The Definition of Health: Towards New Perspectives

Hotspots and trends in health-oriented physical literacy research: a visual analysis based on the WOS database

BACKGROUND

The World Health Organization has proposed that physical activity is a meaningful way to improve the quality of human life and reduce the probability of chronic non-communicable diseases and that humans should change their mindset from the actual effectiveness of physical activity in promoting health to the new view that "physical activity makes life more meaningful." The introduction and development of physical literacy reveal the critical role of physical activity in improving human health and the importance of human initiative in physical activity for healthy development. Therefore, the objectives of this paper are (1) to conduct a bibliometric analysis of the literature on physical literacy, assessing the scope, frequency, and geographical distribution of research publications from various countries and institutions from 2015 to 2023; (2) to visualize keywords in articles on the topic of Physical literacy to analyze whether there is a link between physical literacy and health, and (3) based on the results of the visual analysis, we propose that proper health is built on the sense of physical literacy and further construct the circular path of physical literacy, physical activity, and physical health improvement.

METHODS

Using VOSviewer software v.1.6.18, this study searched the core collection of the Web of Science database from 2015 to April 15, 2023, using "physical literacy" as a keyword to explore the current international research on physical literacy.

RESULTS

A total of 3,446 articles were included, and a correlation map was derived based on the co-occurrence frequency of keywords, which showed that physical literacy was highly correlated with six concepts: health literacy, physical activity, health, children, adolescents, and prevention.

CONCLUSION

Based on the analysis of literature visualization techniques, there is a high correlation between physical literacy and health, and international physical literacy research is in a trend of multi-point amplification, with research hotspots gradually shifting from the field of sports to the field of health and closely related to the field of health, indicating that physical literacy aims to promote the achievement of individual health by driving humans to increase physical activity.

Health through the eyes of youths: a qualitative study

Background

Emerging definitions of health have suggested a shift in focus to one's ability to manage their health condition, function, and social determinants of health. The construct of health for youths with mental health and substance use disorders (MHSU) is complex and multi-dimensional with interplay between biological, behavioral, and social conditions. Expanding definitions of health is crucial in the measurement of health and evaluation of integrated youth services (IYS) systems for people with MHSU disorders. Hence, it is critical to understand the construct of health from the perspective of a young person living with a MHSU disorder.

Methods

This study was conducted using inductive thematic analysis. Three focus groups were conducted from July to August 2017.

Results

A total of 22 youths (17-24 years) took part in this study. Results showed that health is a multidimensional construct situated in the ecosystem of a person's environment. Health can be understood from two macro themes: Individual health and Determinants of health. It consisted of physical health, mental health, day-to-day functioning, and being in control of your own health condition. Systemic and social factors were factors that influenced the state of health.

Conclusion

This study contributes to a conceptualization of good health in youth with MHSU disorders. This conceptualization can aid in the development of more accurate measures of health and functioning and the evaluation of mental health services for youth with MHSU.

Development and validation of a Context-sensitive Positive Health Questionnaire (CPHQ): A factor analysis and multivariate regression study

BACKGROUND

The concept of Positive Health (PH) has gained increasing attention as a way of measuring individuals' ability to adapt in the face of contextual challenges. However, a suitable measurement instrument for PH that encompasses contextual factors has not yet been developed. This paper responds to this need by developing a Context-specific Positive Health (CPH) measurement instrument that aligns with the Capability Approach (CA).

METHODS

The measurement instrument was developed and tested among a representative sample of 1002 Dutch internet survey panel members with diverse sociodemographic backgrounds. The instrument was developed in two stages: a preparation phase consisting of focus groups and expert consultations, and a validation among a representative panel of Dutch citizens. The goal of the preparation phase, was to pilot test and refine previously proposed Positive Health questionnaires into an initial version of the CPHQ. The validation phase aimed to examine the initial CPHQ's factorial validity using Factor Analysis, and its concurrent validity using Multivariate Regression Analysis.

RESULTS

The developed questionnaire demonstrated adequate factorial and concurrent validity. Furthermore, it explicitly includes an assessment of resilience, this being a key component of PH.

CONCLUSIONS

The introduced measurement tool, the CPHQ, comprises 11 dimensions that we have labeled as follows: relaxation, autonomy, fitness, perceived environmental safety, exclusion, social support, financial resources, political representation, health literacy, resilience, and enjoyment. In this article, we present four major contributions. Firstly, we embedded the measurement in a theoretical framework. Secondly, we focused the questionnaire on a key concept of Positive Health - the "ability to adapt." Thirdly, we addressed issues of health inequality by considering contextual factors. Finally, we facilitated the development of more understandable measurement items.

Stiffness and Elasticity of Aorta Assessed Using Computed Tomography Angiography as a Marker of Cardiovascular Health-A Cross-Sectional Study

