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1.
BMC Pregnancy Childbirth ; 24(1): 353, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741050

RESUMO

INTRODUCTION: Non-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence. METHODS: We measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico's cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations. RESULTS: The national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care. CONCLUSION: While a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.


Assuntos
Cesárea , Humanos , Feminino , México/epidemiologia , Gravidez , Adulto , Estudos Transversais , Prevalência , Cesárea/estatística & dados numéricos , Adulto Jovem , Parto , Adolescente , Consentimento Livre e Esclarecido/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Inquéritos e Questionários , Esterilização Reprodutiva/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos
2.
BMC Public Health ; 24(1): 1301, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741063

RESUMO

BACKGROUND: Anemia is a common complication of HIV/AIDS, particularly in adolescents and young adults across various countries and regions. However, little is known about the changing prevalence trends of anemia impairment in this population over time. METHODS: Data on anemia in adolescents and young adults with HIV/AIDS from 1990 to 2019 were collected from the Global Burden of Disease. Prevalence was calculated by gender, region, and country for individuals aged 10-24, and trends were measured using estimating annual percentage changes (EAPC). RESULTS: Globally, the prevalence of adolescents and young adults with HIV/AIDS increased from 103.95 per 100,000 population in 1990 to 203.78 in 2019. However, anemia impairment has decreased over the past three decades, with a global percentage decreasing from 70.6% in 1990 to 34.7% in 2019, mainly presenting as mild to moderate anemia and significantly higher in females than males. The largest decreases were observed in Central Sub-Saharan Africa, North America, and Eastern Sub-Saharan Africa, with EAPCs of -2.8, -2.34, and -2.17, respectively. Tajikistan (78.76%) and Madagascar (74.65%) had the highest anemia impairment percentage in 2019, while China (16.61%) and Iceland (13.73%) had the lowest. Anemia impairment was closely related to sociodemographic index (SDI) levels, with a high proportion of impairment in low SDI regions but a stable decreasing trend (EAPC = -0.37). CONCLUSION: Continued anemia monitoring and management are crucial for patients with HIV, especially in high-prevalence regions and among females. Public health policies and interventions can improve the quality of life and reduce morbidity and mortality.


Assuntos
Anemia , Infecções por HIV , Humanos , Adolescente , Masculino , Feminino , Anemia/epidemiologia , Prevalência , Adulto Jovem , Infecções por HIV/epidemiologia , Infecções por HIV/complicações , Criança , Saúde Global/estatística & dados numéricos , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/complicações , Carga Global da Doença
3.
BMC Pediatr ; 24(1): 329, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741083

RESUMO

BACKGROUND: Febrile seizures (FS) are the most common seizure disorder in children and a common neurologic complication in children with coronavirus disease 2019 (COVID-19). This study aimed to identify differences in clinical characteristics and disease burden between FS with and without COVID-19. MATERIALS AND METHODS: We conducted a retrospective analysis of medical data at our hospital from December 2019 to July 2023, focusing on hospitalized patients under the age of 14 diagnosed with FS who underwent COVID-19 polymerase chain reaction (PCR) testing. Descriptive statistics and analysis of variance were employed to compare the COVID-19 and non-COVID-19 groups in terms of clinical characteristics and disease burden. RESULTS: A total of 514 patients were included, with 106 testing positive for COVID-19 and 408 testing negative. Patients with COVID-19 were older (34.87 ± 6.16 vs. 28.61 ± 11.35 months, P < 0.001) and had a higher proportion of males (79.2% vs. 62.3%, P = 0.001). The COVID-19 group had longer seizure durations (4.57 ± 4.38 vs. 3.22 ± 2.91 min, P = 0.006) and more complex FS (25.5% vs. 15.9%, P = 0.022). Laboratory tests showed lower lymphocyte counts in the COVID-19 group (1.87 ± 1.48 vs. 2.75 ± 1.51 × 103/µL, P < 0.001) and higher creatine kinase levels (158.49 ± 82.89 vs. 110.89 ± 56.11 U/L, P < 0.001). No significant differences were found in hospital costs, length of hospitalization, and intensive care unit admissions. CONCLUSION: Clinicians should be knowledgeable about the distinct clinical characteristics of FS in children with COVID-19. Despite distinct features, the prognosis remains favorable and does not require excessive intervention. Ongoing monitoring and research are needed to fully understand the impact of COVID-19 on FS and optimize management strategies.


