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1.
BMC Health Serv Res ; 24(1): 89, 2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38233909

RESUMO

BACKGROUND: Community-Based Health Insurance (CBHI) schemes are recognized as an important health financing pathway to achieving universal health coverage (UHC). Although previous studies have documented CBHIs in low-income countries, the majority of these have been provider-based. Non-provider based schemes have received comparatively less empirical attention. We sought to describe a novel non-provider based CBHI munno mubulwadde (your friend indeed) comprising informal sector members in rural central Uganda to understand the structure of the scheme, the experiences of scheme members in terms of the perceived benefits and barriers to retention in the scheme. METHODS: We report qualitative findings from a larger mixed-methods study. We conducted in-depth interviews with insured members (n = 18) and scheme administrators (n = 12). Four focus groups were conducted with insured members (38 participants). Data were inductively analyzed by thematic approach. RESULTS: Munno mubulwadde is a union of ten CBHI schemes coordinated by one administrative structure. Members were predominantly low-income rural informal sector households who pay annual premiums ranging from $17 and $50 annually and received medical care at 13 scheme-contracted private health facilities in Luwero District in Central Uganda. Insured members reported that scheme membership protected them from catastrophic health expenditure during episodes of sickness among household members, and especially so among households with children under-five who were reported to fall sick frequently, the scheme enabled members to receive perceived better quality health care at private providers in the study district relative to the nearest public facilities. The identified barriers to retention in the scheme include inconvenient dates for premium payment that are misaligned with harvest periods for cash crops (e.g. maize corn) on which members depended for their agrarian livelihoods, long distances to insurance-contracted private providers, falling prices of cash crops which diminished real incomes and affordability of insurance premiums in successive years after initial enrolment. CONCLUSION: Munno mubulwadde was perceived by as a valuable financial cushion during episodes of illness by rural informal sector households. Policy interventions for promoting price stability of cash crops in central Uganda could enhance retention of members in this non-provider CBHI which is worthy of further research as an additional funding pathway for realizing UHC in Uganda and other low-income settings.


Assuntos
Seguro de Saúde Baseado na Comunidade , Criança , Humanos , Seguro Saúde , Uganda , Amigos , Cobertura Universal do Seguro de Saúde
2.
Soc Psychiatry Psychiatr Epidemiol ; 59(3): 431-442, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37072564

RESUMO

PURPOSE: Mental health research has powerfully documented inequities related to characteristics, such as ethnicity and gender. Yet how and where disparities like unmet need occur have been more elusive. Drawing from a now modest body of research that deployed the Network Episode Model (NEM), we examine how individuals create patterns of response to mental health problems, influenced by the culture and resources embedded in their social networks. METHODS: The Person-to-Person Health Interview Study (P2P; N ~ 2,700, 2018-2021) provides representative, community-based, NEM-tailored data. Both descriptive, latent class and multinomial regression analyses mark mental health care-seeking patterns, including individuals consulted and activities used, as well as the influence of the structure and cultural content of social networks. RESULTS: Latent class analysis detected five pathways with good fit statistics. The Networked General Care Path (37.0%) and The Kin General Care Path (14.5%) differ only in whether friends are activated in using the general care sector. The Networked Multi-Sector Care Path (32.5%) and The Saturated Path (12.6%) involve family, friends, and both general and specialty care with only the latter expanding consultation to coworkers and clergy. The Null Path (3.3%), or no contacts, is not used as perceived problem severity increases. Network size and strength are associated with the more complex pathways that activate ties, respectively. Trust in doctors is associated with pathways that include specialty providers but not others at work or church. Race, age, and rural residence have specific pathway effects, while gender has no significant impact. CONCLUSIONS: Social networks propel individuals with mental health problems into action. Tie strength and trust produce care responses that are fuller and more targeted. Considering the nature of homophily, results also suggest that majority status and college education are clearly implicated in networked pathways. Overall, findings support community-targeted rather than individually based efforts to increase service use.


Assuntos
Serviços de Saúde Mental , Saúde Mental , Humanos , Amigos , Confiança , Atenção à Saúde
3.
J Am Board Fam Med ; 36(6): 1020-1022, 2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-37907350

RESUMO

Social isolation is a risk factor for many diseases and overall increased mortality. Alternatively human connection has been noted to lead to healthier lives and longevity. Medical clinicians need to be more aware of this condition and consider how to prescribe friendship. This is not just an issue for the elderly; many Americans are being ravaged by being alone. There are many organizations that we can refer our patients to in order to make connections. This lesson is one we as physicians need to embrace ourselves as loneliness during our busy days is affecting us too.


