Kàren Morgan

BACKGROUND: Health behaviours do not occur in isolation. Rather they cluster together. It is important to examine patterns of health behaviours to inform a more holistic approach to health in both health promotion and illness prevention strategies. Examination of patterns is also important because of the increased risk of mortality, morbidity and synergistic effects of health behaviours. This study examines the clustering of health behaviours in a nationally representative sample of Irish adults and explores the association of these clusters with mental health, self-rated health and quality of life. METHODS: TwoStep Cluster analysis using SPSS was carried out on the SLÁN 2007 data (national Survey of Lifestyle, Attitudes and Nutrition, n = 10,364; response rate =62%; food frequency n = 9,223; cluster analysis n = 7,350). Patterns of smoking, drinking alcohol, physical activity and diet were considered. Associations with positive and negative mental health, quality of life and self-rated health were assessed. RESULTS: Six health behaviour clusters were identified: Former Smokers, 21.3% (n = 1,564), Temperate, 14.6% (n = 1,075), Physically Inactive, 17.8% (n = 1,310), Healthy Lifestyle, 9.3% (n = 681), Multiple Risk Factor, 17% (n = 1248), and Mixed Lifestyle, 20% (n = 1,472). Cluster profiles varied with men aged 18-29 years, in the lower social classes most likely to adopt unhealthy behaviour patterns. In contrast, women from the higher social classes and aged 65 years and over were most likely to be in the Healthy Lifestyle cluster. Having healthier patterns of behaviour was associated with positive lower levels of psychological distress and higher levels of energy vitality. CONCLUSION: The current study identifies discernible patterns of lifestyle behaviours in the Irish population which are similar to those of our European counterparts. Healthier clusters (Former Smokers, Temperate and Healthy Lifestyle) reported higher levels of energy vitality, lower levels of psychological distress, better self-rated health and better quality of life. In contrast, those in the Multiple Risk Factor cluster had the lowest levels of energy and vitality and the highest levels of psychological distress. Identification of these discernible patterns because of their relationship with mortality, morbidity and longevity is important for identifying national and international health behaviour patterns.

BACKGROUND: Health examination surveys (HESs), carried out in Europe since the 1950's, provide valuable information about the general population's health for health monitoring, policy making, and research. Survey participation rates, important for representativeness, have been falling. International comparisons are hampered by differing exclusion criteria and definitions for non-response. METHOD: Information was collected about seven national HESs in Europe conducted in 2007-2012. These surveys can be classified into household and individual-based surveys, depending on the sampling frames used. Participation rates of randomly selected adult samples were calculated for four survey modules using standardised definitions and compared by sex, age-group, geographical areas within countries, and over time, where possible. RESULTS: All surveys covered residents not just citizens; three countries excluded those in institutions. In two surveys, physical examinations and blood sample collection were conducted at the participants' home; the others occurred at examination clinics. Recruitment processes varied considerably between surveys. Monetary incentives were used in four surveys. Initial participation rates aged 35-64 were 45% in the Netherlands (phase II), 54% in Germany (new and previous participants combined), 55% in Italy, and 65% in Finland. In Ireland, England and Scotland, household participation rates were 66%, 66% and 63% respectively. Participation rates were generally higher in women and increased with age. Almost all participants attending an examination centre agreed to all modules but surveys conducted in the participants' home had falling responses to each stage. Participation rates in most primate cities were substantially lower than the national average. Age-standardized response rates to blood pressure measurement among those aged 35-64 in Finland, Germany and England fell by 0.7-1.5 percentage points p.a. between 1998-2002 and 2010-2012. Longer trends in some countries show a more marked fall. CONCLUSIONS: The coverage of the general population in these seven national HESs was good, based on the sampling frames used and the sample sizes. Pre-notification and reminders were used effectively in those with highest participation rates. Participation rates varied by age, sex, geographical area, and survey design. They have fallen in most countries; the Netherlands data shows that they can be maintained at higher levels but at much higher cost.