Assuntos
COVID-19 , Convulsões Febris , Humanos , COVID-19/complicações , COVID-19/diagnóstico , Masculino , Feminino , Estudos Retrospectivos , Pré-Escolar , Criança , Lactente , Efeitos Psicossociais da Doença , SARS-CoV-2 , Hospitalização/estatística & dados numéricos , Adolescente , Tempo de Internação/estatística & dados numéricos
4.
BMC Public Health ; 24(1): 1297, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741152

RESUMO

BACKGROUND: Transportation plays a significant role in health, community resilience, and access to basic needs such as healthcare, social services, education, and job opportunities. Health and community resilience are, however, impacted by a multitude of complex and unequal factors, such as transportation restrictions exacerbated by the Israeli occupation. The goal of the research was to examine the intricate relationships that exist in Palestine between movement restrictions imposed by occupation, health outcomes, and community resilience. METHOD: A self-structured questionnaire, devised based on expert conversations and previous literature, was used in this descriptive, quantitative study to explore health and resilience outcomes. Age, gender, marital status, place of residence, and means of transportation were among the various factors that were utilized to describe the socio-demographics of the study sample (n = 202). The researchers employed stepwise multiple regression and descriptive statistics for the data analysis. RESULTS: Study findings indicated that transportation restrictions have significant direct and indirect health consequences. A significant direct effect is observed, signifying a negative correlation between restrictions and health; increased transportation restrictions are consistently correlated with a decline in health. The study emphasized how place of residence affects health outcomes, with higher scores for campers and people living in green line areas. It also underscores that public means of transportation are found to be better for health outcomes than private cars. CONCLUSION: This study emphasized that roadblocks, checkpoints, and military incursions make it difficult for Palestinians to receive medical care, which has a detrimental impact on their health and well-being. It also underscores the need for significant reforms in Palestinian health and transportation systems to enhance infrastructure and healthcare access. The Palestinian Authority should invest in public transportation and community resilience programs to address transportation-related health issues, especially in villages, due to frequent settler attacks.


Assuntos
Acessibilidade aos Serviços de Saúde , Resiliência Psicológica , Meios de Transporte , Humanos , Masculino , Feminino , Adulto , Israel , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem , Adolescente
5.
Health Promot Chronic Dis Prev Can ; 44(5): 197-207, 2024 May.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-38748477

RESUMO

INTRODUCTION: The goal of this study was to examine potential disparities in positive mental health (PMH) among adults in Canada by sexual orientation and gender modality. METHODS: Using 2019 Canadian Community Health Survey (CCHS) Annual Component data (N = 57 034), we compared mean life satisfaction and the prevalence of high self-rated mental health (SRMH), happiness and community belonging between heterosexual and sexual minority adults, and between cisgender and gender minority adults. We used 2019 CCHS Rapid Response on PMH data (N = 11 486) to compare the prevalence of high psychological well-being between heterosexual and sexual minority adults. Linear and logistic regression analyses examined the between-group differences in mean life satisfaction and the other PMH outcomes, respectively. RESULTS: Sexual minority (vs. heterosexual) adults reported lower mean life satisfaction (B = -0.7, 95% CI: -0.8, -0.5) and were less likely to report high SRMH (OR = 0.4, 95% CI: 0.3, 0.5), happiness (OR = 0.4, 95% CI: 0.3, 0.5), community belonging (OR = 0.6, 95% CI: 0.5, 0.7) and psychological well-being (OR = 0.4, 95% CI: 0.3, 0.6). Differences were not always significant for specific sexual minority groups in sexstratified analyses. Gender minority adults reported lower mean life satisfaction and were less likely to report high SRMH and happiness than cisgender adults. CONCLUSION: Future research could investigate how these PMH disparities arise, risk and protective factors in these populations, how other sociodemographic factors interact with sexual orientation and gender identity to influence PMH and changes in disparities over time.


Assuntos
Saúde Mental , Minorias Sexuais e de Gênero , Humanos , Masculino , Feminino , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Canadá/epidemiologia , Adulto , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Satisfação Pessoal , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos , Felicidade , Adulto Jovem , Heterossexualidade/estatística & dados numéricos , Heterossexualidade/psicologia , Adolescente , Idoso
6.
BMC Public Health ; 24(1): 1284, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38745219

RESUMO

BACKGROUND: The health condition during childhood has been shown to influence an individual's health and socioeconomic status in adulthood. Understanding the concentration and persistence patterns in children's healthcare expenditures is crucial for providing risk protection and promoting the well-being of children. Studies regarding the concentration and persistence of health expenditures have focused mainly on elderly individuals in developed regions. To gain insights into factors that contribute to childhood health expenditures, this article examined children with high costs (that is, in the top 10% of the expenditure distribution) and explored the characteristics and spending patterns that distinguished them from other patients in the context of the largest developing economy-China. METHODS: By using a unique individual-level administrative claims dataset over a 5-year observation period, this study identified spending concentrations and the proportion of children whose costs remained high over five years using a linear probability model and logit regression analysis. RESULTS: Teenagers from 12 to 17 years old were more likely to persist in the high-cost group than any other age groups in the study. Pediatric complex chronic conditions and other severe health ailments were predictive factors for entry into and persistence in the high-cost category. More than half of the total health expenditures were attributed to children in the top 10% expenditure group. In addition, risk protection and healthcare insurance support for high-cost children was found to be inadequate, particularly for children from low-income families. CONCLUSIONS: Healthcare support for children impacts individual development and family financial status. This study described the characteristics and spending patterns of children patients in the largest developing country. The fact that over half of total expenditures are concentrated toward 10% of patients makes it valuable to consider relevant support for this group, especially for families whose medical costs are higher than income.


