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1.
Longit Life Course Stud ; 15(3): 322-347, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38954411

RESUMO

Spain is one of the eight EU-27 countries that failed to reduce early school leaving (ESL) below 10% in 2020, and now faces the challenge of achieving a rate below 9% by 2030. The determinants of this phenomenon are usually studied using cross-sectional data at the micro level and without differentiation by gender. In this study, we analyse it for the first time for Spain using panel data (between 2002 and 2020), taking into account the high regional inequalities at the macroeconomic level and the masculinisation of the phenomenon. The results show a positive relationship between ESL and socio-economic variables such as the adolescent fertility rate, immigration, unemployment or the weight of the industrial and construction sectors in the regional economy, with significant gender differences that invite us to discuss educational policies. Surprisingly, youth unemployment has only small but significant impact on female ESL.


Assuntos
Fatores Socioeconômicos , Humanos , Espanha , Feminino , Masculino , Adolescente , Estudos Longitudinais , Fatores Sexuais , Desemprego , Estudos Transversais , Instituições Acadêmicas , Evasão Escolar/estatística & dados numéricos , Adulto Jovem
2.
Turkiye Parazitol Derg ; 48(2): 89-95, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38958403

RESUMO

Objective: This research aims to update knowledge on the regional and national sickness burden attributable to cystic echinococcosis (CE) from 1990 to 2019, as well as epidemiology and disease control, with a particular emphasis on the People's Central Asian Regions. Methods: We calculated the morbidity, mortality, and disability-adjusted life years at the global, regional, and national levels for CE in all central Asian countries from 1990 to 2019, and we analyzed the association between GDP per capita and the disease burden of CE. Results: In 2019, the three greatest numbers of CE cases were recorded in Kazakhstan [23986; 95% uncertainty interval (UI); 19796; 28908]; Uzbekistan (41079; 18351; 76048); and Tajikistan (10887; 4891; 20170) among all 9 countries. The three countries with the greatest ASIR of CE were estimated to be Kazakhstan (127.56; 95% UI: 105.34-153.8), Uzbekistan (123.53; 95% UI: 58.65-219.16), and Tajikistan (121.88; 58.57-213.93). Kyrgyzstan, Tajikistan, and Uzbekistan had the biggest increases (125%, 97%, and 83%, respectively) in the number of incident cases of CE, whereas Georgia, Kazakhstan, and Armenia saw the largest decreases (45%, 8%, and 3%, respectively). Conclusion: To reduce the illness burden caused by CE, our findings may help public health professionals and policymakers design cost-benefit initiatives. To lessen the impact of CE on society, it is suggested that more money be given to the region's most endemic nations. Echinococcosis, cystic, negative health effects, life-years lost due to disability, rate of occurrence as a function of age, rate of death as a function of age.


Assuntos
Equinococose , Humanos , Equinococose/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Anos de Vida Ajustados por Deficiência , Adolescente , Adulto Jovem , Efeitos Psicossociais da Doença , Ásia Central/epidemiologia , Idoso , Criança , Uzbequistão/epidemiologia
3.
Health Aff (Millwood) ; 43(7): 1021-1031, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38950294

RESUMO

Health care payment reforms in the US have aimed to encourage the use of high-value care while discouraging the use of low-value care. However, little is known about whether the use of high- and low-value care differs by income level. Using data from the 2010-19 Medical Expenditure Panel Survey, we examined the use of specified types of high- and low-value care by income level. We found that high-income adults were significantly more likely than low-income adults to use nearly all types of high-value care. Findings were consistent across age categories, although differences by income level in the use of high-value care were smaller among the elderly. Our analysis of differences in the use of low-value care had mixed results. Among nonelderly adults, significant differences between those with high and low incomes were found for five of nine low-value services, and among elderly adults, significant differences by income level were found for three of twelve low-value services. Understanding the mechanisms underlying these disparities is crucial to developing effective policies and interventions to ensure equitable access to high-value care and discourage low-value services for all patients, regardless of income.


