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1.
Zhonghua Xin Xue Guan Bing Za Zhi ; 48(1): 54-60, 2020 Jan 24.
Artículo en Chino | MEDLINE | ID: mdl-32008296

RESUMEN

Objective: To investigate the sex- and age-specific association between resting heart rate and hypertension in rural adult residents of Henan province. Methods: At baseline, a total of 20 194 participants were randomly selected from Xin'an County of Henan province between July 2007 and August 2008. After excluding participants with hypertension or without resting heart rate data at baseline, and participants died or without hypertension outcome or diagnosed as gestational hypertension during follow-up between July 2013 and October 2014, 10 212 participants were finally included in this study. Multiple linear regression model was used to examine the association between resting heart rate and change of blood pressure. Logistic regression model was used to estimate the association between resting heart rate and risk of hypertension. Results: There were 2 059 new hypertensive cases (839 male) during the 6 years follow-up. After controlling for potential confounders, per 5 beats/minutes increases in resting heart rate was associated with 0.18 mmHg (1 mmHg=0.133 kPa) (95%CI 0.01-0.36 mmHg, P=0.046) absolute increase in systolic blood pressure and 7% higher risk of developing hypertension in women (95%CI 1.03-1.11, P<0.05). Compared with resting heart rate<70 beats/minutes, the adjusted RRs for 76-82 and>82 beats/minutes groups were 1.39 (95%CI 1.18-1.63, P<0.05) and 1.22 (95%CI 1.02-1.45, P<0.05), respectively. For both age groups, increased resting heart rate was positively associated with risk of hypertension in women(RR=1.05(95% CI 1.01-1.10), P<0.05 (the women those <60 years); RR=1.14(95% CI 1.04-1.25), P<0.05 (the women those≥60 years). However, no significant association was found between resting heart rate and hypertension in male residents. Conclusions: Increased resting heart rate is associated with high risk of hypertension in women who live in rural area, especially in elder women of this cohort.


Asunto(s)
Hipertensión , Adulto , Presión Sanguínea , Estudios de Cohortes , Femenino , Frecuencia Cardíaca , Humanos , Masculino , Factores de Riesgo , Población Rural
2.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(1): 42-47, 2020 Feb 01.
Artículo en Chino | MEDLINE | ID: mdl-32037765

RESUMEN

OBJECTIVE: To investigate the status of oral health knowledge, attitude, behavior of 12-15 years old children and provide a theoretical basis of prevention. METHODS: Multi-stage stratified sampling method was used to extract four middle school students from Chongqing districts and counties (2 in the main urban area and 2 suburbs), and their oral health knowledge, attitudes and behaviors were investigated through questionnaires. All data were entered using Epidata and statistical analysis was performed using SPSS 21.0 software. RESULTS: A total of 3 902 valid questionnaires were collected. The proportion of people who had good brushing habits was 39.7% (1 548), the average oral health knowledge accuracy rate was 58.9%, and the average oral health positive attitude was 88.6%. The number of middle school students who attended the dental experience was 54.5% (2 127), and that of the school who received oral health education was 17.5% (681). There were gender and regional differences in brushing habits. CONCLUSIONS: The knowledge and behavior of oral health among 12-15-year-old middle school students in Chongqing need to be improved. Oral health education for middle school students should be strengthened, especially in rural and suburban areas.


Asunto(s)
Educación en Salud Dental , Salud Bucal , Adolescente , Actitud Frente a la Salud , Niño , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Población Rural , Encuestas y Cuestionarios , Cepillado Dental
3.
Medicine (Baltimore) ; 99(6): e19105, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028437

RESUMEN

This study is to explore the quality of life (QoL) of the rural poor elderly in central China (Anhui province) and the influencing factors.A multi-stage random sampling method was used to extract 3352 effective samples of the rural elderly in Anhui, including 1206 poor and 2146 non-poor elderly subjects. Euro QoL 5-dimension questionnaire (EQ-5D) was used for the measurement of QoL. Descriptive statistics and χ test were used to compare and analyze the sociodemographic characteristics and QoL scores between poor and non-poor elderly. Multiple linear regression was used to assess the influencing factors of QoL.There were significant differences in gender, age, education levels, professions, chronic diseases, physical discomfort within 2 weeks, hospitalization within 1 year, economic sources, and migrant workers between the rural poor and non-poor elderly groups. The QoL of rural poor elderly scored significantly higher than the non-poor elderly, in all these five dimensions. The average EuroQol Visual Analogue Scale (EQ-VAS) of poor elderly was 65.689, lower than the non-poor elderly (71.039). After controlling the confounding factors, there was a significant statistical difference in the total utility score of EQ-5D between the poor and non-poor elderly groups.The QoL of poor elderly in central China is lower than non-poor elderly, with the worst dimension of pain/discomfort. The QoL of rural poor elderly in this area could be affected by many factors, to which more attention should be paid.


