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1.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 40: e2020172, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1250813

RESUMO

ABSTRACT Objective: To screen children under 24 months of age for neuropsychomotor and social-emotional development in a municipality of the Brazilian semi-arid region, using the Survey of Well-Being of Young Children (SWYC) scale. Methods: This is a quantitative cross-sectional study with a non-probabilistic sample, involving children aged 1 to 24 months and their respective mothers, recruited from primary care services in the municipality of Picos, Piauí, Northeastern Brazil. The screening for neuropsychomotor and social-emotional development using the SWYC scale also provided information about the family context. In addition, we administered a questionnaire to assess the children's demographic and socioeconomic factors. Descriptive data analysis was performed. Results: The sample consisted mostly of adult mothers (84.0%), with more than 8 years of schooling (83.3%), belonging to the C, D, and E socioeconomic classes (75.3%). The prevalence of suspected cases of delayed neuropsychomotor development and social-emotional changes was 12.7 and 42.2%, respectively. Conclusions: The results point to the existence of children at risk of delayed development, particularly in the social-emotional domain, reaffirming the need to adopt child development screening as a health service routine, with the implementation of appropriate intervention programs.


RESUMO Objetivo: Realizar a triagem para desenvolvimento neuropsicomotor e socioemocional em crianças menores de 24 meses, em município da região do semiárido brasileiro, utilizando a escala Survey of Wellbeing of Young Children (SWYC). Métodos: Estudo transversal, com abordagem quantitativa, amostra não proba­bilística, envolvendo crianças entre 1 e 24 meses e suas respectivas mães, selecionadas em serviços de saúde da atenção básica do município de Picos, Piauí. A triagem do desenvolvimento neuropsicomotor e socioemocional com uso da escala SWYC também forneceu informações sobre o contexto familiar. Além disso, utilizou-se questionário para avaliar fatores demográficos e socioeconômicos das crianças. Realizou-se a análise descritiva dos dados. Resultados: A amostra foi constituída de mães em sua maioria adultas (84,0%), com mais de oito anos de estudo (83,3%), pertencentes às classes socioeconômicas C, D e E (75,3%). A prevalência de casos suspeitos de atraso no desenvolvimento neuropsicomotor e de alterações socioemocionais foi de 12,7 e 42,2%, respectivamente. Conclusões: Os resultados apontam a existência de crianças em risco de desenvolvimento, sobretudo socioemocional, reafirmando a necessidade da adoção da triagem para desenvolvimento infantil como rotina nos serviços de saúde, com a implantação de programas de intervenção apropriados.

2.
Rev. enferm. UERJ ; 29: e57581, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224578

RESUMO

Objetivo: descrever as características sociodemográficas e de saúde de mulheres e homens com 75 anos ou mais de idade, no baseline e follow-up de quatro anos e verificar para mulheres e homens as mudanças nas condições de saúde. Métodos: estudo longitudinal com 109 idosos de 75 anos ou mais de idade de um município no Triângulo Mineiro. A coleta dos dados, realizada em dois momentos (2014-2018), ocorreu no domicílio com a aplicação de instrumentos validados no Brasil. Procederam-se às análises descritiva e teste t pareado (p<0,05). Os projetos foram aprovados pelo Comitê de Ética e Pesquisa com Seres Humanos. Resultados: verificaram-se, em ambos os sexos, aumento do número de morbidades e diminuição do escore total das atividades instrumentais da vida diária. Entre as mulheres observou-se, ainda, aumento do número de quedas e do escore de fragilidade. Conclusão: ao longo do seguimento houve piora nas condições de saúde dos idosos, sendo mais expressiva entre as mulheres.


Objective: to describe the sociodemographic and health characteristics of women and men aged 75 or over, at baseline and after four years of follow-up, and to ascertain changes in their health status. Methods: in this longitudinal study of 109 elderly people aged 75 or over from a city in the Triângulo Mineiro, data were collected at two points (2014 and 2018), at home, by applying instruments validated for use in Brazil. Descriptive analysis and paired t-tests were performed (p < 0.05). The projects were approved by the human research ethics committee. Results: in both genders, the number of morbidities increased and the total score for instrumental activities of daily living decreased. Among women, the number of falls and frailty score also increased. Conclusion: the older people's health status worsened over the course of follow-up, more so among the women.


