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1.
Heliyon ; 10(7): e28376, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38590899

RESUMEN

This article aims to determine the level and trend of the impact of the educational level of CEOs and CFOs on the profitability of real estate and construction companies in Vietnam. Because Vietnam is an emerging economy, insights into the profitability of this market will be lessons learned for other economies with similar characteristics. This quantitative study is based on secondary data collected from audited financial statements, annual reports of 123 Vietnamese real estate and construction companies, and macroeconomic data. Pool OLS, Fixed effect and Random effect regression models and the Hausman test are used to find the appropriate model. The study uses GLS regression to overcome heteroscedasticity and autocorrelation and uses the generalized method of moments (GMM) to overcome endogeneity. We find that the profitability of listed construction and real estate companies with highly educated CEOs is no higher than that of other companies. Furthermore, companies whose CFOs have master's or doctorate degrees are less likely to be profitable. Other findings confirm the heterogeneous effects of operating efficiency, economic growth rate, and financial leverage on different profitability measures. The study also proves that company age, firm size, net working capital, liquidity ratio and inflation rate do not affect profitability.

2.
Clin Neurophysiol ; 161: 27-39, 2024 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-38432186

RESUMEN

OBJECTIVES: This cross-sectional study sought to evaluate the effectiveness of the Montreal Cognitive Assessment (MoCA) and saccade in discerning the cognitive function levels among community populations characterized by diverse educational backgrounds. METHODS: Data from 665 Western China individuals encompassed MoCA scores and saccade performance. The study examined how education level and age influenced these assessments and highlighted the contrasting abilities of these measures in detecting cognitive abnormalities. RESULTS: The saccade model revealed a consistent cognitive impairment prevalence (15.5%) compared to previous clinical data (9.7% to 23.3%), while MoCA exhibited variable rates (25.1% to 52.8%). Notably, saccades and MoCA significantly diverged in detecting cognitive dysfunction. Additionally, education level had a greater impact on MoCA (effect size: 0.272) compared to saccades (0.024) affecting all MoCA sub-items, with age exerting a smaller influence on MoCA (0.037) compared to saccades (0.056). CONCLUSION: Saccades are less susceptible to the influence of education level when compared to MoCA, making saccade a potentially more suitable cognitive screening tool for rural community populations. SIGNIFICANCE: This study represents a pioneering approach by employing saccade detection within community populations to distinguish cognitive function status.

3.
BMC Public Health ; 24(1): 757, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38468229

RESUMEN

BACKGROUND: Disparities in avoidable mortality have never been evaluated in Italy at the national level. The present study aimed to assess the association between socioeconomic status and avoidable mortality. METHODS: The nationwide closed cohort of the 2011 Census of Population and Housing was followed up for 2012-2019 mortality. Outcomes of preventable and of treatable mortality were separately evaluated among people aged 30-74. Education level (elementary school or less, middle school, high school diploma, university degree or more) and residence macro area (North-West, North-East, Center, South-Islands) were the exposures, for which adjusted mortality rate ratios (MRRs) were calculated through multivariate quasi-Poisson regression models, adjusted for age at death. Relative index of inequalities was estimated for preventable, treatable, and non-avoidable mortality and for some specific causes. RESULTS: The cohort consisted of 35,708,459 residents (48.8% men, 17.5% aged 65-74), 34% with a high school diploma, 33.5% living in the South-Islands; 1,127,760 deaths were observed, of which 65.2% for avoidable causes (40.4% preventable and 24.9% treatable). Inverse trends between education level and mortality were observed for all causes; comparing the least with the most educated groups, a strong association was observed for preventable (males MRR = 2.39; females MRR = 1.65) and for treatable causes of death (males MRR = 1.93; females MRR = 1.45). The greatest inequalities were observed for HIV/AIDS and alcohol-related diseases (both sexes), drug-related diseases and tuberculosis (males), and diabetes mellitus, cardiovascular diseases, and renal failure (females). Excess risk of preventable and of treatable mortality were observed for the South-Islands. CONCLUSIONS: Socioeconomic inequalities in mortality persist in Italy, with an extremely varied response to policies at the regional level, representing a possible missed gain in health and suggesting a reassessment of priorities and definition of health targets.