Assuntos
Gastos em Saúde , Humanos , China , Criança , Gastos em Saúde/estatística & dados numéricos , Adolescente , Feminino , Masculino , Pré-Escolar , Lactente , Recém-Nascido
7.
BMC Psychiatry ; 24(1): 363, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38745314

RESUMO

OBJECTIVE: This study aims to assess the prevalence of needle phobia among Saudi and Egyptian adult populations. In addition, underlying causes and strategies that can be utilized to address needle fear were investigated. METHODS: A cross-sectional online survey study was conducted in Saudi Arabia and Egypt between 1 May and 30 June 2023. Participants aged 18 years and above and living in Saudi Arabia and Egypt were eligible to complete the survey. Participants were invited to participate in this study through social media platforms (Facebook, X, Snapchat, and Instagram). A convenience sampling technique was used to recruit the study participants. A 21-item questionnaire consisting of four sections including a Likert scale score was used to answer the research objectives. Numeric data were presented as mean ± SD. For categorical variables, percentages were used. Comparison between groups were made by Student's t-test or Mann Whitney test according to data distribution. Chi squared tests for categorical values were conducted. A binary logistic regression analysis was conducted to investigate factors associated with needle phobia. RESULTS: A total of 4065 participants were involved in this study (Saudi Arabia: 2628 and Egypt: 1437). Around one-third of the study participants (36.5%) confirmed that they have needle phobia. Most of the study participants (81.1%) reported that they have had needle phobia since they were under 18 years of age. Pain, general anxiety, and fear of making a mistake during the procedure were the most commonly reported contributors for fear of needles during or before a medical procedure. Around 15.8% of the study participants reported that they have tried to get rid of phobia from needles. Non-surgical alternatives (such as oral medications and patches) and using smaller/thinner needles were the most commonly reported interventions that reduced fear of needles. Binary logistic regression analysis identified that females, those who are aged (41-50 years), widowed, those with bachelor's degrees and higher education, and those unemployed were more likely to have needle phobia compared to others. CONCLUSION: Our study highlighted the high prevalence of needle fear within an adult population in Egypt and Saudi Arabia. Females, those who are aged (41-50 years), those widowed, those with higher education degrees, those unemployed, those working in the health sector and people with low income were more likely to have needle phobia compared to others.


Assuntos
Agulhas , Transtornos Fóbicos , Humanos , Arábia Saudita/epidemiologia , Feminino , Transtornos Fóbicos/epidemiologia , Masculino , Adulto , Egito/epidemiologia , Estudos Transversais , Prevalência , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Inquéritos e Questionários
8.
PLoS Med ; 21(5): e1004401, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38701084

RESUMO

BACKGROUND: Emerging evidence suggests that shortened, simplified treatment regimens for rifampicin-resistant tuberculosis (RR-TB) can achieve comparable end-of-treatment (EOT) outcomes to longer regimens. We compared a 6-month regimen containing bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM) to a standard of care strategy using a 9- or 18-month regimen depending on whether fluoroquinolone resistance (FQ-R) was detected on drug susceptibility testing (DST). METHODS AND FINDINGS: The primary objective was to determine whether 6 months of BPaLM is a cost-effective treatment strategy for RR-TB. We used genomic and demographic data to parameterize a mathematical model estimating long-term health outcomes measured in quality-adjusted life years (QALYs) and lifetime costs in 2022 USD ($) for each treatment strategy for patients 15 years and older diagnosed with pulmonary RR-TB in Moldova, a country with a high burden of TB drug resistance. For each individual, we simulated the natural history of TB and associated treatment outcomes, as well as the process of acquiring resistance to each of 12 anti-TB drugs. Compared to the standard of care, 6 months of BPaLM was cost-effective. This strategy was estimated to reduce lifetime costs by $3,366 (95% UI: [1,465, 5,742] p < 0.001) per individual, with a nonsignificant change in QALYs (-0.06; 95% UI: [-0.49, 0.03] p = 0.790). For those stopping moxifloxacin under the BPaLM regimen, continuing with BPaL plus clofazimine (BPaLC) provided more QALYs at lower cost than continuing with BPaL alone. Strategies based on 6 months of BPaLM had at least a 93% chance of being cost-effective, so long as BPaLC was continued in the event of stopping moxifloxacin. BPaLM for 6 months also reduced the average time spent with TB resistant to amikacin, bedaquiline, clofazimine, cycloserine, moxifloxacin, and pyrazinamide, while it increased the average time spent with TB resistant to delamanid and pretomanid. Sensitivity analyses showed 6 months of BPaLM to be cost-effective across a broad range of values for the relative effectiveness of BPaLM, and the proportion of the cohort with FQ-R. Compared to the standard of care, 6 months of BPaLM would be expected to save Moldova's national TB program budget $7.1 million (95% UI: [1.3 million, 15.4 million] p = 0.002) over the 5-year period from implementation. Our analysis did not account for all possible interactions between specific drugs with regard to treatment outcomes, resistance acquisition, or the consequences of specific types of severe adverse events, nor did we model how the intervention may affect TB transmission dynamics. CONCLUSIONS: Compared to standard of care, longer regimens, the implementation of the 6-month BPaLM regimen could improve the cost-effectiveness of care for individuals diagnosed with RR-TB, particularly in settings with a high burden of drug-resistant TB. Further research may be warranted to explore the impact and cost-effectiveness of shorter RR-TB regimens across settings with varied drug-resistant TB burdens and national income levels.