Assuntos
Renda , Humanos , Estados Unidos , Adulto , Masculino , Pessoa de Meia-Idade , Feminino , Idoso , Gastos em Saúde/estatística & dados numéricos , Adulto Jovem , Adolescente
4.
Health Aff (Millwood) ; 43(7): 979-984, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38950301

RESUMO

The COVID-19 Uninsured Program, administered by the Health Resources and Services Administration (HRSA), reimbursed providers for administering COVID-19 vaccines to uninsured US adults from December 11, 2020, through April 5, 2022. Using HRSA claims data covering forty-two states, we estimated that the program funded about 38.9 million COVID-19 vaccine doses, accounting for 5.7 percent of total doses distributed and 10.9 percent of doses administered to adults ages 19-64.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Pessoas sem Cobertura de Seguro de Saúde , Humanos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Estados Unidos , COVID-19/prevenção & controle , Adulto , Vacinas contra COVID-19/provisão & distribuição , Vacinas contra COVID-19/economia , Pessoa de Meia-Idade , Feminino , Masculino , United States Health Resources and Services Administration , Adulto Jovem , SARS-CoV-2 , Programas de Imunização/economia
5.
PLoS One ; 19(7): e0300193, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38949999

RESUMO

The NHS 111 service triages over 16,650,745 calls per year and approximately 48% of callers are triaged to a primary care disposition, such as a telephone appointment with a general practitioner (GP). However, there has been little assessment of the ability of primary care services to meet this demand. If a timely service cannot be provided to patients, it could result in patients calling 999 or attending emergency departments (ED) instead. This study aimed to explore the patient journey for callers who were triaged to a primary care disposition, and the ability of primary care services to meet this demand. We obtained routine, retrospective data from the Connected Yorkshire research database, and identified all 111 calls between the 1st January 2021 and 31st December 2021 for callers registered with a GP in the Bradford or Airedale region of West Yorkshire, who were triaged to a primary care disposition. Subsequent healthcare system access (111, 999, primary and secondary care) in the 72 hours following the index 111 call was identified, and a descriptive analysis of the healthcare trajectory of patients was undertaken. There were 56,102 index 111 calls, and a primary care service was the first interaction in 26,690/56,102 (47.6%) of cases, with 15,470/26,690 (58%) commenced within the specified triage time frame. Calls to 999 were higher in the cohort who had no prior contact with primary care (58% vs 42%) as were ED attendances (58.2% vs 41.8), although the proportion of avoidable ED attendances was similar (10.5% vs 11.8%). Less than half of 111 callers triaged to a primary care disposition make contact with a primary care service, and even when they do, call triage time frames are frequently not met, suggesting that current primary care provision cannot meet the demand from 111.


Assuntos
Atenção Primária à Saúde , Triagem , Humanos , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Retrospectivos , Triagem/estatística & dados numéricos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Idoso , Medicina Estatal , Adolescente , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adulto Jovem , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Criança , Lactente , Pré-Escolar , Idoso de 80 Anos ou mais , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos
6.
PLoS One ; 19(7): e0306280, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38950031

