Research on social and economic factors influencing regional mortality patterns in China.

Regional population mortality correlates with regional socioeconomic development. This study aimed to identify the key socioeconomic factors influencing mortality patterns in Chinese provinces. Using data from the Seventh Population Census, we analyzed mortality patterns by gender and urban‒rural division in 31 provinces. Using a functional regression model, we assessed the influence of fourteen indicators on mortality patterns. Main findings: (1) China shows notable gender and urban‒rural mortality variations across age groups. Males generally have higher mortality than females, and rural areas experience elevated mortality rates compared to urban areas. Mortality in individuals younger than 40 years is influenced mainly by urban‒rural factors, with gender becoming more noticeable in the 40-84 age group. (2) The substantial marginal impact of socioeconomic factors on mortality patterns generally becomes evident after the age of 45, with less pronounced differences in their impact on early-life mortality patterns. (3) Various factors have age-specific impacts on mortality. Education has a negative effect on mortality in individuals aged 0-29, extending to those aged 30-59 and diminishing in older age groups. Urbanization positively influences the probability of death in individuals aged 45-54 years, while the impact of traffic accidents increases with age. Among elderly people, the effect of socioeconomic variables is smaller, highlighting the intricate and heterogeneous nature of these influences and acknowledging certain limitations.

A global clustering of terrestrial food production systems.

Food production is at the heart of global sustainability challenges, with unsustainable practices being a major driver of biodiversity loss, emissions and land degradation. The concept of foodscapes, defined as the characteristics of food production along biophysical and socio-economic gradients, could be a way addressing those challenges. By identifying homologues foodscapes classes possible interventions and leverage points for more sustainable agriculture could be identified. Here we provide a globally consistent approximation of the world's foodscape classes. We integrate global data on biophysical and socio-economic factors to identify a minimum set of emergent clusters and evaluate their characteristics, vulnerabilities and risks with regards to global change factors. Overall, we find food production globally to be highly concentrated in a few areas. Worryingly, we find particularly intensively cultivated or irrigated foodscape classes to be under considerable climatic and degradation risks. Our work can serve as baseline for global-scale zoning and gap analyses, while also revealing homologous areas for possible agricultural interventions.

The role of individual and contextual economic factors in obesity among adolescents: A cross-sectional study including 143 160 participants from 41 countries.

Background: To our knowledge, no previous study has examined the role of index of economic freedom (IEF) in the prevalence of excess weight and obesity in adolescents. The aim of this study was to determine the association between both individual and contextual economic factors and the prevalence of overweight and obesity (i.e. excess weight) or obesity in adolescents from different countries. Methods: A cross-sectional study was carried out using data from the 2017/2018 wave of the Health Behaviour School-Aged Children study. Body mass index z-score was determined following the International Obesity Task Force criteria and, subsequently, excess weight and obesity were computed. The Family Affluence Scale was used to assess socioeconomic status. The index of IEF was used to estimate the benefits of economic freedom, both for individuals and for society as a whole. Results: An inverse association was shown between socioeconomic status (SES) and excess weight or obesity, with adolescents with high SES and medium SES being less likely to have excess weight compared to adolescents with low SES (medium SES: odds ratio (OR) = 0.79; 95% confidence interval (CI) = 0.77-0.82, P < 0.001; high SES: OR = 0.65; 95% CI = 0.62-0.68, P < 0.001). For obesity, lower odds were also found for adolescents with medium SES (medium SES: OR = 0.74; 95% CI = 0.69-0.80, P < 0.001) or high SES (high SES: OR = 0.55; 95% CI 0.49-0.61, P < 0.001), in comparison with their counterparts with low SES. On the other hand, it was observed a greater likelihood of having excess weight and obesity in mostly unfree countries (excess weight: OR = 0.72; 95% CI = 0.51-1.00, P = 0.052; obesity: OR = 0.60; 95% CI = 0.39-0.92, P = 0.019) compared to free/mostly free countries. These results remained significant after adjusting for several sociodemographic and lifestyle covariates. Conclusions: Both individual and contextual factors seem to have a crucial role in the prevalence of excess weight and obesity in adolescents.