Asunto(s)
Pobreza , Calidad de Vida , Población Rural , Factores de Edad , Anciano , Anciano de 80 o más Años , China , Femenino , Estado de Salud , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Pobreza/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Encuestas y Cuestionarios
4.
Medicine (Baltimore) ; 99(6): e19135, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028440

RESUMEN

This study is to evaluate the screening methods of cervical cancers for rural females in Kash bachu, Xinjiang, China.A total number of 3000 married females were surveyed, and subjected to the gynecological examination. In these subjects, 1993 females received the careHPV (human papillomavirus) test, while 1007 females underwent the visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI). The subjects positive for careHPV detection were subjected to Cervista, Cobas 4800, and Aptima HPV detection, and Thinprep Cytologic Test (TCT). The subjects positive for 1 detection only received colposcopy cervical biopsy.A total of 569 subjects received the cervical biopsy, and the positive rate was 2.3% (69/3000), while the detection rate for CIN (cervical intraepithelial neoplasia) II and above levels was 1.13% (34/3000). Receiver operator characteristic (ROC) curve analysis showed that, the area under the curve (AUC) value for the careHPV test was 0.671, which was higher than the VIA/VILI (0.619), suggesting higher diagnostic value for the careHPV test. For the Cervista, Cobas 4800, Aptima HPV detection, and TCT methods, the highest AUC value was observed for the TCT method, indicating that the TCT method is the most valuable for the cervical cancer screening.The diagnostic value of careHPV test is superior to the VIA/VILA detection method. The TCT method has the greatest value for the cervical cancer screening. The Cervista HPV detection method should be considered where the conditions are limited.


Asunto(s)
Detección Precóz del Cáncer/métodos , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Biopsia , Cuello del Útero/patología , China , Colposcopía , Femenino , Humanos , Infecciones por Papillomavirus/diagnóstico , Población Rural , Neoplasias del Cuello Uterino/patología
5.
Mymensingh Med J ; 29(1): 5-15, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915329

RESUMEN

Acute post-streptococcal glomerulonephritis (APSGN) is the commonest cause of acute glomerulonephritis (AGN), which usually present with gross hematuria, mild edema, oliguria, hypertension and varying degree of renal insufficiency. It is more common among the population of school going age where poverty, overcrowding and poor hygienic conditions are prevailing. This cross sectional observational study was aimed to know the socio-demographic variables, clinical profile and immediate outcome of AGN in hospitalized children and was conducted in the Pediatric department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from November 2014 to April 2015. A detailed history was taken from the parents in each case with a written questionnaire. A written consent was also taken from the guardian of the including patients and also permission was taken from the ethical committee of MMCH. Thorough clinical examination and available relevant investigations were done in all patients. Progresses of the patient were monitored by daily clinical examinations and also by investigations. Data were analyzed by statistical package for social science (SPSS) windows version 18. Results were verified by doing standard test for significance. Among total 60 cases male was 58.3% & female was 41.7%. The common age group of presentation was between 7-12 years (73%), peak age of incidence was 7-9 years. Most of them came from low socioeconomic status (83.3%), 63.3% from rural area with average 5-6 member's family size. Most of the parents were illiterate. History of (H/O) skin infection was present in 35(58.3%) patients, 15(25%) had H/O sore throat, 15% did not give any H/O infection before presentation. Average duration of gap between infection and appearance of clinical feature was 7-14 days in 73.40%and 15-21 days was in 45.7% in case of sore throat & skin infection respectively. Almost all (95%) patients presented with puffiness of face, others presented with scanty micturition, gross hematuria, respiratory distress, fever, convulsion and altered sensorium. Edema (75%), hypertension (88.3%), pallor (38%), tachypnea (25%), tachycardia (26.7%) were the important clinical findings. Microscopic hematuria was present among 96.66% patients; low complement level was found in 85% cases. There is significant association between low socioeconomic statuses with more hospital stay. Only one patient died due to heart failure and 98.3% patient had complete recovery. Results of this study conclude that most of the patients came from rural illiterate family with low socioeconomic background. Skin infection is the commonest cause of acute glomerulonephritis. Edema, scanty micturation, hematuria and hypertension are the common mode of presentation. Heart failure and hypertensive encephalopathy are the common complication of AGN. Immediate prognosis of AGN was excellent.


