The effect of married status on cancer-specific mortality in nonmetastatic pelvic liposarcoma patients according to sex.

BACKGROUND: In nonmetastatic pelvic liposarcoma patients, it is unknown whether married status is associated with better cancer-control outcome defined as cancer-specific mortality (CSM). We addressed this knowledge gap and hypothesized that married status is associated with lower CSM rates in both male and female patients. METHODS: Within the Surveillance, Epidemiology, and End Results database (2000-2020), nonmetastatic pelvic liposarcoma patients were identified. Kaplan-Meier plots and univariable and multivariable Cox regression models (CRMs) predicting CSM according to marital status were used in the overall cohort and in male and female subgroups. RESULTS: Of 1078 liposarcoma patients, 764 (71%) were male and 314 (29%) female. Of 764 male patients, 542 (71%) were married. Conversely, of 314 female patients, 192 (61%) were married. In the overall cohort, 5-year cancer-specific mortality-free survival (CSM-FS) rates were 89% for married versus 83% for unmarried patients (Δ = 6%). In multivariable CRMs, married status did not independently predict lower CSM (hazard ratio [HR]: 0.74, p = 0.06). In males, 5-year CSM-FS rates were 89% for married versus 86% for unmarried patients (Δ = 3%). In multivariable CRMs, married status did not independently predict lower CSM (HR: 0.85, p = 0.4). In females, 5-year CSM-FS rates were 88% for married versus 79% for unmarried patients (Δ = 9%). In multivariable CRMs, married status independently predicted lower CSM (HR: 0.58, p = 0.03). CONCLUSIONS: In nonmetastatic pelvic liposarcoma patients, married status independently predicted lower CSM only in female patients. In consequence, unmarried female patients should ideally require more assistance and more frequent follow-up than their married counterparts.

New Evidence From Census 2020 on the Residential Segregation of Same-Sex Households: A Research Note.

The 2020 decennial census provides new insights into the demography of same-sex households and can shed light on ongoing debates in urban and gayborhood studies. Although the U.S. Census gives a vast undercount of the LGBTQ population, it is still the largest source of nationally representative data on same-sex households and is accessible over three time points (2000, 2010, 2020). In this research note, we use 2020 census data to examine the residential patterns of same-sex households down to the neighborhood level. By employing the index of dissimilarity, we present results for the 100 largest U.S. cities and 100 largest metropolitan areas that demonstrate moderate yet persistent segregation. In a continuation of prior trends, male same-sex households remain more segregated from different-sex households than do female same-sex households. We find moderate levels of within-group segregation by gender and marital status-representing new demographic trends. Finally, metropolitan areas have a higher dissimilarity index than cities, revealing greater levels of segregation when factoring in suburban areas. We discuss these trends in light of debates regarding the spatial organization of sexuality in residential contexts and outline future avenues for research utilizing recently released 2020 census data.

Adverse childhood experiences, marital status and depressive symptoms in later life among the Chinese middle-aged and older adults : the mediating role of marital status.

BACKGROUND: Many studies have shown that adverse childhood experiences (ACEs) lead to adverse social relations in middle-aged and older adults and harm physical and mental health, but few studies have focused on the impact of ACEs on marital status in middle-aged and older adults and the potential influence of marital status between ACEs and depressive symptoms. PURPOSE: This study aimed to analyze the effect of ACEs on marital status and depressive symptoms in the Chinese middle-aged and older adults, and to explore the mediating role of marital status in the association between ACEs and depressive symptoms in middle-aged and older adults. METHOD: This study used the China Health and Retirement Longitudinal Study (CHARLS) 2014 life history survey and 2015 and 2018 follow-up data to analyze, ten ACEs conditions and marital status were collected by questionnaire, using the Center for Epidemiological Studies Depression Scale (CESD-10) 10-item short form to assess depressive symptoms. The association between cumulative ACEs and marital status was assessed by constructing a multinomial logistic regression (MLR) model, as well as a binary logistic regression model to assess the association between ACEs and depressive symptoms. The mediating role of marital status in the association between ACEs and depressive symptoms was also assessed. RESULTS: A total of 10,246 individuals aged 45 years or older were included in the analysis. Compared to individuals who did not experience ACEs, those who experienced two or more ACEs had a higher risk of being unmarried (seperated/divorced/never married) (OR = 1.67, 95% CI=[1.10,2.51]) and a higher risk of depressive symptoms (OR = 1.66, 95% CI=[1.49,1.84]) in middle and old age. Unmarried status partially mediated the association of ACEs with depressive symptoms. CONCLUSION: Chinese middle-aged and older people who experienced two or more ACEs have higher risks of unmarried status and depressive symptoms, and unmarried status partially mediated the ACEs-depressive symptom association. These findings reveal the fact that we need to develop life-cycle public health strategies to reduce exposure to ACEs and society should give more attention to the marital status of older people, thereby reducing the risk of depression among middle-aged and older adults in China.

Comprehensively evaluating the relationships between marital status and other family factors with cardiovascular disease and long-term overall mortality in the elderly: a study of 48 510 Chinese individuals.