Spatiotemporal heterogeneity and long-term impact of meteorological, environmental, and socio-economic factors on scrub typhus in China from 2006 to 2018.

BACKGROUND: Large-scale outbreaks of scrub typhus combined with its emergence in new areas as a vector-borne rickettsiosis highlight the ongoing neglect of this disease. This study aims to explore the long-term changes and regional leading factors of scrub typhus in China, with the goal of providing valuable insights for disease prevention and control. METHODS: This study utilized a Bayesian space-time hierarchical model (BSTHM) to examine the spatiotemporal heterogeneity of scrub typhus and analyze the relationship between environmental factors and scrub typhus in southern and northern China from 2006 to 2018. Additionally, a GeoDetector model was employed to assess the predominant influences of geographical and socioeconomic factors in both regions. RESULTS: Scrub typhus exhibits a seasonal pattern, typically occurring during the summer and autumn months (June to November), with a peak in October. Geographically, the high-risk regions, or hot spots, are concentrated in the south, while the low-risk regions, or cold spots, are located in the north. Moreover, the distribution of scrub typhus is influenced by environment and socio-economic factors. In the north and south, the dominant factors are the monthly normalized vegetation index (NDVI) and temperature. An increase in NDVI per interquartile range (IQR) leads to a 7.580% decrease in scrub typhus risk in northern China, and a 19.180% increase in the southern. Similarly, of 1 IQR increase in temperature reduces the risk of scrub typhus by 10.720% in the north but increases it by 15.800% in the south. In terms of geographical and socio-economic factors, illiteracy rate and altitude are the key determinants in the respective areas, with q-values of 0.844 and 0.882. CONCLUSIONS: These results indicated that appropriate climate, environment, and social conditions would increase the risk of scrub typhus. This study provided helpful suggestions and a basis for reasonably allocating resources and controlling the occurrence of scrub typhus.

Efforts to Improve Diversity, Equality, and Inclusion in Sports Medicine via Community Engagement Initiatives Within American Cities Divided by Racial, Social, and Economic Factors.

Although the twenty-first century has seen major advances in evidence-based medicine to improve health, athletic performance, and injury prevention, our inability to implement these best practices across underserved American communities has limited the impact of these breakthroughs in sports medicine. Rochester, NY is stereotypical of American communities in which an economically challenged racially diverse urban center with grossly underperforming public schools is surrounded by adequately resourced predominantly Caucasian state-of-the-art education systems. As these great disparities perpetuate and further degrade our society in the absence of interventions, the need for community engagement initiatives is self-evident.

Changes in Health Care Workers' Economic Outcomes Following Medicaid Expansion.

Importance: The extent to which changes in health sector finances impact economic outcomes among health care workers, especially lower-income workers, is not well known. Objective: To assess the association between state adoption of the Affordable Care Act's Medicaid expansion-which led to substantial improvements in health care organization finances-and health care workers' annual incomes and benefits, and whether these associations varied across low- and high-wage occupations. Design, Setting, and Participants: Difference-in-differences analysis to assess differential changes in health care workers' economic outcomes before and after Medicaid expansion among workers in 30 states that expanded Medicaid relative to workers in 16 states that did not, by examining US individuals aged 18 through 65 years employed in the health care industry surveyed in the 2010-2019 American Community Surveys. Exposure: Time-varying state-level adoption of Medicaid expansion. Main Outcomes and Measures: Primary outcome was annual earned income; secondary outcomes included receipt of employer-sponsored health insurance, Medicaid, and Supplemental Nutrition Assistance Program benefits. Results: The sample included 1 322 263 health care workers from 2010-2019. Health care workers in expansion states were similar to those in nonexpansion states in age, sex, and educational attainment, but those in expansion states were less likely to identify as non-Hispanic Black. Medicaid expansion was associated with a 2.16% increase in annual incomes (95% CI, 0.66%-3.65%; P = .005). This effect was driven by significant increases in annual incomes among the top 2 highest-earning quintiles (ß coefficient, 2.91%-3.72%), which includes registered nurses, physicians, and executives. Health care workers in lower-earning quintiles did not experience any significant changes. Medicaid expansion was associated with a 3.15 percentage point increase in the likelihood that a health care worker received Medicaid benefits (95% CI, 2.46 to 3.84; P < .001), with the largest increases among the 2 lowest-earning quintiles, which includes health aides, orderlies, and sanitation workers. There were significant decreases in employer-sponsored health insurance and increases in SNAP following Medicaid expansion. Conclusion and Relevance: Medicaid expansion was associated with increases in compensation for health care workers, but only among the highest earners. These findings suggest that improvements in health care sector finances may increase economic inequality among health care workers, with implications for worker health and well-being.