Asunto(s)
Enfermedades Cardiovasculares , Masculino , Femenino , Humanos , Causas de Muerte , Escolaridad , Italia/epidemiología , Clase Social , Factores Socioeconómicos , Mortalidad
4.
J Environ Manage ; 356: 120687, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38547821

RESUMEN

Based on the panel data of 22 inland provinces in China from 2010 to 2020, this study constructs and measures the level of rural ecological environment in China. The impact of the financial performance of green-listed companies on the rural ecological environment and its moderating and threshold effects are analyzed. The following conclusions are drawn: (1) During 2010-2020, China's rural ecological environment shows a trend of "fluctuating-decreasing-rising" with significant regional non-equilibrium characteristics. (2) The financial performance of green-listed companies has a significantly negative impact on rural ecology. This negative impact has a crucial heterogeneous feature, with a more significant negative impact in areas with a higher rural ecological environment index and less substantial performance in regions with a lower rural ecological environment index. (3) There is a significant positive moderating effect of education level and digitalization on the relationship between the financial performance of green-listed companies on the level of rural ecological development. As moderating variables, the digitalization and education level weakens the negative impact of green-listed companies' performance on the ecological environment. The positive impact of the financial performance of green-listed companies on the development level of the rural ecological environment is more vital in areas with higher per capita education levels and digitalization in rural areas. (4) There is a significant threshold effect on the financial performance of green-listed companies on the level of rural ecological development. When the financial performance of green-listed companies exceeds a particular threshold value, the impact of the financial performance of green-listed companies on the development level of the rural ecological environment is significantly positive. Based on the above findings, this paper puts forward corresponding countermeasure suggestions.


Asunto(s)
Ambiente , Planificación Social , China , Desarrollo Económico
5.
Front Public Health ; 12: 1338122, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38496397

RESUMEN

China's one-child policy was in effect from 1982 to 2015. However, the literature examining the association between people's trust in local government and intergenerational transmission of fertility intentions is scarce. To fill this gap, we investigated the impact of individuals' sibship size on their ideal number of children, the mediating effect of their trust in local government on the issue of fertility between two successive generations, and the moderating effect of education level on sibship size related to trust in local governments. Based on the 2019 Chinese Social Survey data, 2,340 respondents aged 18-35 participated in the analysis. The results showed that (i) individuals' number of siblings significantly positively predicted their ideal number of children; (ii) individuals' number of siblings significantly negatively predicted their trust in the local government, which in turn significantly negatively influenced fertility intentions; (iii) the mediating mechanism was significant in residents with higher levels of education, but not in people with lower degrees of education. Fertility-boosting incentives can prioritize couples who are the only child in their family. It is necessary for local governments to improve their credibility and strengthen their pregnancy-related communication with groups with higher levels of education.


Asunto(s)
Intención , Confianza , Femenino , Humanos , Embarazo , Demografía , Fertilidad , Gobierno , Política Pública , Adolescente , Adulto Joven , Adulto
6.
Heliyon ; 10(2): e24630, 2024 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-38304776

RESUMEN

The prevalence of overweight among Chinese children under 5 years of age has been increasing steadily. Using data from China Health and Nutrition Survey (CHNS) spanning from 1991 to 2015, this study investigates the relationship between maternal employment status, maternal education level, and the prevalence of child overweight among Chinese children under 5 years old. The findings indicate that having mothers with low middle school education significantly reduces their children's body mass index z-scores (BMIZ) (p < 0.05). However, no significant association is observed between maternal education level and childhood overweight in urban areas. In rural areas, only when the maternal education level is college or above, there is a significant increase in BMIZ (p < 0.01). The impact of maternal education level on childhood obesity is influenced by household per capita income, and when household per capita income reaches a certain level, higher maternal education is negatively associated with child BMIZ. The study also reveals a significant negative association between maternal employment (p < 0.01),average weekly working days (p < 0.01), and the BMIZ of children under 5 years of age, while the interaction effect between them is positive and significant. This study has recommended some policy interventions, by promoting parental education on child feeding and parenting, providing professional child care, and offering financial subsidies to families with children under 5.

