Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.672
Filtrar
1.
Medicine (Baltimore) ; 99(8): e19167, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080095

RESUMEN

To verify the validity of functional health literacy scale and analyze what influences functional health literacy.Using convenience sampling method based on cross-sectional data to select 589 left-behind senior high-school students in an ethnic minority area, using the functional health literacy scale.The scale results were relatively strong, and the absolute fitness index, value-added fitness index, and simple fitness index reached the fitness standards. The overall functional health literacy score was (0.65 ±â€Š0.12), which falls within the upper middle class. Gender(t = 2.40, P < .05), ethnicity (t = 4.28, P < .001), place of residence (t =  = 4.51, P < .001), mother's education level (F = 3.608, P < .05), self-assessment of grades for 1 year (F = 25.781, P < .001), and whether the participant liked the health education content (F = 9.416, P < .001) had impacts on overall functional health literacy.The study results show that relatively satisfactory reliability and validity and can be applied further analysis for improving students functional health literacy levels.


Asunto(s)
Grupos Étnicos/estadística & datos numéricos , Alfabetización en Salud/estadística & datos numéricos , Grupos Minoritarios/estadística & datos numéricos , Encuestas y Cuestionarios/normas , Éxito Académico , Adolescente , China/epidemiología , Estudios Transversales , Femenino , Educación en Salud/estadística & datos numéricos , Humanos , Masculino , Reproducibilidad de los Resultados , República de Corea/etnología , Características de la Residencia/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Factores Sexuales
2.
J Glob Health ; 10(1): 010601, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32082546

RESUMEN

Background: An estimated 1.2 million children under five years of age die each year in India, with pneumonia and diarrhea among the leading causes. Increasing care-seeking is important to reduce mortality and morbidity from these causes. This paper explores the determinants and patterns of care-seeking for childhood illness in rural Pune district, India. Methods: Mothers having at least one child <5 years from the study area of the Vadu Health and Demographic Surveillance System were enrolled in a prospective cohort study. Household sociodemographic information was collected through a baseline questionnaire administered at enrollment. Participants were visited up to six times between July 2015 and February 2016 to collect information on recent childhood acute illness and associated care-seeking behavior. Multivariate logistic regression explored the associations between care-seeking and child, participant, and household characteristics. Results: We enrolled 743 mothers with 1066 eligible children, completing 2585 follow-up interviews (90% completion). Overall acute illness prevalence in children was 26% with care sought from a health facility during 71% of episodes. Multivariable logistic regression showed care-seeking was associated with the number of reported symptoms (Odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.5-3.9) and household insurance coverage (OR = 2.2, 95% CI = 1.1-4.3). We observed an interaction between the associations of illness severity and maternal employment on care-seeking. Somewhat-to-very severe illness was associated with increased care-seeking among both employed (OR = 5.0, 95% CI = 2.2-11.1) and currently unemployed mothers (OR = 7.0, 95% CI = 3.9-12.6). Maternal employment was associated with reduced care-seeking for non-severe illness (OR = 0.3, 95% CI = 0.1-0.7), but not associated with care-seeking for somewhat-to-very severe illness. Child sex was not associated with care-seeking. Conclusions: This study demonstrates the importance of illness characteristics in determining facility-based care-seeking while also suggesting that maternal employment resulted in decreased care-seeking among non-severe illness episodes. The nature of the association between maternal employment and care-seeking is unclear and should be explored through additional studies. Similarly, the absence of male bias in care-seeking should be examined to assess for potential bias at other stages in the management of childhood illness.