Objetivo: describir las características sociodemográficas y de salud de mujeres y hombres de 75 años o más, en la base de referencia y el seguimiento durante cuatro años, y verificar los cambios en las condiciones de salud de mujeres y hombres. Métodos: estudio longitudinal con 109 personas mayores, de 75 años o más, de un municipio del Triângulo Mineiro. La recolección de datos, realizada en dos momentos (2014-2018), se realizó en sus domicilios aplicando instrumentos validados en Brasil. Se realizaron análisis descriptivos y prueba t pareada (p <0.05). Los proyectos fueron aprobados por el Comité de Ética en Investigación con Humanos. Resultados: en ambos os sexos, hubo un aumento en el número de morbilidades y una disminución en la puntuación total de las actividades instrumentales de la vida diaria. Entre las mujeres, se observó asimismo un aumento en el número de caídas y la puntuación de fragilidad. Conclusión: a lo largo del seguimiento, las condiciones de salud de las personas mayores empeoraron, más expresivamente entre las mujeres.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Nível de Saúde , Saúde do Idoso , Seguimentos , Estudos Longitudinais , Determinantes Sociais da Saúde
3.
MEDICC Rev ; 23(3-4): 4-6, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34516529
4.
MMWR Morb Mortal Wkly Rep ; 70(35): 1183-1190, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34473682

RESUMO

The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents aged 11-12 years routinely receive tetanus, diphtheria, and acellular pertussis (Tdap); meningococcal conjugate (MenACWY); and human papillomavirus (HPV) vaccines. Catch-up vaccination is recommended for hepatitis B (HepB); hepatitis A (HepA); measles, mumps, and rubella (MMR); and varicella (VAR) vaccines for adolescents whose childhood vaccinations are not current. Adolescents are also recommended to receive a booster dose of MenACWY vaccine at age 16 years, and shared clinical decision-making is recommended for the serogroup B meningococcal vaccine (MenB) for persons aged 16-23 years (1). To estimate coverage with recommended vaccines, CDC analyzed data from the 2020 National Immunization Survey-Teen (NIS-Teen) for 20,163 adolescents aged 13-17 years.* Coverage with ≥1 dose of HPV vaccine increased from 71.5% in 2019 to 75.1% in 2020. The percentage of adolescents who were up to date† with HPV vaccination (HPV UTD) increased from 54.2% in 2019 to 58.6% in 2020. Coverage with ≥1 dose of Tdap, ≥1 dose (and among adolescents aged 17 years, ≥2 doses) of MenACWY remained similar to coverage in 2019 (90.1%, 89.3%, and 54.4% respectively). Coverage increased for ≥2 doses of HepA among adolescents aged 13-17 years and ≥1 dose of MenB among adolescents aged 17 years. Adolescents living below the federal poverty level§ had higher HPV vaccination coverage than adolescents living at or above the poverty level. Adolescents living outside a metropolitan statistical area (MSA)¶ had lower coverage with ≥1 MenACWY and ≥1 HPV dose, and a lower proportion being HPV UTD than adolescents in MSA principal cities. In 2020, the COVID-19 pandemic disrupted routine immunization services. Results from the 2020 NIS-Teen reflect adolescent vaccination coverage before the COVID-19 pandemic. The 2020 NIS-Teen data could be used to assess the impact of the COVID-19 pandemic on catch-up vaccination but not on routine adolescent vaccination because adolescents included in the survey were aged ≥13 years, past the age when most routine adolescent vaccines are recommended, and most vaccinations occurred before March 2020. Continued efforts to reach adolescents whose routine medical care has been affected by the COVID-19 pandemic are necessary to protect persons and communities from vaccine-preventable diseases and outbreaks.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas Meningocócicas/administração & dosagem , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Comitês Consultivos , COVID-19/epidemiologia , Centers for Disease Control and Prevention, U.S. , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Esquemas de Imunização , Masculino , Guias de Prática Clínica como Assunto , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Vacinas Conjugadas/administração & dosagem
5.
Rev Chilena Infectol ; 38(3): 432-437, 2021 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-34479302