7.
Front Psychol ; 15: 1289158, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38375115

RESUMEN

Aim: The Strengths and Difficulties Questionnaire self-report (SDQ-SR) is a valid instrument for detection of emotional and behavioral problems. The aim of this study was to compare the psychometric properties of the SDQ-SR for low and higher educated adolescents, and to explore its suitability. Methods: We included 426 adolescents. We compared internal consistency for low-educated, i.e., at maximum pre-vocational secondary education, and higher educated adolescents and assessed whether the five-factor structure of the SDQ holds across educational levels. We also interviewed 24 low-educated adolescents, and 17 professionals. Results: On most SDQ subscales the low-educated adolescents had more problematic mean scores than the higher educated adolescents. Findings on the invariance factor analyses were inconsistent, with some measures showing a bad fit of the five factor model, and this occurring relatively more for the low-educated adolescents. Professionals and adolescents reported that the SDQ included difficult wordings. Discussion: Our findings imply that the scale structure of the SDQ-SR is slightly poorer for low educated adolescents. Given this caveat, psychometric properties of the SDQ-SR are generally sufficient for use, regardless of educational level.

8.
J Pediatr Nurs ; 75: 205-212, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38194763

RESUMEN

PURPOSE: The purpose of this study was to examine the correlation between parental education level and outcomes for children with long-term ventilator dependence (LTVD) and their families and whether parent communication behaviors with hospital nurses moderated the relationship. Advances in medical technology and policy changes allow children with LTVD to be cared for at home. The child's diagnosis and disease severity affect their health outcomes, as do their family's social determinants of health (SDoH) such as parent education. DESIGN AND METHODS: This secondary data analysis used chi-square tests to evaluate the correlation between parental education level and outcomes. Generalized linear mixed effect models were used to examine the moderation effect of parent communication behaviors. RESULTS: Lower parental education level was associated with more child respiratory infections and more parental uncertainty within one month following hospital discharge. Lower parent education level was also associated with fewer unplanned contacts with providers within one week post-discharge. Additionally, parent use of Verifying Understanding communication behaviors moderated the relationship between parental education level and number of respiratory infections and amount of parental uncertainty. Finally, parent use of Negotiating Roles moderated the association between education level and number of unplanned visits. CONCLUSIONS: Contradicting previous research, lower parental education level does not consistently correspond to adverse outcomes and may be explained by parents' determination to ensure optimal outcomes for their children with LTVD. PRACTICE IMPLICATIONS: Overall, healthcare providers should not be concerned that children with LTVD will have different outcomes based on their parents' education level.


Asunto(s)
Cuidados Posteriores , Infecciones del Sistema Respiratorio , Niño , Humanos , Alta del Paciente , Padres , Comunicación , Escolaridad , Ventiladores Mecánicos
9.
Front Public Health ; 12: 1197150, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38292911

RESUMEN

Purpose: The purpose of this study was to explore the relationship between education level and health behavior including sleep, work activity, exercise activity, and sedentary behavior among emerging adults. Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2007 and 2018. The study sample included 4,484 emerging adults aged 18-25 years and the weighted participants were 30,057,813. Weighted multivariable regression analysis was performed to investigate the association between education level and the aforementioned health behavior, adjusting for age, gender, race/ethnicity, marital status, poverty-income ratio, BMI, smoking, and alcohol drinking status. Results: This study revealed that higher education level was associated with shorter sleep duration [Fully adjusted model, ß (95% CI): -0.588 (-0.929, -0.246), p < 0.001]. Additionally, those with higher education levels were more likely to allocate time in sedentary behavior [ß (95% CI): 90.162 (41.087, 139.238), p < 0.001]. Moreover, higher education level was related to less work activity [ß (95% CI): -806.991 (-1,500.280, -113.703), p = 0.023] and more exercise activity time [ß (95% CI): 118.196 (-21.992, 258.385), p = 0.097]. Subgroup analysis further verified this trend and detected that males with higher education level tended to participate in less work activity [ß (95% CI): -1,139.972 (-2,136.707, -143.237), p = 0.026] while females with higher education level tended to engage in more exercise activity [Fully adjusted model, ß (95% CI): 141.709 (45.468, 237.950), p = 0.004]. Conclusion: This study highlighted the importance of education level as a significant factor in promoting healthy behavior among emerging adults. The findings underscored the need for the Ministry of Education to prioritize educating this demographic about the significance of maintaining adequate sleep patterns and reducing sedentary habits. Encouraging them to allocate more time for work and physical activities can significantly contribute to their overall wellbeing and success, ultimately fostering a healthier next generation.