RESUMO

BACKGROUND: In the Republic of Ireland, the COVID-19 crisis led to sexual health service closures while clinical staff were redeployed to the pandemic response. Gay, bisexual and other men who have sex with men (gbMSM) face pre-existing sexual health inequalities which may have been exacerbated. The aim of this study is to understand sexual health service accessibility for gbMSM in Ireland during the COVID-19 crisis. METHODS: EMERGE recruited 980 gbMSM in Ireland (June-July 2021) to an anonymous online survey investigating well-being and service access through geo-location sexual networking apps (Grindr/Growlr), social media (Facebook/Instagram/Twitter) and collaborators. We fit multiple regression models reporting odds ratios (ORs) to understand how demographic and behavioural characteristics (age, sexual orientation, HIV testing history/status, region of residence, region of birth and education) were associated with ability to access services. RESULTS: Of the respondents, 410 gbMSM accessed sexual health services with some or no difficulty and 176 attempted but were unable to access services during the COVID-19 crisis. A further 382 gbMSM did not attempt to access services and were excluded from this sample and analysis. Baseline: mean age 35.4 years, 88% gay, 83% previously tested for HIV, 69% Dublin-based, 71% born in Ireland and 74% with high level of education. In multiple regression, gbMSM aged 56+ years (aOR = 0.38, 95%CI:0.16, 0.88), not previously tested for HIV (aOR = 0.46, 95%CI:0.23, 0.93) and with medium and low education (aOR = 0.55 95%CI:0.35, 0.85) had lowest odds of successfully accessing services. GbMSM with HIV were most likely to be able to access services successfully (aOR = 2.68 95%CI:1.83, 6.08). Most disrupted services were: STI testing, HIV testing and PrEP. CONCLUSIONS: Service access difficulties were found to largely map onto pre-existing sexual health inequalities for gbMSM. Future service development efforts should prioritise (re)engaging older gbMSM, those who have not previously tested for HIV and those without high levels of education.


Assuntos
COVID-19 , Acessibilidade aos Serviços de Saúde , Homossexualidade Masculina , Saúde Sexual , Humanos , Masculino , COVID-19/epidemiologia , Irlanda/epidemiologia , Adulto , Pessoa de Meia-Idade , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adolescente , SARS-CoV-2/isolamento & purificação , Pandemias , Infecções por HIV/epidemiologia , Idoso , Bissexualidade/estatística & dados numéricos
7.
Pan Afr Med J ; 48: 9, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38946741

RESUMO

Introduction: treatment of severe burn injury generally requires enormous human and material resources including specialized intensive care, staged surgery, and continued restoration. This contributes to the enormous burden on patients and their families. The cost of burn treatment is influenced by many factors including the demographic and clinical characteristics of the patient. This study aimed to determine the costs of burn care and its associated predictive factors in Korle-Bu Teaching Hospital, Ghana. Methods: an analytical cross-sectional study was conducted among 65 consenting adult patients on admission at the Burns Centre of the Korle-Bu Teaching Hospital. Demographic and clinical characteristics of patients as well as the direct cost of burns treatment were obtained. Multiple regression analysis was done to determine the predictors of the direct cost of burn care. Results: a total of sixty-five (65) participants were enrolled in the study with a male-to-female ratio of 1.4: 1 and a mean age of 35.9 ± 14.6 years. Nearly 85% sustained between 10-30% total body surface area burns whilst only 6.2% (4) had burns more than 30% of total body surface area. The mean total cost of burns treatment was GHS 22,333.15 (USD 3,897.58). Surgical treatment, wound dressing and medication charges accounted for 45.6%, 27.5% and 9.8% of the total cost of burn respectively. Conclusion: the direct costs of burn treatment were substantially high and were predicted by the percentage of total body surface area burn and length of hospital stay.


Assuntos
Queimaduras , Hospitais de Ensino , Humanos , Gana , Estudos Transversais , Queimaduras/economia , Queimaduras/terapia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Hospitais de Ensino/economia , Adulto Jovem , Centros de Atenção Terciária/economia , Adolescente , Unidades de Queimados/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Tempo de Internação/economia , Idoso , Efeitos Psicossociais da Doença , Análise de Regressão
8.
Sci Rep ; 14(1): 14982, 2024 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951554