RESUMO

Maxence Van der Meersch (1907-1951) was a French writer whose novels encompassed social inequities of the time. Among them, those related to tuberculosis are of special interest. This was a common disease that affected his family members and ultimately caused his death. In his narrations, the author refers to the various signs of the illness, the diagnostic methods, the patients' behaviour, their environment, how it affected their employment situation, the economic difficulties, treatment resources and complications. As the novels' plots are developed throughout the so called "sanatorial age of tuberculosis", the author describes the events occurring in a public sanatorium. The similitude among the situations lived by the writer and his wife, and those of the imaginary couples in the novels are highlighted. During his last years, Van der Meersch's success declined due to the complications of his illness, and because of the harsh criticism towards some of his writings. Particularly, the critiques posed by the medical professionals of the time, who rejected the raw language, inaccurate technical descriptions, and, above all, the promotion of an objected anti-tuberculosis regime.


Assuntos
Tuberculose , Humanos
6.
Yearb Med Inform ; 30(1): 100-104, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34479383

RESUMO

OBJECTIVE: To select the best papers that made original and high impact contributions in the area of human factors and organizational issues in biomedical informatics in 2020. METHODS: A rigorous extraction process based on queries from Web of Science® and PubMed/Medline was conducted to identify the scientific contributions published in 2020 that address human factors and organizational issues in biomedical informatics. The screening of papers on titles and abstracts independently by the two section editors led to a total of 1,562 papers. These papers were discussed for a selection of 12 finalist papers, which were then reviewed by the two section editors, two chief editors, and by three external reviewers from internationally renowned research teams. RESULTS: The query process resulted in 12 papers that reveal interesting and rigorous methods and important studies in human factors that move the field forward, particularly in clinical informatics and emerging technologies such as brain-computer interfaces. This year three papers were clearly outstanding and help advance in the field. They provide examples of applying existing frameworks together in novel and highly illuminating ways, showing the value of theory development in human factors. Emerging themes included several which discussed physician burnout, mobile health, and health equity. Those concerning the Corona Virus Disease 2019 (Covid-19) were included as part of that section. CONCLUSION: The selected papers make important contributions to human factors and organizational issues, expanding and deepening our knowledge of how to apply theory and applications of new technologies in health.


Assuntos
Registros Eletrônicos de Saúde , Equidade em Saúde , Informática Médica/organização & administração , Interface Usuário-Computador , Esgotamento Profissional , Humanos
7.
J Urban Health ; 98(Suppl 1): 15-30, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34480327

RESUMO

Housing is a paradigmatic example of a social determinant of health, as it influences and is influenced by structural determinants, such as social, macroeconomic, and public policies, politics, education, income, and ethnicity/race, all intersecting to shaping the health and well-being of populations. It can therefore be argued that housing policy is critically linked to health policy. However, the extent to which this linkage is understood and addressed in public policies is limited and highly diverse across and within countries. This analysis seeks to describe the linkages between housing policies and health and well-being using examples from three countries at different levels of the wealth spectrum: Singapore, the UK, and Kenya.We conducted a comparative policy analysis across three country contexts (Singapore, the UK, and Kenya) to document the extent to which housing policies address health and well-being, highlighting commonalities and differences among them. To guide our analysis, we used the United Nations (UN) definition of adequate housing as it offers a broad framework to analyze the impact of housing on health and well-being.The anatomy of housing policies has a strong correlation to the provision of adequate housing across Singapore, the UK, and Kenya, especially for vulnerable groups. The paper demonstrates that contextual factors including population composition (i.e., aging versus youthful), political ideologies, legal frameworks (i.e., welfare versus market-based provision of housing), and presence (or absence) of adequate, quality, timely, reliable, robust data systems for decision-making, which are taken up by stakeholders/state, have strong implications of the type of housing policies developed and implemented, in turn directly and indirectly impacting the overall health and well-being of populations.This analysis demonstrates the value of viewing housing policies as public health policies that could significantly impact the health and well-being of populations, especially vulnerable groups. Moreover, the findings highlight the importance of the Health in All Policies approach to facilitate integrated policy responses to address social determinants of health such as housing. This is more critical than ever, given the context of the global pandemic that has led to worsening overall health and well-being.


