Social and regional variations in health status and health behaviours among Swiss young adults

OBJECTIVE To provide nationwide data on health status and health behaviours among young adults in Switzerland, and to illustrate social and regional variations. METHODS Data came from the Swiss Federal Surveys of Adolescents, conducted in 2010/11. The sample consisted of 32,424 young men and 1,467 young women. We used logistic regression models to examine patterns of social inequality for three measures of health status and three measures of health behaviour. RESULTS Among men, lower self-rated health, overweight and lower physical fitness levels were associated with lower educational and fewer financial resources. Patterns were similar among young women. Unfavourable self-rated health (odds ratio [OR]: men 0.83, women 0.75) and overweight (OR: men 0.84, women 0.85; p >0.05) were less common in the French- than in the German-language region. Low physical fitness was more common in the French- than in the German-language region. In both sexes, daily smoking was associated with fewer educational resources, and physical inactivity was associated with lower educational and fewer financial resources. Males from the Italian-language region were three times more likely to be physically inactive than their German-speaking counterparts (OR 2.95). Risk drinking was more widespread among males in the French- than in the German-speaking language region (OR 1.47). CONCLUSIONS Striking social and moderate regional differences exist in health status and health behaviours among young Swiss males and females. The current findings offer new empirical evidence on social determinants of health in Switzerland and suggest education, material resources and regional conditions to be addressed in public health practice and in more focused future research.

Health literacy among young adults: a short survey tool for public health and health promotion research

Health literacy (HL) is context-specific. In public health and health promotion, HL in the private realm refers to individuals' knowledge and skills to prevent disease and to promote health in everyday life. However, there is a scarcity of measurement tools explicitly geared to private realm contexts. Our aim was to develop and test a short survey tool that captures different dimensions of HL in the context of family and friends. We used cross-sectional data from the Swiss Federal Surveys of Adolescents from 2010 to 2011, comprising 7983 males and 366 females between 18 and 25 years. HL was assessed through a set of eight items (self-reports). We used principal component analysis to explore the underlying factor structure among these items in the male sample and confirmatory factor analysis to verify the factor structure in the female sample. The results showed that the tested item set represented dimensions of functional, interactive and critical HL. Two sub-dimensions, understanding versus finding health-relevant information, denoted functional HL. Interactive and critical HL were each represented with two items. A sum score based on all eight items (Cronbach's α: 0.64) showed expected positive associations with own and parental education among males and females (p < 0.05). The short item set appears to be a feasible measurement tool to assess HL in the private realm. Its broader application in survey studies may help to improve our understanding of how this form of HL is distributed in the general population.

The effects of exercise on self-rated sleep among adults with chronic sleep complaints

Purpose The purpose of this study was to evaluate whether and to what extent the observed effects on self-rated sleep in a previous study using a combined treatment program with physical exercise and sleep education can be attributed by the physical activity (PA) component. Methods The present study reports supplementary analysis of an already described and published study. Data were provided by a nonclinical sample of 98 normal-active adults with chronic initiating and the maintaining of sleep complaints. The additional analysis included sleep log, exercise log, and daily pedometer data which were collected during a baseline week and 6-week of a combined intervention. Results The results indicate that the number of steps (p = 0.02) and the duration of PA (p = 0.01) is significantly related to the improvement in subjective sleep measures and therefore reveal an independent effect within this combined sleep program. Sleep diary data (recuperation of sleep, number of awakenings after sleep onset, and wake time after sleep onset time) improved significant (all p < 0.01) over the intervention program. About 50% of the participants stated that the PA had an effect on their improvement. Conclusion Improvements on subjective sleep quality after a combined intervention cannot be attributed to the cognitive component alone, but PA has an independent effect. Adults with chronic sleep complaints benefit from exercise. Therefore structured PA should be implemented in any sleep management programs.

Gender differences in disordered eating and weight dissatisfaction in Swiss adults: Which factors matter?

Background Research results from large, national population-based studies investigating gender differences in weight dissatisfaction and disordered eating across the adult life span are still limited. Gender is a significant factor in relation to weight dissatisfaction and disordered eating. However, the reasons for gender differences in these conditions are still poorly understood. The aim of this study was to examine gender differences in weight dissatisfaction and disordered eating in the general Swiss adult population and to identify gender-specific risk factors. Methods The study population consisted of 18156 Swiss adults who completed the population-based Swiss Health Survey 2007. Self-reported weight dissatisfaction, disordered eating and associated risk factors were assessed. In order to examine whether determinants of weight dissatisfaction and disordered eating (dieting to lose weight, binge eating, and irregular eating) differ in men and women, multivariate logistic regressions were applied separately for women and men. Results Although more men than women were overweight, more women than men reported weight dissatisfaction. Weight category, smoking status, education, and physical activity were significantly associated with weight dissatisfaction in men and women. In women, nationality and age were also significant factors. Gender-specific risk factors such as physical activity or weight category were identified for specific disordered eating behaviours. Conclusions The results suggest that gender specific associations between predictors and disordered eating behaviour should be considered in the development of effective prevention programs against disordered eating.

