated with poorer health, and an increase in student life challenges is associated with a decrease in health.

Efficacy of a Novel Vertebral Body Augmentation System in the Treatment of Patients with Symptomatic Vertebral Body Fractures

Purpose To evaluate the safety and efficacy of a novel augmentation implant in the treatment of patients with symptomatic vertebral body fractures. Materials and Methods Thirty consecutive patients (seven males and 23 females), mean age of 70 years (range 56 to 89) with osteoporotic fractures and/or low-energy trauma fractures (osteoporosis confirmed by CT), were enrolled in an IRB-approved prospective study. The type of fracture was classified according to the Magerl classification. The patients were treated with the Tektona® dedicated vertebral body augmentation system. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores were obtained after 1, 6 and 12 months. Quality of life was assessed with the SF36 score. Results A total of 37 vertebral bodies, mostly from T6 to L5, were treated in the 30 enrolled patients. In 67.6% of the cases (n = 25), lumbar fractures were treated. Most of the fractures (43%; n = 16) were A1.1 according to the Magerl classification. A significant pain reduction evaluated by VAS scores (p < 0.0001) was observed on average 7.6 (before the procedure) to 2.8 (immediately post-treatment), 2.1 and 2.7 (after 6 and 12 months later, respectively). The mean ODI score was 55.5% before treatment, and this was statistically significant reduced to 22.3% and 26.9%, respectively, at 6 and 12 months after treatment (p < 0.0001). The SF36 scores, both physical and mental components, showed statistically significant variations (p < 0.0001) whose direction was subpopulation dependent. Conclusion Patients with confirmed osteoporosis, suffering from symptomatic vertebral body fractures (osteoporotic and/or low-energy traumatic), were treated safely and effectively using this novel implant.

The Influence of Non-Clinical Patient Factors on Clinical Decision Making: Uncovering the Impact on Mental Health

BackgroundUnderstanding how non-clinical patient factors (NCpF) such as gender, educational level and socioeconomic status impact clinical decisions regarding one’s mental health is important for appropriate and equitable care. Main AimThis research aims to i) investigate the feasibility of using administrative health data to investigate clinical decision making in mental health; ii) understand the impact of NCpF on mental health-related diagnosis, treatment, and referral decisions. Methods/ApproachThree waves of the Welsh Health Survey, containing a five-item Mental Health Inventory (Short- Form SF36), and NCpF information were used to create our interest cohort. The records with a low SF36, a ‘gold standard’ identifier of common mental health conditions, were then linked to the healthcare records datasets (Primary Care GP Dataset, Patient Episode Database for Wales, Emergency Department Dataset, Outpatient Referral Dataset, Annual District Death Extract) securely stored on the Secure Anonymised Information Linkage Databank. ResultsWe will present the methodological challenges and benefits of using administrative data the study of decision making in mental health. The differences in NCpF between those with a low SF36 and a mental health diagnosis, symptoms and treatment as well as those with a similar SF36 score but no diagnosis, symptoms or treatment recorded will be presented and discussed. ConclusionAdministrative data can provide a unique opportunity to investigate issues related with clinical decision-making in mental health and improve health equity. Having a better understanding of the influence of NCpF on mental health decisions is necessary to prevent inequity in mental health care.

Penilaian Kualitas Hidup Pasien Hemodialisis Rutin dengan Anemia di Yogyakarta

Anemia is often experienced by hemodialysis patients and can have an impact on the quality of life. This study aims to determine the effect of hemoglobin (Hb), hematocrit (Ht), and the characteristics and sociodemographic of the subjects on quality of life. The method used in this study was cross sectional and consecutive sampling technique. The data is retrieved by interviews which then analyzed using dummy multiple regression. Inclusion criteria included routine hemodialysis patients and did not receive blood transfusions. The validity and reliability test of the KDQoL-SF36 questionnaire showed reliable results. The results of the study on 112 subjects obtained an increase in Hb levels positively correlated with an increase in the KDQoL-SF36 score but not for an increase in Ht levels. Increased KDQoL-SF36 score illustrates the better quality of life of patients. Characteristics and sociodemography that influence quality of life include comorbid dummy hypertension-diabetes and work status. The condition of anemia can worsen the quality of life for hemodialysis patients.