Assuntos
Habitação , Determinantes Sociais da Saúde , Humanos , Quênia , Política Pública , Singapura , Reino Unido
8.
J Urban Health ; 98(Suppl 1): 51-59, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34480328

RESUMO

The inclusion of social determinants of health offers a more comprehensive lens to fully appreciate and effectively address health. However, decision-makers across sectors still struggle to appropriately recognise and act upon these determinants, as illustrated by the ongoing COVID-19 pandemic. Consequently, improving the health of populations remains challenging. This paper seeks to draw insights from the literature to better understand decision-making processes affecting health and the potential to integrate data on social determinants. We summarised commonly cited conceptual approaches across all stages of the policy process, from agenda-setting to evaluation. Nine conceptual approaches were identified, including two frameworks, two models and five theories. From across the selected literature, it became clear that the context, the actors and the type of the health issue are critical variables in decision-making for health, a process that by nature is a dynamic and adaptable one. The majority of these conceptual approaches implicitly suggest a possible role for data on social determinants of health in decision-making. We suggest two main avenues to make the link more explicit: the use of data in giving health problems the appropriate visibility and credibility they require and the use of social determinants of health as a broader framing to more effectively attract the attention of a diverse group of decision-makers with the power to allocate resources. Social determinants of health present opportunities for decision-making, which can target modifiable factors influencing health-i.e. interventions to improve or reduce risks to population health. Future work is needed to build on this review and propose an improved, people-centred and evidence-informed decision-making tool that strongly and explicitly integrates data on social determinants of health.


Assuntos
COVID-19 , Determinantes Sociais da Saúde , Política de Saúde , Humanos , Pandemias , SARS-CoV-2
9.
Ann Surg Oncol ; 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34490527

RESUMO

BACKGROUND: Little is known about the surgical patterns of American Indian/Alaska Native (AI/AN) breast cancer patients. The purpose of this study is to determine whether there are disparities in breast cancer surgery and radiation therapy between non-Hispanic AI/AN (NH-AI/AN) women and non-Hispanic White (NHW) women. METHODS: Data from the National Program of Cancer Registries of the Centers for Disease Control and Surveillance, Epidemiology, and End Results were used for this cross-sectional study. Female patients with invasive breast cancer diagnosed 2010-2015 were stratified by race/ethnicity, surgical procedure, radiation, and region. Percentage distributions of mastectomy and lumpectomy were compared overall and by region and stage. RESULTS: From 2010 to 2015 there were 3292 NH-AI/AN women and 165,225 NHW women diagnosed with breast cancer. For early stage (AJCC stage 1 and 2), NH-AI/AN women had overall significantly higher percentage of mastectomy (41% vs 34.4%, p < 0.001) and significantly lower percentage of lumpectomy (59% vs 65.6%) compared with NHW women, without significant differences in post-lumpectomy radiation (71% vs 70%). There were regional variations, notably in the Northern Plains, where the percentage of mastectomy for early-stage disease was 48.9% for NH-AI/AN women versus 35.9% for NHW women, and in Alaska with 47% for NH-AI/AN women versus 33.3% for NHW women (p < 0.001). There were no overall significant differences in type of surgery or radiation for late-stage disease between groups. CONCLUSION: This is the first study to show disparities in surgical management of NH-AI/AN women with breast cancer. For early-stage disease, NH-AI/AN women undergo a higher percentage of mastectomy. Future clinical directions could focus on the factors that drive awareness, decision-making, and access to breast conservation.

10.
CMAJ ; 193(35): E1377-E1384, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493564

RESUMO

BACKGROUND: Cannabis use is increasing among young adults, but its effects on cardiovascular health are poorly understood. We aimed to assess the association between recent cannabis use and history of myocardial infarction (MI) in young adults (aged 18-44 yr). METHODS: We performed a cross-sectional study using pooled data from the 2017 and 2018 cohorts of the American Behavioral Risk Factor Surveillance System survey of US adults. We analyzed the association between any recent cannabis use and history of MI using a weighted logistic regression model that adjusted for demographic factors, socioeconomic factors, health-related behaviours, concomitant substance use and other comorbidities. We also assessed this association after stratifying by frequency of use and by primary method of consumption. RESULTS: Among 33 173 young adults (18.5 million weighted), 4610 respondents (3.2 million weighted) reported recent cannabis use (17.5%, 95% confidence interval [CI] 16.8%-18.2%). A history of MI was more frequent among recent cannabis users (n = 61 of 4610, 1.3%) relative to nonusers (n = 240 of 28 563 [0.8%], adjusted odds ratio [OR] 2.07, 95% CI 1.12-3.82). A history of MI was associated with cannabis use of more than 4 times per month (adjusted OR 2.31, 95% CI 1.18-4.50), and with smoking as a primary method of consumption (adjusted OR 2.01, 95% CI 1.02-3.98). INTERPRETATION: Our study provides evidence supporting an association between recent cannabis use and history of MI in young adults. Increasing cannabis use in an at-risk population could have negative implications for cardiovascular health.