Asunto(s)
Ejercicio Físico , Conductas Relacionadas con la Salud , Adulto , Masculino , Femenino , Humanos , Adolescente , Adulto Joven , Encuestas Nutricionales , Análisis de Regresión , Escolaridad
10.
Can J Diabetes ; 2024 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-38218396

RESUMEN

OBJECTIVES: Physical activity is associated with improved health in people with type 1 diabetes. However, physical activity level may be associated with socioeconomic status. The primary aim was to investigate the association between education level and physical activity level amongst people with type 1 diabetes. METHODS: In this cross-sectional study, data on physical activity level (high or low) was measured using the Saltin-Grimby Physical Activity Level Scale, and education level (low, medium, or high) was self-reported. RESULTS: Respondents were recruited from outpatient clinics (Steno Diabetes Centre Aarhus (DK), Nordsjællands Hospital (DK) or Sheffield Diabetes and Endocrine Centre (UK)), by healthcare personnel from September 2019 to July 2021. 324 people with type 1 diabetes were included (54% male, median age 50 years (IQR 30-60)). Education level was low in 10%, medium in 33%, and high in 57%. A logistic regression analysis, adjusted for age, sex, cohabitation status and nationality, found that a medium vs. high education level was associated with lower odds of a high physical activity level OR 0.55 [95% CI 0.32;0.94], p=0.029, while no association was found for low vs. high education level with high physical activity level (OR 0.56 [0.25; 1.29], p=0.173). CONCLUSIONS: Medium education level compared with a high education level was associated with a lower level of physical activity in people with type 1 diabetes. Healthcare professionals are advised to be attentive of physical activity levels amongst people type 1 diabetes. The study was approved by the Danish Data Protection Agency: P-2016-48.s SPONSOR: Peter Lommer Kristensen.

11.
J Affect Disord ; 350: 188-196, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38220112

RESUMEN

BACKGROUND: Previous research suggests that maternal parenting stress is a significant predictor of social-emotional problems in children. However, little is known regarding the mother-child relationship and the effect of maternal adverse childhood experiences (ACEs) on this association. METHODS: Three waves of longitudinal panel data were collected from 2893 Chinese preschoolers with a follow-up interval of 6 months. The mothers of preschoolers were asked to complete anonymous questionnaires concerning demographic variables, maternal ACEs and parenting stress in Wave 1, mother-child relationships in Wave 2, and children's social-emotional problems in Wave 3. The parallel mediation model was conducted to analyze the mediating role of three dimensions of mother-child relationships, and the moderation model was conducted to examine the moderating role of maternal ACEs. RESULTS: The results showed that maternal parenting stress predicted children's social-emotional problems directly or indirectly through the mother-child relationship, with an intimate mother-child relationship mediating this main effect negatively but a conflicted and dependent mother-child relationship mediating this main effect positively. In addition, moderating results indicated that the main effect of maternal parenting stress on children's social-emotional problems was more marked among participants with at least one maternal ACEs than those without maternal ACEs. Furthermore, the moderating effect was only detected in children whose mothers had a high school education or less. LIMITATIONS: The subjectivity of mothers' reports may somewhat reduce the credibility due to the possible overestimation or underestimation of children's social-emotional problems. CONCLUSION: These findings provide new evidence for the effects of maternal parenting stress on children's social-emotional development and highlight the need for more attention to children with mothers having ACE exposure, lower educational level and poor parent-child relationships.


Asunto(s)
Experiencias Adversas de la Infancia , Responsabilidad Parental , Femenino , Humanos , Responsabilidad Parental/psicología , Emociones , Madres/psicología , Relaciones Madre-Hijo/psicología , China
12.
Support Care Cancer ; 32(2): 139, 2024 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-38289479

RESUMEN

BACKGROUND: We investigated the inequalities in health-related quality of life (HRQoL) among cancer survivors in Korea, focusing on income and education levels. The slope index of inequality (SII) and relative index of inequality (RII) were utilized to analyze these disparities. METHODS: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2007 and 2021 was analyzed. The HRQoL was assessed using the EQ-5D questionnaire, which included five problem areas: mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Logistic regression was employed to calculate the odds ratios (ORs) for each education and income level, indicating the probability of reporting problems. Furthermore, the slope index of inequality (SII) and relative index of inequality (RII) were calculated to evaluate the inequalities in HRQoL. RESULTS: Among the 3396 cancer survivors, a considerable proportion reported pain/discomfort (29.6%) and mobility problems (21.1%). The logistic regression results demonstrated a higher likelihood of experiencing problems in all five EQ-5D items among individuals with lower income or education levels. Specifically, compared to the high-income group, the adjusted ORs for mobility problems were 2.19, 1.64, and 1.08 for the low, low-medium, and medium-high-income groups, respectively (p-value < 0.05). Notably, significant income inequalities in HRQoL problems were observed, with the greatest disparities seen in self-care and usual activity problems, as indicated by the SII and RII values. CONCLUSION: Socioeconomic disparities in HRQoL exist among cancer survivors in Korea, particularly related to income levels. Addressing the financial burdens of cancer treatment for individuals with low-income levels may help improve their HRQoL and mitigate these inequalities.