Cardiovascular (CV) health can be measured using the American Health Association's Life's Simple 7 scale (ALS7). Aortic stiffness (AoS) and elasticity (AoE) can be assessed using various methods, e.g., computed tomography (CT). To measure AoE, we use aortic strain and distensibility (AoD). The aim of this study was to examine the relationship between ALS7, AoS, and AoE. The study group (SG) was composed of 96 patients (mean age 70.41 ± 8.32 years) with a BMI of 25.58 ± 3.12 kg/m2; 28.1% were smokers, 54.2% had hypertension, 11.4% had diabetes, and 67.7% had hypercholesterolemia. The SG was further divided into three subgroups (optimal (ALS7-H), intermediate (ALS7-I), and inadequate (ALS7-L)) based on the ALS7. The AoS and AoE were assessed in each of them. We found that the ALS7-I and ALS7-H had significantly lower AoS values compared to the ALS7-L (AoS: 3.50 ± 0.53 and 4.10 ± 0.70 vs. 4.57 ± 1.03, respectively). The opposite relationship was observed for AoE measured with AoD in the ALS7-H vs. ALS7-L (AoD: 0.23 ± 0.14 vs. 0.11 ± 0.09 cm2/dyn). AoS correlated (r = 0.61) with systolic blood pressure (BP). In our regression model, higher scores on the ALS7 in BP, smoking, and BMI were independent protective factors against greater AoS. Higher ALS7 scores in BP, smoking, BMI, and physical activity were protective factors against lesser aortic strain. Higher scores in ALS7 for BP and smoking were protective factors against lesser AoD. We conclude that better cardiovascular health expressed via higher scores obtained on the ALS7 is associated with lower AoS and higher AoE on CT.

Conceptualizations of health, ability to act upon those definitions and desire for supports among families from historically marginalized communities

Respect for parents' values and clinician-parent collaboration is less common among families from historically marginalized communities. We investigated how parents from marginalized communities operationalize health and their preferences for paediatric primary care. We recruited families who spoke English, Haitian Creole or Spanish with at least one child younger than 6 years old. Staff queried families' values and life experiences, perspectives on health and healthcare, social supports and resources. Fourteen interviews with the parents of 26 children were thematically analysed. Interviews revealed the following four themes: (1) parents' definitions of 'health' extend beyond physical health; (2) families' ability to actuate health definitions is complicated by poverty's impact on agency; (3) parents engage in ongoing problem recognition and identify solutions, but enacting solutions can be derailed by barriers and (4) parents want support from professionals and peers who acknowledged the hard work of parenting. Eliciting parents' multidimensional conceptualizations of health can support families' goal achievement and concern identification in the context of isolation, limited agency and few resources. Efforts to improve family centred care and reduce disparities in paediatric primary care must be responsive to the strengths, challenges, resources and priorities of marginalized families.

Correlation analysis of mental health conditions and personality of patients with alcohol addiction

BACKGROUND

Alcohol addiction, or alcohol dependence, refers to a psychological state of strong craving for alcohol caused by drinking when both the drinking times and alcohol consumption reach a certain level. Alcohol addiction can cause irreversible damage, leading to mental illness or mental disorders, negative changes in their original personality, and a tendency to safety incidents such as committing suicide or violent attacks on others. Significant attention needs to be given to the mental health of alcohol addicts, which could reflect their abnormal personality traits. However, only a few papers on this issue have been reported in China.

AIM

To investigate the correlation between mental health and personality in patients with alcohol addiction.

METHODS

In this single-center observational study, we selected 80 patients with alcohol addiction as the research subjects, according to the criteria of the K10 scale to evaluate the mental health of patients with alcohol addiction, and divided these patients into four groups based on the evaluation results: Good, average, relatively poor and bad. And then analyzed the correlation between mental health conditions and personality characteristics from these four groups of patients.

RESULTS

The average score of the K10 scale (Kessler 10 Simple Psychological Status Assessment Scale) in 80 patients with alcohol addiction was 25.45 points, the median score was 25 points, the highest score was 50 points, and the lowest score was 11 points. Pearson's analysis showed that the K10 score was positively correlated with the scores of these two subscales, such as the P-subscale and the N-subscale (P < 0.05). In contrast, the K10 score had no significant correlation with the scores from the E-subscale and the L-subscale (P > 0.05).

CONCLUSION

The mental health conditions of patients with alcohol addiction are positively correlated with their personality characteristics.

Mapping a comprehensive assessment tool to a holistic definition of health for person-centred care planning in home care: a modified eDelphi study

BACKGROUND

Researchers in the Netherlands proposed the Pillars for Positive Health (PPH) as a broadly encompassing health definition to support more realistic and meaningful care planning for people living with chronic disease and other life-long health conditions. The PPH was subsequently converted to the My Positive Health (MPH) spider web visualization tool. This study sought to identify opportunities for more person-centred care planning at the point of care in home care, using the MPH tool as a framework to link comprehensive assessment and dialogue-based goal-setting.

METHODS

A modified eDelphi method was used to conduct domain mapping with a purposively sampled expert panel (n = 25). The panel consisted of researchers, health care providers, older adults and caregivers. A two-stage eDelphi process was conducted, with each stage consisting of three survey rounds. In the first stage, participants were asked to map 201 elements of the interRAI Home Care (interRAI HC) comprehensive assessment tool to the six MPH domains or "No pillar of best fit". The second stage focused on identifying opportunities to adapt or expand comprehensive assessment as it relates to the MPH domains.

RESULTS

In Stage 1, 189 of 201 elements reached consensus in domain mapping. These included: 80 elements for Bodily Functions, 32 for Daily Functioning, 32 for Mental Wellbeing, 24 for Quality of Life, 10 for Participation, and 1 for Meaningfulness. Ten elements were identified to have no pillar of best fit. The 12 elements that did not reach consensus in Stage 1 formed the basis for Stage 2, where expert panel participants proposed four new assessment elements in Meaningfulness and Participation and 11 additional descriptors across the six MPH domains. Of these, two elements and nine of the 11 descriptors reached consensus.

CONCLUSION

Findings show that elements of the interRAI HC are oriented toward the physical, functional, and mental health domains. Consequently, complementary assessment elements and/or tools may be needed to support comprehensive assessment of 'Meaningfulness' and 'Participation' in person-centred home and community care. Additional descriptors may also be needed to aid communication regarding the understanding and application of MPH domains.