Asunto(s)
Glomerulonefritis/diagnóstico , Tiempo de Internación/estadística & datos numéricos , Enfermedad Aguda , Bangladesh/epidemiología , Niño , Estudios Transversales , Femenino , Glomerulonefritis/epidemiología , Humanos , Incidencia , Masculino , Pediatría , Población Rural , Factores Socioeconómicos
6.
Mymensingh Med J ; 29(1): 43-47, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915334

RESUMEN

Hypertension is a major public health challenge to population in socio-economic and epidemiological transition. It is a risk factor for cardiovascular mortality which accounts for 20-50 per cent of all deaths. Hypertension has been recognized among young adults more frequently in recent years. Data regarding hypertension in Bangladesh is often insufficient. The purpose of the study was to find out the risk factors of hypertension in young adults of Bangladesh. The study was conducted among 322 purposively selected young adults aged 20 to 49 years attending in the outpatient department of one public and five private hospitals of Mymensingh and Dhaka division of Bangladesh during the period of January 2018 to December 2018. More than half (54.4%) of the patients were at or below the age of 40 years. Mean age of the patients was 38.7±7.8 years and 58.7% were male. Maximum patients (87.6%) were married and with variable educational and occupational status. More than three fourth of the patients (76.7%) were from urban area whereas 14.3% from rural and 9.0% were from sub-urban area. Family history of hypertension was positive in 86.6% of patients. Blood pressure was categorized according to JNC 7. About half (49.4%) of the patients were stage I hypertensive; 22.4% were stage II hypertensive and 28.3% were pre-hypertensive. The major risk factor was tobacco smoking (46.0%), obesity (29.2%), dyslipidaemia (25.2%), high salt intake 21.8% and use of chewable tobacco (13.7%). Serum creatinine was found raised in 11.5%, cardiomegaly in 2.2% and concentric left ventricular hypertrophy in 18.6% of patients. In 38.5% patients hypertension was complicated affecting heart (27.0%) and kidney (11.5%). Common comorbidities were ischaemic heart diseases (20.5%) and diabetes mellitus (13.4%). Tobacco use, obesity, dyslipidaemia and high salt intake are the major modifiable risk factors found in hypertensive young adults. In addition to medication these factors should be addressed for prevention and effective control of hypertension.


Asunto(s)
Presión Sanguínea/fisiología , Diabetes Mellitus/epidemiología , Cardiopatías/epidemiología , Hipertensión/epidemiología , Adulto , Bangladesh/epidemiología , Comorbilidad , Femenino , Humanos , Hipertensión/diagnóstico , Isquemia/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Población Rural/estadística & datos numéricos , Clase Social , Población Urbana/estadística & datos numéricos , Adulto Joven
7.
Mymensingh Med J ; 29(1): 129-135, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915348

RESUMEN

Tetanus is a potentially preventable neurological infectious disorder with paucity of literature in Bangladesh. We aimed to see the demography and symptom profile of tetanus cases managed at the Infectious disease Hospital Sylhet. This hospital based cross-sectional descriptive study was conducted within the time period of January to December 2012 among 50 consecutive admitted patients in the Infectious Disease Hospital, Sylhet, Bangladesh who were diagnosed as a case of tetanus and fulfilling the inclusion criteria and exclusion criteria. Neonatal tetanus was considered as exclusion criteria and clinical diagnosis of tetanus was considered as the tetanus. Data were collected purposively with pretested predesigned questionnaire. Data were processed manually and analyzed with the help of SPSS Version 16.0. The mean±SD age was 33.00±16.8 years, ranging from 10 to 70 years. Among the 50 respondents, 72.0% were male, 50% from lower class, 34% were students and 30.0% had their educational status of primary level, 60.0% from rural social background. Trismus was found in 98.0% of the cases, rigidity in 96.0% cases, body ache in 94.0% cases, dysphagia in 92.0% cases, neck pain in 78.0% cases, dysarthria in 92.0% cases, reflex spasm in 66.0% cases, opisthotonus in 46.0% cases and urinary retention in 26.0% cases. In this study rural male people with lower socioeconomic status individuals were mostly affected with trismus, rigidity, body ache and dysphagia symptoms.