Asunto(s)
Supervivientes de Cáncer , Neoplasias , Humanos , Encuestas Nutricionales , Calidad de Vida , República de Corea , Dolor , Pobreza
13.
Diabet Med ; : e15283, 2024 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-38213059

RESUMEN

AIMS: The aim of the study was to estimate the effect of household relative poverty on the risk of diabetic ketoacidosis at diagnosis of children with type 1 diabetes using an international standard measurement of relative poverty. METHODS: A national population-based retrospective study was conducted. The Swedish National Diabetes Register (NDR) was linked with data from Sweden's public statistical agency (Statistics Sweden). Children who were diagnosed with new-onset type 1 diabetes in the period of 2014-2019 were common identifiers. The definition of diabetic ketoacidosis was venous pH <7.30 or a serum bicarbonate level <18 mmol/L. The exposure variable was defined according to the standard definition of the persistent at-risk-of-poverty rate used by the statistical office of the European Union (Eurostat) and several other European public statistical agencies. Univariate and multi-variable analyses were used to calculate the effect of relative poverty on the risk of diabetic ketoacidosis. RESULTS: Children from households with relative poverty had a 41% higher risk of diabetic ketoacidosis (1.41, CI 1.12-1.77, p = 0.004) and more than double the risk of severe diabetic ketoacidosis (pH <7.10) (RR 2.10, CI 1.35-3.25, p = 0.001), as compared to children from households without relative poverty. CONCLUSIONS: Relative poverty significantly increases the risk of diabetic ketoacidosis at onset of type 1 diabetes in children, even in a high-income country with publicly reimbursed health care.

14.
Artículo en Alemán | MEDLINE | ID: mdl-38233669

RESUMEN

BACKGROUND: In the ongoing professional, societal, and political discussion, the hypothesis is repeatedly put forward that a large portion of patients who independently visit the emergency department could also be treated in other care settings such as by a general practitioner, the statutory medical on-call service, or in emergency clinics. Various reasons are cited for why these alternative care settings are not utilized in these cases. OBJECTIVES: This study investigates the motives of patients who presented independently at the emergency department, as well as the socio-demographic parameters of this study cohort. MATERIALS AND METHODS: The survey was carried out as part of a prospective monocentric observational study of internal medicine patients at a university emergency department. RESULTS: A total of 1086 patients were included in the study. In total, 33% of the study participants visited the emergency department based on a physician's recommendation or referral instead of opting for an alternative care option. The main reason for visiting the emergency department was the subjectively assessed urgency of their symptoms. Among the patients who presented independently at the emergency department, 28% required further inpatient care during the course of treatment. Awareness of alternative care pathways, such as utilizing emergency medical services, seeking care from the statutory medical on-call service, or visiting an emergency clinic, was low. CONCLUSIONS: Emergency departments remain an important point of contact for patients who present there independently, without being brought by emergency medical services. The motives behind why patients choose a visit to the emergency department over treatment in an alternative care setting vary. If alternatives are to be used instead of emergency departments, structures first need to be established or expanded.

15.
Int J Environ Health Res ; : 1-11, 2024 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-38254327

RESUMEN

INTRODUCTION: This study aimed to investigate the relationship between Med-Diet adherence with sustainable nutrition and environmental footprints in academicians. METHODS: The study involved 153 academicians aged 23-64 working in a university in Turkey. Data were collected through a questionnaire including socio-demographic characteristics, anthropometric measurements, Mediterranean Diet Adherence Scale (MEDAS) and Sustainable and Healthy Eating Behaviours Scale (SHEBS). Carbon and water footprints were calculated. RESULTS: All sub-scales of SHEBS were higher in individuals who adhered to Med-Diet than those who did not (p<0.05). The carbon and water footprints of individuals with high adherence to the Med-Diet were lower than those of no adherence (p<0.05). Each 1-point increase in MEDAS score was associated with a 1-point increase in SHEBS score, a 0.15 CO2 eq/kg and a 0.001 m3/year decrease in the amount of carbon and water footprint of food. CONCLUSION: Higher adherence to the Med-Diet was associated with higher sustainable nutrition behaviours, and lower environmental footprints.