BACKGROUND: Marital status is associated with cardiovascular disease (CVD) incidence and overall mortality, yet limited research on this topic in elderly individuals is available. Our aim was to comprehensively assess the impact of marital status and other family factors on CVD incidence and long-term mortality among elderly people. METHODS: Data from the Chinese Longitudinal Healthy Longevity Survey (2002/2005/2008-2018) for participants aged ≥60 years were analysed. A cross-sectional study initially examined the correlation between spouses, offspring, living arrangements, and CVD using logistic regression. Subsequently, a retrospective cohort study investigated the long-term associations of these factors with overall mortality via Kaplan-Meier and Cox regression analyses. RESULTS: The study involved 48 510 subjects (average age: 87 years). The cross-sectional analysis revealed a correlation between living with a spouse and an increased incidence of heart disease (adjusted OR 1.27, 95% CI 1.04-1.55) and cerebrovascular disease/stroke (adjusted OR 1.26, 95% CI 1.11-1.42). According to the retrospective cohort analysis, living with a spouse significantly reduced overall mortality (adjusted HR 0.84, 95% CI 0.80-0.87), irrespective of marital relationship quality. Conversely, living with offspring (adjusted HR 1.12, 95% CI 1.08-1.16), having more children (adjusted Pnonlinearity = 0.427) or cohabitants (adjusted Pnonlinearity < 0.0001) were associated with increased overall mortality. CONCLUSION: In the elderly population, being married and living with a spouse were not significantly associated with a decrease in CVD incidence but were associated with a reduction in long-term overall mortality. Living with offspring, having more children, or having a larger family size did not replicate the protective effect but indicated greater overall mortality.

Immediate and delayed effects of environmental temperature on schizophrenia admissions in Liuzhou, China, 2013-2020: a time series analysis.

This study aimed to investigate the associations between environmental temperature and schizophrenia admissions in Liuzhou, China. A Poisson generalized linear model combined with a distributed lag nonlinear model was used to analyze the effects of daily mean temperature on schizophrenia admissions from 2013 to 2020 in Liuzhou. Additionally, subgroup analyses were conducted to investigate possible modifications stratified by gender, marital status, and age. In this study, 10,420 schizophrenia admissions were included. The relative risks of schizophrenia admissions increased as the temperature rose, and the lag effects of high temperature on schizophrenia admissions were observed when the daily mean temperature reached 21.65°C. The largest single effect was observed at lag0, while the largest cumulative effect was observed at lag6. The single effects of high temperatures on schizophrenia admissions were statistically significant in both males and females, but the cumulative effects were statistically significant only in males, with the greatest effect at lag0-7. The single effect of high temperatures on admissions for unmarried schizophrenics was greatest at lag5, while the maximum cumulative effect for unmarried schizophrenia was observed at lag0-7. The single effects of high temperatures on schizophrenia admissions were observed in those aged 0-20, 21-40, and 41-60. The cumulative effects for schizophrenics aged 21-40 were observed from lag0-3 to lag0-7, with the maximum effect at lag0-7. In conclusion, the risk of schizophrenia admissions increased as the environmental temperature increased. The schizophrenics who were unmarried appeared to be more vulnerable to the single and cumulative effects of high temperature.

Maternal and foetal risks associated with teenage pregnancy - a comparative retrospective study in Turkey.

BACKGROUND: Adolescent pregnancy is defined as pregnancy occurring in young women between the ages of 10 and 19 years. Adolescent pregnancies, which are among the social healthcare concerns in developed and developing countries, have negative effects on maternal and infant health. Pregnancy in adolescence puts the health of both the mother and child at risk, as adolescent pregnancies have higher rates of eclampsia, systemic infection, low birth weight, and preterm delivery compared to other pregnancies. In this study, the effects of education level, smoking, and marital status on maternal and foetal outcomes in adolescent pregnancies were evaluated. METHODS: The records of a total of 960 pregnant women (480 pregnant adolescents aged 15-19 years and 480 pregnant adult women aged 20-26 years) were examined retrospectively. The demographic data of the groups and maternal and foetal outcomes of the pregnancies were compared. A logistic regression model was established as a statistical method for reducing confounding effects. RESULTS: Unmarried women were statistically significantly more prevalent in the adolescent group (38.3% vs. 7.3%). Among the considered risk factors, preeclampsia (2.9% vs. 0.8%) and smoking (29.8% vs. 9.8%) were statistically significantly more common in the adolescent group. When the groups were compared in terms of risk factors in pregnancy, it was found that pregnancy in adolescence was associated with a 3.04-fold higher risk of smoking, 5.25-fold higher risk of being unmarried, 3.50-fold higher risk of preeclampsia, and 1.70-fold higher risk of intrauterine growth retardation (IUGR). CONCLUSIONS: This study demonstrates an increased risk of preeclampsia, IUGR, and smoking during pregnancy in adolescent pregnant women. These findings can be used to identify adolescent pregnancies requiring specific assistance and to take measures to reduce the probability of adverse outcomes.