Estimating the effect of socio-economic factors on infant mortality rates in Latin America between 2000 and 2019: a panel data analysis.

OBJECTIVES: Infant mortality is a crucial indicator of socio-economic development, reflecting the conditions in which children are born and raised. Despite notable reductions in Latin America, infant mortality rates remain relatively high compared to other regions worldwide. By understanding the socio-economic factors that influence infant mortality, we not only uncover immediate causes of infant deaths but also shed light on broader socio-economic and healthcare disparities contributing to the burden of disease. This study analyzes the impact of socio-economic factors on infant mortality rates in Latin America from 2000 to 2019, estimating the speed and magnitude of the response of infant mortality rates to changes in specific socio-economic factors. STUDY DESIGN: Longitudinal panel study. METHODS: Panel data regression models were used to examine the influence of specific socio-economic factors on infant mortality rates in Latin America. Additionally, impulse response functions estimated by local projections were used to estimate the speed and magnitude of the impact of socio-economic factors on infant mortality rates. RESULTS: The results highlight the importance of factors such as healthcare expenditure, female literacy, public expenditures on education, maternal mortality, physician density, total fertility rate, and tuberculosis incidence as significant determinants of infant mortality rates in the region. CONCLUSION: This study adds to the existing literature by offering empirical evidence on the association between these socio-economic factors and infant mortality in Latin America. It also provides a foundation for future research that investigates specific cases within Latin America and examines the variations of these socio-economic factors within those countries.

Barriers and enabling structural forces affecting access to antiretroviral therapy in Nigeria.

BACKGROUND: Access to antiretroviral therapy (ART) helps to improve quality of life and reduces the spread of HIV. However, while a lot of studies focus on supply factors, such as resources for the purchase of antiretroviral drugs, demand and structural forces are not given much emphasis. In this paper it is argued that structural forces shape the way people access antiretroviral therapy in Nigeria. METHODS: A Grounded Theory methodology was undertaken in the research. Semi structured qualitative interviews were administered to select people living with HIV/AIDS in Nigeria. This was facilitated by the Network of People Living with HIV/AIDS in Nigeria (NEPWHAN) to understand their perspectives with regard to barriers and enablers to ART access in Nigeria. Thirty persons living with HIV/AIDS were interviewed and recorded. The interview recordings were transcribed and coded using a constructionist epistemological approach. This was triangulated with results of preliminary and secondary literature review analysis. RESULTS: In this research, the participants discussed structural forces (barriers and enablers) that influenced how they accessed ART. These included economic factors such as poverty that enabled transactional sex. Unequal gender relations and perceptions influenced how they accessed ART. The participants' belief in 'God' and religious activities such as 'prayer' and the use of 'traditional medicine' had an impact on how and when they accessed ART. Political activity at the international, national, and local levels influenced access to ART as well as resources. The individual's familial, social, and organisational connections also influenced their ease of accessing ART. CONCLUSIONS: This study identifies structural forces that affect access to antiretroviral therapy and provides recommendations on how they can be harnessed to enable improved access to ART and consequently improved health.

Demographic and socio-economic factors affecting bed net ownership, usage, and malaria transmission among adult patients seeking healthcare in two Ghanaian urban cities.