Assuntos
Amigos , Médicos , Humanos , Idoso , Relações Interpessoais , Solidão , Fatores de Risco
4.
Neuroimage ; 285: 120473, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38040400

RESUMO

Collaboration is a critical skill in everyday life. It has been suggested that collaborative performance may be influenced by social factors such as interpersonal distance, which is defined as the perceived psychological distance between individuals. Previous literature has reported that close interpersonal distance may promote the level of self-other integration between interacting members, and in turn, enhance collaborative performance. These studies mainly focused on interdependent collaboration, which requires high levels of shared representations and self-other integration. However, little is known about the effect of interpersonal distance on independent collaboration (e.g., the joint Simon task), in which individuals perform the task independently while the final outcome is determined by the parties. To address this issue, we simultaneously measured the frontal activations of ninety-four pairs of participants using a functional near-infrared spectroscopy (fNIRS)-based hyperscanning technique while they performed a joint Simon task. Behavioral results showed that the Joint Simon Effect (JSE), defined as the RT difference between incongruent and congruent conditions indicating the level of self-other integration between collaborators, was larger in the friend group than in the stranger group. Consistently, the inter-brain neural synchronization (INS) across the dorsolateral and medial parts of the prefrontal cortex was also stronger in the friend group. In addition, INS in the left dorsolateral prefrontal cortex negatively predicted JSE only in the friend group. These results suggest that close interpersonal distance may enhance the shared mental representation among collaborators, which in turn influences their collaborative performance.


Assuntos
Mapeamento Encefálico , Relações Interpessoais , Humanos , Mapeamento Encefálico/métodos , Espectroscopia de Luz Próxima ao Infravermelho , Córtex Pré-Frontal/diagnóstico por imagem , Amigos , Encéfalo , Comportamento Cooperativo
5.
Addiction ; 119(3): 488-498, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37994195

RESUMO

AIMS: We investigated whether (1) adolescents selected friends with a similar socio-economic status (SES), (2) smoking and alcohol consumption spread in networks and (3) the exclusion of non-smokers or non-drinkers differed between SES groups. DESIGN: This was a longitudinal study using stochastic actor-oriented models to analyze complete social network data over three waves. SETTING: Eight Hungarian secondary schools with socio-economically diverse classes took part. PARTICIPANTS: This study comprised 232 adolescents aged between 14 and 15 years in the first wave. MEASUREMENTS: Self-reported smoking behavior, alcohol consumption behavior and friendship ties were measured. SES was measured based upon entitlement to an income-tested regular child protection benefit. FINDINGS: Non-low-SES adolescents were most likely to form friendships with peers from their own SES group [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.02-1.11]. Adolescents adjusted their smoking behavior (OR = 24.05, 95% CI = 1.27-454.86) but not their alcohol consumption (OR = 1.65, 95% CI = 0.62-4.39) to follow the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 0.98, 95% CI = 0.87-1.10), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.16, 95% CI = 1.01-1.33), but this association was not significantly different according to SES. CONCLUSIONS: Hungarian adolescents appear to prefer friendships within their own socio-economic status group, and smoking and alcohol consumption spread within those friendship networks. Socio-economic groups do not differ in the extent to which they encourage smoking or alcohol consumption.


Assuntos
Comportamento do Adolescente , Fumar , Criança , Humanos , Adolescente , Estudos Longitudinais , Fumar/epidemiologia , Fumar Tabaco , Amigos , Classe Social , Rede Social , Consumo de Bebidas Alcoólicas/epidemiologia , Fatores Socioeconômicos
6.
Br J Dev Psychol ; 42(1): 78-96, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37929648

RESUMO

The goals of this study were to examine maternal beliefs about the primary benefits and costs of their children's time spent with friends, and to explore child age and gender differences in these beliefs. Participants were N = 512 mothers (Mchildage = 10.18 years; 11% ethnic minority). Open-ended responses to questions about the benefits and costs were coded and analysed, with results indicating that mothers consider opportunities for social skills and social-cognitive development a primary benefit of spending time with friends. Negative friend influence was the most commonly cited cost of friendship. Child age was associated with a number of maternal beliefs (e.g., mothers of adolescents were more likely than mothers of young children to report intimacy as a benefit), but child gender was not. Findings highlight the importance of considering child age in studies of maternal beliefs about friendship and set the stage for future research in this area.