In this study, we examine the risks of adolescent pregnancies. Adolescent pregnancy is a public health problem, and it is more common in underdeveloped or developing countries. We believe that non-governmental organisations and governments should take precautions regarding adolescent pregnancies and protect this legally vulnerable sociodemographic group from pregnancy. For healthier and more conscientious pregnancy experiences, mothers must be of appropriate age, having passed the period of adolescence. Adolescent pregnancies, which come with many risks, and especially risks of preeclampsia, premature birth, and maternal death, should be minimised or prevented.

Genetic propensity to depression and the role of partnership status.

Social relationships and genetic propensity are known to affect depression risk, but their joint effects are poorly understood. This study examined the association of a polygenic index for depression with time to antidepressant (AD) purchasing and the moderating role of partnership status. We analysed data from 30,192 Finnish individuals who participated in the FINRISK and Health 2000 and 2011 surveys and had register and medication data available. We measured genetic risk with a polygenic index (PGI) for depression. Depression was assessed through antidepressant purchases. We estimated an accelerated failure time model with partnership status as time-varying and different sets of confounder adjustments. The predicted cumulative hazard of antidepressant purchasing varied across PGI and partnership status. At follow-up year 10, being widowed was associated with the largest cumulative hazard of 0.34 (95%CI: 0.28-0.39) in the 80th and 0.20 (95%CI: 0.17-0.23) in the 20th PGI percentile, followed by divorced, single, married and cohabiting. Cohabiting was associated with a cumulative hazard of 0.19 (95%CI: 0.16-0.23) in the 80th and 0.11 (95%CI: 0.1-0.13) in the 20th PGI percentile. We found no evidence for an interaction between the PGI and partnership status. Results were robust to different model specifications, gender stratification, and the choice of PGI. Although antidepressant purchasing correlated with both PGI and partnership status, we found no evidence that partnership status could partially offset or amplify the association between the PGI for depression and antidepressant purchasing incidence.

Pathways to retirement in West Germany: Does divorce matter?

The aim of this paper is to explore how divorce is linked to pathways to retirement in West Germany and to understand whether and how patterns are gendered. Using German pension insurance data, I employ sequence and cluster analysis to map and group pathways to retirement of women and men who retired in 2018. Pathways to retirement are defined based on monthly pension insurance histories from age 50 to 65. I find nine distinct pathways to retirement, ranging from unemployment to stable low to high income pathways and to an early retirement pathway through the reduced-earnings-capacity pension, the latter representing 9.3% of the sample. Based on multinomial logistic regression models, I analyse how marital status, distinguishing between divorced and (re)married, was related to different pathways to retirement. The results show that divorced people were more likely than married people to retire through indirect and unstable pathways to retirement characterised by early exit from the labour market and receipt of reduced-earnings-capacity pensions and/or unemployment benefits. Whereas the relationship between divorce and pathways to retirement seemed to be overall unfavourable for men, the results for women are more ambiguous. Divorced women were also more likely to retire through a stable high-income pathway than married women. Nevertheless, the results suggest that divorce is associated with an early retirement pathway through the reduced-earnings-capacity pension for both women and men.

Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals.

Background: Physical activity is associated with improved health and function in older adults, yet most older adults are sedentary. Loneliness is associated with decreased physical activity at the cross-section, but longitudinal studies are scarce. We examined longitudinal associations between loneliness and physical activity-and whether they were modified by marital status and network size (the number of children, relatives, and friends a person interacts with at least once a month). Methods: We analyzed data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project with a mean follow-up of 4.8 years (mean age 79.6 ± 7.7, 74.9% women). Loneliness was assessed using the de Jong Gierveld Loneliness Scale. Physical activity was assessed as the frequency with which participants engaged in five categories of activities (e.g., walking, gardening, calisthenics, bicycling, and swimming). Linear mixed effects models examined associations between baseline loneliness and change in physical activity over time after adjusting for demographics, depressive symptoms, global cognition, disability, network size, marital status, social support, and social and cognitive activities. We assessed for effect modification by marital status and network size. Results: Associations between loneliness and physical activity differed by marital status. In widowed individuals, baseline loneliness was associated with a 0.06 h/week greater decrease in physical activity per year compared to those who were not lonely (p = 0.005, CI -0.1, 0.02)-which equaled a 150% decrease in physical activity per year. Loneliness did not predict a statistically significant decrease in physical activity in married or unmarried individuals. Discussion: Loneliness is associated with decreased physical activity in widowed older adults and should be considered in the design of interventions to prevent or slow the decline in physical activity and promote healthy aging.