16.
J Affect Disord ; 347: 645-655, 2024 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-38008290

RESUMEN

Adolescent depression, as a common problem, has always been the focus of attention and research. However, no consistent conclusion has been drawn on its relationship with parental education level. Therefore, this study used meta-analysis and dose-response analysis techniques to explore the overall relationship between the two, and further explore the moderating factors affecting the relationship between the two through subgroup analysis and meta-regression analysis. After a literature search and screening, a total of 22 literatures were included, including 634,821 adolescents aged 9-25, distributed in 10 countries. The results showed that: (1) Overall parental education level was negatively correlated with adolescent depressive symptoms (RR = 0.88. p < 0.001), and there was a dose-response relationship between the two. (2) Geographical location (p = 0.002 < 0.05) and national economic development (p = 0.03 < 0.05) significantly moderated and affected the association between parental education level and adolescent depression, thus presenting a global inconsistency. The results of this study provide a more accurate conclusion on the relationship between parental education and adolescent depression to some extent, highlight the importance and necessity of considering family, economic and cultural factors when studying and solving adolescent depression problems, and guide us to pay more attention to the cross-regional and cross-cultural differences in adolescent depression problems.


Asunto(s)
Conducta del Adolescente , Depresión , Humanos , Adolescente , Depresión/epidemiología , Padres , Escolaridad
17.
Eur J Obstet Gynecol Reprod Biol ; 293: 9-14, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38096705

RESUMEN

OBJECTIVE: To develop a predictive model for peripartum infection among high risk laboring patients in Cameroon, Africa. STUDY DESIGN: We conducted a secondary analysis of the Cameroon Antibiotic Prophylaxis Trial (NCT03248297), a multicenter 3-arm double-blind randomized controlled trial of oral azithromycin ± amoxicillin among term pregnancies with prolonged labor or rupture of membranes in Cameroon 1/2018-5/2020. Patients with chorioamnionitis prior to randomization, study drug contraindications, or planned cesarean were excluded. The outcome of interest was a composite of maternal peripartum infection (chorioamnionitis, endometritis, sepsis by World Health Organization criteria, wound infection/abscess) diagnosed up to 6 weeks postpartum. Potential predictors were compared between patients with and without the composite outcome, and evaluated at a 0.05 alpha level. Statistically significant exposures were analyzed using multivariable regression (to generate adjusted odds ratios and 95 % confidence intervals) with backwards selection to generate a parsimonious model. Receiver operating characteristic curves with associated area under the curve assessed the model's predictive ability. A nomogram based on the final best fit multivariable model was constructed. RESULTS: Of 756 patients in the parent trial, 652 were analyzed: 45 (7 %) had peripartum infection. Those with infection were more likely to be nulliparous, lower education level, higher gestational age, receive antibiotics per hospital protocols, and undergo cesarean. In our best-fit multivariable model, none/primary education (vs university), cesarean birth, and antibiotic receipt per physician discretion (vs for cesarean prophylaxis) were significantly associated with increased infection risk. This model was moderately predictive (AUC = 0.75, 95 % CI 0.67-0.82). When using this 3 factor model, for a patient with a cesarean birth, receipt of antibiotics per physician discretion, and university education, the probability of peripartum infection was 35 % (95 % CI 0.11-0.73). CONCLUSIONS: While several variables such as parity are associated with infectious morbidity within 6 weeks among high risk laboring patients in Cameroon, only education level, antibiotic indication, and cesarean birth were independently associated, and a model including these 3 factors was moderately predictive. Validation of our findings in a larger population is warranted.