Asunto(s)
Trastornos de Deglución/etiología , Tétanos/diagnóstico , Trismo/etiología , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Anciano , Bangladesh/epidemiología , Niño , Estudios Transversales , Trastornos de Deglución/epidemiología , Demografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Población Rural , Distribución por Sexo , Factores Socioeconómicos , Tétanos/complicaciones , Tétanos/epidemiología , Tétanos/terapia , Resultado del Tratamiento , Trismo/epidemiología , Adulto Joven
8.
Medicine (Baltimore) ; 99(2): e18625, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914043

RESUMEN

BACKGROUND: Inequality in health and health care remains a rather challenging issue in China, existing both in rural and urban area, and between rural and urban. This study used nationally representative data to assess inequality in both rural and urban China separately and to identify socioeconomic factors that may contribute to this inequality. METHODS: This study used 2008 National Health Services Survey data. Demographic characteristics, income, health status, medical service utilization, and medical expenses were collected. Horizontal inequality analysis was performed using nonlinear regression method. RESULTS: Positive inequity in outpatient services and inpatient service was evident in both rural and urban area of China. Greater inequity of outpatient service use in urban than that in rural areas was evident (horizontal inequity index [HI] = 0.085 vs 0.029). In contrast, rural areas had greater inequity of inpatient service use compared to urban areas (HI = 0.21 vs 0.16). The decomposition analysis found that the household income made the greatest pro-rich contribution in both rural and urban China. However, chronic diseases and aging were also important contributors to the inequality in rural area. CONCLUSION: The inequality in health service in both rural and urban China was mainly attributed to the household income. In addition, chronic disease and aging were associated with inequality in rural population. Those findings provide evidences for policymaker to develop a sustainable social welfare system in China.


Asunto(s)
Utilización de Instalaciones y Servicios/estadística & datos numéricos , Disparidades en Atención de Salud/economía , Aceptación de la Atención de Salud/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , China , Femenino , Gastos en Salud/estadística & datos numéricos , Estado de Salud , Humanos , Renta/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Adulto Joven
9.
Epidemiol Psychiatr Sci ; 29: e92, 2020 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-31928567

RESUMEN

AIMS: Research from high-income countries has implicated travel distance to mental health services as an important factor influencing treatment-seeking for mental disorders. This study aimed to test the extent to which travel distance to the nearest depression treatment provider is associated with treatment-seeking for depression in rural India. METHODS: We used data from a population-based survey of adults with probable depression (n = 568), and calculated travel distance from households to the nearest public depression treatment provider with network analysis using Geographic Information Systems (GIS). We tested the association between travel distance to the nearest public depression treatment provider and 12 month self-reported use of services for depression. RESULTS: We found no association between travel distance and the probability of seeking treatment for depression (OR 1.00, 95% CI 0.98-1.02, p = 0.78). Those living in the immediate vicinity of public depression treatment providers were just as unlikely to seek treatment as those living 20 km or more away by road. There was evidence of interaction effects by caste, employment status and perceived need for health care, but these effect sizes were generally small. CONCLUSIONS: Geographic accessibility - as measured by travel distance - is not the primary barrier to seeking treatment for depression in rural India. Reducing travel distance to public mental health services will not of itself reduce the depression treatment gap for depression, at least in this setting, and decisions about the best platform to deliver mental health services should not be made on this basis.


Asunto(s)
Depresión/terapia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Conducta de Búsqueda de Ayuda , Servicios de Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud , Población Rural/estadística & datos numéricos , Viaje/estadística & datos numéricos , Adulto , Estudios Transversales , Depresión/diagnóstico , Depresión/psicología , Femenino , Sistemas de Información Geográfica , Encuestas de Atención de la Salud , Investigación sobre Servicios de Salud , Humanos , India , Masculino , Vigilancia de la Población , Factores de Tiempo
10.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 18-20, 2020 Jan 06.
Artículo en Chino | MEDLINE | ID: mdl-31914564

RESUMEN

With the acceleration of the population aging in China, the health problems and the demands of health services such as health check-up for rural residents should attract the attention of the whole society. The group standard entitled Health check-up guide for rural residents (T/CHAA 005-2019), was written by experienced researchers from Chinese Center for Disease Control and Prevention and other professional institutes coordinated by Chinese Health Association. The standard aims to establish a service model that takes health information collection as a means, health risk assessment, health risk intervention and information services as the core, improving the health of rural residents as the target.