11.
CMAJ ; 193(35): E1398-E1399, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493569
12.
J Aging Health ; : 8982643211040706, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470533

RESUMO

OBJECTIVE: To characterize frailty phenotype in a representative cohort of older Americans and examine determinants of health factors. METHODS: Retrospective analysis of data from 5,553 adults ≥60 years old in the 2011-2016 cross-sectional National Health and Nutrition Examination Survey (NHANES). World Health Organization "Determinants of Health" conceptual model was used to prioritize variables for multinomial logistic regression for the outcome of modified Fried frailty phenotype. RESULTS: 482 participants (9%) were frail and 2432 (44%) prefrail. Four factors were highly associated with frailty: difficulty with ≥1 activity of daily living (77%; OR 24.81 p < 0.01), ≥2 hospitalizations in the previous year (17%, OR 3.94 p < 0.01), having >2 comorbidities (27%; OR 3.33 p < 0.01), and polypharmacy (66%; OR 2.38 p < 0.01). DISCUSSION: A modified Fried frailty assessment incorporating five self-reported criteria may be useful as a rapid nursing screen in low-resource settings. These assessments can streamline nursing care coordination and case management activities, thereby facilitating targeted frailty interventions to support healthy aging in vulnerable populations.

13.
Am J Obstet Gynecol ; 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34473964

RESUMO

BACKGROUND: Gender disparities in medicine have been demonstrated in the past, including differences in the attainment of roles in administration and in physician income. OBJECTIVE: Our objective was to determine the differences in Medicare payments based on the provider gender and training track among female pelvic medicine and reconstructive surgeons. STUDY DESIGN: Medicare payments from the Provider Utilization Aggregate Files were used to determine the payments made by Medicare to urogynecologists. This database was merged with the National Provider Identifier registry with information on subspecialty training, years since graduation, and the geographic pricing cost index used for Medicare payment adjustments. Physicians with <90% female patients and those who graduated medical school <7 years ago in obstetrics and gynecology or <8 years ago in urology were excluded. The effects of gender, specialty of training, number of services provided, years of practice, and geographic pricing cost index on physician reimbursement were evaluated using linear mixed modeling. RESULTS: A total of 578 surgeons with female pelvic medicine and reconstructive surgery subspecialty training met the inclusion criteria. Of those, 517 (89%) were trained as gynecologists, whereas 61 (11%) were trained as urologists. Furthermore, 265 (51%) of the gynecology-trained surgeons and 39 (80%) of the urology-trained surgeons were women. Among the urology-trained surgeons, the median female surgeon was paid $85,962 and their male counterparts were paid $121,531 (41% payment difference). In addition, urology-trained female pelvic medicine and reconstructive surgery surgeons performed a median of 1135 services and their male counterparts performed a median of 1793 services (57% volume difference). Similarly, among gynecology-trained surgeons, the median female payment was $59,277 with 880 services performed, whereas male gynecology-trained surgeons received a median of $66,880 with 791 services performed, representing a difference of 12% in payments and 11% in services. With linear mixed modeling, male physicians were paid more than female physicians while controlling for specialty training, number of services performed, years of practice, and geographic pricing cost index (P<.001). CONCLUSION: Although Medicare payments are based on an equation, differences in reimbursement by physician gender exist in female pelvic medicine and reconstructive surgery with female surgeons receiving lower payments from Medicare. The differences in reimbursement could not be solely explained by differences in patient volume, area of practice, or years of experience alone, suggesting that, similar to other fields in medicine, female surgeons in female pelvic medicine and reconstructive surgery are not paid as much as their male counterparts.