Asunto(s)
Diarrea/terapia , Madres/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Neumonía/terapia , Población Rural , Adulto , Preescolar , Diarrea/epidemiología , Diarrea/mortalidad , Empleo/estadística & datos numéricos , Femenino , Humanos , India/epidemiología , Lactante , Recién Nacido , Masculino , Madres/estadística & datos numéricos , Neumonía/epidemiología , Neumonía/mortalidad , Estudios Prospectivos , Población Rural/estadística & datos numéricos , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Adulto Joven
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(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
5.
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
6.
BMC Public Health ; 20(1): 18, 2020 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-31910840

RESUMEN

BACKGROUND: The health-related quality of life (HRQoL) of adolescents with CP in low and middle-income countries is often poor, as is the case in Bangladesh. This exploratory study examined what factors predict the proxy-reported HRQoL of adolescents with CP in rural Bangladesh, a typical low- and middle-income country (LMIC). METHODS: Adolescents with CP (10 to 18y) were identified using the Bangladesh Cerebral Palsy Register. HRQoL was assessed using the Cerebral Palsy Quality of Life-Teens proxy-report questionnaire (CPQoL-Teens), adolescent mental health using the Strengths and Difficulty Questionnaire (SDQ) and caregiver mental health using the Depression, Anxiety and Stress Scale (DASS-21). Theoretical and statistical interests (i.e. bivariate analysis, p < 0.05) identified potential predictors which were entered into hierarchical multiple linear regression (HMLR) models in order of clinical significance; HMLR related adolescent clinical characteristics, adolescent and caregiver mental health and proxies of socioeconomic status to CPQoL-Teens dimensions. RESULTS: One hundred fifty-four adolescents with CP (mean age 15y 1mo, SD 1y 8mo, female 31.2%) participated in this study. Twenty-four factors were identified to explore for relationship to adolescent proxy-reported HRQoL. Fifteen of the factors correlated to one or more CPQoL-Teens dimension; strongest correlation was between 'feelings about functioning' and motor impairment (r = 0.545). Nine were predictive of CPQoL-Teens dimensions; adolescent sex, school attendance, severity of motor impairment, hearing and speech impairment, mother's education, primary caregiver depression and stress, and having a sanitary latrine at home resulting in score changes of between 0.79 (95% CI 0.24 to 1.35) to 35.1 (95% CI 6.03 to 64.22). CONCLUSIONS: Many of the factors predicting the proxy-reported HRQoL of adolescents with CP are amenable to intervention, and have the potential to improve adolescent wellbeing. Several determinants are priorities of the sustainable development goals (SDGs); these findings should inform resource prioritization to improve the wellbeing of adolescents with CP in Bangladesh and other LMICs.


Asunto(s)
Cuidadores/psicología , Parálisis Cerebral/psicología , Áreas de Pobreza , Calidad de Vida/psicología , Población Rural/estadística & datos numéricos , Adolescente , Bangladesh , Femenino , Humanos , Masculino , Análisis Multivariante , Encuestas y Cuestionarios
7.
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
8.
J Surg Res ; 246: 106-112, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31563830

RESUMEN

BACKGROUND: Nongovernmental organizations conduct short-term surgical outreach to lessen the substantial global burden of surgical disease. Long-term outcomes of short-term surgical missions (STSMs) are underreported, raising concern for clinical sequelae and patient satisfaction with essential general surgeries. This study aims to describe long-term follow-up results of one general surgical nongovernmental organization's provision of care in rural Ghana with focus on patient-related outcomes and satisfaction. METHODS: From 2013 to 2018, Tetteh Quarshie Memorial Hospital in Mampong, Ghana, was the host site of annual 1-wk International Surgical Health Initiative (ISHI) STSMs. Beginning in 2016, an ISHI provider-hosted follow-up clinics augmented by mobile telephone support. Surgical patients from 2013 to 2016 were contacted by the local nursing staff and evaluated for long-term outcomes and self-reported satisfaction. RESULTS: Sixty-nine of 256 patients (27%) responded; 39 patients (57%) were interviewed and examined by an ISHI physician, whereas 30 patients (43%) received mobile telephone follow-up. Mean age was 47 (±18) y, with 44% female patients, and mean duration of follow-up was 1.5 (±1) y. Eleven patients (16%) had surgical and anesthesia complications. All patients reported improvement in symptoms and activity level. Eighty-six patients reported complete satisfaction (5/5). Factors associated with reduced patient satisfaction (<5/5) included increased age and complications. CONCLUSIONS: To our knowledge, this is one of the first studies focusing on patient-reported outcomes for the evaluation of long-term follow-up of general surgery STSMs. With mobile technology, long-term follow-up is achievable toward obtaining meaningful outcomes. Complications in this series are within an acceptable range, whereas symptom improvement and overall satisfaction are high.