Asunto(s)
Corioamnionitis , Trabajo de Parto , Humanos , Embarazo , Femenino , Corioamnionitis/epidemiología , Camerún/epidemiología , Periodo Periparto , Antibacterianos/uso terapéutico
18.
Front Psychiatry ; 14: 1258272, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38076700

RESUMEN

Background: Switzerland ranks among the top three healthcare systems in the world with regards to healthcare access, suggesting a high degree of health equity. However, Switzerland has few preventive strategies against smoking abuse. The aim of this study is to clarify whether educational level and citizenship status have an influence on the prevalence of smoking in Switzerland and whether there is health inequity related to a lack of preventive strategies. Methods: We based our analysis on publicly available health data published in the Swiss government's Swiss health survey (1992-2017). We compared the prevalence of smoking across the years and correlated these data with levels of educational attainment, citizenship status and age. Results: A continuous significant decline in smokers is observed in the highest education group (TERT). Over time, prevalence was reduced from 29% in 1992 to 23% in 2017 (p < 0.001). The intermediate-level educational group (SEK 2) showed smaller but also significant decline on a 0.05 sigificance level over the same period, from 31% to 29% (p = 0.003). The lowest educational group showed a nonsignificant decline from 28% to 27% (p = 0.6). The population who holds Swiss citizenship showed a decrease in smoking from 28% to 26% within the time frame (p < 0.001). People without Swiss citizenship had a much higher prevalence of smokers, at 38% in 1992 and declining to 32% in 2017 (p < 0.001). All cohorts from age 15 to age 64 have a far higher prevalence of smokers than cohorts at an older age, with the highest prevalence in the 25-34 age group. Conclusion: In Switzerland, individuals with lower levels of education and non-Swiss populations are more susceptible to health risk of smoking. This is despite the existence of a high-quality healthcare system that has nevertheless failed to negated health inequities.

19.
Ren Fail ; 45(2): 2292163, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38087474

RESUMEN

BACKGROUND: Educational attainment significantly influences post-transplant outcomes in kidney transplant patients. However, research on specific attributes of lower-educated subgroups remains underexplored. This study utilized unsupervised machine learning to segment kidney transplant recipients based on education, further analyzing the relationship between these segments and post-transplant results. METHODS: Using the OPTN/UNOS 2017-2019 data, consensus clustering was applied to 20,474 kidney transplant recipients, all below a college/university educational threshold. The analysis concentrated on recipient, donor, and transplant features, aiming to discern pivotal attributes for each cluster and compare post-transplant results. RESULTS: Four distinct clusters emerged. Cluster 1 comprised younger, non-diabetic, first-time recipients from non-hypertensive younger donors. Cluster 2 predominantly included white patients receiving their first-time kidney transplant either preemptively or within three years, mainly from living donors. Cluster 3 included younger re-transplant recipients, marked by elevated PRA, fewer HLA mismatches. In contrast, Cluster 4 captured older, diabetic patients transplanted after prolonged dialysis duration, primarily from lower-grade donors. Interestingly, Cluster 2 showcased the most favorable post-transplant outcomes. Conversely, Clusters 1, 3, and 4 revealed heightened risks for graft failure and mortality in comparison. CONCLUSIONS: Through unsupervised machine learning, this study proficiently categorized kidney recipients with lesser education into four distinct clusters. Notably, the standout performance of Cluster 2 provides invaluable insights, underscoring the necessity for adept risk assessment and tailored transplant strategies, potentially elevating care standards for this patient cohort.


Asunto(s)
Trasplante de Riñón , Obtención de Tejidos y Órganos , Humanos , Receptores de Trasplantes , Supervivencia de Injerto , Donadores Vivos , Escolaridad , Aprendizaje Automático , Rechazo de Injerto/prevención & control
20.
Behav Sci (Basel) ; 13(12)2023 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-38131874

RESUMEN

This study aimed to investigate the disaster or emergency coping skills of people with intellectual disabilities and the factors that affect these skills. The panel survey on the lives of people with disabilities from the 3rd dataset (2020) of the Korea Development Institute for the Disabled was used for this analysis. Response data from 275 people with intellectual disabilities aged 10 years or older were analyzed. Differences between disaster or emergency coping skill levels and sub-questions of skills, according to the general characteristics of people with intellectual disabilities, were identified, as well as factors affecting the level of disaster or emergency coping skills. The results show that the coping skills level was low; among the sub-questions, the use of fire extinguishers and awareness of the location of fire extinguishers or emergency bells in the event of a disaster or emergency were also low. Factors affecting the level of coping skills were found to be the level of education and experience in comprehensive disaster coping training. The results of this study suggest that training and education on disaster or emergency coping skills for people with intellectual disabilities are necessary and that programs should be developed for this purpose.

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