Asunto(s)
Examen Físico/normas , Guías de Práctica Clínica como Asunto/normas , Población Rural , China , Humanos
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 37-38, 2020 Jan 06.
Artículo en Chino | MEDLINE | ID: mdl-31914566

RESUMEN

This standard stipulates the principles, institutional requirements, inspection items, service modes, data management and utilization requirements for carrying out the health check-up for rural residents. It is applicable to the standardized management of the health check-up for rural residents aged 15 years old and above under the relevant national laws and regulations.


Asunto(s)
Examen Físico/normas , Guías de Práctica Clínica como Asunto/normas , Población Rural , Adolescente , Adulto , China , Humanos , Pautas de la Práctica en Medicina/legislación & jurisprudencia
13.
Forensic Sci Int ; 306: 110062, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31786514

RESUMEN

The renowned work of Clyde Snow and the development of the Equipo Argentino de Anthropología Forense (EAAF) team has inspired the use of forensic anthropological and archaeological skills in human rights interventions around the world. Whether for medico-legal intervention and acquisition of evidence or humanitarian repatriation and identification of human remains, forensic expertise has garnered attention in the global arena. Arguably fulfilling evidentiary and psychosocial needs, there has been growing interest in this post-conflict redress. However, as part of the critique of these interventions, scholars and practitioners have pointed out - primarily in medico-legal investigations - a lack of sensitization of local communities regarding forensic work, increasing the potential for re-traumatization, unrealistic expectations, or an unintentional increase in political tensions. Research regarding forensic intervention and human remains have permeated social sciences, peace and conflict studies, and science and technology studies, revealing both intentional and unintentional impacts of forensic sciences after mass violence. In an effort to mitigate negative impacts of medico-legal or humanitarian interventions, the research described here sought to sensitize communities in Uganda about forensic methods. Findings from this study suggest that sensitization is necessary and desired, and that a multi-step approach can assist in managing expectations.


Asunto(s)
Conflictos Armados , Antropología Forense/organización & administración , Sobrevivientes/psicología , Altruismo , Arqueología , Recursos Audiovisuales , Entierro , Relaciones Comunidad-Institución , Grupos Focales , Antropología Forense/educación , Derechos Humanos , Humanos , Población Rural , Uganda
14.
Ambio ; 49(1): 281-298, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30852779

RESUMEN

The main determinants of agricultural employment are related to households' access to private assets and the influence of inherited social-economic stratification and power relationships. However, despite the recommendations of rural studies which have shown the importance of multilevel approaches to rural poverty, very few studies have explored quantitatively the effects of common-pool resources and household livelihood capitals on agricultural employment. Understanding the influence of access to both common-pool resources and private assets on rural livelihoods can enrich our understanding of the drivers of rural poverty in agrarian societies, which is central to achieving sustainable development pathways. Based on a participatory assessment conducted in rural communities in India, this paper differentiates two levels of livelihood capitals (household capitals and community capitals) and quantifies them using national census data and remotely sensed satellite sensor data. We characterise the effects of these two levels of livelihood capitals on precarious agricultural employment by using multilevel logistic regression. Our study brings a new perspective on livelihood studies and rural economics by demonstrating that common-pool resources and private assets do not have the same effect on agricultural livelihoods. It identifies that a lack of access to human, financial and social capitals at the household level increases the levels of precarious agricultural employment, such as daily-wage agricultural labour. Households located in communities with greater access to collective natural capital are less likely to be agricultural labourers. The statistical models also show that proximity to rural centres and access to financial infrastructures increase the likelihood of being a landless agricultural labourer. These findings suggest that investment in rural infrastructure might increase livelihood vulnerability, if not accompanied by an improvement in the provisioning of complementary rural services, such as access to rural finance, and by the implementation of agricultural tenancy laws to protect smallholders' productive assets.