BACKGROUND: The most cost-effective malaria prevention and control strategy is the use of a bed net. However, several factors affect the ownership and usage of bed nets among the adult population. Hence, this study aimed to examine socio-demographic factors affecting bed net ownership, usage and malaria transmission among adult patients seeking healthcare in two Ghanaian urban cities. METHODS: This hospital-based cross-sectional study was conducted, between January and September 2021, at Bremang Seventh-Day Adventist Hospital, Suame Municipal, Ashanti Region and Sunyani Municipal Hospital, Sunyani, Bono Region, Ghana. Structured questionnaires were administered to a total of 550 participants to ascertain their ownership and usage of the bed nets. Afterwards, finger prick blood samples were collected for malaria microscopy. Crude and adjusted prevalence ratios (PR) and their respective 95% CIs were calculated, using Poisson regression with robust standard errors, to show associated variables in bivariate and multivariate analyses respectively. R software (version 4.1.1) was used to perform all statistical analyses. RESULTS: About 53.3% (n = 293) of participants owned at least one-bed net but only 21.5% (n = 118) slept under it the previous night. Those married were 2.0 (95% CI: 1.6 - 2.5) and 2.4 (95% CI: 1.6 - 3.5) times more likely to own and use a bed net respectively than those who never married. Also, pregnant women were 1.3 (95% CI: 1.1 - 1.6) and 1.8 (95% CI: 1.3 - 2.5) times more likely to own and use a bed net respectively than non-pregnant. Even though income levels were not associated with bed net ownership and usage, students were 0.4 (95% CI: 0.2 - 0.6) and 0.2 (95% CI: 0.1 - 0.5) times less likely to own and use bed net respectively compared to formally employed persons. The overall malaria prevalence rate was 7.8%. Malaria-negative patients were 1.6 (95% CI: 1.2 - 2.0) and 2.4 (95% CI: 1.4 - 4.1) times more likely to own and use bed nets respectively than malaria positive. Patients with tertiary education recorded the lowest malaria prevalence (3.5%, n = 4). None of those with a monthly income > $300 recorded a case of malaria. On the contrary, majority 83%, n/N = 25/30) of the malaria-positive patients earned ≤ $150. CONCLUSION: The National Malaria Control Program should conduct comprehensive mapping of all urban population segments before launching mass bed net distribution campaigns, taking into account demographic and socioeconomic factors to enhance bed net utilization and reduce malaria prevalence.

Socio-economic factors associated with post-traumatic stress symptoms among adolescents and young people during the first wave of the COVID-19 pandemic.

This study assessed the association between sociodemographic factors and post-traumatic stress symptoms (PTSS) among 18-24-year-olds during the first wave of the COVID-19 pandemic. This was a secondary analysis of data from 4508 individuals collected through an online survey conducted between June and January 2021. PTSS was measured as a dependent variable using the checklist for post-traumatic stress disorder in civilians. Age, birth sex, sexual, level of education, access to emotional and social support, and emotional distress were the independent variables. A multivariate logistic regression analysis was conducted to determine the associations between the dependent and independent variables while controlling for the country related confounding variables. Females (AOR:2.023), sexual minority individuals (AOR:1.868), those who did not disclose their sexual identify (AOR:1.476), those with poor access to emotional and social support (AOR:4.699) and individuals with no formal education (AOR:13.908), and only primary level education (AOR:4.521) had higher odds of PTSS. The study highlights the multifaceted nature of PTSS during the pandemic and suggests the importance of promoting access of young people, especially females, sexual minority individuals and those with low educational status, to emotional/social support to mitigate the probability of PTSS, especially among sexual minority individuals.

Spatial associations between chronic kidney disease and socio-economic factors in Thailand.