Assuntos
Etnicidade , Amigos , Criança , Feminino , Humanos , Adolescente , Pré-Escolar , Amigos/psicologia , Análise Custo-Benefício , Grupos Minoritários , Mães
7.
J Interpers Violence ; 39(1-2): 107-132, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37599430

RESUMO

Economic adolescent relationship abuse (ARA) includes coercive behaviors leading to interference with education, employment, and finances. To date, no study has examined help seeking among adolescents and young adults if they were to experience economic ARA. The goals of this article include examining: (a) help-seeking intentions of adolescents regarding economic ARA; (b) help-seeking sources and reasons for not seeking help; and (c) differences in help-seeking intentions based on age, race/ethnicity, gender identity, and experiences of economic ARA. We conducted a cross-sectional survey of adolescents ages 13-19 focused on economic ARA experiences and help seeking. We performed descriptive statistics of help-seeking intentions, sources, and barriers. We utilized logistic regression, adjusted for age, race/ethnicity, and gender identity, to explore associations between economic ARA victimization and help-seeking intentions. Of 2,852 participants, 56% said they would seek help for economic ARA. Adolescents with positive help-seeking intentions shared that they would seek help from their parents (43%) or friends (35%). Those less likely to seek help were concerned about others finding out (32%), not being believed (31%), or authority figures being notified (31%). Help-seeking intentions were lower among Black/African American adolescents (aOR = 0.55, CI [0.43, 0.70]) and Multiracial adolescents (aOR = 0.26, CI [0.16, 0.42]) compared to White adolescents. Help-seeking intentions were higher among gender diverse adolescents (aOR = 5.78, CI [2.98, 11.22]) and those ages 15-17 years (aOR = 1.84, CI [1.36, 2.47]) compared to those identifying as female and ages 18-19 years. Help-seeking intentions were lower among adolescents who experienced economic ARA (aOR = 0.61, CI [0.51, 0.72]). While the majority of adolescents reported that they would seek help if they experienced economic ARA, those who had experienced economic ARA were less likely to report intentions to seek help. Supportive interventions for adolescents experiencing economic ARA are needed.


Assuntos
Vítimas de Crime , Intenção , Adulto Jovem , Humanos , Masculino , Feminino , Adolescente , Estudos Transversais , Identidade de Gênero , Amigos
8.
PLoS One ; 18(9): e0291257, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37682954

RESUMO

OBJECTIVE: Adolescents with fewer sources of environmental reinforcement may be at risk for alcohol use. Behavioral economic theories posit that engagement in some activities may facilitate alcohol use, whereas other activities may be incompatible with use and reduce likelihood of alcohol use. It is unclear which types of activities may facilitate or may be incompatible with alcohol use in adolescence. Using a national sample of adolescents, the current study examined differences in engagement with types of activities that may be incompatible with alcohol use, compared among adolescents who endorsed alcohol use, and adolescents who did not. METHOD: Data from the 2019 Monitoring the Future (MTF) study (N = 4626) were analyzed. Potentially incompatible and facilitating activities, and alcohol-involved activities were identified from pre-existing survey measures. Confirmatory factor analysis, measurement invariance, and structural equation modeling were used to examine patterns in activity engagement among those who endorsed alcohol use and those who did not. RESULTS: Participants who did not endorse alcohol use reported higher engagement in activities that may be incompatible with alcohol use, including enjoyment from school and going to the mall (p < .001). Participants who endorsed alcohol use reported higher engagement in activities that may facilitate alcohol use (p < .001), such as spending time with friends and attending parties. Facilitating activities (ß = 0.15, p < .001) and alcohol-involved activities (ß = 0.70, p < .001) were positively associated with alcohol use frequency. Observed effect sizes were small in magnitude for all findings. CONCLUSIONS: The findings support the premise of behavioral economic theory, suggesting some activities may serve as protective factors against alcohol use frequency while other activities may facilitate alcohol use among adolescents. National surveys may consider adding specific measure of activity engagement to identify activities that may be incompatible with alcohol use among adolescents.