Asunto(s)
Pobreza , Población Rural , Agricultura , Países en Desarrollo , Economía , Empleo , Composición Familiar , Humanos , India , Factores Socioeconómicos
15.
J Surg Res ; 245: 629-635, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31522036

RESUMEN

BACKGROUND: Emergency general surgery (EGS) accounts for more than 2 million U.S. hospital admissions annually. Low-income EGS patients have higher rates of postoperative adverse events (AEs) than high-income patients. This may be related to health care segregation (a disparity in access to high-quality centers). The emergent nature of EGS conditions and the limited number of EGS providers in rural areas may result in less health care segregation and thereby less variability in EGS outcomes in rural areas. The objective of this study was to assess the impact of income on AEs for both rural and urban EGS patients. MATERIALS AND METHODS: The National Inpatient Sample (2007-2014) was queried for patients receiving one of 10 common EGS procedures. Multivariate regression models stratified by income quartiles in urban and rural cohorts adjusting for sociodemographic, clinical, and other hospital-based factors were used to determine the rates of surgical AEs (mortality, complications, and failure to rescue [FTR]). RESULTS: 1,687,088 EGS patients were identified; 16.60% (n = 280,034) of them were rural. In the urban cohort, lower income quartiles were associated with higher odds of AEs (mortality OR, 1.21 [95% CI, 1.15-1.27], complications, 1.07 [1.06-1.09]; FTR, 1.17 [1.10-1.24] P < 0.001). In the rural context, income quartiles were not associated with the higher odds of AE (mortality OR, 1.14 [0.83-1.55], P = 0.42; complications, 1.06 [0.97-1,16], P = 1.17; FTR, 1.12 [0.79-1.59], P = 0.52). CONCLUSIONS: Lower income is associated with higher postoperative AEs in the urban setting but not in a rural environment. This socioeconomic disparity in EGS outcomes in urban settings may reflect health care segregation, a differential access to high-quality health care for low-income patients.


Asunto(s)
Tratamiento de Urgencia/efectos adversos , Disparidades en Atención de Salud/economía , Renta/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Procedimientos Quirúrgicos Operativos/efectos adversos , Adolescente , Adulto , Servicio de Urgencia en Hospital/estadística & datos numéricos , Tratamiento de Urgencia/estadística & datos numéricos , Fracaso de Rescate en Atención a la Salud/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Mortalidad Hospitalaria , Hospitales Rurales/estadística & datos numéricos , Hospitales Urbanos/estadística & datos numéricos , Humanos , Pacientes Internos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Población Rural/estadística & datos numéricos , Procedimientos Quirúrgicos Operativos/estadística & datos numéricos , Estados Unidos/epidemiología , Población Urbana/estadística & datos numéricos , Adulto Joven
16.
J Surg Res ; 245: 390-395, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31425881

RESUMEN

BACKGROUND: Cesarean sections (c-sections), the most common surgical procedures performed worldwide, are essential in reducing maternal and neonatal deaths. There is a paucity of research studies on c-section care and outcomes in rural African settings. The objective of this study was to describe demographic characteristics, clinical management, and maternal and neonatal outcomes among women receiving c-sections at Kirehe District Hospital (KDH) in rural Rwanda. METHODS: This retrospective cohort study included all women aged ≥ 18 y residing in KDH catchment area who delivered by c-section at KDH between April 1 and September 30, 2017. Demographic and clinical characteristics of these women and their newborns were collected using patient interviews and medical chart extraction. Descriptive analyses were performed, and frequency and percentages are reported. RESULTS: Of the 621 women included in the study, 45.7% (n = 284) were aged 25-34 y; 42.2% (n = 262) were married; 67.5% (n = 419) had primary education; and 75.7% (n = 470) were farmers by occupation. Burundian refugees living in the nearby Mahama Refugee Camp comprised 13.7% (n = 85) of the study population. The most common indication for c-section was having undergone a c-section previously (31.9%, n = 198), followed by acute fetal distress (30.8%, n = 191). Among those with previous c-section as the sole indication for surgery, 85.4% presented as either urgent or emergent cases. Postoperatively, 67.7% spent less than 4 d at the hospital and 96.1% had no postoperative complications before discharge. Approximately 10% (59/572) of neonates were admitted to the neonatal unit, with the most common reason being neonatal infection (59.6%, n = 31). CONCLUSIONS: Our study found that previous delivery via c-section was the primary indication for c-section and that most of these cases were emergent or urgent on presentation. This study highlights the need for further research to explore the feasibility, safety, and appropriateness of vaginal birth after cesarean in rural district hospitals in sub-Saharan Africa.