14.
Res Nurs Health ; 44(5): 737-739, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34477221
15.
World Neurosurg ; 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34478887

RESUMO

OBJECTIVE: To investigate racial disparities in 30-day postoperative outcomes of craniotomy for glioma resection. METHODS: 2006-2019 American College of Surgeons' National Surgical Quality Improvement Program files were queried for all patients who underwent a craniotomy for a supratentorial glioma resection. Racial disparities in preoperative variables were studied between the demographic cohorts of Asian, African Americans, Hispanics, and Caucasian. Fisher exact tests were used to examine association of preoperative variables with race. Multivariable logistic regression models, adjusted for all preoperative variables associated with race, were used to determine the odds ratios of postoperative outcomes for each demographic cohort in comparison with Caucasian patients. RESULTS: A total of 12,544 patients were identified: 4% Asian, 5% African American, 7% Hispanic, and 85% Caucasian. African American patients had significantly higher adjusted odds than Caucasian patients of major adverse cardiovascular events (adjusted odds ratio [aOR]: 1.827, 95% confidence interval [CI]: 1.155-2.891, P = 0.01), pulmonary events (aOR: 1.683, 95% CI: 1.145-2.473, P = 0.008), and urinary tract infection (aOR: 2.016, 95% CI: 1.221-3.327, P = 0.006). Asian patients had significantly higher odds than Caucasian patients of requiring a transfusion (aOR: 2.094, 95% CI: 1.343-3.266, P = 0.001). All demographic cohorts had higher odds of having an extended length of stay than Caucasian patients. CONCLUSIONS: African American patients who undergo a craniotomy for glioma resection have almost twice the odds of Caucasian patients of having a postoperative major cardiovascular complication, pulmonary complication, or urinary tract infection. All minority groups have higher odds of an extended length of stay as compared with Caucasian patients.

16.
J Evid Based Dent Pract ; 21(3): 101587, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34479663

RESUMO

OBJECTIVE: This meta-evaluation aimed to summarize all available evidence regarding different fissure sealants on occlusal caries prevention, arrest, retention rate, adverse effect, and cost-effectiveness; when compared with no intervention, other preventive or minimally-invasive procedures. MATERIALS AND METHODS: The systematic reviews and meta-analyses were identified via four electronic databases and manual searching. Two independent reviewers performed study selection, data extraction, quality assessment with AMSTAR-2. RESULTS: Among the 366 records yielded, 38 systematic reviews were identified as eligible 24 of them included meta-analyses. Moderate evidence has supported the efficacies of resin-based sealants (RBS) in occlusal caries prevention, arrest and cost-effectiveness compared to no interventions. Low to very low certainty of evidence suggested similar effectiveness of glass-ionomer cements in caries prevention with RBS and more superior performance of resin infiltration in arresting non-cavitated occlusal lesions. CONCLUSION: This meta-evaluation supports the use of RBS on permanent molars to reduce occlusal caries occurrence, arrest lesion progression and alleviate oral health inequalities between individuals of different socioeconomic status. This meta-evaluation also advocates further research on glass-ionomer cements and resin infiltration with respect to their efficacies in caries prevention and arrest.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Cimentos de Ionômeros de Vidro , Humanos , Dente Molar
17.
Public Health ; 198: 218-222, 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34481278

RESUMO

OBJECTIVES: During the COVID-19 pandemic, the prevalence of psychological distress rose from 11% in 2019 to more than 40% in 2020. This study aims to examine the disparities among US adult men and women. STUDY DESIGN: We used 21 waves of cross-sectional data from the Household Pulse Survey that were collected between April and December 2020 for the study. The Household Pulse Survey was developed by the U.S. Census Bureau to document the social and economic impact of COVID-19. METHODS: The study population included four groups of adults: emerging adults (18-24 years); young adults (25-44 years); middle-aged adults (45-64 years); and older adults (65-88 years). Psychological distress was measured by their Generalized Anxiety Disorder score and the Patient Health Questionnaire. The prevalence of psychological stress was calculated using logistic models adjusted for socio-demographic variables including race/ethnicity, education, household income, and household structure. All descriptive and regression analysis considered survey weights. RESULTS: Younger age groups experienced higher prevalence of psychological distress than older age groups. Among emerging adults, the prevalence of anxiety (42.6%) and depression (39.5%) was more than twice as high as older adults who experienced prevalence of anxiety at 20% and depression at 16.6%. Gender differences were also more apparent in emerging adults. Women between 18 and 24 years reported higher differential rates of anxiety and depression than those with men (anxiety: 43.9% vs. 28.3%; depression: 33.3% vs. 24.9%). CONCLUSION: Understanding the complex dynamics between COVID-19 and psychological distress has emerged as a public health priority. Mitigating the negative mental health consequences associated with the COVID-19 pandemic, for younger generations and females in particular, will require local efforts to rebuild capacity for social integration and social connection.