Assuntos
Consumo de Bebidas Alcoólicas , Economia Comportamental , Humanos , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Etanol , Análise Fatorial , Amigos
9.
PLoS One ; 18(8): e0289543, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37540637

RESUMO

The competitive balance model was proposed as an extension of the structural balance theory, aiming to account for heterogeneities observed in real-world networks. In this model, different paradigms lead to form different friendship and enmity. As an example, friendship or enmity between countries can have a political or religious basis. The suggested Hamiltonian is symmetrical between paradigms. Our analyses show that a balanced state can be achieved if just one paradigm prevails in the network and the paradigm shift is possible only by imposing an external field. In this paper, we investigate the influence of the external field on the evolution of the network. We drive the mean-field solutions of the model and verify the accuracy of our analytical solutions by performing Monte-Carlo simulations. We observe that the external field breaks the symmetry of the system. The response of the system to this external field, contingent upon temperature, can be either paramagnetic or ferromagnetic. We observed a hysteresis behavior in the ferromagnetic regime. Once communities are formed based on a certain paradigm, then they resist change. We found that to avoid wasting energy we need to know the level of stochastic behavior in the network. Analogous to magnetic systems, we observe that susceptibility adheres to Curie's law.


Assuntos
Amigos , Magnetismo , Humanos , Imãs , Método de Monte Carlo
10.
Intellect Dev Disabil ; 61(4): 326-344, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-37536692

RESUMO

We investigated socially inclusive participation in mainstream community groups and religious services by U.S. adults with intellectual and developmental disabilities using weighted secondary analyses of 2018-2019 National Core Indicators data. Overall, 34.4% participated in community groups and 42.4% in religious services. Some 45.0% had an unmet desire for community-group participation, whereas most (75.0%) attended a religious service as often as preferred. The type of companion varied by living arrangements and age group. Attending community groups and religious services were each strongly associated with better friendship outcomes but were not related to loneliness. The large unmet demand for community-group participation reveals a major gap. The friendship outcomes underline the benefits of socially inclusive community participation.


Assuntos
Deficiência Intelectual , Criança , Humanos , Adulto , Deficiências do Desenvolvimento , Amigos , Participação da Comunidade , Inclusão Escolar
11.
Soc Sci Res ; 114: 102916, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37597930

RESUMO

Social ties between members of in- and outgroups are theorized to reduce individual levels of prejudice. However, instances of intergroup contact are not isolated events; cross-group interactions are embedded in broader networks defined by various social processes that guide the formation and maintenance of interpersonal relationships. This project reconsiders the potential benefits of intergroup contact by applying a network perspective to examine whether friendships between youth of different sexualities can shape individuals' homophobic attitudes. The impact of cross-sexuality ties is evaluated through the application of stochastic actor-oriented models (SAOMs) to a two-wave sample of Dutch adolescents. Results indicate that the benefits of cross-sexuality connections become negligible when we account for how patterns of network connectivity and segregation are informed by other individual-level traits, such as age, religious background, ethnicity, and gender. In other words, heterosexual adolescents who are situated in network positions that provide opportunities to form cross-sexuality friendships would be expected to report less homophobic attitudes even in the absence of this intergroup contact. These findings suggest that the cross-sexuality contact observed in the social world often represents instances of "preaching to the choir," limiting the potential for intergroup connections to challenge systems of social inequality.


Assuntos
Amigos , Minorias Sexuais e de Gênero , Adolescente , Humanos , Heterossexualidade , Atitude , Rede Social
12.
J Res Adolesc ; 33(4): 1458-1464, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37559441

RESUMO

This brief report characterizes the tendency of adolescent friends to be similar on civic behaviors and critical consciousness. Using two waves of network data from a high school that serves primarily low-income Latiné youth (2019, N = 519; 2020, N = 521), the present study examined homophily on service, activism, and awareness of inequities. The results of Exponential Random Graph Models indicated that adolescents tended to be friends with peers who had similar service behavior and awareness of inequities, but not activism. The findings suggest that schools could foster civic engagement by providing infrastructure that encourages civic interactions between peers. The current study highlights the potential that social network analysis holds for generating novel insights into the relational underpinnings of youth civic engagement.