Young adults' narratives about living with home mechanical ventilation - a phenomenological hermeneutical study

PURPOSE

An increasing number of children and young adults with complex medical conditions and respiratory failure are treated with home mechanical ventilation (HMV). The current study aimed to describe how young adults using HMV experience their everyday life with the ventilator, their physical impairments and their opportunities for an educational and professional career.

MATERIALS AND METHODS

Data were collected via narrative interviews with nine young HMV users (3 females and 6 males, aged 18-31 years) in their homes. Two were ventilated invasively, six were ventilated non-invasively and one was treated with continuous positive airway pressure (CPAP) via facemask. Data were analysed using a phenomenological hermeneutical method.

RESULT

A multi-professional team contributed to participants' safety and ability to participate in society through higher education and professional work. A good and valuable life, mostly feeling healthy were experienced but also prejudice and stiffened social society structures.

CONCLUSION

The findings of this study prove the importance of having long-standing access to a competent and supportive available multi-professional healthcare team when living with a long-term complex condition. These teams provided well-functioning human and technological support in everyday lives.

Health as Complete Well-Being: The WHO Definition and Beyond

The paper defends the World Health Organisation (WHO) definition of health against widespread criticism. The common objections are due to a possible misinterpretation of the word complete in the descriptor of health as 'complete physical, mental and social well-being'. Complete here does not necessarily refer to perfect well-being but can alternatively mean exhaustive well-being, that is, containing all its constitutive features. In line with the alternative reading, I argue that the WHO definition puts forward a holistic account, not a notion of perfect health. I use historical and analytical evidence to defend this interpretation. In the second part of the paper, I further investigate the two different notions of health (holistic health and perfect health). I argue that both ideas are relevant but that the holistic interpretation is more adept for political aims.

Defining health through a critical materialist political economy lens

It has been recognized since antiquity that the organization of society and how it distributes resources are the primary determinants of health. Yet most definitions of health in the academic and practice literatures limit their focus to the individual's experience of health and functional abilities, neglecting the structures and processes of societies in which the individual is embedded. We draw upon developments in the critical health communication and critical materialist political economy of health literatures to provide a definition of health that directs attention to the role that economic and political systems play in either equitably or inequitably distributing the resources necessary for health. Since these distributions interact with the individual's unique biological and psychological dispositions and situations to produce health, it is important to identify their sources and means of making their distributions more equitable. Because it is through communication that humans interpret society, themselves, and others, a concise definition of health that draws attention to these societal features and their roles on a day-to-day basis in promoting or threatening health is essential.

Nurses' intention to care for patients with infectious disease: a content analysis study

OBJECTIVE

This present study was designed to explain the concept of nurses intention to care of patients with infectious diseases.

METHODS

This study is a deductive content analysis study that was performed from May 2022 to Jun 2022 in three hospitals in Iran. In total 21 nurses were chosen by purposive sampling and for deta collection used semi-structured interviews. Data analysis was done using Elo and Kingas method.

RESULTS

This study have revealed the formation of seven distinct themes, namely Job satisfaction, Professional ethics, Personal values, Standard precautions, Preserving health, Support, and Attitude of patients and their families. These themes are comprised of 17 categories and 59 subcategories.

CONCLUSION

By comprehending the dimensions of nurses' intentions to care for patients with infectious diseases, it is possible to develop suitable planning and strategies to meet the healthcare requirements of such patients. Managers can take action by examining the issues and demands of nurses, and by providing job security, they can establish a Healthcare service systems with high security that can effectively respond during an outbreak of infectious diseases. Additionally, Nursing managers can prevent nurses from leaving their jobs by taking appropriate intervention, increasing their motivation, and enhancing their satisfaction.

Antibacterial efficiency over time and barrier properties of wood coatings with colloidal silver

This work aims to represent a standard application for understanding the extent of the antibacterial efficacy of coatings with different amounts of colloidal silver on wooden surfaces over time. The key variable that was intended to be evaluated in this study was the "time efficiency," with concerns about the possible efficacy in the durability of the surfaces. By highlighting the "expiry date" of the agents, as in the case with other products, the study aimed to confirm the validity of the simulation tests conducted in the laboratory with degradation tests. Furthermore, the role of the silver amount on the barrier performance of the coatings was assessed by liquid resistance, water uptake, and perspiration tests, evaluating the aesthetic durability of the coatings by means of colorimetric analyses. Ultimately, this work demonstrates that these coatings may represent alternatives in terms of prolonged antimicrobial activity when compared with the biocide agents currently in use, capable to offer good resistance to detergent solutions and to water. Nevertheless, due to silver's susceptibility to extended exposure to acidic solutions, the findings of the research discourage the utilization of colloidal silver in wood paints intended for use in public settings. KEY POINTS: • Colloidal silver does not alter the deposition process and does not introduce defects in the wood paint. • Coatings containing silver show high antimicrobial activity over time, against both E.coli and S.aureus. • The silver-based filler resists contact with detergents and aqueous solutions but suffers oxidation processes in acidic environments.

Complex systems approaches to the adaptability of human functions and behavior in health, aging, and chronic diseases: protocol for a meta-narrative review

BACKGROUND

Evaluating the adaptability of human functions and behavior has become a subject of growing interest due to aging populations and the increased prevalence of chronic diseases. Various research traditions, based on complex systems theories, have addressed the adaptability of human functions and behavior. However, despite the different research traditions, no review has so far compared them to provide a reliable and useful synthetic tool. Based on an adapted methodology, study objectives are to refine common and divergent traits in the way adaptability of the human functions and behavior has been studied via complex system approaches, with a special focus on aging and chronic diseases. In order to meet this objective, we will use the methodology of the meta-narrative review, and we present in this article the protocol that we will follow.