¿Cuántos años tienes?, ¿estás casado?, ¿tienes hijos? preguntas irrelevantes y discriminación encubierta en la selección de personal / How old are you? are you married? do you have children? irrelevant questions and covert discrimination in personnel selection / Quantos anos você tem? você é casado? você tem filhos? perguntas irrelevantes e discriminação oculta na seleção de pessoal

La selección de personal ha demostrado ser un procedimiento de incalculable valor para las organizaciones. Sin embargo, en la práctica los empleadores suelen (y prefieren) utilizar los métodos de selección de escaza y cuestionable evidencia. En el contexto boliviano, el uso de preguntas personales relacionadas a la edad, estado civil, sexo, raza, embarazo, entre otros, parece estar bastante extendido. Aunque, la utilidad que justifique su inclusión sigue sin demostrarse. En el presente artículo, analizo la relevancia y el soporte de las preguntas personales en función de su contribución para tres propósitos de la selección de personal: validez para predecir el desempeño laboral, reclutamiento y discriminación. Finalmente, proporciono algunas sugerencias: (1) para mejorar la eficiencia de los procesos de selección, y (2) para enmendar y fortalecer las leyes contra la discriminación en la selección de la legislación laboral boliviana.

The selection of personnel has proven to be an invaluable procedure for organizations. However, in practice employers often (and prefer) to use the selection methods of scarce and questionable evidence. In the Bolivian context, the use of personal questions related to age, marital status, sex, race, pregnancy, among others, seems to be quite widespread. Although the usefulness that justifies its inclusion remains unproven. In this article, I analyze the relevance and support of personal questions based on their contribution to three purposes of personnel selection: validity to predict job performance, recruitment, and discrimination. Finally, I provide some suggestions: (1) to improve the efficiency of the selection processes, and (2) to amend and strengthen the laws against discrimination in the selection of Bolivian labor law.

A seleção de pessoal provou ser um procedimento inestimável para as organizações. No entanto, na prática, os empregadores costumam (e preferem) usar métodos de seleção de evidências escassas e questionáveis. No contexto boliviano, o uso de perguntas pessoais relacionadas à idade, estado civil, sexo, raça, gravidez, entre outros, parece ser bastante difundido. Embora a utilidade que justifique a sua inclusão permaneça não comprovada. Neste artigo, analiso a relevância e o suporte de perguntas pessoais com base em sua contribuição para três propósitos de seleção de pessoal: validade para prever o desempenho no trabalho, recrutamento e discriminação. Finalmente, apresento algumas sugestões: (1) melhorar a eficiência dos processos de seleção e (2) alterar e fortalecer as leis contra a discriminação na seleção da legislação trabalhista boliviana.

Factores asociados a la ideación suicida y el dolor crónico en pacientes adultos mayores asistidos en un hospital general de la ciudad de Buenos Aires / Associated factors with suicidal ideation and chronic pain in elderly patients assisted in a general hospital of the city of Buenos Aires

Introducción: el siguiente estudio tuvo como finalidad explorar algunas características demográficas asociadas al dolor crónico y el desarrollo de ideas de suicidio en una población de pacientes mayores de 65 años. Método: se realizó un estudio observacional y analítico de corte transversal mediante el relevamiento de datos a partir historias clínicas de pacientes mayores de 65 años que concurrieron a los consultorios externos del equipo de geriatría del Servicio de Psiquiatría del Hospital Italiano de Buenos Aires, entre junio de 2018 y diciembre de 2018. Resultados: se incluyó en el estudio un total de 222 pacientes, de los cuales 50 (23%) presentaron indicadores de dolor crónico y 33 pacientes (14,6%) lo hicieron de ideación suicida. Mediante estudio de correlación se estableció que estar ocupado, padecer dolor crónico y haber tenido más de una internación psiquiátrica son factores que incrementan el riesgo de presentar ideación suicida. Las variables ideación suicida, edad, y el estado civil ‒separado o divorciado en comparación con estar casado‒ son factores asociados a la presencia de dolor crónico. Conclusiones: el dolor crónico y la ideación suicida son factores que contribuyen a aumentar la fragilidad en personas mayores y deben ser estudiados en mayor profundidad para comprender los distintos modos de expresión de la patología psiquiátrica en esta población. (AU)

Introduction: the following study aimed to explore some demographic characteristics associated with chronic pain and the development of suicidal ideas in a population of patients over 65 years. Method: an cross-sectional observational and analytical study was carried out by collecting data from clinical histories of patients over 65 years of age who attended the external offices of the geriatrics team of the Psychiatry service of the Italian Hospital of Buenos Aires between June 2018 and December 2018. Results: a total of 222 patients were included in the study, of which 50 (23%) presented indicators of chronic pain and 33 patients (14.6%) had suicidal ideation. A correlation study established that being employed, suffering from chronic pain and having had more than one psychiatric hospitalization are factors that increase the risk of presenting suicidal ideation. The variables suicidal ideation, age, and separated or divorced marital status compared to being married are factors associated with the presence of chronic pain. Conclusions: chronic pain and suicidal ideation are factors that contribute to increasing frailty in elderly patients and should be studied in greater depth to understand the different modes of expression of psychiatric pathology in this population. (AU)

Factores de riesgo para intento de suicidio en personas con trastorno depresivo en atención secundaria / Risk factors for suicide attempts in people with depressive disorders treated in secondary health care