Assuntos
Comportamento do Adolescente , Amigos , Humanos , Adolescente , Grupo Associado , Desenvolvimento do Adolescente , Rede Social
13.
J Pediatr Psychol ; 48(9): 768-777, 2023 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-37639625

RESUMO

OBJECTIVE: Skateboarding is an increasingly popular sport among youth, despite the fact that children and adolescents are the age groups most frequently injured when skateboarding. A greater understanding of the psycho-social factors that motivate participation in skateboarding, including why youth return to the sport after serious injury from skateboarding, is needed to inform injury prevention efforts. This study addressed that gap in knowledge. METHODS: Twenty-six Canadian adolescent skateboarders 14-17 years of age (20 males and 6 females) who had previously sustained medically attended injuries while skateboarding participated in individual interviews to explore their perspectives on skateboarding and injury risk, including reasons for returning to the sport after injury. RESULTS: Thematic analyses revealed that participants perceived many unique benefits from skateboarding, including interpersonal benefits, mental and physical health benefits, pleasure, personal growth, and identity development. Participants uniformly identified that a major drawback was the risk of injury, with trickle-down effects of injury including a loss of social contacts (e.g., missing friends), challenges to individual identity from not participating, and injury-specific negative outcomes (e.g., pain, physical limitations). When exploring reasons participants returned to the sport and to the trick or activity that precipitated their injury, the primary theme identified was that the benefits of skateboarding significantly outweighed the costs associated with potential re-injury. CONCLUSION: Results paint a nuanced picture of psycho-social factors that impact youths' skateboarding and decisions to return to the sport after injury. Implications for injury prevention are discussed.


Assuntos
Patinação , Criança , Feminino , Masculino , Adolescente , Humanos , Canadá , Amigos , Dor
14.
Clin Genitourin Cancer ; 21(6): e467-e473, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37301665

RESUMO

PURPOSE: Eligibility criteria illustrate the characteristics of the study population and promote the safety of participants. However, overreliance on restrictive eligibility criteria may limit the generalizability of outcomes. As a result, the American Society of Clinical Oncology (ASCO) and Friends of Cancer Research (Friends) issued statements to curtail these challenges. In this study, we aimed to assess restrictiveness in eligibility criteria across advanced prostate cancer clinical trials. MATERIALS AND METHODS: We identified all phase I, II, and III advanced prostate cancer clinical trials between June 30, 2012, and June 30, 2022, through Clinicaltrials.gov. We evaluated whether a clinical trial excluded, conditionally included, or did not report 4 common criteria: brain metastases, prior or concurrent malignancies, HIV infection, and hepatitis B virus (HBV)/hepatitis C virus (HCV) infection. Performance status (PS) criteria were recorded based on the Eastern Cooperative Oncology Group (ECOG) scale. RESULTS: Out of 699 clinical trials within our search strategy, 265 (37.9%) trials possessed all the required data and were included in our analysis. The most common excluded condition of our interest was brain metastases (60.8%), followed by HIV positivity (46.4%), HBV/HCV positivity (46.0%), and concurrent malignancies (15.5%). Additionally, 50.9% of clinical trials only included patients with ECOG PS 0 to 1. HIV and HBV/HCV infection were exclusion criteria of 22 (80.8%) and 19 (73.1%) immunotherapy trials, respectively. CONCLUSION: Patients with brain metastases, prior or concurrent malignancies, HIV infection, HBV/HCV infection, or low-functioning PS were overly restricted from participating in advanced prostate clinical trials. Advocating for broader criteria may ameliorate generalizability.


Assuntos
Neoplasias Encefálicas , Infecções por HIV , Hepatite C , Neoplasias da Próstata , Masculino , Humanos , Infecções por HIV/tratamento farmacológico , Amigos , Neoplasias da Próstata/terapia , Oncologia
15.
Soc Sci Med ; 327: 115937, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37167920

RESUMO

BACKGROUND: Social isolation has become a serious public health issue. However, most previous studies examine the relationship between social isolation and a single outcome. We aimed to conduct holistic assessments to understand the multidimensional impacts of social isolation on health and well-being. METHODS: We used the three-wave data (2013, 2016, and 2019) obtained from the Japan Gerontological Evaluation Study. Our exposure, obtained from the 2016 survey, was the Social Isolation Index (SII) comprising five components: no partner, poor interaction with children, poor interaction with relatives, poor interaction with friends, and no social participation). We assessed 36 health and well-being outcomes across six dimensions obtained from the 2019 survey: physical/cognitive health, health behaviours, mental health, subjective well-being, social isolation, and cognitive social capital. Pre-exposure characteristics and prior outcome levels in 2013 were adjusted. We included 47,318 respondents for 4 outcomes (death, dementia, and functional disability) and 34,187 respondents for 32 other outcomes. The Bonferroni correction was used to correct for multiple tests. RESULTS: The total SII scores were associated with a wide range of health and well-being outcomes across the six dimensions. Specifically, we found a robust association between an SII score of four or greater with mortality (Odds ratio: 1.89; 95% CI: 1.46-2.43). Among the five components of the SII, poor interaction with friends and no social participation showed robust associations with a wide range of health and well-being. We also found some robust evidence regarding effect modification by gender and age in the associations between the components of the SII and health and well-being. CONCLUSIONS: Social isolation, specifically social interaction with friends and social participation, may affect a wide range of health and well-being among older adults.