Chronic kidney disease (CKD) is a persistent, progressive condition characterized by gradual decline of kidney functions leading to a range of health issues. This research used recent data from the Ministry of Public Health in Thailand and applied spatial regression and local indicators of spatial association (LISA) to examine the spatial associations with night-time light, Internet access and the local number of health personnel per population. Univariate Moran's I scatter plot for CKD in Thailand's provinces revealed a significant positive spatial autocorrelation with a value of 0.393. High-High (HH) CKD clusters were found to be predominantly located in the North, with Low-Low (LL) ones in the South. The LISA analysis identified one HH and one LL with regard to Internet access, 15 HH and five LL clusters related to night-time light and eight HH and five LL clusters associated with the number of health personnel in the area. Spatial regression unveiled significant and meaningful connections between various factors and CKD in Thailand. Night-time light displayed a positive association with CKD in both the spatial error model (SEM) and the spatial lag model (SLM), with coefficients of 3.356 and 2.999, respectively. Conversely, Internet access exhibited corresponding negative CKD associations with a SEM coefficient of - 0.035 and a SLM one of -0.039. Similarly, the health staff/population ratio also demonstrated negative associations with SEM and SLM, with coefficients of -0.033 and -0.068, respectively. SEM emerged as the most suitable spatial regression model with 54.8% according to R2. Also, the Akaike information criterion (AIC) test indicated a better performance for this model, resulting in 697.148 and 698.198 for SEM and SLM, respectively. These findings emphasize the complex interconnection between factors contributing to the prevalence of CKD in Thailand and suggest that socioeconomic and health service factors are significant contributing factors. Addressing this issue will necessitate concentrated efforts to enhance access to health services, especially in urban areas experiencing rapid economic growth.

Identifying determinants of adherence to adjuvant endocrine therapy following breast cancer: A systematic review of reviews.

BACKGROUND: In oestrogen-receptor positive breast cancer, daily oral adjuvant endocrine therapy (ET) for at least 5 years significantly reduces risks of recurrence and breast cancer-specific mortality. However, many women are poorly adherent to ET. Development of effective adherence support requires comprehensive understanding of influences on adherence. We undertook an umbrella review to identify determinants of ET adherence. METHODS: We searched PubMed, Embase, CINAHL, PsycINFO, Cochrane and PROSPERO (inception to 08/2022) to identify systematic reviews on factors influencing ET adherence. Abstracted determinants were mapped to the World Health Organization's dimensions of adherence. Reviews were quality appraised and overlap assessed. RESULTS: Of 5732 citations screened, 17 reviews were eligible (9 quantitative primary studies; 4 qualitative primary studies; 4 qualitative or quantitative studies) including 215 primary papers. All five WHO dimensions influenced ET non-adherence: The most consistently identified non-adherence determinants were patient-related factors (e.g. lower perceived ET necessity, more treatment concerns, perceptions of ET 'cons' vs. 'pros'). Healthcare system/healthcare professional-related factors (e.g. perceived lower quality health professional interaction/relationship) were also important and, to a somewhat lesser extent, socio-economic factors (e.g. lower levels of social/economic/material support). Evidence was more mixed for medication-related and condition-related factors, but several may be relevant (e.g. experiencing side-effects, cost). Potentially modifiable factors are more influential than non-modifiable/fixed factors (e.g. patient characteristics). CONCLUSIONS: The evidence-base on ET adherence determinants is extensive. Future empirical studies should focus on less well-researched areas and settings. The determinants themselves are numerous and complex in indicating that adherence support should be multifaceted, addressing multiple determinants.

Socio-demographic and economic factors associated with the consumption of processed foods in South Africa - Evidence from Demographic and Health Survey VII.

OBJECTIVE: The primary objective of this study was to examine the socio-demographic and economic factors associated with the consumption of processed foods in South Africa. STUDY DESIGN: This is an empirical study where secondary data analysis was performed from the South African Demographic and Health Survey VII. METHODS: A nationally representative sample of 10,336 participants (aged ≥15 years) was included in the analysis. Using regression models, we studied the association between socio-demographic and economic predictors and the intake of processed foods. RESULTS: The regression models found that the odds of consumption of any type of processed foods were significantly high in all South African provinces but specifically higher in urban settings, those with any level of education, and young adults. The odds of processed meat consumption were significantly higher among the coloured population, while that of fried food, fast food, and salty snacks was significant in the white population. The odds of consumption increased irrespective of marital status and were higher among males, specifically among those in the poorer and poorest wealth quintiles. CONCLUSION: These findings warrant advocacy and action for healthy food choices in the population. The role of industry, ethnic vulnerability, and gender stereotypes in food preparation are areas that need priority attention.