Asunto(s)
Altruismo , Misiones Médicas/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Procedimientos Quirúrgicos Operativos/efectos adversos , Adulto , Anciano , Femenino , Estudios de Seguimiento , Ghana/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Complicaciones Posoperatorias/etiología , Población Rural/estadística & datos numéricos , Procedimientos Quirúrgicos Operativos/estadística & datos numéricos , Resultado del Tratamiento
9.
Int J Cancer ; 146(5): 1333-1345, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-31525258

RESUMEN

The current study aimed to investigate the relationship between red and white meat subtypes, processed meat (divided into traditional "Khlii, Kaddid" and industrially processed meat) and colorectal cancer (CRC) risk, considering CRC subsites, in Moroccan adults. A case-control study was conducted including 2,906 matched case-control pairs recruited from the five largest university hospitals in Morocco. Dietary data were collected through a validated Food Frequency Questionnaire (FFQ). Multivariable odds ratios (OR) and 95% confidence intervals (CI), for the association of CRC risk with meat consumption (high vs. low intake), were estimated using conditional logistic regression models, adjusted for relevant confounding variables. Overall, consumption of red meat was positively associated with colon cancer and CRC risk (OR = 1.23, 95% CI = 1.05-1.44; OR = 1.14, 95% CI = 1.02-1.27), respectively. In contrast, no significant association was observed between the consumption of red meat and rectal cancer risk (OR = 1.05, 95% = 0.90-1.23). Interestingly, while processed meat from industrial processes was positively associated with colon cancer, rectal cancer and CRC (OR = 1.61, 95% CI = 1.27-2.04; OR = 1.73, 95% CI = 1.34-2.23; OR = 1.67, 95% CI = 1.41-1.98), processed meat prepared using traditional methods was inversely associated with colon cancer and CRC risk (OR = 0.74, 95% CI = 0.57-0.98; OR = 0.77, 95% CI = 0.64-0.93), respectively. Furthermore, positive associations were observed between poultry intake and colon cancer risk among men (OR = 1.27, 95% CI = 1.01-1.59). Our study showed similar associations between the consumption of red meat and CRC risk in Morocco as in developed countries, while inverse associations were found for traditionally processed meat products. This is the first study to investigate the differential effects of traditional vs. westernized processed meat products in a developing country. Other studies are needed to confirm these findings and to understand the physiological pathways underlying these associations.


Asunto(s)
Neoplasias Colorrectales/epidemiología , Productos de la Carne/estadística & datos numéricos , Carne/estadística & datos numéricos , Animales , Estudios de Casos y Controles , Neoplasias Colorrectales/etiología , Femenino , Humanos , Modelos Logísticos , Masculino , Marruecos/epidemiología , Aves de Corral , Carne Roja/estadística & datos numéricos , Riesgo , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos
10.
Int J Infect Dis ; 91: 261-263, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31863877

RESUMEN

Tick-borne relapsing fever (TBRF) borreliae are one of the main causes of fever in rural Africa and can cause miscarriages. This article reports Borrelia crocidurae as a probable cause of spontaneous miscarriage, which was detected through vaginal self-sampling. This appears to be the first such report.