Assuntos
Isolamento Social , Participação Social , Criança , Humanos , Idoso , Isolamento Social/psicologia , Saúde Mental , Inquéritos e Questionários , Amigos/psicologia , Estudos Longitudinais
16.
Dev Psychol ; 59(7): 1300-1314, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37199922

RESUMO

Sexual health communication in adolescence is important for sexual well-being. With limited empirical work utilizing longitudinal methodologies, this study aimed to investigate how the frequency of sexual communication with parents, peers, and dating partners changes across adolescence and varies based on sex, race/ethnicity, and sexual orientation. Participants included 886 U.S. adolescents (54.4% females; 45.9% White, 22.6% Hispanic/Latinx, 21.6% Black/African American) surveyed yearly from middle school through 12th grade. Growth curve models were used to estimate trajectories of the frequency in communication. Results showed curvilinear trajectories for adolescents' sexual communication with their parents, best friends, and dating partners over time. Although all three trajectories showed curvilinear patterns, sexual communication with parents and best friends increased earlier in adolescence and leveled off, while sexual communication with dating partners was lower in early adolescence and showed a steep increase across adolescence. Communication trajectories significantly diverged depending on adolescents' sex and race/ethnicity but not their sexual orientation. This study provides the first evidence of developmental changes over time in adolescent sexual communication with parents, best friends, and dating partners. Developmental implications for adolescents' sexual decision making are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Comportamento do Adolescente , Amigos , Humanos , Masculino , Adolescente , Feminino , Comportamento Sexual , Comunicação , Pais
17.
Front Public Health ; 11: 1100129, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36815169

RESUMO

Background: Despite the efforts to promote universal coverage for family planning, inequalities are still high in several countries. Our aim was to identify which sources of contraceptives women mostly rely on in low- and middle-income countries (LMICs). We also explored the different sources according to age and marital status. Methods: We used data from national health surveys carried out in 59 LMICs since 2010. Among all sexually active women at reproductive age, we explored inequalities in demand for family planning satisfied by modern methods (mDFPS) and in the source of modern contraceptives according to women's age, classified as: 15-19, 20-34, or 35-49 years of age. Among adolescents, mDFPS and source of method were explored by marital status, classified as married or in union and not married nor in a union. Results: mDFPS was lower among adolescents than among adult women in 28 of the 59 countries. The lowest levels of mDFPS among adolescents were identified in Albania (6.1%) and Chad (8.2%). According to adolescents' marital status, the pattern of inequalities in mDFPS varied widely between regions, with married and unmarried adolescents showing similar levels of coverage in Latin America and the Caribbean, higher coverage among unmarried adolescents in Africa, and lower coverage among unmarried adolescents in Asia. Public and private health services were the main sources, with a lower share of the public sector among adolescents in almost all countries. The proportion of adolescents who obtained their contraceptives in the public sector was lower among unmarried girls than married ones in 31 of the 38 countries with data. Friends or relatives were a more significant source of contraceptives among unmarried compared to married adolescents in all regions. Conclusions: Our findings indicate lower levels of mDFPS and lower use of the public sector by adolescents, especially unmarried girls. More attention is needed to provide high-quality and affordable family planning services for adolescents, especially for those who are not married.