RESUMO

Our objective was to study disparities in access to contraception during the COVID-19 pandemic. We performed a cross-sectional study at the University of Campinas, Brazil using a Google questionnaire applied from December 2021 until February 2022, disseminated via snowball technique. The survey asked about sociodemographic characteristics and contraceptive use, as well as the demand for new methods and difficulties in continuing to use contraceptives during the COVID-19 pandemic. We analyzed 1018 completed questionnaires; in total, 742 (72.9%) were women aged between 20 and 39 years, 746 (73.3%) were White and 602 (59.2%) used contraceptives. During the COVID-19 pandemic, about 23% of respondents changed their method and approximately 20% of respondents looked for new methods. Among the latter, 31.3% reported some difficulty with obtaining guidance on new methods while only 5.3% of the respondents reported some difficulty with continuing their contraceptive. The main difficulty in both cases was the difficulty with getting a healthcare provider appointment. Our results point to a particular epidemiological population, of younger black and biracial women, with lower education and lower income, which suffered health disparities during the COVID-19 pandemic and found difficulties with using contraceptives and accessing family planning services.


Assuntos
COVID-19 , Anticoncepção , Acessibilidade aos Serviços de Saúde , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Brasil/epidemiologia , Feminino , Adulto , Estudos Transversais , Adulto Jovem , Anticoncepção/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , Inquéritos e Questionários , Comportamento Contraceptivo/estatística & dados numéricos , Pandemias , Disparidades em Assistência à Saúde/estatística & dados numéricos
9.
Ghana Med J ; 58(1): 34-43, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38957284

RESUMO

Objectives: To assess and compare the level of Birth Preparedness and Complications Readiness (BPCR) and determine the predicting effect of socio-demographic factors on it among couples in rural and urban communities of Ekiti State. Design: A community-based comparative cross-sectional study. Setting: The study was conducted in twelve rural and twelve urban communities in Ekiti State. Participants: Couples from rural and urban communities. Female partners were women of reproductive age group (15-49 years) who gave birth within twelve months before the survey. Main outcome measures: Proportion of couples that were well prepared for birth and obstetric emergencies, and its socio-demographic determinants. Results: The proportion of couples that were well prepared for birth and its complications was significantly higher in urban (60.5%) than rural (48.4%) communities. The study also revealed that living above poverty line (95% CI=1.01-3.79), parity and spousal age difference less than five years (95% CI=1.09 - 2.40) were positive predictors of BPCR among respondents. Conclusions: Urban residents were better prepared than their rural counterparts. Living above poverty line, parity, and spousal age difference less than five years were positive predictors of BPCR. There is a need to emphasize on educating couples on the importance of identifying blood donors as a vital component of BPCR. Funding: None declared.


Assuntos
População Rural , População Urbana , Humanos , Adulto , Feminino , Nigéria , Estudos Transversais , Pessoa de Meia-Idade , Gravidez , Adulto Jovem , Adolescente , Masculino , Conhecimentos, Atitudes e Prática em Saúde , Complicações do Trabalho de Parto , Paridade , Parto/psicologia , Parto Obstétrico , Inquéritos e Questionários
10.
BMC Public Health ; 24(1): 1757, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956532

RESUMO

BACKGROUND: A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being. METHODS: We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014. RESULTS: Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network. CONCLUSIONS: Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.


Assuntos
Emigrantes e Imigrantes , Emigração e Imigração , Humanos , Feminino , Adulto , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Pessoa de Meia-Idade , Emigração e Imigração/legislação & jurisprudência , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Michigan , Acessibilidade aos Serviços de Saúde , Política Pública , Racismo , Teoria Fundamentada , Pesquisa Qualitativa , Promoção da Saúde/métodos , Adulto Jovem
11.
Rev Bras Epidemiol ; 27: e240033, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38958369