Assuntos
Antituberculosos , Análise Custo-Benefício , Moxifloxacina , Anos de Vida Ajustados por Qualidade de Vida , Rifampina , Tuberculose Resistente a Múltiplos Medicamentos , Humanos , Moldávia , Rifampina/uso terapêutico , Rifampina/economia , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/economia , Antituberculosos/uso terapêutico , Antituberculosos/economia , Moxifloxacina/uso terapêutico , Moxifloxacina/economia , Adulto , Masculino , Feminino , Modelos Teóricos , Quimioterapia Combinada , Linezolida/uso terapêutico , Linezolida/economia , Diarilquinolinas/uso terapêutico , Diarilquinolinas/economia , Pessoa de Meia-Idade , Resultado do Tratamento , Esquema de Medicação , Adolescente , Mycobacterium tuberculosis/efeitos dos fármacos
9.
PLoS Negl Trop Dis ; 18(5): e0012154, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38713728

RESUMO

Rabies remains a burden in Africa, disproportionately affecting the most vulnerable despite the availability of effective vaccines. Nigeria, the most populous African country, needs rapid disease control actions and commitments to achieve the goal of eliminating dog-mediated rabies by 2030. Surveillance is an essential element of effective disease control strategies. This study examined the current state of operationality of the rabies surveillance system for early case detection and management in Gombe state, Nigeria, through a One Health lens. It further examined the barriers impeding the effectiveness of the surveillance based on the perception of surveillance workers. Qualitative and quantitative methods were used to assess the structure of the system and its functioning. Data on dog bite and rabid cases obtained from the veterinary services in Gombe state were analysed descriptively. A total of 13 key informants were interviewed using a semi-structured interview guide. Qualitative data were analysed using thematic analysis to explore in depth the factors that influenced the operationality of the system. A total of 157 potential human exposures to rabies were identified in this study, out of which two people reportedly died at the health facility after showing symptoms highly suggestive of rabies. In terms of rabies surveillance and control, cross-sectoral collaboration was found between the human health and veterinary sectors for risk assessment of potential rabies exposures and its management. Some identified factors affecting the operations of the surveillance were inadequate funding, lack of infrastructure, lack of feedback from higher authorities and insufficient knowledge of rabies prevention and management. To improve the capacity for case detection and management within the state, the appropriate authorities may focus on increasing awareness about the disease to the populace to increase the number of cases identified by the system, employ more workers and strengthen the surveillance capability of existing workers.


Assuntos
Raiva , Raiva/epidemiologia , Raiva/prevenção & controle , Raiva/veterinária , Nigéria/epidemiologia , Humanos , Animais , Cães , Doenças do Cão/epidemiologia , Doenças do Cão/prevenção & controle , Doenças do Cão/virologia , Feminino , Masculino , Adulto , Mordeduras e Picadas/epidemiologia , Pessoa de Meia-Idade , Monitoramento Epidemiológico , Adulto Jovem , Adolescente , Saúde Única
10.
Public Health ; 231: 154-157, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38692090