Asunto(s)
Aborto Espontáneo/microbiología , Borrelia/aislamiento & purificación , Fiebre Recurrente/microbiología , Vagina/microbiología , Adulto , Borrelia/clasificación , Borrelia/genética , Femenino , Humanos , Embarazo , Fiebre Recurrente/diagnóstico , Población Rural/estadística & datos numéricos , Senegal
11.
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
12.
Clin Exp Hypertens ; 42(1): 8-15, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30563368

RESUMEN

Background: Fast resting heart rate (RHR) is easily neglected in clinical practice of hypertension treatment.Aims: We aimed to investigate the prevalence of fast RHR and associated factors in hypertensive and normotensive individuals.Methods: We retrospectively analyzed data from two cross-sectional studies conducted in China. A total of 6763 hypertensive patients and 2807 age and sex-matched normotensive subjects with complete data on resting electrocardiogram and medical history were included. Fast RHR was defined as RHR > 85 bpm.Results: The prevalence of fast RHR was higher in hypertensive patients as compared with the normotensives (14.4% vs 7.1%, P < 0.01). In both hypertensive and normotensive subjects, fast RHR appeared as a "U-type" distribution as aging and a "inverted J type" trend as body mass index (BMI) increasing. Multivariate regression analysis showed that fast RHR was associated with age >65 or <25 years old (OR = 1.32, 95% CI 1.08-1.61), BMI <18.5 kg/m2 (OR = 2.94, 95%CI 1.47-5.87) and hypercholesterolemia (OR = 1.30, 95%CI 1.10-1.53) in hypertensive patients. Fast RHR in the normotensives was associated with female (OR = 1.78, 95%CI 1.27-2.48), pre-hypertensive state (OR = 2.38, 95%CI 1.61-3.52), and rural area origin (OR = 1.50, 95%CI 1.01-2.42). Stroke and diabetes conferred closer relevance to fast RHR in both hypertensive (OR = 1.31, 95%CI 1.02-1.69 and OR 2.26, 95%CI 1.60-3.21) and normotensive individuals (OR = 2.67, 95%CI 1.36-5.21 and OR = 2.77, 95%CI 1.47-5.23).Conclusion: Fast RHR might be common in patients with hypertension. Prior stroke and diabetes history is common associated with fast RHR. Other factors associated with fast RHR seem to be different between hypertensive patients and normotensive subjects.Abbreviations: BMI: body mass index; CI: Confidence Interval; DBP: diastolic blood pressure; ECG: electrocardiogram; OR: odd ratio; RHR: resting heart rate; SBP: systolic blood pressure.


Asunto(s)
Diabetes Mellitus/fisiopatología , Frecuencia Cardíaca , Hipertensión/epidemiología , Hipertensión/fisiopatología , Accidente Cerebrovascular/fisiopatología , Adulto , Factores de Edad , Anciano , Presión Sanguínea , Estudios de Casos y Controles , China/epidemiología , Comorbilidad , Estudios Transversales , Diabetes Mellitus/epidemiología , Electrocardiografía , Femenino , Humanos , Hipercolesterolemia/epidemiología , Hipercolesterolemia/fisiopatología , Masculino , Persona de Mediana Edad , Prehipertensión/epidemiología , Prehipertensión/fisiopatología , Prevalencia , Descanso/fisiología , Estudios Retrospectivos , Población Rural/estadística & datos numéricos , Factores Sexuales , Accidente Cerebrovascular/epidemiología
13.
Forensic Sci Int ; 307: 110117, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31881372

RESUMEN

The ability to conduct accurate retrospective homicide comparative research is reliant on the publishing of robust studies that assess the specifics of homicides in a standardised manner. To address these matters at the Institute of Forensic Medicine (IFM) in Pristina, Kosovo, the IFM homicide data of the years 2006-2015 was retrospectively studied. In general, there was a year on year downward trend in the number of homicide deaths in Kosovo per 100,000 people, however it was noted that a standardisation method to record homicides in Kosovo has not been developed and as such, the data may not be complete. In addition, the analysis of the IFM data demonstrated that firearms were consistently used in 73.76 % of all homicides committed between 2006-2015 but the examination of, and the specific documentation of the types of firearms used was not recorded. This is important to provide evidence to enforce legislation to reduce the availability of these weapons and ultimately the number of homicides. Consequently, this study aimed to compare global homicide trends relative to the retrospective homicide data from Kosovo, to inform and address the need for prevention programmes and to establish standardised recording of homicides in Kosovo.