Snow depth influences harvest of a boreal ungulate more than socio-economic factors: Implications for food security in a changing climate.

Climate change may affect the ability of hunters to harvest wildlife and, hence, threaten food security of local people. However, few studies have investigated the relative influence of environmental conditions on wildlife harvest rates. We harnessed a 24-year dataset of harvest dates for a boreal ungulate in a region where climate change is having pronounced impacts on snow depth, precipitation, and temperatures to investigate the effect of weather on harvest rates. We used generalized linear models and a model selection framework to examine the influence of weather covariates (snow depth, mean daily temperature, precipitation) and socio-economic factors (gasoline and red meat prices, employment rates, and moose [Alces americanus] harvest) on harvest rates of bison (Bison bison) in Yukon, Canada, at two temporal scales: annual and daily. At an annual scale, snow depth was the only covariate that was important in explaining bison harvest. No socioeconomic variables improved our model beyond the null. At the daily scale, snow depth and mean daily temperature influenced bison harvest rates, with a 1 SD increase resulting in a 14 % and 9 % increase in daily harvest rates, respectively. Increased snow depth facilitates ease of travel in remote, roadless areas by snowmobile to locate bison and truncates movements of bison, resulting in increased harvest rates. Decreased snow depth due to climate change will impact hunter access to boreal ungulates and food security for northern people. More broadly, our data suggests that in some socioecological systems, environmental covariates have a greater influence on wildlife harvest rates than socioeconomic factors and need to be considered in future studies to better understand and predict harvest rates.

Socio-economic factors determine maternal and neonatal outcomes in women with peripartum cardiomyopathy: A study of the ESC EORP PPCM registry.

BACKGROUND: Peripartum cardiomyopathy (PPCM) is a global disease with substantial morbidity and mortality. The aim of this study was to analyze to what extent socioeconomic factors were associated with maternal and neonatal outcomes. METHODS: In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global PPCM registry, under the auspices of the ESC EORP Programme. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-level sociodemographic factors (Gini index coefficient [GINI index], health expenditure [HE] and human developmental index [HDI]). RESULTS: 739 women from 49 countries (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]) were enrolled. Low HDI was associated with greater left ventricular (LV) dilatation at time of diagnosis. However, baseline LV ejection fraction did not differ according to sociodemographic factors. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Six-month mortality was higher in countries with low HE; and LV non-recovery in those with low HDI, low HE and lower levels of education. Maternal outcome (death, re-hospitalization, or persistent LV dysfunction) was independently associated with income. Neonatal death was significantly more common in countries with low HE and low HDI, but was not influenced by maternal income or education attainment. CONCLUSIONS: Maternal and neonatal outcomes depend on country-specific socioeconomic characteristics. Attempts should therefore be made to allocate adequate resources to health and education, to improve maternal and fetal outcomes in PPCM.

Socio-economic factors and medical conditions affecting regular stomach cancer screening in Korea: a retrospective longitudinal study using national public health data for 11 years.

OBJECTIVE: This study aimed to explore socio-economic factors and medical conditions that affect regular stomach cancer (SC) screening among Korean adults. STUDY DESIGN: This was a retrospective observational study. METHODS: Study subjects were 5545 adults aged ≥40 years who participated in the 2007-2012 Korean National Health and Nutrition Examination Survey and were followed up to year 2017 based on data linking to the Korean National Health Insurance Service and Korean Health Insurance Review and Assessment. Socio-economic factors included sex, age, residential area, education, occupation, marital status, disability, public and private health insurance, service through local public health organizations, history of cancer except for SC, and family history of SC. Medical factors included six gastric lesions with the possibility of facilitating SC screening, including benign gastric neoplasm, chronic atrophic gastritis, gastric polyp, Helicobacter pylori infection, intestinal metaplasia, and peptic ulcers. The outcome was adherence to SC screening, which was divided into non-adherence, irregular adherence, and regular adherence. RESULTS: After adjusting for the effects of socio-economic factors, multivariate ordinal logistic regression revealed that participants with a history of four types of gastric lesions were more likely to regularly participate in SC screening: chronic atrophic gastritis (odds ratio [OR] 1.567; 95% confidence interval [CI] = 1.276-1.923), gastric polyps (OR 1.565; 95% CI = 1.223-2.003), H. pylori infection (OR 1.637; 95% CI = 1.338-2.003), and peptic ulcer (OR 2.226; 95% CI 1.750-2.831). CONCLUSIONS: To improve participation in SC screening, it is necessary to implement personalized strategies for individuals at risk for gastric cancer in addition to population-based strategies for vulnerable groups.