METHODS

The meta-narrative review explores the contrasting and complementary ways in which researchers have studied a subject in order to synthesize information and extract theoretical and applied recommendations. In order to carry out this protocol, we detail our methodology of article extraction, coding, and synthesis. We present the six main stages of our review, from the planning stage to the recommendation stage, and the way we will implement the six principles that underpin the construction of a meta-narrative review.

DISCUSSION

The use of a meta-narrative review methodology will yield greater visibility and comprehension of the adaptability of human functions and behavior studied via complex systems-based approaches. In a broader perspective, this paper is also geared to help future researchers carry out a meta-narrative review by highlighting the main challenges encountered and anticipated as well as elements to be taken into account before starting such a project.

The Use of Digital Health Services Among Patients and Citizens Living at Home: Scoping Review

BACKGROUND

The development of digital health services reflects not only the technical development of services but also a change in attitude and the way of thinking. It has become a cornerstone for engaging and activating patients and citizens in health management while living at home. Digital health services are also aimed at enhancing the efficiency and quality of services, while simultaneously providing services more cost-effectively. In 2020, the COVID-19 pandemic accelerated worldwide the development and use of digital services in response to requirements for social distancing and other regulations.

OBJECTIVE

The aim of this review is to identify and summarize how digital health services are being used among patients and citizens while living at home.

METHODS

The Joanna Briggs Institute (JBI) methodology for scoping reviews was used as guidance. A search conducted in 3 databases (CINAHL, PubMed, Scopus) resulted in 419 papers. The reporting was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR), and the analysis of the included papers was performed using a framework consisting of 5 clusters describing the use of digital health services. After screening and excluding papers that did not match the inclusion criteria, 88 (21%) papers from 2010 to 2022 were included in the final analysis.

RESULTS

Results indicated that digital health services are used in different situations and among different kinds of populations. In most studies, digital health services were used in the form of video visits or consultations. The telephone was also used regularly for consultations. Other services, such as remote monitoring and transmitting of recorded information and the use the of internet or portals for searching information, were observed as well. Alerts, emergency systems, and reminders were observed to offer possibilities of use, for example, among older people. The digital health services also showed to have potential for use in patient education.

CONCLUSIONS

The development of digital services reflects a shift toward the provision of care regardless of time and place. It also reflects a shift toward emphasis on patient-centered care, meaning activating and engaging patients in their own care as they use digital services for various health-related purposes. Despite the development of digital services, many challenges (eg, adequate infrastructure) still prevail worldwide.

Everyday navigation between adaptation and resistance: How young people negotiate their well-being in relation to assigned migrant positions in school

Concerning the so-called "refugee crisis" in 2015 and how it affected the position of young migrants in society, researchers have underscored the value of studies challenging one-sided images of migrant youth. This study examines how migrant positions are constituted, negotiated, and related to young people's well-being. The study was undertaken using an ethnographic approach combined with the theoretical concept of translocational positionality to acknowledge how positions are created through historical and political processes and, at the same time, are context-dependent over time and space and thus contain incongruities. Our findings show how the newly arrived youth used multiple ways to navigate the school's everyday life and ascribed migrant positions to achieve well-being as illustrated through the distancing, adapting, defense, and the contradictory positions. Based on our findings, we understand the negotiations that occur in forming migrant positions within the school as asymmetric. At the same time, the youths' diverse and often contradictory positionality showed in various ways the striving for increased agency and well-being.

Psychometric Properties of Suboptimal Health Status Instruments: A Systematic Review

BACKGROUND

Suboptimal health status (SHS) measurement has now been recognized as an essential construct in predictive, preventive, and personalized medicine. Currently, there are limited tools, and an ongoing debate about appropriate tools. Therefore, it is crucial to evaluate and generate conclusive evidence about the psychometric properties of available SHS tools.

OBJECTIVE

This research aimed to identify and critically assess the psychometric properties of available SHS instruments and provide recommendations for their future use.

METHODS

Articles were retrieved by following the guidelines of the PRISMA checklist, and the robustness of methods and evidence about the measurement properties was assessed using the adapted COSMIN checklist. The review was registered in PROSPERO.

RESULTS

The systematic review identified 14 publications describing four subjective SHS measures with established psychometric properties; these included the Suboptimal Health Status Questionnaire-25 (SHSQ-25), Sub-health Measurement Scale Version 1.0 (SHMS V1.0), Multidimensional Sub-health Questionnaire of Adolescents (MSQA), and the Sub-Health Self-Rating Scale (SSS). Most studies were conducted in China and reported three reliability indices: (1) the internal consistency measured by Cronbach's α value ranged between 0.70 and 0.96; (2) the test-retest reliability; and (3) the split-half reliability coefficient values ranged between 0.64 and 0.98, and between 0.83 and 0.96, respectively. For the values of validity coefficients in the case of SHSQ-25 > 0.71, the SHMS-1.0 ranged from 0.64 to 0.87, and the SSS ranged from 0.74 to 0.96. Using these existing and well-characterized tools rather than constructing original tools is beneficial, given that the existing choice demonstrated sound psychometric properties and established norms.

CONCLUSIONS

The SHSQ-25 stood out as being more suitable for the general population and routine health surveys, because it is short and easy to complete. Therefore, there is a need to adapt this tool by translating it into other languages, including Arabic, and establishing norms based on populations from other regions of the world.