Background: Depression is the most common psychiatric disorder in people with suicidal behavior. The knowledge of its risk factors should help to design preventive strategies. Aim: To describe suicidal behavior and risk factors for attempted suicide in people with major depressive disorders (MDD). Material and Methods: A 12-month follow-up study was conducted in 112 outpatients at three psychiatric care centers of Ñuble, Chile, with baseline and quarterly assessments. Demographic, psychosocial and clinical factors as potential risk factors of suicide attempts, were assessed. A clinical interview with DSM-IV diagnostic criteria checklist, Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results: Sixty seven percent of participants had suicidal ideation and 43.8% had attempted suicide. Suicide risk was significantly higher in participants with a single major depressive episode (odds ratio [OR] = 3.98; 95% confidence intervals [CI] = 1,29-12,32 p = 0.02) and those with previous suicide attempts (OR = 13.15; 95% CI = 3,87-44.7 p < 0.01). Young age, not having a partner, being unemployed, having a severe major depressive episode, having psychotic symptoms, having a personality disorder and being devoid of medical illness increased the risk of suicide attempts, but they did not reach statistical significance. Conclusions: Significant risk factors should be specially considered when designing suicide preventive strategies in patients with MDD.

Migrant nurses in Brazil: demographic characteristics, migration flow and relationship with the training process / Enfermeiros migrantes no Brasil: características demográficas, fluxos migratórios e relação com o processo de formação / Enfermeros migrantes en Brasil: características demográficas, flujos migratorios y relación con el proceso de formación

Objective to analyze the migration of nurses in Brazil, describe the demographic characteristics of migrant nurses, the main migration flows, and establish relationships with the training process. Method a descriptive, exploratory study, based on 2010 Census data. The data were analyzed using descriptive statistics. Result there were 355,383 nurses in Brazil in 2010. Of these, 36,479 (10.3%) reported having moved compared to the year 2005: 18,073 (5.1%) for intrastate migration, 17,525 (4.8%) interstate migration, and 871 (0.2%) international migration. Females (86.3%), Caucasians (65.2%), and unmarried (48.3%) nurses prevailed in the population, without considerable variation between groups according to migration situation. The findings indicate that the migration flows are driven by the training process for states that concentrate a greater number of courses and positions in undergraduate and graduate studies, and the motivation of employment opportunity in regions of economic expansion in the country. Conclusion it is necessary to deepen the discussion on the movement of nurses in Brazil, their motivations, and international migration.

Objetivo analisar a migração de enfermeiros no Brasil, descrevendo as características demográficas dos enfermeiros migrantes, os principais fluxos migratórios, estabelecendo relações com o processo formativo. Método estudo descritivo exploratório, a partir dos dados do Censo Demográfico do ano 2010. Os dados foram tratados pela estatística descritiva. Resultado havia 355.383 enfermeiros residentes no Brasil no ano 2010. Desses, 36.479 (10,3%) relataram movimentação na comparação com o ano 2005, sendo 18.073 (5,1%) por migração intraestadual, 17.525 (4,8%) por migração interestadual e 871 (0,2%) por migração internacional. Predominou, na população de enfermeiros, o sexo feminino (86,3%), a raça/cor da pele branca (65,2%) e o estado civil solteiro (48,3%), sem variações consideráveis entre os grupos, segundo a situação de migração. Os achados indicam fluxos de migração orientados pelo processo de formação para Estados que concentram número de cursos e vagas na graduação e pós-graduação stricto sensu e a motivação por oportunidade de empregos em regiões de expansão econômica do país. Conclusão é necessário aprofundar a discussão sobre a movimentação de enfermeiros no Brasil, suas motivações e fluxos migratórios internacionais.

Objetivo analizar la migración de enfermeros en Brasil, describiendo las características demográficas de los enfermeros migrantes, los principales flujos migratorios, estableciendo relaciones con el proceso de formación. Método estudio descriptivo exploratorio, a partir de los datos del Censo Demográfico del año 2010. Los datos se analizaron utilizando la estadística descriptiva. Resultado había 355,383 enfermeros residentes en Brasil en el año 2010. De esos, 36,479 (10.3%) reportaron movimiento en comparación con el año 2005, de los cuales 18,073 (5.1%) fue por migración dentro del estado, 17,525 (4.8%) por migración entre los estado y 871 (0.2%) por migración internacional. Ha predominado, en la población de enfermeros, el sexo femenino (86.3%), la raza/color de la piel blanca (65.2%) y el estado civil soltero (48.3%), sin variaciones considerables entre los grupos, según la situación de migración. Los hallazgos indican flujos de migración motivados por el proceso de formación para Estados que concentra un número de cursos y lugares en a nivel licenciatura y postgrado stricto sensu y la motivación por oportunidad de empleos en regiones de expansión económica del país. Conclusión es necesario profundizar la discusión sobre el movimiento de enfermeros en Brasil, sus motivaciones y flujos migratorios internacionales.

Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus / Variáveis clínicas e sociodemográficas associadas com o estresse relacionado ao diabetes em pacientes com diabetes mellitus tipo 2

ABSTRACT Objective: To evaluate the relation between diabetes-related distress and the clinical and sociodemographic characteristics of type 2 diabetes mellitus patients. Methods: A cross-sectional study based on a secondary analysis of data collected at a specialized care outpatient center in Brazil. Participants completed a questionnaire on sociodemographic and clinical characteristics and the Brazilian version of the Diabetes Distress Scale (B-DDS). Results: About 31% of the 130 eligible patients reported diabetes distress, and the mean B-DDS score was 2.6. Multiple regression analysis showed the B-DDS score was positively correlated with marital status (p=0.0230), use of diet and physical activities for diabetes management (p=0.0180), and use of insulin therapy (p=0.0030). The “emotional burden”, “regimen-related distress”, and “interpersonal distress” domains from B-DDS were associated with the use of insulin therapy (p=0.0010), marital status (p=0.0110), and the presence of three or more comorbidities (p=0.0175). Conclusion: These findings suggest the clinical and sociodemographic variables are relatively weak predictors of diabetes-related distress. The highest scores in the B-DDS were observed in the emotional burden domain, indicating the presence of diabetes distress among the participants of the study.

RESUMO Objetivo: Avaliar a relação entre o estresse relacionado ao diabetes e as características clínicas e sociodemográficas de pacientes com diabetes mellitus do tipo 2. Métodos: Estudo transversal com base na análise secundária de dados coletados em um ambulatório de atendimento terciário no Brasil. Os participantes preencheram um questionário sobre as características sociodemográficas e clínicas, e a versão brasileira da Diabetes Distress Scale (B-DDS). Resultados: Aproximadamente 31% dos 130 pacientes elegíveis relataram estresse relacionado ao diabetes, e a média do escore da B-DDS foi de 2,6. O modelo de regressão múltipla mostrou que a pontuação B-DDS foi positivamente correlacionada com o estado civil (p=0,0230), realização de dieta e atividades físicas (p=0,0180), e uso de insulina (p=0,0030). Os domínios da B-DDS “carga emocional”, “estresse relacionado ao regime terapêutico” e “estresse nas relações interpessoais” foram associados a uso de insulina (p=0,0010), estado civil (p=0,0110) e presença de três ou mais comorbidades (p=0,0175). Conclusão: Estes resultados sugerem que as variáveis clínicas e sociodemográficas são preditores relativamente fracos para o estresse relacionado ao diabetes. No domínio “carga emocional”, foi observada a maior pontuação da B-DDS, indicando a presença do estresse relacionado ao diabetes entre os pacientes deste estudo.

Metabolic syndrome and sexual function in postmenopausal women

ABSTRACT Objective The purpose of this study was to evaluate whether female sexual dysfunction (FSD) is associated with metabolic syndrome (MS) and to identify factors that contribute to FSD in postmenopausal women. Subjects and methods This was a cross-sectional study in 111 sexually active women aged 45-65 years. We applied the Female Sexual Function Index (FSFI) to evaluate the participant’s sexual function and a structured questionnaire to collect demographic, socioeconomic, clinical, anthropometric, and laboratory data. Results The prevalences of MS and FSD were 68.5% and 70.3%, respectively. After logistic regression analysis, we identified the following variables associated with FSD: married status (prevalence ratio [PR] 1.69, 95% confidence interval [95% CI] 1.16-2.47, p < 0.01), 6-10 years elapsed since menopause (PR 1.60, 95% CI 1.22-2.09, p < 0.01), occurrence of climacteric symptoms (PR 1.01, 95% CI 1.00-1.02, p = 0.03), and history of sexual abuse (PR 1.40, 95% CI 1.12-1.73, p < 0.01). Conclusion We found a high prevalence of MS and FSD, but no association between both. Married status, time elapsed since menopause, climacteric symptoms, and history of sexual abuse emerged as factors associated with FSD on multivariate analysis.

Quality of life evaluation of frail elderly in Campinas, São Paulo / Avaliação de qualidade de vida em idosos frágeis em Campinas, SP

Summary Objective: describe the quality of life of frail elderly assisted by the Centro de Referência à Saúde do Idoso (CRI), Campinas, São Paulo, Brazil. Methods: the convenience sample included 122 frail elderly being treated from January 2010 to July 2011, out of a total of 668 frail elderly who were referred to the CRI after application of the brief evaluation form of the elderly, recommended by Ministry of Health, which identifies the elderly with some degree of frailty. Descriptive observational study collected data through sociodemographic questionnaire and quality of life questionnaires: WHOQOL-BREF, WHOQOLOLD and SF-36. Results: the study included 122 frail elderly. Of these, 74.6% (91) were female, mean age 73 years, 46.7% (57) were married, 51.6% (63) had less than 3 years of schooling and 87.7% (107) reported income of one to four minimum wages. The mean total score of the WHOQOL-BREF was 56.6, the WHOQOL-OLD 57.6 and SF-36 Physical Component Summary 34.5 and Mental Component Summary 43.6. Conclusion: knowledge of the impairment profile of quality of life among frail elderly is, therefore, essential for planning health care to this population.