Desfechos neonatais adversos e fatores associados entre gestantes com diabetes mellitus gestacional e de risco habitual / Neonatal adverse outcomes and associated factors among pregnant women with gestational and usual risk of diabetes mellitus

Objetivo: Avaliar os desfechos neonatais adversos e fatores associados entre gestantes com diabetes mellitus gestacional e de risco gestacional habitual. Métodos: Estudo transversal, de âmbito nacional e de base hospitalar, conduzido entre fevereiro de 2011 e outubro de 2012. Foram excluídas as mulheres com gestações múltiplas ou natimortos. As informações foram coletadas via questionário padronizado, cartão de pré-natal e/ou prontuário. Resultados: Das 12.712 puérperas avaliadas, 1.915 tinham diabetes mellitus gestacional e 10.797 foram classificadas em risco gestacional habitual. Verificou-se que 74,1% das mulheres com diabetes receberam assistência pré-natal adequada/mais que adequada em relação a 65% das mulheres com risco gestacional habitual. Em contrapartida, o grupo das mulheres com diabetes foi composto em sua maioria por mulheres acima de 35 anos, com hipertensão prévia, excesso de peso pré-gestacional e ganho de peso gestacional excessivo, multíparas, com histórico de cesárea e abortos. Os desfechos "prematuridade" e "nascimento de recém-nascido grande para idade gestacional" foram superiores entre as mulheres com diabetes. Conclusão: As mulheres com diabete detiveram condições demográficas, antecedentes clínicos/obstétricos e desfechos neonatais mais desfavoráveis em relação às mulheres de risco gestacional habitual. Apesar disso, o pré-natal foi um dos fatores que exerceu extrema importância para que outros desfechos negativos (óbito neonatal e o Apgar<5) não fossem superiores entre as mulheres com diabete sem relação às de risco gestacional habitual. Portanto, reitera-se o papel do pré-natal entre as mulheres brasileiras, sobretudo as de alto risco gestacional.

Objective: To assess adverse neonatal outcomes and associated factors between pregnant women with gestational diabetes mellitus and usual gestational risk. Methods: Cross-sectional, nationwide, hospital-based study, conducted from February 2011 to October 2012. Women with multiple pregnancies or stillbirths were excluded. Information was collected using a standardized questionnaire, prenatal card and/or medical records. Results: Out of a total of 12,712 postpartum women evaluated, 1,915 had gestational diabetes mellitus and 10,797 were classified as usual gestational risk. It was observed that 74.1% of diabetics received adequate/more than adequate prenatal care compared to 65% of women with usual gestational risk. On the other hand, the group of diabetics was composed mostly of women over 35 years of age, with underlying hypertension, pre-gestational excess weight and excess gestational weight gain who were multiparous, with history of cesarean deliveries and abortions. The outcomes of "prematurity" and "birth of large-sized newborn" for the gestational age were higher among diabetics. Conclusion: Diabetic women had more unfavorable demographic conditions, clinical/obstetric history and neonatal outcomes compared to women with usual gestational risk. Nevertheless, prenatal care was a factor of extreme importance to prevent other negative outcomes (neonatal death and Apgar <5) to increase among diabetic women compared to those with usual gestational risk. Therefore, the role of prenatal care among Brazilian women is reiterated, especially among the high gestational risk women.