Asunto(s)
Cesárea/estadística & datos numéricos , Atención Perioperativa , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Complicaciones Posoperatorias/epidemiología , Embarazo , Estudios Retrospectivos , Rwanda/epidemiología , Adulto Joven
17.
Anthropol Anz ; 77(1): 1-11, 2020 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-31845957

RESUMEN

Numerous studies have established a positive association between economic development and physical growth of humans. While South Korea has commonly been credited as the world's fastest growing economy after World War II, multivariate research conducted on the height development of South Koreans remains insufficient, as previous studies were limited to descriptive analysis by exploring broad anthropometric trends. Pooling several waves of the Korea National Health and Nutrition Examination Surveys (KNHANES), heights of men and women were first plotted by sex and birth decade. Heights of men and women increased from about 169 cm to 176 cm and 157 cm to 162 cm, respectively, over the second half of the twentieth century. Next, upon regressing height on basic social, economic, educational and demographic confounding variables contained in the datasets, individuals born in rural districts were found to be significantly shorter by 0.3 to 0.7 cm than their urban counterparts. Yet, residential dummies proxied by administrative provinces did not come out as consistent in the regressions. Expectedly, individuals with a low household income were significantly shorter (by 0.5 to 0.6 cm) than those in the high income group. Most strikingly, individuals with a high education level were 4 to 5 cm taller than those with low education (no or only elementary education). This suggests that educational status has been the most important factor influencing heights of South Koreans. The latter finding has not been given much discussion in the anthropometric literature, which has traditionally focused on gross-nutritional and income indicators as drivers of human growth.


Asunto(s)
Estatura , Escolaridad , Población Rural , Factores Socioeconómicos , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea
18.
Trab. educ. saúde ; 18(1): e0022858, 2020.
Artículo en Portugués | LILACS | ID: biblio-1020985

RESUMEN

Resumo O objetivo foi compreender as principais necessidades e reivindicações de homens trabalhadores rurais frente a uma equipe de Atenção Primária à Saúde, Japonvar, MG, Brasil. Trata-se de um estudo qualitativo, guiado pela abordagem hermenêutica-dialética. Foram realizadas 41 entrevistas em profundidade, registros em diário de campo e coleta de dados secundários. Na análise, utilizamos os níveis de interpretação, permitindo a construção de duas categorias temáticas para as necessidades de saúde: 'aumento no fornecimento de medicamentos' e 'acesso a exames especializados e específicos para a próstata'. Também foram desenvolvidas duas categorias para as reivindicações sociais: 'reconhecimento como usuários do serviço de saúde' e 'grupos de educação em saúde com temáticas masculinas'. A discussão foi alicerçada nos atributos da Atenção Primária à Saúde e na Teoria dos Marcadores Sociais e Interseccionalidades. O estudo possibilitou compreender o processo produtivo, conhecer as características clínico-epidemiológicas e discutir a invisibilidade dos trabalhadores rurais na procura e acesso aos serviços de saúde. Observamos uma valorização do modelo assistencial curativista e a contribuição positiva das reivindicações dos homens para o fortalecimento dos movimentos de luta pelo direito social à saúde.


Abstract The aim was to understand the main needs and demands of male rural workers regarding a Primary Health Care team in Southeastern Brazil. It is a qualitative study, which was guided by the hermeneutic-dialectical approach. We conducted 41 in-depth interviews, recorded notes on field journals, and collected secondary data. In the analysis, we used the levels of interpretation, which enabled the development of two thematic categories for the health needs: "increase in the supply of medicines" and "access to specialized and specific prostate exams." We also developed two categories for the social demands: "acknowledgment as users of the health service" and "education in health groups dealing with male issues." The discussion was based on the attributes of Primary Health Care and on the Social Markers and Intersectionality Theory. The study enabled us to comprehend the production process, to get to know the clinical-epidemiological characteristics, and to discuss the invisibility of the rural workers in the demand for and access to health services. We observed a high regard for the curative care model, and the positive contribution of the demand of the men to the strengthening of the movements of struggle for the right to social health.