Resumo Objetivo: descrever a qualidade de vida dos idosos frágeis atendidos pelo Centro de Referência à Saúde do Idoso (CRI), de Campinas, São Paulo. Métodos: a amostra de conveniência incluiu 122 idosos frágeis, que iniciaram tratamento a partir de janeiro de 2010 até julho de 2011, de um universo de 668 idosos frágeis encaminhados ao CRI após aplicação da ficha de avaliação breve do idoso, preconizada pelo Ministério da Saúde, que identifica o idoso com algum grau de fragilidade. Estudo observacional descritivo coletou dados por meio de questionário sociodemográfico e questionários de qualidade de vida: WHOQOL-BREF, WHOQOL- -OLD e SF-36. Resultados: participaram do estudo 122 idosos frágeis. Desses, 74,6% (91) eram do sexo feminino, com média de idade de 73 anos, 46,7% (57) eram casados, 51,6% (63) apresentaram até 3 anos de escolaridade e 87,7% (107) informaram renda de um a quatro salários mínimos. O escore total médio do WHOQOL-BREF foi 56,6, o do WHOQOL- OLD, 57,6; e no SF-36 o Componente Físico Sumarizado foi 34,5, enquanto o Componente Mental Sumarizado foi de 43,6. Conclusão: o conhecimento do perfil de comprometimento de qualidade de vida de idosos frágeis é, portanto, fundamental para o planejamento da atenção à saúde dessa população.

Beyond biology: the impact of marital status on survival of patients with adrenocortical carcinoma

Purpose: To analyze the association of marital status and survival of patients with ACC using a population-based database. Material and Methods: Patients with ACC were abstracted from the Surveillance Epidemiology and End Results (SEER) database from 1988-2010 (n=1271). Variables included marital status (married vs single/divorced/widowed (SDW)), gender, age, race, tumor (T) and node (N) classification, receipt of surgery, and SEER stage. Statistical analysis was performed using Cox proportional hazard models to generate hazard ratios and 95% confidence intervals. Results: There were 728 (57.3%) females and median age was 56 years (IQR 44-66). Patients who were alive were more frequently married (65.6% vs 61.6%, p=0.008), female (61.1% vs 58.0%, p=0.001), younger (median 51 vs 57 years, p=0.0001), submitted to adrenalectomy (88.6% vs 63.8%, p<0.0001), and more favorable SEER stage (localized-64.9% vs 29.9%; regional–25.1% vs 30.1%; distant 4.8% vs 31.5%, p<0.0001) compared to patients dead of disease (DOD). On multivariable analysis, factors significantly associated with all-cause mortality were SDW status (HR 1.28, 95% CI 1.091.51), age, non-operative management, and N+ disease. Risk factors for disease-specific mortality included SDW status (HR 1.30, 95% CI 1.07-1.56), age, non-operative management, T-classification, and N+ disease. Conclusions: Marital status is significantly associated with survival in patients with ACC. Our results suggest that the decreased survival seen among SDW individuals highlights an area for further research and needed intervention to reduce disparity.

Prevalência de doação de sangue e fatores associados em Florianópolis, Sul do Brasil: estudo de base populacional / Prevalence of blood donation and associated factors in Florianópolis, Southern Brazil: a population-based study / Prevalencia de la donación de sangre y factores asociados en Florianópolis, sur de Brasil: un estudio basado en la población

Os principais objetivos foram estimar a prevalência de doação de sangue e identificar fatores associados. Foi realizado estudo de base populacional (n = 1.720), incluindo participantes com idade de 20 a 59 anos, residentes em Florianópolis, Região Sul do Brasil. Os participantes relataram doação de sangue alguma vez em 30,6% dos casos, e nos últimos 12 meses em 6,2% dos casos. Entre os últimos, 31,8% afirmaram doação de repetição (mais de uma vez ao ano), 80,4% doação espontânea e 15,9% doação para reposição. De acordo com a regressão de Poisson (p < 0,05), sexo masculino, cor da pele autorreferida preta ou parda, maior faixa etária, maior escolaridade e coabitação com doador de sangue estiveram associados à doação alguma vez. Menor faixa etária e estado conjugal solteiro e maior escolaridade estiveram associados com doação nos últimos 12 meses. Constatamos maior prevalência de doação e maior percentagem de doadores mais jovens nesse grupo, assim como menor porcentagem de doadores de reposição do que previamente descrito no Brasil.

The main objectives of this study were to estimate the prevalence of blood donation and to identify associated factors. A populated-based cross-sectional study was carried out (n = 1,720) including subjects 20 to 59 years of age in Florianópolis, Santa Catarina State, Brazil. Blood donation any time in life and in the previous year was reported by 30.6% and 6.2% of respondents, respectively. Among the latter, 31.8% reported repeat donation (at least twice in the previous year), 80.4% reported voluntary donation, and 15.9% replacement donation. Multivariate Poisson regression (p < 0.05) showed that male gender, black or brown self-reported skin color, higher age group, higher educational level, and living with other blood donors were all associated with ever donating blood, whereas younger age, single marital status, and higher educational level were associated with donating in the previous year. We found higher prevalence of blood donation in the previous year and higher percentage of young donors in this group, as well as lower percentage of replacement donors than previously reported in Brazil.