Leveraging Responsible, Explainable, and Local Artificial Intelligence Solutions for Clinical Public Health in the Global South

In the present paper, we will explore how artificial intelligence (AI) and big data analytics (BDA) can help address clinical public and global health needs in the Global South, leveraging and capitalizing on our experience with the "Africa-Canada Artificial Intelligence and Data Innovation Consortium" (ACADIC) Project in the Global South, and focusing on the ethical and regulatory challenges we had to face. "Clinical public health" can be defined as an interdisciplinary field, at the intersection of clinical medicine and public health, whilst "clinical global health" is the practice of clinical public health with a special focus on health issue management in resource-limited settings and contexts, including the Global South. As such, clinical public and global health represent vital approaches, instrumental in (i) applying a community/population perspective to clinical practice as well as a clinical lens to community/population health, (ii) identifying health needs both at the individual and community/population levels, (iii) systematically addressing the determinants of health, including the social and structural ones, (iv) reaching the goals of population's health and well-being, especially of socially vulnerable, underserved communities, (v) better coordinating and integrating the delivery of healthcare provisions, (vi) strengthening health promotion, health protection, and health equity, and (vii) closing gender inequality and other (ethnic and socio-economic) disparities and gaps. Clinical public and global health are called to respond to the more pressing healthcare needs and challenges of our contemporary society, for which AI and BDA can help unlock new options and perspectives. In the aftermath of the still ongoing COVID-19 pandemic, the future trend of AI and BDA in the healthcare field will be devoted to building a more healthy, resilient society, able to face several challenges arising from globally networked hyper-risks, including ageing, multimorbidity, chronic disease accumulation, and climate change.

What is behind the lifestyle risk factors for head and neck cancer?

Lifestyle factors are known to be influential determinants of health. According to the World Health Organization (WHO), approximately one third of deaths involve unhealthy lifestyle habits. Among lifestyle risk factors for head and neck cancers (HNC), alcohol consumption and smoking have an undeniable role in the multifactorial aetiology of the disease. In recent years, the promotion of healthy lifestyle choices has gained significant attention as contributory to improving health and disease prevention. Interventions to tackle these risk factors are vitally important in disease prevention and progression. However, in order to effectively prevent the disease and reduce the risk factors, it is crucial to identify what upstream reasons lead to the adoption of these lifestyle risk factors in the first place. Stress being a constant aspect of modern-day life is known to contribute to alcohol and smoking practices. In this review paper, relevant literature was searched in PubMed database for stress, lifestyle factors, HNC and cancer to explore the role of stress and its associated biological pathways as an upstream factor in the adoption of lifestyle risk factors that cause HNC. It highlights the importance of stress pathways and the Hypothalamus Pituitary Adrenal (HPA) axis as a locus of interaction between stress, alcohol, smoking and cancer. Despite their widely accepted harmful effects, alcohol and smoking remain deeply rooted in contemporary life. A greater understanding of the impact of stress on lifestyle choices and an exploration of the mechanisms resulting in stress, alcohol- and smoking- related cancer may highlight opportunities for improved prevention measures through the modification of unhealthy lifestyle choices.

Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review

BACKGROUND

Indigenous youth in Canada face profound health inequities which are shaped by the rippling effects of intergenerational trauma, caused by the historical and contemporary colonial policies that reinforce negative stereotypes regarding them. Moreover, wellness promotion strategies for these youth are replete with individualistic Western concepts that excludes avenues for them to access holistic practices grounded in their culture. Our scoping review explored strategies, approaches, and ways health and wellness can be enhanced by, for, and with Indigenous youth in Canada by identifying barriers/roadblocks and facilitators/strengths to enhancing wellness among Indigenous youth in Canada.

METHODS

We applied a systematic approach to searching and critically reviewing peer-reviewed literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews [PRISMA-ScR] as a reporting guideline. Our search strategy focused on specific keywords and MeSH terms for three major areas: Indigenous youth, health, and Canada. We used these keywords, to systematically search the following electronic databases published in English between January 01, 2017, to May 22, 2021: Medline [Ovid], PubMed, ERIC, Web of Science, Scopus, and iportal. We also used hand-searching and snowballing methods to identify relevant articles. Data collected were analysed for contents and themes.

RESULTS

From an initial 1695 articles collated, 20 articles met inclusion criteria for this review. Key facilitators/strengths to enhancing health and wellness by, for, and with Indigenous youth that emerged from our review included: promoting culturally appropriate interventions to engage Indigenous youth; using strength-based approaches; reliance on the wisdom of community Elders; taking responsibility; and providing access to wellness supports. Key barriers/roadblocks included: lack of community support for wellness promotion activities among Indigenous youth; structural/organizational issues within Indigenous communities; discrimination and social exclusion; cultural illiteracy among youth; cultural discordance with mainstream health systems and services; and addictions and risky behaviours.

CONCLUSION

This scoping review extracted 20 relevant articles about ways to engage Indigenous youth in health and wellness enhancement. Our findings demonstrate the importance of promoting health by, and with Indigenous youth, by engaging them in activities reflexive of their cultural norms, rather than imposing control measures that are incompatible with their value systems.