RESUMO

OBJECTIVES: The prevalence of depression related to precarious employment (PE) has become a significant public health concern, given the declining trend of the standard employment relationship. Research has focused on the mental health detrimental effects of employment conditions, whereas there is scarce evidence concerning the burden of depression that could be prevented by targeting precariousness. This paper estimates the impact of PE on the risk of depression and the attributable fraction within the active and working salaried population in Spain. STUDY DESIGN: Observational cross-sectional on data drawn from the Spanish portion of European Health Survey 2020. METHODS: After applying selection criteria and descriptives, binary logistic regression models stratified by sex are used to examine the associations between a 9-categories combination of employment precariousness and occupational social class, and depressive symptoms. RESULTS: There is a higher risk of depression among individuals in PE and among those who are unemployed, with a notable gradient based on occupational social class for women. Adjusting by sex, age and foreign-born origin, we estimate that approximately 15.0% (95% confidence interval [CI]: 1.0%-26.2%) of depression cases among the working population and 33.3% (95% CI: 23.2%-43.2) among the active population can be attributed to PE. CONCLUSIONS: These findings highlight the public health impact of PE on mental health, provide evidence to estimate the economic burden linked to employment-related mental health, and underscore the need for policy changes and interventions at the level of labour markets and workplaces to mitigate the detrimental effects of PE.


Assuntos
Depressão , Emprego , Humanos , Espanha/epidemiologia , Feminino , Masculino , Adulto , Depressão/epidemiologia , Depressão/psicologia , Estudos Transversais , Emprego/psicologia , Emprego/estatística & dados numéricos , Pessoa de Meia-Idade , Medição de Risco , Adulto Jovem , Inquéritos Epidemiológicos , Prevalência , Adolescente , Classe Social
11.
Food Chem ; 451: 139498, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38703730

RESUMO

Concerns about dioxin-like compounds have increased; however, the monitoring of polychlorinated naphthalenes (PCNs) in food and the assessment of dietary intake remain limited. In this study, various foods were collected from Korean markets and analyzed for PCNs. Fishery products exhibited the highest mean concentration (48.0 pg/g ww) and toxic equivalent (TEQ) (0.0185 pg-TEQ/g ww). Agricultural products were the largest contributors (35.7%) to the total dietary intake of PCNTEQ, followed by livestock products (33.6%), fishery products (20.2%), and processed foods (10.5%). The mean intake of PCNTEQ for the Korean population was 0.901 pg-TEQ/day for males and 0.601 pg-TEQ/day for females. Generally, males and younger groups had higher daily intakes of PCNTEQ, but they did not exceed the tolerable weekly intakes. Nonetheless, it is important to manage potential health risks associated with PCNs and other dioxin-like compounds by identifying major food items contributing to PCN exposure and considering age and gender differences.


Assuntos
Contaminação de Alimentos , Naftalenos , República da Coreia , Humanos , Contaminação de Alimentos/análise , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Naftalenos/análise , Adolescente , Criança , Poluentes Ambientais/análise , Idoso , Pré-Escolar , Exposição Dietética/análise , Animais
12.
Span J Psychiatry Ment Health ; 17(2): 95-102, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38720188

RESUMO

BACKGROUND: Socioeconomic status (SES) and gender play a key role in mental health. The objective of this study was to assess socioeconomic and gender mental health inequalities in adolescents and young adults using a population-based registry. MATERIALS AND METHODS: We conducted a lifetime follow-up study of all residents in the Basque Country between 1 and 30 years old (n=609,381) as of 31 December 2018. Primary care, specialized outpatient, and hospital care records were searched for diagnoses. SES was assessed based on household income. We estimated disaggregated lifetime prevalence of substance use, behaviour, anxiety, depression, psychosis, and attention deficit hyperactivity disorder. The local Institute of Statistics validated the mortality data. The likelihood of risks was estimated using logistic regression. RESULTS: Overall, 96,671 individuals (15.9%) had a diagnosed mental disorder, with clear gradients by gender and SES. Females of medium-to-high SES had the lowest prevalence of all mental disorders, except anxiety and depression. This group was followed by males of the same SES and females of low SES, while the highest prevalence of mental disorders was observed in low-SES males. The lower income categories had higher risks of psychiatric admission (adjusted odds ratio [AOR]: 3.64 for females; 6.66 for males) and death (AOR: 5.42). People with a mental health diagnosis had higher mortality (AOR: 2.38). CONCLUSIONS: Our work evidenced important SES and gender inequalities in the mental health and premature mortality of adolescents and young adults, findings that should drive the development and implementation of early preventive interventions.