Coronavirus disease 2019 (COVID-19) has become a global health threat and has placed an extraordinary demand on healthcare workers around the world. In this study, we aim to examine the prevalence of burnout and its associated factors and experience among Malaysian healthcare workers during the COVID-19 pandemic through an embedded mixed-method study design. We found that more than half of Malaysian healthcare workers in this sample experienced burnout. Direct involvement in COVID-19 screening or treatment, having a medical condition, and less psychological support in the workplace emerged to be the significant factors in personal-, work-, and patient-related burnout. Participants described their workloads, uncertainties caused by the pandemic, challenging work-family balance, and stretched workplace relationships as the sources of burnout. Exhaustion appeared to be the major symptom, and many participants utilized problem-focused coping to deal with the adversities experienced during the pandemic. Participants reported physical-, occupational-, psychological-, and social-related negative impacts resulting from burnout. As the pandemic trajectory is yet unknown, these findings provide early insight and guidance for possible interventions.

Using four brief assessment scales, profiles of mental health and psychological well-being were obtained from 507 old (aged 65-74 years) and 535 very old (aged 75+) individuals randomly sampled from the community. Assessments of dementia and depression were subsequently validated against diagnostic ratings made by experienced psychogeriatricians. Levels of agreement between psychometric and clinical ratings of dementia (kappa = 0.83) and depression (kappa = 0.66) were satisfactory. The old and very old groups reported similar levels of anxiety and personal disturbance, and showed a similar prevalence of depression. However, those aged 75+ showed higher levels of dementia and significantly lower levels of social involvement and morale.

This is the third national Survey of Lifestyle, Attitudes and Nutrition (SLÁN) in Ireland, conducted in 2007 using face-to-face interviews with adults aged 18 years or over, interviewed at home addresses. SLÁN 2007 follows on from two previous surveys using postal questionnaires - in 1998, involving 6,539 respondents with a 62% response rate, and in 2002, involving 5,992 respondents with a 53% response rate.
\n
\n• The SLÁN 2007 main survey involved 10,364 respondents (62% response rate), with a sub-study on body size with 967 younger adults (aged 18-44 years) and a more detailed physical examination involving nurse assessment and blood and urine sampling in 1,207 adults (aged 45 years and over). The sample was representative of the general population in Ireland when compared with Census 2006 fi gures and was further weighted to match the Census for analysis. Most fi ndings were analysed by gender, age and social class categories. The results of SLÁN 2007 are compared with those of SLÁN 1998 and 2002 where possible, and with HBSC 2006 where relevant.
\n
\nAlcohol and use of illicit drugs: 
\n• Most men (85%) and women (77%) drank alcohol on some occasions. One-quarter (28%) reported excessive drinking (i.e. having 6 or more standard drinks on one occasion) in the last year. This was more common in younger respondents and those in lower social class groups.
\n
\n• Comparisons with previous surveys were made, again with caution because of the changed survey methods (from self-report postal questionnaire in 1998 and 2002, to personal interview in 2007). Of those respondents who have had an alcoholic drink within the previous year, the average number of alcoholic drinks consumed in an average week across the three surveys decreased from 11 drinks (1998) to 9 (2002) to 7 (2007).
\n
\n• The percentage of drivers who reported driving a car after consuming 2 or more standard drinks in the past year has also decreased from 2002 (16%) to 2007 (12%).
\n
\n• There was a decrease in the percentage of respondents who reported consuming 6 or more standard drinks at least once a week, from 45% (2002) to 28% (2007). Comparable data were not available for 1998. The percentages consuming over the recommended weekly alcohol limit (21 or more units for men and 14 or more units for women) also decreased over the course of the three surveys, from 15% (1998) to 13% (2002) to 8% (2007).
\n
\n• Across 5 categories of illicit drugs assessed, only marijuana was used by more than one in 100 respondents in 2007 (5% reported using marijuana in the previous year). Use of all 5 categories of drug was similar or lower in 2007 than in 1998.