Avaliação do risco de sarcopenia em pacientes diabéticos tipo 2 / Assessment of the risk of sarcopenia in individuals with type 2 diabetes

Introdução: Diabéticos podem apresentar perda de força e massa muscular de forma acentuada. Assim, as triagens SARC-F e SARC-CALF são úteis na investigação do risco de sarcopenia. Objetivo: Associar o risco de sarcopenia em pacientes diabéticos com as variáveis sociodemográficas, econômicas, clínicas, antropométricas e de estilo de vida. Método: Estudo do tipo série de casos realizado com adultos diabéticos tipo 2, de ambos os sexos, com idade entre 20 e 59 anos. A avaliação do risco de sarcopenia se deu pela aplicação dos questionários SARC-F e SARC-CALF. Para caracterização da amostra e associação com o risco de sarcopenia, foram coletados dados sociodemográficos e econômicos, medidas antropométricas, condições clínicas e estilo de vida. Resultados: A amostra foi composta por 69 pacientes, com média de idade de 53±7,5 anos e maior proporção de mulheres (63,8%; IC95%: 50,7-75,4). A frequência do risco positivo para sarcopenia segundo o SARC-F e o SARC-CALF foi de 43,48% e 46,38%, respectivamente. O SARC-F não mostrou associação significativa com as variáveis estudadas; já o SARC-CALF associou-se com índice de massa corporal (p <0,001), circunferência da cintura (p <0,001) e hábito de fumar (p = 0,027). Conclusão: O risco de sarcopenia foi observado em aproximadamente metade dos pacientes avaliados. O instrumento SARC-CALF apresentou associação com as variáveis antropométricas e o hábito de fumar, podendo ser considerado satisfatório para avaliar o risco de sarcopenia e intervir de forma precoce e efetiva.

Introduction: Individuals with diabetes often experience an accentuated loss of muscle mass and strength. Thus, the SARC-F and SARC-CALF screening tools are useful for the investigation of the risk of sarcopenia. Objective: Associate the risk of sarcopenia with sociodemographic, economic, clinical, anthropometric and lifestyle variables in individuals with diabetes. Methods: A case-series study was conducted involving male and female adults with type 2 diabetes between 20 and 59 years of age. The assessment of the risk of diabetes was performed using the SARC-F and SARC-CALF instruments. Data were collected on sociodemographic-economic variables, anthropometric measures, clinical conditions and lifestyle for the characterization of the sample and to test associations with the risk of sarcopenia. Results: The sample was composed of 69 patients, with a mean age of 53 ± 7.5 years and a predominance of women (63.8%; 95%CI: 50.7-75.4). The prevalence of risk of sarcopenia was 43.48% and 46.38% based on the SARC-F and SARC-CALF, respectively. Using the SARC-F, no significant associations were found with the variables of interest. Using the SARC-CALF, however, the risk of sarcopenia was associated with body mass index (p < 0.001), waist circumference (p < 0.001) and smoking habit (p = 0.027). Conclusion: Approximately half of the individuals analyzed were at risk of sarcopenia. The SARC-CALF questionnaire was associated with anthropometric variables and the smoking habit and can be considered adequate for the assessment of the risk of sarcopenia, enabling early, effective interventions.

Do demographic and socio-economic factors predict Sense of Coherence among university students?

INTRODUCTION: The COVID-19 pandemic and related containment measures have been threatful for psychological well-being, particularly for young people such as university students. Sense of Coherence (SoC) can help in coping with stressful and anxiety-provoking situations. AIM: The aim of this study is to describe the levels of SoC and to investigate the socio-economic, and demographic predictors in a sample of students attending Florence University, in the timespan between August, 17th and October, 3rd 2020. METHOD AND RESULTS: The cross-sectional online survey was completed by 2,996 students. Higher levels of SoC have been found among males and for respondents reporting a better socioeconomic condition. Regarding the dimensions of SoC, lower levels were reported for comprehensibility and manageability, higher for meaningfulness. CONCLUSIONS: These results reinforce the need to plan and implement health promotion interventions aimed to support and sustain university students in general and specifically those at higher risk of low level of SoC.