Assuntos
Anticoncepção , Anticoncepcionais , Adulto , Humanos , Adolescente , Feminino , Pessoa de Meia-Idade , Países em Desenvolvimento , Amigos , Pessoa Solteira , Serviços de Planejamento Familiar/métodos
18.
Sci Rep ; 13(1): 1756, 2023 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-36720987

RESUMO

Flourishing is an eudaimonic dimension of psychological well-being associated with positive social and health outcomes. Determining correlates of health and well-being is critical for the development of evidence-based best practices, policies, and action plans that target older adults, especially in low- and middle-income countries where research on ageing, health and well-being is still scarce. The study aimed to determine the level of flourishing among older adults in Mongolia and to explore demographic and social factors that contribute to their flourishing in urban and rural areas of Mongolia. We used proportional quota sampling to select a non-probability sample of 304 community-dwelling older adults that reflected the national distribution of older age groups and rural/urban residency. We adapted and administered a widely used standardized questionnaire on flourishing and used multiple regression to establish correlates of flourishing. Study participants reported "very high" levels of flourishing; differences in median scores 53 for urban and 50 for rural older adults were significant. Sex ([Formula: see text], [Formula: see text]), level of education([Formula: see text], [Formula: see text]) and receive help with ADLs ([Formula: see text], [Formula: see text]) were associated with flourishing in rural areas, as were self-rated health ([Formula: see text], [Formula: see text]), number of social activities ([Formula: see text], [Formula: see text]),and friends network ([Formula: see text], [Formula: see text]) in urban areas. Despite facing many challenges to well-being, older adults in Mongolia reported high levels of flourishing. Those in urban areas had higher scores than those in rural areas and predictors of flourishing differed for these groups.


Assuntos
Atividades Cotidianas , Envelhecimento , Humanos , Idoso , Mongólia , Escolaridade , Amigos
19.
Int J Aging Hum Dev ; 96(4): 420-446, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-35422126

RESUMO

Studies examining the impact of social change on individual development and aging postulate the growing importance of flexible relationships, such as friendship. Although friendship is well known as a factor of well-being in later life, the prevalence of friendship in older adult networks and its unequal distribution has been examined only in few studies. Through secondary data analysis of two cross-sectional surveys carried out in Switzerland in 1979 and 2011, respectively, the increasing presence of close friends was confirmed. Our results show that this trend was part of a broader lifestyle change after retirement, with increasing social engagements. However, this trend does not include a general decrease in social inequalities in friendship opportunities. Overall, friendship increase among older adults has contributed to a polarization of living conditions, with a majority of active, healthy persons contrasting with a minority of individuals who accumulate penalties.


Assuntos
Envelhecimento , Amigos , Humanos , Idoso , Estudos Transversais , Fatores Socioeconômicos , Participação Social
20.
Psicol. ciênc. prof ; 43: e255410, 2023. tab
Artigo em Português | LILACS, INDEXPSI | ID: biblio-1529230

RESUMO

Com a instauração da política de cotas, ocorreram profundas transformações no perfil dos estudantes das universidades públicas brasileiras. Essa nova composição do corpo discente, com maior representatividade de minorias e/ou estudantes de baixa renda, traz consigo novas demandas relacionadas à saúde mental do estudante. Apesar disso, ainda são escassas as pesquisas que investiguem esse contexto específico. Este estudo visa comparar a saúde mental de estudantes cotistas e não cotistas, avaliando diferenças nas prevalências de sintomas de depressão, ansiedade e estresse entre os dois grupos. Participaram da pesquisa 6.103 estudantes de graduação de uma universidade pública federal, dos quais 2.983 (48,88%) cotistas e 3.120 (51,12%) não cotistas. O levantamento de dados foi feito por meio de questionário on-line contendo questionário sociodemográfico e de hábitos de vida, e pelo Depression Anxiety and Stress Scale, na sua versão reduzida de 21 itens (DASS-21), utilizada para avaliar sintomas de depressão, ansiedade e estresse. Os resultados indicaram que os estudantes cotistas apresentaram maiores prevalências de sintomas de depressão e ansiedade quando comparados aos não cotistas. As áreas de Ciências Exatas e da Terra, e os Bacharelados Interdisciplinares apresentaram maiores diferenças entre os dois grupos em relação a esses problemas em saúde mental. Os resultados apontam para a necessidade de que as universidades estejam atentas às novas demandas em saúde mental dos estudantes e que estas sejam contempladas nas políticas de atenção à saúde estudantil.(AU)