Comparison between Surgical and Conservative Treatment for Distal Radius Fractures in Patients over 65 Years

Background: Fractures of the distal radius (DRF) are the most common orthopedic injuries, representing one of the typical fractures indicating underlying osteoporosis. The aim of the study was to compare conservative and surgical treatment, analyzing quality of life and clinical outcome in an over 65 years old population. Methods: Ninety one patients were divided into two groups: the ORIF group (39 patients) underwent surgery, and the conservative group (52 patients) was treated conservatively. The clinical and functional outcomes of all patients were evaluated using Short Form 36 (SF36), Modified Mayo Wrist Score (MMWS), Disability of the Arm Shoulder Hand (DASH), and Visual Analogue Scale (VAS). Range of motion at the joint was measured and compared with the contralateral healthy wrist. Results: No significant difference was found between the overall SF36 score, DASH score, MMWS, and VAS results. Role limitation was significantly better in the surgical group (p < 0.05), and complication incidence was significantly higher (p < 0.05) in the conservative group. Conclusion: The results of this study conform to recent literature, suggesting that a surgical reconstruction of the radius articular surface in an elderly population provides no clear clinical advantage. Treatment decisions must arise from careful diagnoses of the fracture and communication with the patient.

A Comprehensive Health Profile of Youths Living with a “Hikikomori” Lifestyle

To understand the health impacts of &ldquo;hikikomori&rdquo; lifestyle and to establish its first comprehensive health profile, a cross-sectional study was designed to measure how well the cases of hikikomori youths of Hong Kong were living, in terms of social, mental and physical aspects. This study involved 104 eligible participants at age 19.02 year-old who had completed the set of questionnaires and a series of anthropometric and physical health measurements. Despite SF36 score of 84.0 indicated good physical functioning in general, participants were lived sedentarily with high incidence of hypertension at 15.4% and prehypertension at 31.7%. Occurrence of hypertension in cases living as hikikomori &gt;6 months was 3-times higher than those newly onset cases. The blood pressure levels were correlated with age and all obesity index parameters measured including waist circumference and body mass index. Half of the hypertensive cases involved the elevation of systolic blood pressure, which suggested higher odds of cardiovascular complications. Participants were mentally stable living with moderate levels of perceived stress and state anxiety, but borderline clinical depression. In conclusion, the hikikomori lifestyle could be a risk behavior that may harm the younger generation physically by promoting obesity and hypertension and probably other chronic illnesses.

Peri-talar Osteotomy as Part of Treatment of Talar Osteochondral Defect of Varus Ankle

Category: Ankle Introduction/Purpose: The etiology of osteochondral defect (OCD) of talus is not fully understood. Besides trauma, malalignment of ankle or hindfoot may play a role in the development of OCD. The aim of this study is to assess the efficacy of peri-talar osteotomy in addition to routine treatment of OCD of talus. Methods: This is a retrospective study of 52 cases of varus talar OCD during the period of 2009.9 to 2014.12. Micro-fracture or autograft transplantation were applied for the OCD first according to the dimension of the lesion in all cases. Then peri-talar osteotomy were performed to correct ankle or hindfoot mal-alignment in 26 cases according to the position of varus deformity, including 18 supramalleolar osteotomy, 6 calcaneal osteotomy and 2 combined distal tibial and calcaneal double osteotomy. Pre- and post-operative radiographic parameters of TAS, TTS, TLS angles and MoA were measured on mortise view, lateral view and hindfoot alignment view respectively. AOFAS-AH score, VAS score and SF36 score were performed to assess both subjective and objective outcome. Results: For the osteotomy group, there were statistically changes (P < 0.05) radiographically (TAS, TTS, MoA, TLS) after surgery. While the radiographic parameters didn’t change in the group without corrective osteotomy. AOFAS-AH score and VAS score increased significantly (P < 0.05) in both the osteotomy group and the non-osteotomy group. The SF36 scores score increased significantly (P < 0.05) in the osteotomy group while not significant in the non-osteotomy group. The AOFAS-AH and SF36 scores were statistically higher in the osteotomy group after surgery (p<0.05), and the VAS score were not statistically different in two groups. There were 5 out of 26 revised cases in the non-osteotomy group while 2 out of 26 revised cases in the osteotomy group. Conclusion: Peri-talar osteotomy in addition to routine treatment of OCD of talus results in better radiographic and functional outcome and lower recurrence for patients of varus talar osteochondral defect. Mechanical malalignment may contribute to progression of OCD of talus and thus should be corrected simultaneously.