Assuntos
Transtornos Mentais , Classe Social , Humanos , Adolescente , Masculino , Feminino , Transtornos Mentais/epidemiologia , Adulto Jovem , Adulto , Fatores Sexuais , Criança , Disparidades nos Níveis de Saúde , Espanha/epidemiologia , Lactente , Fatores Socioeconômicos , Seguimentos , Prevalência , Sistema de Registros
13.
Int J Pediatr Otorhinolaryngol ; 180: 111933, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38692234

RESUMO

OBJECTIVE: To create, validate, and apply an aerodigestive provider assessment survey. METHODS: A survey assessing provider knowledge and current practice in the transition of patients with chronic aerodigestive disorders from pediatric to adult care was drafted by a multidisciplinary expert panel. Once agreement of the initial survey items was obtained, the survey was distributed to a national multidisciplinary panel of aerodigestive experts for review. Responses from the national panel were systematically quantified and a content validity index (CVI) was calculated. A final survey was developed and distributed to pediatric and adult aerodigestive providers. RESULTS: From the initial 22 items presented to the national panel, 20 of the initial questions were included in the final instrument. Two additional questions were developed as a result of feedback from the expert panel. All items included in the survey had an Item Content Validity Index (I-CVI) of >0.85. The average Scale CVI in proportion to the average proportion of relevance (S-CVI/Ave) for the tool was 0.88. The average Scale CVI in proportion to universal agreement (S-CVI/UA) was 0.52. The survey was then administered to pediatric and adult specialty providers at our institution. Twenty-two providers completed the final survey. CONCLUSION: The content validity index measurements from this newly developed survey suggest that it is a valid tool for assessing current knowledge and practice in care transitions among patients with complex aerodigestive needs. The survey developed in this project has been used to identify knowledge gaps and process issues that can be addressed to ease the transition of adolescents from pediatric specialty care into adult specialty care.


Assuntos
Transição para Assistência do Adulto , Humanos , Inquéritos e Questionários , Adulto , Criança , Masculino , Feminino , Doença Crônica/terapia , Pesquisas sobre Atenção à Saúde , Adolescente , Reprodutibilidade dos Testes , Estados Unidos
14.
Food Chem Toxicol ; 188: 114699, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38697496

RESUMO

The aim of this study was to assess Italian consumers' risk of cancer and burden of disease due to dietary exposure to acrylamide. Our model considered six age groups such as infants, toddlers, other children, adolescents, adults, and the elderly, and the consumption of 31 food items. Using a risk-assessment-based approach, we first characterized the risk of neoplastic effects using the margin of exposure method. Then the risk of kidney, endometrial, breast, ovarian cancer, and total cancer was estimated using adjusted cancer slope factors while the burden of disease was quantified using Disability-adjusted Life Years (DALYs). The highest risk for females was related to breast cancer while the lowest was for kidney cancer. We found a comparable risk of total cancer among Italian males and females, estimated at around 1.59 to 3.57 cases per 100,000 individuals annually with the burden ranging between 12.3 - 25.4 and 11.4 - 24.1 DALYs respectively. Our findings provide insights on the multifaceted impact of acrylamide on public health by offering detailed insights into age-specific exposure levels, diverse cancer risks, and the dietary burden of disease related to acrylamide. Targeted interventions and policies can be developed towards mitigating the health risks associated with acrylamide exposure.


Assuntos
Acrilamida , Exposição Dietética , Neoplasias , Humanos , Acrilamida/toxicidade , Acrilamida/análise , Itália/epidemiologia , Feminino , Masculino , Medição de Risco , Adolescente , Lactente , Pré-Escolar , Adulto , Idoso , Criança , Neoplasias/epidemiologia , Neoplasias/induzido quimicamente , Neoplasias/etiologia , Pessoa de Meia-Idade , Adulto Jovem , Contaminação de Alimentos/análise , Efeitos Psicossociais da Doença , Anos de Vida Ajustados por Deficiência
15.
Eat Weight Disord ; 29(1): 36, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38733540

RESUMO

INTRODUCTION: With increasing morbidity and risk of death, obesity has become a serious health problem largely attributable to difficulties in finding proper treatments for related diseases. Many studies show how detecting abnormal eating behaviors could be useful in developing effective clinical treatments. This study aims at validating the Greek version of the Eating Behaviors Assessment for Obesity (EBA-O). METHOD: After a double English/Greek forward/backward translation of the EBA-O, 294 participants completed the Greek version (GR-EBA-O), the Eating Disorder Examination Questionnaire, the Binge Eating Scale, and the Yale Food Addiction Scale. Confirmatory factor analysis (CFA) and construct validity were calculated, and Two-way MANOVA was computed with the factors of GR-EBA-O controlling for sex and BMI categories. RESULTS: CFA confirmed the second-order five factors (i.e., food addiction, night eating, binge eating, sweet eating, and prandial hyperphagia) structure of the original EBA-O with excellent fit indices. GR-EBA-O factors were highly correlated. The GR-EBA-O subscales were also significantly correlated with the remaining measures, demonstrating good concurrent validity. CONCLUSION: The Greek version of the EBA-O has demonstrated sound psychometric properties and appears a reliable and user-friendly tool to identify pathological eating behaviors in obesity. LEVEL OF EVIDENCE: V, descriptive research.