With the introduction of the quota policy, profound changes took place in the profile of students in Brazilian public universities. This new composition of the student body, with greater representation of minorities and/or low-income students, brings new demands related to student mental health. Despite this, there are still few studies investigating this specific context. This study aims to compare the mental health of quota and non-quota students, evaluating differences in the prevalence of symptoms of depression, anxiety, and stress between the two groups. A total of 6,103 undergraduate students from a federal public university participated in the research, of which 2,983 (48.88%) were quota students and 3,120 (51.12%) were nonquota students. Data collection was carried out via an online questionnaire containing a sociodemographic and lifestyle questionnaire, and the Depression Anxiety and Stress Scale, in its reduced version of 21 items (DASS-21) was used to assess symptoms of depression, anxiety, and stress. The results indicated that quota students had higher prevalence of symptoms of depression and anxiety when compared to non-quota students. The areas of Exact and Earth Sciences and Interdisciplinary Bachelors were the ones that showed the greatest differences between the two groups in relation to these mental health problems. The results point to the need for universities to be attentive to the new demands in mental health of students and for these to be included in student health care policies.(AU)


Con la introducción de la política de cuotas, se produjeron cambios profundos en el perfil de los estudiantes de las universidades públicas brasileñas. Esta nueva composición del alumnado, con mayor representación de minorías y/o estudiantes de escasos recursos, trae consigo nuevas demandas relacionadas con la salud mental del alumno. Pero todavía existen pocas investigaciones sobre el contexto específico. Este estudio tiene como objetivo comparar la salud mental de los estudiantes beneficiarios de las políticas de cuotas y los no beneficiarios, y evaluar las diferencias en la prevalencia de síntomas de depresión, ansiedad y estrés entre los dos grupos. En la investigación participaron un total de 6.103 estudiantes de grado de una universidad pública federal, de los cuales 2.983 (48,88%) son estudiantes beneficiarios y 3.120 (51,12%) son estudiantes no beneficiarios. Los datos se recolectaron de un formulario en línea, que estaba compuesto por un cuestionario sociodemográfico y de hábitos de vida, y por la Escala de Depresión, Ansiedad y Estrés, en su versión reducida de 21 ítems (DASS-21), utilizada para evaluar síntomas de depresión, ansiedad y estrés. Los resultados destacaron que los estudiantes beneficiarios de las políticas de cuotas tenían una mayor prevalencia de síntomas de depresión y ansiedad en comparación con los estudiantes no beneficiarios. Las áreas de Ciencias Exactas y de la Tierra y Licenciaturas Interdisciplinarias presentaron las mayores diferencias entre los dos grupos con relación a estos problemas en salud mental. Los resultados apuntan a la necesidad de que las universidades sean conscientes de las nuevas demandas sobre la salud mental de los estudiantes y de que estas se incluyan en las políticas de atención de la salud estudiantil.(AU)


Assuntos
Humanos , Masculino , Feminino , Estudantes , Universidades , Saúde Mental , Satisfação Pessoal , Preconceito , Competência Profissional , Psicologia , Psicometria , Política Pública , Critérios de Admissão Escolar , Instituições Acadêmicas , Comportamento Social , Mudança Social , Classe Social , Condições Sociais , Justiça Social , Mobilidade Social , Ciências Sociais , Fatores Socioeconômicos , Sociologia , Estereotipagem , Estresse Psicológico , Evasão Escolar , Ensino , Violência , Características da População , Negro ou Afro-Americano , Escolha da Profissão , Família , Drogas Ilícitas , Áreas de Pobreza , Faculdades de Saúde Pública , Epidemiologia Descritiva , Pessoas com Deficiência , Teste de Admissão Acadêmica , Violência Doméstica , Diversidade Cultural , Estatística , Cultura , Democracia , Amigos , Grupos Raciais , Depressão , Bebidas Alcoólicas , Educação , Avaliação Educacional , Equidade , Medo , Bolsas de Estudo , Habilidades para Realização de Testes , Racismo , Discriminação Social , Marginalização Social , Medicalização , Produtos do Tabaco , Habilidades Sociais , Fatores Sociológicos , Estilo de Vida Saudável , Desempenho Acadêmico , Sucesso Acadêmico , Desigualdades Étnicas , Privilégio Social , Experiências Adversas da Infância , Povos Indígenas , Angústia Psicológica , Empoderamento , Inclusão Social , Equidade de Gênero , Fatores Econômicos , Minorias Desiguais em Saúde e Populações Vulneráveis , Fatores Sociodemográficos , Enquadramento Interseccional , Minorias Étnicas e Raciais , Vulnerabilidade Social , Quilombolas , Diversidade, Equidade, Inclusão , Baixo Nível Socioeconômico , Segregação Residencial , Hierarquia Social , Direitos Humanos , Inteligência , Relações Interpessoais , Transtornos Mentais , Métodos , Antidepressivos
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