RESUMO

OBJECTIVE: To estimate the probability of infection with hepatitis B (HBV) and C (HCV) viruses in different socioeconomic strata of the population of Recife, Northeast Brazil. METHODS: Study carried out from samples obtained in a survey of residents of a large urban center that had a population base and stratified sampling with random selection of households using the "Brazil Sample" package in the R software. HBV (HBsAg) and anti-HCV was performed using immunochromatographic tests. In cases positive for HBsAg, anti-HBc and HBeAg were tested using chemiluminescence, as well as HBV-DNA using real-time PCR. For cases positive for anti-HCV, the search for this antibody was repeated by chemiluminescence and for HCV-RNA by real-time PCR. The occurrence of HBsAg and anti-HCV cases in the general population was estimated based on a theoretical negative binomial distribution. RESULTS: Among 2,070 samples examined, 5 (0.24%) were HBsAg and 2 (0.1%) anti-HCV positive. The majority of cases had self-reported skin color as black/brown (6/7), education level up to high school (6/7), a steady partner (5/7) and lived in an area of low socioeconomic status (5/7). CONCLUSION: The occurrence of HBsAg and anti-HCV was lower than those previously found in population-based studies and slightly lower than the most recent estimates. Individuals with lower socioeconomic status should be a priority target of public health policies.


Assuntos
Hepatite B , Hepatite C , Fatores Socioeconômicos , Humanos , Brasil/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Criança
12.
Afr J Prim Health Care Fam Med ; 16(1): e1-e8, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38949439

RESUMO

BACKGROUND:  There is a high prevalence of vision impairment and blindness in Africa. The poor access to eye health services, among other barriers, has been found to have a considerable effect on the burden of avoidable vision loss and blindness, particularly in low- and middle-income countries. AIM:  To determine the accessibility of and barriers to the utilisation of eye health services in the Kumasi Metropolis of Ghana. SETTING:  A descriptive cross-sectional survey was conducted in the Kumasi Metropolis of the Ashanti Region in Ghana to identify barriers affecting the utilisation of eye health services. METHODS:  Convenience sampling was used to recruit participants visiting the eye clinics at five selected District Municipal Hospitals for the first time. Data were collected by means of questionnaires and analysed using Statistical Package for Social Sciences (SPSS). RESULTS:  Barriers faced by participants when accessing eye health services included distance to the clinic, cost of services, time spent away from work and/or school, self-medication and long waiting periods. CONCLUSION:  The study found that eye care services in the Kumasi Metropolis, Ghana are largely accessible, but underutilised. Improvement of public health education initiatives through engagement with community groups will also enhance uptake at health care facilities.Contribution: Underutilisation of health services in the Metropolis has been identified in the study and must be addressed by health managers in various sectors. Accessibility is relatively good but can further be improved especially for the elderly to be able to utilise health care services with ease.


Assuntos
Acessibilidade aos Serviços de Saúde , Humanos , Gana , Estudos Transversais , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Adulto , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Inquéritos e Questionários , Idoso , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Oftalmopatias/terapia , Cegueira
13.
Indian J Public Health ; 68(2): 208-213, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38953807

RESUMO

BACKGROUND: Socioeconomic disparity changed healthcare seeking and management cascade of hypertension due to inequity in hypertension care cascade pathway. OBJECTIVES: The inequities in burden and treatment-seeking behavior of hypertension among reproductive age group women were studied from National Family Health Survey-4 (NFHS-4) data. MATERIALS AND METHODS: We analyzed the data from NFHS-4 of women of reproductive age group between 15 and 49 years among the selected households contributing to 699,686 women. Socioeconomic inequities were assessed by expenditure quintile. Inequities in burden and treatment-seeking behavior were reported using the concentration curve and concentration index. RESULTS: The prevalence of hypertension in India was 15% (95% confidence interval: 14.9%-15.4%). One-third (32%) of the hypertensive population received treatment and only 28% of the women had controlled blood pressure. Wealth and education-based inequalities were more in high wealth index. The inequity in screening and awareness was in the northern and northeastern regions. CONCLUSION: There was inequity in the overall hypertension care cascade pathway with more inequity in the northern and northeastern region.