Asunto(s)
Homicidio/tendencias , Adolescente , Adulto , Distribución por Edad , Niño , Preescolar , Víctimas de Crimen/estadística & datos numéricos , Femenino , Armas de Fuego/estadística & datos numéricos , Medicina Legal , Homicidio/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Kosovo/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Heridas por Arma de Fuego/mortalidad , Adulto Joven
14.
Int J Radiat Oncol Biol Phys ; 106(1): 61-66, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-31505246

RESUMEN

PURPOSE: To evaluate the use of single-fraction palliative radiation therapy (SFRT) for the management of bone metastases (BM) in Victoria, Australia. METHODS AND MATERIALS: This is a population-based cohort of patients with cancer who received radiation therapy for BM between 2012 and 2017 as captured in the Victorian Radiotherapy Minimum Data Set. The primary outcome was proportion of SFRT use. The Cochrane-Armitage test for trend was used to evaluate changes in practice over time. Multivariable logistic regression was used to assess factors associated with SFRT use. RESULTS: Of the 18,158 courses of radiation therapy for BM delivered to a total of 10,956 patients, 17% were SFRT. There was no significant change in SFRT use over time, from 18% in 2012 to 19% in 2017 (P = .07). SFRT was less commonly given to the skull (4%) and spine (14%), compared with the shoulder (37%) and ribs (53%). Patients with lung cancer (21%) were most likely to receive SFRT, followed by those with prostate cancers (18%) and gastrointestinal cancers (16%). Patients from regional/remote areas were more likely to have SFRT compared with those in major cities (22% vs 16%, P < .001). Patients treated in public institutions were more likely to have SFRT compared with those treated in private institutions (22% vs 10%, P < .001). In multivariable analyses, increasing age, lung cancer, higher socioeconomic status, residence in regional/ remote areas, and being treated in public institutions were factors independently associated with increased likelihood of receiving SFRT. CONCLUSIONS: SFRT appears underused for BM in Australia over time, with variation in practice by patient, tumor, sociodemographic, geographical, and institutional provider factors.


Asunto(s)
Neoplasias Óseas/radioterapia , Neoplasias Óseas/secundario , Cuidados Paliativos/métodos , Factores de Edad , Anciano , Anciano de 80 o más Años , Australia , Fraccionamiento de la Dosis de Radiación , Femenino , Neoplasias Gastrointestinales , Hospitales Privados/estadística & datos numéricos , Hospitales Públicos/estadística & datos numéricos , Humanos , Neoplasias Pulmonares , Masculino , Persona de Mediana Edad , Cuidados Paliativos/estadística & datos numéricos , Neoplasias de la Próstata , Radioterapia/métodos , Radioterapia/estadística & datos numéricos , Dosificación Radioterapéutica , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Factores de Tiempo , Población Urbana/estadística & datos numéricos
15.
Acta Trop ; 201: 105209, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31600524