Mapping of Research in the Field of Forest Therapy-Related Issues: A Bibliometric Analysis for 2007-2021

Exposure to forest environments promotes human health. The number of relevant studies in this area has increased rapidly. However, an overall review of relevant analyses from the perspectives of bibliometrics and visualization is lacking. A scientometric analysis of 2,545 publications from 2007 to 2021 via the Web of Science database was conducted to identify the knowledge structure and frontiers objectively. The publications were subsequently analyzed in terms of the distribution of journals and countries, citation bursts, major subject areas, and evolutionary stages. The findings showed that the knowledge foundation of forest therapy was multidisciplinary with most published in the fields of environmental sciences and ecology but lacking input from social disciplines. The research hotspots evolved from the early focus on individual benefits obtained from nature to increasing attention on human well-being at the social-ecological scale. More rigorous experiments with strict randomized controlled trials and blinding are needed to accommodate the trend of forest therapy toward non-pharmacological treatments. According to Shneider's four-stage theory, forest therapy research is in the third stage of the scientific research process. More future studies utilizing novel technologies and decision-making frameworks to solve practical issues are needed for introducing health into policies and promoting human well-being.

Managing health in inequitable contexts: Health capacities as integral to life course health development

Health behavior models are widely used in prevention research with children and adolescents; yet, many of these models were developed based on adult experiences and fail to consider the development of health constructs. The concept of health capacity development is a theoretical model of how health capacities, the health-related developmental sociocultural resources individuals use to regulate their coactions with their environments to sustain health, develop. Health capacities are formed through person-environment transactions and thus, are informed by, and help individuals manage, the opportunities and constraints situated in their environments. The extent to which health capacities support long-term adaptive health development varies; yet, health capacities may be leveraged for adaptative functioning. Grounded in the Life Course Health Development (LCHD) framework and the principles of Relational Developmental Systems (RDS) metatheory, the development of three health capacities, their role in managing person-environment coactions, and their potential for facilitating displays of resilient functioning in inequitable contexts are described. Implications of the model, its limitations, and avenues for future research are discussed.

Concepts of health in different contexts: a scoping review

The rationale of our study was that the World Health Organization's (WHO) definition of health from 1947 which includes "… complete physical, mental and social wellbeing…" does not fit the current societal viewpoints anymore. The WHO's definition of health implies that many people with chronic illnesses or disabilities would be considered unhealthy and complete wellbeing would be utopian and unfeasible for them. This is no longer uniformly accepted. Many alternative concepts of health have been discussed in the last decades such as 'positive health', which focusses on someone's capability rather than incapability,. However, the question remains whether a general health concept can guide all healthcare practices. More likely, health concepts need to be specified for professions or settings. The objective of our study was to create a structured overview of published concepts of health from different perspectives by conducting a scoping review using the PRISMA-ScR guideline. A literature search was conducted in Pubmed and Cinahl. Articles eligible for inclusion focussed on the discussion or the conceptualisation of health or health-related concepts in different contexts (such as the perspective of care workers' or patients') published since 2009 (the Dutch Health Council raised the discussion about moving towards a more dynamic perspective on health in that year). Seventy-five articles could be included for thematic analyses. The results showed that most articles described a concept of health consisting of multiple subthemes; no consensus was found on one overall concept of health. This implies that healthcare consumers act based on different health concepts when seeking care than care workers when providing care. Having different understandings of the concepts of health can lead to misunderstandings in practice. In conclusion, from every perspective, and even for every individual, health may mean something different. This finding stresses the importance that care workers' and healthcare consumers' meaning of 'health' has to be clear to all actors involved. Our review supports a more uniform tuning of healthcare between healthcare providers (the organisations), care workers (the professionals) and healthcare consumers (the patients), by creating more awareness of the differences among these actors, which can be a guide in their communication.

Sleep Quality, Mental Health and Learning among High School Students after Reopening Schools during the COVID-19 Pandemic: Results of a Cross-Sectional Online Survey

We aimed to assess whether high school students’ sleep quality, mental health and learning changed during the COVID-19 pandemic as adolescents transitioned from learning online back to studying in person. We conducted an anonymous online cross-sectional survey study at three competitive high schools in Vilnius, Lithuania, after they were reopened. Students provided subjective views on their study quality, their health as well as daily life while studying either virtually or in person and completed the Beck depression inventory (BDI), the Generalized anxiety scale-7 (GAD-7) and the Pittsburgh sleep quality index (PSQI). Among 628 (70.4% female) respondents, 268 (42.7%), 342 (54.5%) and 398 (63.4%) are suspected to have depression, an anxiety disorder or poor sleep, respectively. Students reported better study quality (Z = −12.435, p < 0.001) and physical health (Z = −9.176, p < 0.001), but worse sleep quality (Z = −19.489, p < 0.001), shorter sleep duration (Z = −19.509, p < 0.001) and worse self-reported mental health (Z = −2.220, p < 0.05) while learning in person. However, higher scores of in-person study quality and physical health were associated with lower depression and anxiety levels as well as better sleep. Our study suggests that the reopening of schools may exacerbate sleep and mental health-related issues among high school students but also be beneficial for their academic development and levels of physical activity.

Subjective health and associative social factors in emerging adults with different levels of participation limitations—A cross-sectional study

Background

Participation was shown to be associative with subjective health (SH) in many different populations, including emerging adults.

Objectives

This study aimed to investigate SH and associative variables in emerging adults with different levels of participation limitations.

Methods

Healthy university students who were between 18–25 years of age were included. SH was assessed with the visual analog scale. The participants were grouped based on P-Scale. Multiple linear regressions were conducted to determine the associative variables of SH for each P-Scale group.

Results

A total of 572 participants were included. General health-related quality of life was associated with SH in all P-Scale groups. Other prominent findings of this study showed perception of health, income, and lifestyle were among the most significant associative variables of SH.

Conclusion

Variables associated with emerging adults’ SH change with their participation restrictions. Therefore, different approaches are needed to improve the subjectively perceived health status of emerging adults.

The Impact of the Magnitude of the Group of Bullies on Health-Related Quality of Life and Academic Performance Among Adolescents

This study examines the consequences that physical and verbal/social victimization by peers and the magnitude of the groups of bullies have on academic performance and the psychological and social domains of Health-related Quality of Life (HRQoL). 1428 secondary school students in the south-east Spain completed the Spanish version of the "Adolescent Peer Relations Instrument-Bullying" and "KIDSCREEN-52" questionnaires in order to analyse, respectively, peer victimization and the psychological and social domains of HRQoL. Data on sociodemographic characteristics and academic achievement was also collected. Findings emphasise the potential of peer victimization in all its forms as risk factors explaining poor HRQoL in psychological, social and emotional domains. The number of bullies was an imponent and significant risk factor that explains a worse HRQoL in the five socio-psychological dimensions studied (Odds Ratio 4.08, Odds Ratio 9.25, Odds Ratio 4.69, Odds Ratio 2.91, Odds Ratio 11.92). Nevertheless, peer victimization rarely seems to affect academic achievement. Results suggest that much of prevention and intervention are still needed to reduce peer victimization, focusing on large bullies' groups and their harmful impact on adolescent's HRQoL.

The global health community must stand for health and democracy in Myanmar

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Interdependence between health and peace: a call for a new paradigm

Health and peace, and their relationships to disease/conflict/violence, are complex and multifaceted interrelated terms. Scholars have proposed a variety of definitions for health and peace. The conceptualizations of health and peace share many fundamental elements, including in their social, psychological (emotional and mental) and spiritual dimensions. We argue that health and peace are inter-dependent in a fundamental causal fashion. Health is always positively or negatively affected by conflict; peace can be directly or indirectly fostered through public health program and policy initiatives. Evidence shows that public health professionals and academics have frequently failed to recognize the inter-dependence of health and peace when conceptualizing, and addressing, issues related to health and peace. In contrast, the present article argues in support of a new paradigm for addressing public health issues related to health and peace; such a paradigm is based on the premise that health and peace are inextricably linked, requiring that they be addressed in an integrated, inter-dependent, fashion. Finally, we emphasize that fostering health and peace requires identifying and promoting positive socio-ecological influences on health, rather than limiting our focus to health deficits and obstacles at the individual or community levels.

The health and suffering scale: Item reduction, reliability and validity among women undergoing rehabilitation for exhaustion and long-lasting pain

Aim

To investigate the necessity of an item reduction and to evaluate estimates of dimensionality, reliability and validity of the Health and Suffering Scale among two groups of women, one undergoing rehabilitation for exhaustion and long‐lasting pain and one reference group.

Design

Psychometric evaluation of the scale using cross‐sectional data.

Method

The Health and Suffering Scale is a self‐report scale which measures perceived suffering in relation to health on a semantic visual analogue scale. Classical and modern test theory were applied for item reduction and to explore estimates of reliability and validity.

Results

The Health and Suffering Scale was found to be unidimensional, nine of originally twenty items were part of a consistent factor structure and hierarchical order. These items were internally consistent, discriminated between patients and healthy respondents, and had an excellent level of separation of individuals experiencing various levels of health and suffering. Re‐test reliability estimates were moderate.

Frailty in elderly inpatients with cardiovascular disease: an exploration of associated factors

AIMS

Older patients with cardiovascular diseases (CVDs) are more likely to develop frailty. Few studies have investigated frailty status, and its multiple associated factors, in this population. The aim of the present study was to explore frailty status, and its multidimensional associated factors, in elderly inpatients with CVDs.

METHODS AND RESULTS

In this cross-sectional study, 1021 inpatients with CVDs aged ≥60 years old were recruited through convenience sampling from multiple hospitals in Suzhou, China. The FRAIL scale was used to assess frailty. A self-designed questionnaire gathered sociodemographic, clinical, and health-related information related to the physiological, psychological, and social dimensions of frailty. Among the 629 elderly inpatients with CVDs (73.64 ± 7.93 years old) who met inclusion criteria and completed the assessments, 176 (28.0%) were classified as frail. Univariate analyses demonstrated that the proportion of frailty was significantly associated with multiple factors. Logistic regression analysis indicated that, compared to their counterparts, the risk of frailty was higher in participants with cardiac function classes II, III, and IV [odds ratio (OR) = 1.866, 3.393, and 6.351, respectively]; average and bad mastication function (OR = 2.534 and 2.945, respectively); and often or always using walking aids (OR = 2.713). Conversely, the risk of frailty was lower in participants with good nutritional status (OR = 0.879) and regular exercise habits (OR = 0.573), as compared with their counterparts.

CONCLUSION

Frailty in elderly inpatients with CVDs is common and associated with multiple physiological factors including cardiac function, mastication function, nutritional status, use of walking aids, and regular exercise habits.

Can sustainable health behaviour contribute to ensure healthy lives and wellbeing for all at all ages (SDG 3)? A viewpoint

Sustainable health behaviours and, specifically, eating a sustainable diet and engaging in regular physical activity are healthpromoting behaviours that can simultaneously contribute to reduction of greenhouse gases which are known to contribute to climate change. Good health usually facilitates societal development, and development often promotes improved health. However, while good health may be a prerequisite for societal development, some behavioural determinants of health, such as attitudes towards the environment, and people’s lifestyles and consumption patterns, can impede the sustainability of the development process in the longer term. This perspective paper argues that there is a need to rethink 21^st century health promotion practices by pairing sustainability literacy with health promotion for changing dietary and physical activity behaviour patterns to improve population health and contribute to the achievement of Sustainable Development Goal 3 (to ensure healthy lives and promote wellbeing for all at all ages).