Assuntos
Comportamento Alimentar , Obesidade , Psicometria , Humanos , Feminino , Masculino , Obesidade/psicologia , Adulto , Grécia , Comportamento Alimentar/psicologia , Reprodutibilidade dos Testes , Inquéritos e Questionários , Pessoa de Meia-Idade , Adulto Jovem , Análise Fatorial , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Adolescente , Dependência de Alimentos/psicologia , Dependência de Alimentos/diagnóstico
16.
Neurol Neuroimmunol Neuroinflamm ; 11(4): e200255, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38728608

RESUMO

OBJECTIVES: To estimate the incidence of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis. METHODS: We conducted a retrospective cohort study of >10 million person-years of observation from members of Kaiser Permanente Southern California, 2011-2022. The electronic health record of individuals with text-string mention of NMDA and encephalitis were reviewed to identify persons who met diagnostic criteria for anti-NMDAR encephalitis. Age-standardized and sex-standardized incidences stratified by race and ethnicity were estimated according to the 2020 US Census population. RESULTS: We identified 70 patients who met diagnostic criteria for anti-NMDAR encephalitis. The median age at onset was 23.7 years (IQR = 14.2-31.0 years), and 45 (64%) were female patients. The age-standardized and sex-standardized incidence of anti-NMDAR encephalitis per 1 million person-years was significantly higher in Black (2.94, 95% CI 1.27-4.61), Hispanic (2.17, 95% CI 1.51-2.83), and Asian/Pacific Island persons (2.02, 95% CI 0.77-3.28) compared with White persons (0.40, 95% CI 0.08-0.72). Ovarian teratomas were found in 58.3% of Black female individuals and 10%-28.6% in other groups. DISCUSSION: Anti-NMDA receptor encephalitis disproportionately affected Black, Hispanic, or Asian/Pacific Island persons. Ovarian teratomas were a particularly common trigger in Black female individuals. Future research should seek to identify environmental and biological risk factors that disproportionately affect minoritized individuals residing in the United States.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato , Humanos , Encefalite Antirreceptor de N-Metil-D-Aspartato/etnologia , Encefalite Antirreceptor de N-Metil-D-Aspartato/epidemiologia , Feminino , Adulto , Masculino , Incidência , Adulto Jovem , Estudos Retrospectivos , Adolescente , California/epidemiologia , Hispânico ou Latino/estatística & dados numéricos , Disparidades nos Níveis de Saúde , População Branca/etnologia , Negro ou Afro-Americano/etnologia , Neoplasias Ovarianas/etnologia , Neoplasias Ovarianas/epidemiologia , Teratoma/epidemiologia , Teratoma/etnologia , Pessoa de Meia-Idade , Etnicidade
17.
Int J Behav Nutr Phys Act ; 21(1): 53, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38735934

RESUMO

BACKGROUND: Regulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world's first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils. METHODS: With a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status. RESULTS: Longitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings. CONCLUSIONS: This regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere.


Assuntos
Comportamento Sedentário , Humanos , Adolescente , Masculino , Feminino , Criança , China , Estudos Transversais , Tempo de Tela , Jogos de Vídeo , Promoção da Saúde/métodos , Comportamento do Adolescente , Estudos Longitudinais , Exercício Físico , Estudantes , Comportamento Infantil/psicologia , Instituições Acadêmicas
18.
Cancer Control ; 31: 10732748241255538, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38736171

RESUMO

PURPOSE: Promoting cancer preventive behaviors among adolescents, especially those from lower socioeconomic backgrounds, is crucial due to the significant impact of health behaviors in adolescence on disease risk in adulthood. With India witnessing a rise in cancer incidence and mortality, adolescence becomes a pivotal stage for establishing healthy habits, emphasizing the need for early cancer prevention efforts. METHODS: This cross-sectional study used survey data from 2242 adolescents attending public schools of Mumbai, India. Multiple logistic regression was conducted to determine the associations between cancer preventive behaviors and: (1) the individual and social determinants of health, and (2) media exposure. FINDINGS: Merely 21.5% of the adolescents ate fruits and vegetables daily, 50% of the adolescents exercised 3 or more times a week, and 20% of the adolescents admitted having used tobacco and/or supari. Girls were found to have lower odds of exercising, as well as using tobacco and/or supari. Wealth and father's education were positively associated with all 3 cancer preventive behaviors. Media exposure was negatively associated, with television exposure linked to reduced fruits and vegetables consumption, while movies and social media exposure were associated with increased tobacco and/or supari use. INTERPRETATION: Our findings suggest that individual and social determinants of health and media exposure can influence cancer preventive health behaviors in low socio-economic status (SES) adolescents. Efforts to increase awareness to promote cancer preventive behaviors among the adolescents, particularly low SES adolescents, a population more vulnerable to poor health outcomes, is critical.