Assuntos
Disparidades em Assistência à Saúde , Hipertensão , Aceitação pelo Paciente de Cuidados de Saúde , Fatores Socioeconômicos , Humanos , Hipertensão/epidemiologia , Hipertensão/terapia , Feminino , Índia/epidemiologia , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Prevalência
14.
Indian J Public Health ; 68(2): 310-313, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38953825

RESUMO

The body mass index (BMI) is a commonly employed metric for determining the nutritional status and health risks associated with weight. Tribal women in India face neglect and discrimination in terms of livelihood, nutrition, education, wealth, and health-care access. The study examined 18,697 tribal women from Bihar, West Bengal, Jharkhand, and Odisha, using data from the National Family Health Survey-5. Multinomial logistic regression has been used to determine how the multiple background factors are associated with the BMI of tribal women. The study found that the prevalence of underweight and overweight was 28.5% and 7.6% among tribal women, respectively. Rural tribal women had a higher likelihood of being underweight, whereas urban women were more likely to be overweight. Odisha had a higher prevalence of underweight tribal women, whereas the prevalence is lower in Bihar. The higher prevalence of underweight among tribal women is alarming and necessitates a reconsideration of health infrastructure in the tribal areas.


Assuntos
Índice de Massa Corporal , Sobrepeso , Magreza , Humanos , Índia/epidemiologia , Índia/etnologia , Feminino , Adulto , Magreza/epidemiologia , Sobrepeso/epidemiologia , Adulto Jovem , Prevalência , Fatores Socioeconômicos , Pessoa de Meia-Idade , Adolescente , Inquéritos Epidemiológicos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Estado Nutricional , Disparidades nos Níveis de Saúde , Fatores Sociodemográficos
16.
Soc Sci Med ; 353: 117068, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38954859

RESUMO

Young people's mental health globally has been in decline. Because of their low perceived need, young people's services tend to be the first cut when budgets are reduced. There is a lack of evidence on how a reduction in services and opportunities for young people is associated with their mental health. Additionally, how this may be magnified by place and the assets and challenges of place. The aim of this study is to explore trends in young people's mental health measured by GHQ-12 over time in the twelve regions of the UK. We estimated an interrupted time series model using 2010 as a break point from which there was a shift in government policy to a prolonged period of large reductions in central government funding. Repeated cross-sectional data on young people aged 16-25 is used from the British Household Panel Survey and its successor survey UK Household Longitudinal Survey. Results showed a statistically significant reduction in mental health for young people living in the North East, Wales, and the East of England. The North East was the region with the largest reduction in funding and saw the greatest reduction in young people's mental health. Next, we look at how reductions in local government expenditure related to services for children and young people: children's social services, education, transportation, and culture; explain the observed decline in mental health. We employ a Blinder-Oaxaca Decomposition approach comparing young people's mental health between 2011 and 2017. Results show a marginally statistically significant decrease in young people's mental health over this time. Unobserved factors related to transport spending and children's social services explain some of this gap. Area level factors such as deprivation, infrastructure, and existing assets need to be considered when distributing funding for young people's services to avoid exacerbating regional inequalities in mental health.


Assuntos
Governo Local , Humanos , Estudos Transversais , Adolescente , Reino Unido , Masculino , Feminino , Estudos Longitudinais , Adulto Jovem , Adulto , Saúde Mental/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Serviços de Saúde Mental/tendências , Serviços de Saúde Mental/economia , Inquéritos e Questionários , Disparidades nos Níveis de Saúde , Financiamento Governamental/tendências , Financiamento Governamental/estatística & dados numéricos , Gastos em Saúde/tendências , Gastos em Saúde/estatística & dados numéricos
17.
J Korean Med Sci ; 39(25): e192, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38952345