Resumen El objetivo fue comprender las principales necesidades y reclamaciones de los trabajadores rurales ante un equipo de Atención Primaria de Salud en sudeste de Brasil. Se trata de un estudio cualitativo, guiado por el enfoque hermenéutico-dialéctico. Se realizaron 41 entrevistas en profundidad, registros diarios de campo y recopilación de datos secundarios. En el análisis se utilizaron los niveles de interpretación, permitiendo la construcción de dos categorías temáticas para las necesidades de salud: "aumento del suministro de medicamentos" y "acceso a exámenes especializados y específicos de próstata". También se desarrollaron dos categorías para reivindicaciones sociales: "reconocimiento como usuarios del servicio de salud" y "grupos de educación sanitaria con temas masculinos". La discusión se basó en los atributos de la Atención Primaria de Salud y en la Teoría de Marcadores Sociales e Interseccionalidades. El estudio permitió comprender el proceso productivo, conocer las características clínicas y epidemiológicas y discutir la invisibilidad de los trabajadores rurales en la búsqueda y acceso a los servicios de salud. Observamos una apreciación del modelo de medicina curativa y la contribución positiva de las reivindicaciones de los hombres para fortalecer los movimientos que luchan por el derecho social a la salud.


Asunto(s)
Humanos , Atención Primaria de Salud , Población Rural , Salud del Hombre , Necesidades y Demandas de Servicios de Salud
19.
J Urol ; 203(1): 108-114, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31430233

RESUMEN

PURPOSE: Compared to urban populations, rural populations rank poorly on numerous health indicators, including cancer outcomes. We examined the relationship of rural residence with stage and treatment among patients with prostate cancer, the second most common malignancy in men. MATERIALS AND METHODS: Using the Pennsylvania Cancer Registry we identified all men diagnosed with prostate cancer between 2009 and 2015. Patients were classified as residing in a rural area, a large town or an urban area using the Rural-Urban Commuting Area classification. Our primary outcomes included indicators of prostate cancer treatment and treatment types but we also examined disease stage and mortality. We used the chi-square tests to assess differences between groups and estimated multivariable logistic regression models to assess the association between rural residence and treatment. RESULTS: We identified 51,024 men diagnosed with localized or metastatic prostate cancer between 2009 and 2015. The overall incidence of prostate cancer decreased during the study period from 416 to 304/100,000 men while the incidence of metastatic disease increased from 336 to 538/100,000. Rural residents were less likely to undergo treatment than urban residents even when stratified by low, intermediate and high risk disease (aOR 0.77, 95% CI 0.64-0.91; aOR 0.71, 95% CI 0.58-0.89; and aOR 0.68, 95% CI 0.53-0.89, respectively). Rural status did not affect the receipt of radiation therapy compared to other treatment types. CONCLUSIONS: Prostate cancer treatment differs between urban and rural residents. Rural residents are less likely to receive treatment even when stratified by disease risk.


Asunto(s)
Neoplasias de la Próstata/terapia , Población Rural , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pennsylvania/epidemiología , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/patología , Sistema de Registros
20.
J Sci Food Agric ; 100(1): 394-400, 2020 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-31637726

RESUMEN

BACKGROUND: The present study examined the potential for 'Smart Food' with respect to contributing to the Sustainable Development Goal 2 of ending malnutrition by 2030, using a small-scale capacity building case study in Oe Be Village, Myingyan district, Mandalay region, Myanmar. Within the study site, refined white rice is the major staple, followed by vegetables and animal source food in inadequate quantities. The protein intake in this particular dry zone community meets only 50% of the daily requirement and even less for those children aged less than 23 months. Therefore, to determine the acceptance and opportunity for legumes and millets which are produced locally, nutritious formulations were introduced for various age groups. In addition, a sensory evaluation of the recipes was conducted to test the acceptance of the nutritious products. RESULTS: Two weeks of the inclusion of millets and pigeonpea in the diets of children aged 6-23 months had a positive impact on wasting, stunting and underweight (P = 0.002, 0.014 and 0.023, respectively). Moreover, the acceptability of these new food products by the children was found to be high. These results indicate an unexplored opportunity for specific millets rich in iron, zinc and calcium, as well as for pigeonpea rich in protein, if prepared in a culturally acceptable way. CONCLUSION: The impact and acceptability of this small scale and short-term intervention indicate the potential for Smart Food products in filling the nutrition gap arising from the traditional food consumption habits in the dry zones of Myanmar. © 2019 Society of Chemical Industry.


Asunto(s)
Cajanus/metabolismo , Mijos/metabolismo , Cajanus/química , Calcio en la Dieta/análisis , Calcio en la Dieta/metabolismo , Preescolar , Dieta , Femenino , Humanos , Lactante , Hierro/análisis , Hierro/metabolismo , Masculino , Mijos/química , Mianmar , Estado Nutricional , Población Rural
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