This study investigates factors that can influence cancer preventive behaviors among low socioeconomic status (SES) adolescents, focusing on dietary habits, physical activity, and avoidance of tobacco and areca nut. Our study gathered data from an underrepresented population of India, which is more vulnerable to poor health outcomes and have less access to health care. Our findings can alert public health officials, policy makers and non-governmental organizations to target this population and customize their intervention strategies to promote health and prevent cancer.


Assuntos
Comportamentos Relacionados com a Saúde , Neoplasias , Humanos , Adolescente , Feminino , Estudos Transversais , Índia/epidemiologia , Masculino , Neoplasias/prevenção & controle , Neoplasias/epidemiologia , Determinantes Sociais da Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Comunicação , Exercício Físico , Comportamento do Adolescente/psicologia
19.
Public Health Nutr ; 27(1): e126, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38698611

RESUMO

OBJECTIVE: The present study investigated potential predictors of food insecurity among UK university students during the COVID-19 pandemic. DESIGN: Close-ended questionnaire administered to a cross-sectional sample of UK university students. SETTING: Data were collected using an online survey platform in October 2020, during the COVID-19 pandemic. PARTICIPANTS: A nationally representative sample of UK university students (n 640). RESULTS: Odds ratios (OR) obtained from logistic regression were statistically significant for three measures of economic hardship. First, students who relied on financial aid from student loans were 1·9 times more likely to report being food insecure than students who did not rely on financial aid from student loans. Second, students who could not pay their utility bill (v. those that could pay) were 3·1 times the odds of being food insecure. Finally, as perceived difficulty in paying for accommodation increased across the sample, the odds of being food insecure also increased (OR = 1·9). We also found that students who were recently ill were 2·2 times more likely to be food insecure compared with students who were not recently ill. We did not find any evidence that testing positive for COVID-19 predicted food insecurity, and university supplied food parcels/boxes did not reduce student food insecurity. CONCLUSIONS: Both economic factors and illness play a significant role in self-reported food insecurity in higher education students during pandemic lockdown. Further research is needed to explore food insecurity, economic factors and illness outside of a pandemic context.


Assuntos
COVID-19 , Insegurança Alimentar , SARS-CoV-2 , Estudantes , Humanos , COVID-19/epidemiologia , Estudantes/estatística & dados numéricos , Estudantes/psicologia , Universidades , Feminino , Masculino , Estudos Transversais , Reino Unido/epidemiologia , Adulto Jovem , Inquéritos e Questionários , Adulto , Pandemias , Adolescente , Abastecimento de Alimentos/estatística & dados numéricos , Abastecimento de Alimentos/economia
20.
Front Public Health ; 12: 1379897, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38721543

RESUMO

Background: Precision in evaluating underweight and overweight status among children and adolescents is paramount for averting health and developmental issues. Existing standards for these assessments have faced scrutiny regarding their validity. This study investigates the age and height dependencies within the international standards set by the International Obesity Task Force (IOTF), relying on body mass index (BMI), and contrasts them with Japanese standards utilizing the percentage of overweight (POW). Method: We scrutinized a comprehensive database comprising 7,863,520 children aged 5-17 years, sourced from the School Health Statistics Research initiative conducted by Japan's Ministry of Education, Culture, Sports, Science, and Technology. Employing the quantile regression method, we dissected the structure of weight-for-height distributions across different ages and sexes, quantifying the potentially biased assessments of underweight and overweight status by conventional criteria. Results: Applying IOFT criteria for underweight assessment revealed pronounced height dependence in males aged 11-13 and females aged 10-11. Notably, a discernible bias emerged, wherein children in the lower 25th percentile were classified as underweight five times more frequently than those in the upper 25th percentile. Similarly, the overweight assessment displayed robust height dependence in males aged 8-11 and females aged 7-10, with children in the lower 25th percentile for height deemed obese four or five times more frequently than their counterparts in the upper 25th percentile. Furthermore, using the Japanese POW criteria for assessment revealed significant age dependence in addition to considerably underestimating the percentage of underweight and overweight cases under the age of seven. However, the height dependence for the POW criterion was smaller than the BMI criterion, and the difference between height classes was less than 3-fold. Conclusion: Our findings underscore the intricacies of age-dependent changes in body composition during the growth process in children, emphasizing the absence of gold standards for assessing underweight and overweight. Careful judgment is crucial in cases of short or tall stature at the same age, surpassing sole reliance on conventional criteria results.


Assuntos
Estatura , Obesidade Infantil , Magreza , Padrões de Referência , Humanos , Criança , Adolescente , Feminino , Obesidade Infantil/diagnóstico , Magreza/diagnóstico , Índice de Massa Corporal , Pesos e Medidas Corporais/métodos , Fatores Etários , Japão , Classificação Internacional de Doenças
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