Los principales objetivos fueron estimar la prevalencia de la donación de sangre e identificar los factores asociados. Se realizó un estudio transversal con base poblacional (n = 1.720), incluyendo personas de edades entre 20 y 59 años, que viven en Florianópolis, sur de Brasil. Los participantes informaron que donaron alguna vez en el 30,6% de los casos, y en los últimos 12 meses en el 6,2% de los casos. De ellos, un 31,8% informó de repetición en la donación, el 80,4% informó al menos una donación voluntaria, y el 15,9% al menos una donación de reposición. De acuerdo con la regresión de Poisson (p < 0,05), el sexo masculino, el color de la piel negro o pardo, mayor edad, mayor nivel educativo, y la habitación compartida con otro donante se asociaron con la donación alguna vez. Una menor edad y el estado civil solo se asociaron con al menos una donación en los últimos 12 meses. Constatamos una mayor prevalencia de la donación de sangre en el último año y un mayor porcentaje de donantes jóvenes de este grupo, así como un menor porcentaje de donantes de reposición, respecto a las cifras publicadas en Brasil.

Associação entre estrutura familiar, nível de escolaridade e emprego da mãe com estilo de vida sedentário em crianças em idade escolar primária / Association between family structure, maternal education level, and maternal employment with sedentary lifestyle in primary school-age children

OBJETIVO: Determinar a associação entre a estrutura familiar, o nível de escolaridade e emprego da mãe com o estilo de vida sedentário em crianças em idade escolar primária. MÉTODO: Foram obtidos os dados de 897 crianças com idade entre 6-12 anos. Foi utilizado um questionário para registrar as informações. O índice de massa corporal (IMC) foi determinado utilizando-se a definição específica para idade e sexo do Centro de Controle e Prevenção de Doenças. As crianças foram classificadas como: peso normal (5º-85º percentil), risco de sobrepeso (percentil > 85º e < 95º), sobrepeso (percentil > 95º). Para análise neste estudo, sobrepeso foi definido como IMC igual ou acima do 85º percentil para cada sexo. As razões de chance ajustadas (RCs ajustadas) foram determinadas para inatividade física utilizando o modelo de regressão logística. RESULTADOS: A prevalência de sobrepeso foi de 40,7%, e estilo de vida sedentário, 57,2%. O percentual de famílias de pais separados foi de 23,5%. Aproximadamente 48,7% das mães apresentaram um nível de escolaridade não aceitável, e 38,8% eram mães que trabalhavam fora de casa. Os resultados do modelo de regressão logística mostram que o fato de viver em um ambiente familiar com pais separados (RCs ajustadas = 1,67; IC 95% = 1,04-2,66) está associado ao estilo de vida sedentário em crianças com sobrepeso. No grupo de crianças com peso normal, a análise de regressão logística mostra que viver em uma família com pais separados, com a mãe apresentando nível de escolaridade não aceitável e/ou trabalhando fora de casa, não eram fatores associados a estilo de vida sedentário. CONCLUSÃO: Morar com uma família de pais separados, mais do que ter um baixo nível de escolaridade materno e uma mãe que trabalha fora, parece estar associado a um estilo de vida sedentário em crianças com sobrepeso em idade escolar primária.

OBJECTIVE: To determine the association between family structure, maternal education level, and maternal employment with sedentary lifestyle in primary school-age children. METHOD: Data were obtained from 897 children aged 6 to 12 years. A questionnaire was used to collect information. Body mass index (BMI) was determined using the age- and gender-specific Centers for Disease Control and Prevention definition. Children were categorized as: normal weight (5th percentile < BMI < 85th percentile), at risk for overweight (85th < BMI < 95th percentile), overweight (> 95th percentile). For the analysis, overweight was defined as BMI at or above the 85th percentile for each gender. Adjusted odds ratios (adjusted ORs) for physical inactivity were determined using a logistic regression model. RESULTS: The prevalence of overweight was 40.7%, and of sedentary lifestyle, 57.2%. The percentage of non-intact families was 23.5%. Approximately 48.7% of the mothers had a non-acceptable educational level, and 38.8% of the mothers worked outside of the home. The logistic regression model showed that living in a non-intact family household (adjusted OR = 1.67; 95% CI = 1.04-2.66) is associated with sedentary lifestyle in overweight children. In the group of normal weight children, logistic regression analysis show that living in a non-intact family, having a mother with a non-acceptable education level, and having a mother who works outside of the home were not associated with sedentary lifestyle. CONCLUSION: Living in a non-intact family, more than low maternal educational level and having a working mother, appears to be associated with sedentary lifestyle in overweight primary school-age children.