Beyond questionnaires – Exploring adult education teachers' mathematical beliefs with pictures and interviews

Because of the impact that mathematical beliefs have on an individual’s behaviour, they are generally well researched. However, little mathematical belief research has taken place in the field of adult education. This paper presents preliminary results from a study conducted in this field in Switzerland. It is based on Ernest’s (1989) description of mathematics as an instrumental, Platonist or problem solving construct. The analysis uses pictures drawn by the participants and interviews conducted with them as data. Using a categorising scheme developed by Rolka and Halverscheid (2011), the author argues that adults’ mathematical beliefs are complex and especially personal aspects are difficult to capture with said scheme. Particularly the analysis of visual data requires a more refined method of analysis.

Dental erosive wear assessment among adolescents and adults utilizing the basic erosive wear examination (BEWE) scoring system.

OBJECTIVES To investigate erosive tooth wear and related variables among adolescents and adults in Israel, utilizing the new basic erosive wear examination (BEWE) scoring system, in an attempt to contribute to the ongoing review, evaluation, and further development of an international standardized index. MATERIAL AND METHODS A cross-sectional, descriptive, and analytic survey was conducted among 500 subjects of five age groups. Dental erosion was measured according to the new BEWE scoring system. Independent variables included gender, age, origin, education, employment status, and diet. A backward stepwise linear regression model was applied to identify significantly associated variables. RESULTS Fifty percent of the survey subjects demonstrated erosive tooth wear; among them, 10 % had distinct erosion of over 50 % of the dental surface. Total BEWE score differences by age groups were statistically significant; as the age increased, the mean total BEWE scores increased (p < 0.001). The association between acidic foods and erosion was evident among the younger population (p = 0.038). In a multiple regression model, age (p < 0.001) and diet (p = 0.044) achieved statistical significance as variables associated with dental erosive wear. CONCLUSIONS Our study is one of the first to use the BEWE scoring system in an epidemiological survey among adolescents and adults. It was found that the BEWE index is straightforward, easy to conduct, and comfortably accepted by the examinees. CLINICAL RELEVANCE The present findings, together with further international research, should contribute toward continued evaluation of the BEWE system as an international standard and thereby, toward more optimal understanding, evidence-based treatment, and prevention of dental erosive wear.

Cultural capital and smoking in young adults: applying new indicators to explore social inequalities in health behaviour.

BACKGROUND Associations between social status and health behaviours are well documented, but the mechanisms involved are less understood. Cultural capital theory may contribute to a better understanding by expanding the scope of inequality indicators to include individuals' knowledge, skills, beliefs and material goods to examine how these indicators impact individuals' health lifestyles. We explore the structure and applicability of a set of cultural capital indicators in the empirical exploration of smoking behaviour among young male adults. METHODS We analysed data from the Swiss Federal Survey of Adolescents (CH-X) 2010-11 panel of young Swiss males (n = 10 736). A set of nine theoretically relevant variables (including incorporated, institutionalized and objectified cultural capital) were investigated using exploratory factor analysis. Regression models were run to observe the association between factor scores and smoking outcomes. Outcome measures consisted of daily smoking status and the number of cigarettes smoked by daily smokers. RESULTS Cultural capital indicators aggregated in a three-factor solution representing 'health values', 'education and knowledge' and 'family resources'. Each factor score predicted the smoking outcomes. In young males, scoring low on health values, education and knowledge and family resources was associated with a higher risk of being a daily smoker and of smoking more cigarettes daily. CONCLUSION Cultural capital measures that include, but go beyond, educational attainment can improve prediction models of smoking in young male adults. New measures of cultural capital may thus contribute to our understanding of the social status-based resources that individuals can use towards health behaviours.

The care of adults with congenital heart disease across the globe: Current assessment and future perspective

The number of adults with congenital heart disease (CHD) has increased markedly over the past few decades as a result of astounding successes in pediatric cardiac care. Nevertheless, it is now well understood that CHD is not cured but palliated, such that life-long expert care is required to optimize outcomes. All countries in the world that experience improved survival in CHD must face new challenges inherent to the emergence of a growing and aging CHD population with changing needs and medical and psychosocial issues. Founded in 1992, the International Society for Adult Congenital Heart Disease (ISACHD) is the leading global organization of professionals dedicated to pursuing excellence in the care of adults with CHD worldwide. Recognizing the unique and varied issues involved in caring for adults with CHD, ISACHD established a task force to assess the current status of care for adults with CHD across the globe, highlight major challenges and priorities, and provide future direction. The writing committee consisted of experts from North America, South America, Europe, South Asia, East Asia, and Oceania. The committee was divided into subgroups to review key aspects of adult CHD (ACHD) care. Regional representatives were tasked with investigating and reporting on relevant local issues as accurately as possible, within the constraints of available data. The resulting ISACHD position statement addresses changing patterns of worldwide epidemiology, models of care and organization of care, education and training, and the global research landscape in ACHD.