RESUMO

BACKGROUND: Balancing parenting and work life poses challenges for women with children, potentially making them vulnerable to depression owing to their dual responsibilities. Investigating working mothers' mental health status is important on both the individual and societal levels. This study aimed to explore the relationship between economic activity participation and depressive symptoms among working mothers. METHODS: This study was a cross-sectional study and used data from the Korea National Health and Nutrition Examination Survey collected in 2014, 2016, 2018, and 2020. The participants in the study were women aged 19 to 50 who were residing with their children. In the total, 3,151 participants were used in the analysis. The independent variable was economic activity, categorized into two groups: 1) economically active and 2) economically inactive. The dependent variable was the depressive symptoms, categorized as present for a Patient Health Questionnaire-9 score of ≥ 10 and absent for a score < 10. Multiple logistic regression analysis was performed to assess the association between economic activity and depressive symptoms, and sensitivity analyses were performed based on the severity of depressive symptoms. RESULTS: Among women with children, economically active women had reduced odds ratio of depressive symptoms compared with economically inactive women (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.36-0.80). In additional analysis, women working as wage earners had the lowest odds of depressive symptoms (OR, 0.43; 95% CI, 0.28-0.66). Women working an average of 40 hours or less per week were least likely to have depressive symptoms (OR, 0.42; 95% CI, 0.25-0.69). CONCLUSION: Economic activity is significantly associated with depressive symptoms among women with children. Environmental support and policy approaches are needed to ensure that women remain economically active after childbirth.


Assuntos
Depressão , Mães , Poder Familiar , Humanos , Feminino , Depressão/epidemiologia , Depressão/psicologia , Adulto , Estudos Transversais , República da Coreia/epidemiologia , Mães/psicologia , Poder Familiar/psicologia , Adulto Jovem , Pessoa de Meia-Idade , Inquéritos Nutricionais , Razão de Chances , Modelos Logísticos , Criança , Mulheres Trabalhadoras/psicologia
18.
BMJ Open ; 14(7): e083870, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38955365

RESUMO

INTRODUCTION: Health behaviours such as exercise and diet strongly influence well-being and disease risk, providing the opportunity for interventions tailored to diverse individual contexts. Precise behaviour interventions are critical during adolescence and young adulthood (ages 10-25), a formative period shaping lifelong well-being. We will conduct a systematic review of just-in-time adaptive interventions (JITAIs) for health behaviour and well-being in adolescents and young adults (AYAs). A JITAI is an emerging digital health design that provides precise health support by monitoring and adjusting to individual, specific and evolving contexts in real time. Despite demonstrated potential, no published reviews have explored how JITAIs can dynamically adapt to intersectional health factors of diverse AYAs. We will identify the JITAIs' distal and proximal outcomes and their tailoring mechanisms, and report their effectiveness. We will also explore studies' considerations of health equity. This will form a comprehensive assessment of JITAIs and their role in promoting health behaviours of AYAs. We will integrate evidence to guide the development and implementation of precise, effective and equitable digital health interventions for AYAs. METHODS AND ANALYSIS: In adherence to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we will conduct a systematic search across multiple databases, including CENTRAL, MEDLINE and WHO Global Index Medicus. We will include peer-reviewed studies on JITAIs targeting health of AYAs in multiple languages. Two independent reviewers will conduct screening and data extraction of study and participant characteristics, JITAI designs, health outcome measures and equity considerations. We will provide a narrative synthesis of findings and, if data allows, conduct a meta-analysis. ETHICS AND DISSEMINATION: As we will not collect primary data, we do not require ethical approval. We will disseminate the review findings through peer-reviewed journal publication, conferences and stakeholder meetings to inform participatory research. PROSPERO REGISTRATION NUMBER: CRD42023473117.


Assuntos
Comportamentos Relacionados com a Saúde , Revisões Sistemáticas como Assunto , Humanos , Adolescente , Adulto Jovem , Projetos de Pesquisa , Promoção da Saúde/métodos , Exercício Físico
19.
Transl Psychiatry ; 14(1): 271, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956031

RESUMO

The Addictions Neuroclinical Assessment (ANA) is a neurobiologically-informed framework designed to understand the etiology and heterogeneity of Alcohol Use Disorder (AUD). Previous studies validated the three neurofunctional domains of ANA: Incentive Salience (IS), Negative Emotionality (NE) and Executive Function (EF) using secondary data. The present cross-sectional observational study assessed these domains in an independent, prospective clinical sample. Adults across the drinking spectrum (N = 300) completed the ANA battery, a standardized collection of behavioral tasks and self-report assessments. Factor analyses were used to identify latent factors underlying each domain. Associations between identified domain factors were evaluated using structural equation models. Receiver operating characteristics analyses were used to determine factors with the strongest ability to classify individuals with problematic drinking and AUD. We found (1) two factors underlie the IS domain: alcohol motivation and alcohol insensitivity. (2) Three factors were identified for the NE domain: internalizing, externalizing, and psychological strength. (3) Five factors were found for the EF domain: inhibitory control, working memory, rumination, interoception, and impulsivity. (4) These ten factors showed varying degrees of cross-correlations, with alcohol motivation, internalizing, and impulsivity exhibiting the strongest correlations. (5) Alcohol motivation, alcohol insensitivity, and impulsivity showed the greatest ability in classifying individuals with problematic drinking and AUD. Thus, the present study identified unique factors underlying each ANA domain assessed using a standardized assessment battery. These results revealed additional dimensionality to the ANA domains, bringing together different constructs from the field into a single cohesive framework and advancing the field of addiction phenotyping. Future work will focus on identifying neurobiological correlates and identifying AUD subtypes based on these factors.


Assuntos
Alcoolismo , Função Executiva , Motivação , Testes Neuropsicológicos , Humanos , Masculino , Feminino , Adulto , Estudos Transversais , Alcoolismo/fisiopatologia , Alcoolismo/psicologia , Função Executiva/fisiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Comportamento Impulsivo/fisiologia , Adulto Jovem , Comportamento Aditivo/psicologia , Comportamento Aditivo/fisiopatologia , Emoções/fisiologia , Análise Fatorial
20.
Med Sci Monit ; 30: e944352, 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38894516

RESUMO

BACKGROUND The use of herbal medicines (HMs) is increasing, which raises concerns of herb-drug interactions (HDIs). This questionnaire-based study aimed to evaluate knowledge of HMs and HDIs in 147 undergraduate nursing students in Riyadh, Saudi Arabia, between March 2022 to June 2022. MATERIAL AND METHODS An online cross-sectional study was conducted among 147 nursing undergraduates at King Saud University, Riyadh, Saudi Arabia from March 2022 to June 2022, using a self-administered 24-item questionnaire. The convenience sampling method was used to evaluate the knowledge of HMs and interactions of anticoagulants, anti-inflammatory drugs, antibiotics, and antiplatelet drugs with herbs like ginkgo biloba, St. John's wort, garlic, ginger, green tea, and chamomile tea. RESULTS The findings of this study reported that 74.8% of the undergraduates used HMs. With regard to HDIs, 20.4% of nursing undergraduates identified the interaction between gingko biloba and drugs like ibuprofen and warfarin, while 13.6% identified interactions between drugs like warfarin with green tea, ginger, and chamomile tea. Regarding general knowledge, 59% of the students (n=84) reported good knowledge of HMs. Previous history of HM use significantly affected the mean HM knowledge score (t=4.635; P=0.0001). CONCLUSIONS To summarize, Saudi nursing students showed a lack of understanding and knowledge of HDIs. Ability to identify specific HDIs, like ginkgo biloba interactions with warfarin and ibuprofen, and warfarin interactions with green tea and ginger, was limited. There is a need to introduce HM and HDI courses in the academic curriculum.


Assuntos
Interações Ervas-Drogas , Estudantes de Enfermagem , Humanos , Arábia Saudita , Estudos Transversais , Feminino , Masculino , Inquéritos e Questionários , Adulto Jovem , Adulto , Conhecimentos, Atitudes e Prática em Saúde , Medicina Herbária/métodos
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