18.
J Psychiatr Res ; 143: 138-143, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34487990

RESUMO

BACKGROUND: Historically, individuals managing serious mental illness (SMI) have often been excluded from research, typically because of concern that these individuals may not be able to understand and provide truly informed consent. As treatment has improved, the assumption that individuals managing SMI may not be capable of consent needs to be re-examined. Systematic exclusion from research may limit empirically tested treatments available for people managing SMI, and may contribute to the health care disparities seen in this population. OBJECTIVES: This article examines this issue by documenting current rates of research exclusion for high disease burden conditions, based on empirical review of studies in ClinicalTrials.gov. RESEARCH DESIGN: Current rates of exclusion from studies for psychiatric conditions were assessed through systematic review of relevant clinical trials on ClinicalTrials.gov. SUBJECTS: Subjects in this inquiry are either articles accessed in the literature reviews, or descriptions of studies in public data on ClinicalTrials.gov. MEASURES: The primary measure was a previously published coding system to document the extent and types of research exclusion related to psychiatric status. RESULTS: Among studies of interventions for substance use disorders and chronic pain, individuals managing SMI were more likely to be excluded than those with other psychiatric disorders at statistically significant levels. This was not the case among studies of interventions for ischemic heart disease. In studies of substance use disorders, 9% explicitly excluded SMI and 83% could exclude people with SMI based on broader exclusion criteria. In studies of chronic pain these two categories of exclusion were 16% and 55%, and in studies of ischemic heart disease, these two categories of exclusion were 1% and 20%. CONCLUSIONS: Evidence indicates that it is ethically and scientifically more appropriate to exclude based on capacity to consent than membership in the group of individuals managing SMI. The discussion outlines techniques researchers can use for more equitable and generalizable sampling.

19.
Transpl Infect Dis ; : e13723, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34494707
20.
Public Health ; 198: 307-314, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34507137

RESUMO

OBJECTIVES: Arts engagement has been positively linked with mental health and well-being; however, socio-economic inequalities may be prevalent in access to and uptake of arts engagement reflecting on inequalities in mental health. This study estimated socio-economic inequality and horizontal inequity (unfair inequality) in arts engagement and depression symptoms of older adults in England. Trends in inequality and inequity were measured over a period of ten years. STUDY DESIGN: This is a repeated cross-sectional study. METHODS: In this analysis, we used data from six waves (waves 2 to 7) of the nationally representative English Longitudinal Study of Ageing. We estimated socio-economic inequality using concentration curves that plot the distribution of arts engagement and depression symptoms against the distribution of wealth. A concentration index was used to measure the magnitude of the inequality. Unfair inequality was then calculated for need-standardised arts engagement using a horizontal inequity index (HII). RESULTS: The study sample included adults aged 50 years and older from waves 2 (2004/2005, n = 6620) to 7 (2014/2015, n = 3329). Engagement with cinema, galleries and theatre was pro-rich unequal, i.e. concentrated among the wealthier, but inequality in depression was pro-poor unequal, i.e. concentrated more among the less wealthy. While pro-rich inequality in arts engagement decreased from wave 2 (conc. index: 0·291, 95% confidence interval 0·27 to 0·31) to wave 7 (conc. index: 0·275, 95% confidence interval 0·24 to 0·30), pro-poor inequality in depression increased from wave 2 (conc. index: -0·164, 95% confidence interval -0·18 to -0·14) to wave 7 (conc. index: -0·189, 95% confidence interval -0·21 to -0·16). Depression-standardised arts engagement showed horizontal inequity that increased from wave 2 (HII: 0·455, 95% confidence interval 0·42 to 0·48) to wave 7 (HII: 0·464, 95% confidence interval 0·42 to 0·50). CONCLUSIONS: Our findings suggest that while socio-economic inequality in arts engagement might appear to have reduced over time, once arts engagement is standardised for need, inequality has actually worsened over time and can be interpreted as inequitable (unfair). Relying on need-unstandardised estimates of inequality might thus provide a false sense of achievement to policy makers and lead to improper social prescribing interventions being emplaced.

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