Conceptualizing Social Determinants of Neighborhood Health through a Youth Lens

This study reports on findings from a youth participatory action research of children's well-being and health. We draw upon the Social Determinants of Health framework, including a focus on structural racism and intersectionality, to holistically explore the ways in which youth (ages 13-17) experience multiple forms of marginalization within the neighborhood, and how these experiences influence their well-being outcomes. We employed the data collection techniques of focus group discussion, community mapping, photovoice, and follow-up small group discussions with 14 African American youth in Cleveland, Ohio. Utilizing participatory thematic analysis, the participants established four main thematic categories connected to the neighborhood which have a strong influence on youth health and well-being. These categories included: (1) Crime and safety; (2) Housing and the built environment; (3) Social Influence; (4) Community Activities. By involving youth as co-constructors of the research, we elicited perspectives on the pathways between a healthy neighborhood to healthy residents, with implications for future research, policy, and intervention programming aimed at improving the health and well-being of children and youth.

Towards the Healthy Community: Residents’ Perceptions of Integrating Urban Agriculture into the Old Community Micro-Transformation in Guangzhou, China

In the renewal of old communities, one of the development directions is to improve health and enhance well-being. A healthy community includes four aspects of health, namely, healthy production, healthy lifestyle, healthy environment and ecosystem, and healthy physical and mental states of residents living in the community. Urban agriculture (UA), as a form of the community garden, is a supplementary form for the lack of production function in the urban community. It also has the potential to contribute to sustainable and resilient urban communities. This study focuses on analysing the health benefits of UA and attempts to identify old community residents’ attitudes and perceptions towards UA and understand their confusion and worry. The purpose of this study is to promote the healthy and sustainable development of old communities by integrating UA into the micro-transformation of old communities and provide planning and design strategies and community development ideas for the micro-transformation. Surveys were conducted on 10 old communities in Yuexiu district, located in Guangzhou, China. Statistical analysis was conducted using IBM Statistical SPSS version 26 to obtain information on the factor structure of residents’ perceptions towards the health benefits of UA. The analysis results showed significant differences between gender groups and the status of children on old community residents’ perceptions towards general UA benefits. The main factors accounting for old community residents’ perceptions towards the health benefits of UA were environmental health benefits, physical and psychological health benefits, and community health benefits. When developing UA in old communities, co-construction and co-sharing mode, public participation mode, and promotion mode are three important development strategies. Construction location, design style, and seasonal design are also critical for the construction of UA in old communities.

Landscapes of care and despair for rural youth - a qualitative study in the northern Swedish 'periphery'

Background

This study emerges as a response to the lack of youth perspectives when it comes to discussions about access to and experiences of health and social services in rural areas. It subsequently contributes to the literature by positioning young people at the centre of this debate, and by taking a more holistic approach to the topic than is typically the case. Specifically, based on the idea that a good life in proper health for young people may be contingent on notions of care that are bounded up in multi-layered social and spatial environments, the aim of this study was to explore what characterises ‘landscapes of care’ for rural youth.

Methods

In this qualitative study, the participants included young people and professionals residing in five diverse areas across the northern Swedish ‘peripheral’ inland. Individual interviews (16 in total) and focus group discussions (26 in total) were conducted with 63 youth aged 14–27 years and with 44 professionals operating across sectors such as health centres, school health, integration units, youth clinics and youth clubs. Following an emergent design and using thematic analysis, we developed one main theme, ‘landscapes of care and despair’, comprising the two themes: ‘(dis)connectedness’ and ‘extended support or troubling gaps’.

Results

The findings illustrate how various health-promoting and potentially harmful aspects acting at structural, organisational and interpersonal levels contributed to dynamic landscapes characterised simultaneously by care and despair. In particular, our study shows how rural youths’ feelings of belongingness to people and places coupled with opportunities to participate in society and access practical and emotional support appear to facilitate their care within rural settings. However, although the results indicate that some in the diverse group of rural youth were cared for and about, a negative picture was painted in parallel. These aspects of despair included youths’ senses of exclusion and marginalisation, degrading attitudes towards them and their problems, as well as recurrent gaps in the provision and practices of care.

Conclusions

To gain a more comprehensive understanding about the health of rural youth, this study highlights the benefits investigating ‘care-ful’ and ‘uncaring’ aspects bounded up in dynamic and multi-layered landscapes.

Defining health and health inequalities

OBJECTIVES

To examine existing definitions of health and health inequalities and to synthesise the most useful of these using explicit rationale and the most parsimonious text.

STUDY DESIGN

Literature review and synthesis.

METHODS

Existing definitions of health and health inequalities were identified, and their normative properties were extracted and then critically appraised. Using explicit reasoning, new definitions, synthesising the most useful aspects of existing definitions, were created.

RESULTS

A definition of health as a structural, functional and emotional state that is compatible with effective life as an individual and as a member of society and a definition of health inequalities as the systematic, avoidable and unfair differences in health outcomes that can be observed between populations, between social groups within the same population or as a gradient across a population ranked by social position are proposed. Population health is a less commonly used term but can usefully be defined to encompass the average, distribution and inequalities in health within a society.

CONCLUSIONS

Clarifying what is meant by the terms health and health inequalities, and the assumptions, emphasis and values that different definitions contain, is important for public health research, practice and policy.