RESUMEN

Multidrug resistance is one of the top three threats to global public health. Understanding resistance of bacteria is important to help decrease resistance and improve the development of novel antimicrobial agents or other alternative tools to combat public health challenges. Thus, the goal of this study was to investigate the vancomycin and florfenicol resistance genes of five E. faecalis and 15 E. faecium isolated from patients with urinary tract infections. There were 20 Enterococcus obtained from the library collection of randomly selected private hospitals located in the city of El Qanater El Khayreya; these samples were isolated during 2017. Samples were evaluated for their phenotypic characterization of virulence factors, antimicrobial resistance and PCR was conducted to detect the prescence of the vancomycin vanABC and florfenicol resistance genes encoding the catAB, fexAB and cfu. There were six different antibiotic resistance profiles observed. The 20 isolates showed resistance to clindamycin, oxytetracycline and gentamycin. Resistance was evident to ciprofloxacin, norfloxacin and florfenicol in the absence of the cfr gene in all of the 20 Enterococcus isolates. In addition, all isolates produced biofilms and were classified as extensive drug resistant. MARindices of the isolates were >0.6. The MARindex of human isolates of enterococci suggest these pathogens originate from a high-risk source of contamination where antibiotics are often used. This information highlights a possible public health concern to the Egyptian community. The results also suggest the emergence of a linezolid sensitive-vancomycin resistant E. faecium and E. faecalis in the absence of the cfr gene.


Asunto(s)
Antibacterianos/uso terapéutico , Farmacorresistencia Microbiana/efectos de los fármacos , Farmacorresistencia Microbiana/genética , Enterococcus faecalis/efectos de los fármacos , Enterococcus faecium/efectos de los fármacos , Tianfenicol/análogos & derivados , Infecciones Urinarias/microbiología , Vancomicina/uso terapéutico , Egipto , Humanos , Pruebas de Sensibilidad Microbiana , Población Rural/estadística & datos numéricos , Tianfenicol/uso terapéutico , Población Urbana/estadística & datos numéricos , Factores de Virulencia
16.
Acta Trop ; 201: 105221, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31654901

RESUMEN

Opisthorchiasis-associated cholangiocarcinoma (OV-CCA) is a major public health problem in Greater Mekong Subregion (GMS) Countries, the poorest region in Asia. People in this region have similar traditions or respect the same religion. There is no difference in lifestyle and food culture. Excluding Thailand, publications on risk factors for OV-CCA from the GMS Countries are few, especially data on behavioral risk factors for OV-CCA. Therefore, this study aimed to assess the behavior-related risk factors and to compare the risk of OV-CCA among rural people living along the Mekong River in five GMS countries. It was a cross-sectional analytic study during June and October 2017. All participants with informed consent completed the questionnaires. Descriptive statistics were used to describe the prevalence of risk factors. Odds ratio with 95% confidence intervals were used to compare the risk of OV-CCA. It was found that there were more drinkers than non-drinkers in all areas, except in Vietnam. The highest history of liver fluke infection was found in Cambodia. Praziquantel use and consumption of raw freshwater fish dishes were mostly found in Lao PDR. The highest consumption of nitrosamine-contaminated foodstuffs was found in Ubon Ratchathani, Thailand. The spatial comparison of OV-CCA risk showed that Lao PDR and Ubon Ratchathani were two risk areas when compared to Tachileik, Myanmar (a reference area). This study provided the behavior-related risk factors for OV-CCA among people in five GMS Countries which would be a major jigsaw puzzle leading to proactive surveillance for OV-CCA prevention in the future.


Asunto(s)
Conductos Biliares Intrahepáticos/patología , Colangiocarcinoma/epidemiología , Opistorquiasis/epidemiología , Asunción de Riesgos , Población Rural/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Animales , Neoplasias de los Conductos Biliares/epidemiología , Cambodia/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mianmar/epidemiología , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Tailandia/epidemiología , Vietnam/epidemiología
17.
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
18.
Adv Gerontol ; 32(4): 658-663, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31800197

RESUMEN

In the article, the author presented the level and dynamics of the general morbidity of the population older than the working age of the Belgorod region for 2010-2017, which decreased by 10,9%. It showed differences in the incidence rates of the urban and rural population, which is 23,2% lower than the urban one. In the structure of general morbidity, circulatory system diseases ranked first (32,8%, rural - 39,6%); the second - diseases of the musculoskeletal system (11,9%, rural - 10,5%); third, respiratory diseases (9,5%, rural - 9%). He provided the incidence with the diagnosis established for the first time in his life, which decreased by 19,2%, the rural population increased by 9,3%, but it was 30,9% lower than the urban one. At the same time, in the form 025 / in persons with senile (75-84 years) and advanced age (85 years and older), 4 to 8 chronic diseases confirming polymorbidity were registered. Negative environmental factors of urban residents contribute to the greater accumulation of chronic diseases in them, on the one hand, and the difficulty of avoiding dubbing and the possibility of over-accounting, on the other. The rural population is less susceptible to the negative factors of urbanization, however, due to the lack of access to medical care, there is an underreporting of diseases and the incidence of diseases remains much lower - urban. This is indirectly confirmed by the high mortality rate of the rural population (higher by 24,1% - urban).


Asunto(s)
Enfermedad Crónica , Morbilidad , Población Rural , Población Urbana , Anciano , Anciano de 80 o más Años , Enfermedad Crónica/epidemiología , Humanos , Incidencia , Masculino , Población Rural/estadística & datos numéricos , Federación de Rusia/epidemiología , Población Urbana/estadística & datos numéricos
19.
Hu Li Za Zhi ; 66(6): 13-19, 2019 Dec.
Artículo en Chino | MEDLINE | ID: mdl-31802450

RESUMEN

Diabetes is one of the most prevalent chronic diseases affecting public health. The Taiwan government implemented the Diabetes Shared Care Program to deliver continuous medical care and provide health education in order to help clients with diabetes learn self-management. However, rural older adults with diabetes often have poor access to medical resources and thus face obstacles to obtaining and using the services of this program. This paper introduces the current status of the Diabetes Shared Care Program, discusses the concept of self-management education and support for diabetes cases, and proposes community-based strategies, including (1) provide DSMES (diabetes self-management education and support) with multi-types of services, (2) increase non-professional personnel training, and (3) provide culture-congruent health education, in order to strengthen the diabetes self-management capabilities of rural older adults.


Asunto(s)
Diabetes Mellitus/terapia , Educación del Paciente como Asunto , Población Rural , Automanejo/educación , Anciano , Humanos , Población Rural/estadística & datos numéricos , Taiwán
20.
J Glob Health ; 9(2): 020601, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31788232

RESUMEN

Background: Various hypertension predictive models have been developed worldwide; however, there is no existing predictive model for hypertension among Chinese rural populations. Methods: This is a 6-year population-based prospective cohort in rural areas of China. Data was collected in 2007-2008 (baseline survey) and 2013-2014 (follow-up survey) from 8319 participants ranging in age from 35 to 74 years old. Specified gender hypertension predictive models were established based on multivariate Cox regression, Artificial Neural Network (ANN), Naive Bayes Classifier (NBC), and Classification and Regression Tree (CART) in the training set. External validation was conducted in the testing set. The estimated models were assessed by discrimination and calibration, respectively. Results: During the follow-up period, 432 men and 604 women developed hypertension in the training set. Assessment for established models in men suggested men office-based model (M1) was better than others. C-index of M1 model in the testing set was 0.771 (95% confidence Interval (CI) = 0.750, 0.791), and calibration χ2 = 6.3057 (P = 0.7090). In women, women office-based model (W1) and ANN were better than the other models assessed. The C-indexes for the W1 model and the ANN model in the testing set were 0.765 (95% CI = 0.746, 0.783) and 0.756 (95% CI = 0.737, 0.775) and the calibrations χ2 were 6.7832 (P = 0.1478) and 4.7447 (P = 0.3145), respectively. Conclusions: Not all machine-learning models performed better than the traditional Cox regression models. The W1 and ANN models for women and M1 model for men have better predictive performance which could potentially be recommended for predicting hypertension risk among rural populations.


Asunto(s)
Hipertensión/epidemiología , Modelos Estadísticos , Población Rural/estadística & datos numéricos , Adulto , Anciano , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Medición de Riesgo
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA