Impact of social marginalization on oral health-related quality of life in older adults.

The aim of this study was to determine the association between oral health-related quality of life (OHRQoL) and social marginalization in people aged 60 years and older enrolled in social security in Mexico. A cross-sectional and analytical study was carried out in older adults. To assess the OHRQoL, the OHIP-14 instrument was applied, and the degree of social marginalization and sociodemographic characteristics were analyzed. Measures of central tendency and dispersion, simple frequencies and proportions were estimated. Student's t-test was used for comparison of means, and prevalence ratio (PR) and logistic regression were used to assess associations, all with a significance value of 0.05 and 95% confidence intervals. Perceived OHRQoL in the population measured through the OHIP-14 reached an average value of 9.84 ± 8.91, with the highest value in the dimension of physical pain (2.06 ± 1.91). Perceived treatment need was higher among people with social marginality (p = 0.011). The multivariate analysis shows that marginalized people have a lower OHRQoL. Socially marginalized older adults showed a low a better perception of OHRQoL, independent of demographic and clinical factors.

Impact of social marginalization on oral health-related quality of life in older adults

Abstract The aim of this study was to determine the association between oral health-related quality of life (OHRQoL) and social marginalization in people aged 60 years and older enrolled in social security in Mexico. A cross-sectional and analytical study was carried out in older adults. To assess the OHRQoL, the OHIP-14 instrument was applied, and the degree of social marginalization and sociodemographic characteristics were analyzed. Measures of central tendency and dispersion, simple frequencies and proportions were estimated. Student's t-test was used for comparison of means, and prevalence ratio (PR) and logistic regression were used to assess associations, all with a significance value of 0.05 and 95% confidence intervals. Perceived OHRQoL in the population measured through the OHIP-14 reached an average value of 9.84 ± 8.91, with the highest value in the dimension of physical pain (2.06 ± 1.91). Perceived treatment need was higher among people with social marginality (p = 0.011). The multivariate analysis shows that marginalized people have a lower OHRQoL. Socially marginalized older adults showed a low a better perception of OHRQoL, independent of demographic and clinical factors.

Favipiravir and/or nitazoxanide: a randomized, double-blind, 2×2 design, placebo-controlled trial of early therapy in COVID-19 in health workers, their household members, and patients treated at IMSS (FANTAZE).

BACKGROUND: The 2020 pandemic of SARS-CoV-2 causing COVID-19 disease is an unprecedented global emergency. COVID-19 appears to be a disease with an early phase where the virus replicates, coinciding with the first presentation of symptoms, followed by a later 'inflammatory' phase which results in severe disease in some individuals. It is known from other rapidly progressive infections such as sepsis and influenza that early treatment with antimicrobials is associated with a better outcome. The hypothesis is that this holds for COVID-19 and that early antiviral treatment may prevent progression to the later phase of the disease. METHODS: Trial design: Phase IIA randomised, double-blind, 2 × 2 design, placebo-controlled, interventional trial. RANDOMISATION: Participants will be randomised 1:1 by stratification, with the following factors: gender, obesity, symptomatic or asymptomatic, current smoking status presence or absence of comorbidity, and if the participant has or has not been vaccinated. BLINDING: Participants and investigators will both be blinded to treatment allocation (double-blind). DISCUSSION: We propose to conduct a proof-of-principle placebo-controlled clinical trial of favipiravir plus or minus nitazoxanide in health workers, their household members and patients treated at the Mexican Social Security Institute (IMSS) facilities. Participants with or without symptomatic COVID-19 or who tested positive will be assigned to receive favipiravir plus nitazoxanide or favipiravir plus nitazoxanide placebo. The primary outcome will be the difference in the amount of virus ('viral load') in the upper respiratory tract after 5 days of therapy. Secondary outcomes will include hospitalization, major morbidity and mortality, pharmacokinetics, and impact of antiviral therapy on viral genetic mutation rate. If favipiravir with nitazoxanide demonstrates important antiviral effects without significant toxicity, there will be a strong case for a larger trial in people at high risk of hospitalization or intensive care admission, for example older patients and/or those with comorbidities and with early disease. TRIAL REGISTRATION: ClinicalTrials.gov NCT04918927 . Registered on June 9, 2021.

Homicidios en jóvenes y desigualdades sociales en México, 2017

[RESUMEN]. Objetivo. Conocer la asociación entre las condiciones sociales y económicas y las tasas de homicidios en jóvenes de 10 a 24 años de edad en México en 2017. Métodos. En este estudio ecológico se estudiaron las desigualdades sociales asociadas con los homicidios en la población de 10 a 24 años en 2017 en México a través de fuentes secundarias de información, correspondientes a las defunciones por homicidio por entidad federativa en México. Las desigualdades sociales en salud se estudiaron mediante la medición absoluta y relativa de las brechas de desigualdad y se estimaron razones de prevalencias de mortalidad con modelos de regresión de Poisson. Resultados. En 2017 se produjeron 8 094 homicidios en la población joven, que fueron más frecuentes en hombres (86,7%). Las brechas de desigualdad entre los estados fueron importantes. La desocupación de la población de mayores de 12 años, los hogares conformados por personas que no son familiares, la baja asistencia escolar y el ingreso por debajo de la línea de bienestar se asociaron de manera significativa con las tasas de homicidios. Conclusiones. La asociación de los determinantes sociales con los homicidios en la población estudiada es fuerte. Deben implementarse políticas y acciones intersectoriales que puedan ayudar a reducir las brechas de desigualdad y lograr mejores condiciones de vida y niveles de bienestar y salud de las personas y sus comunidades.

[ABSTRACT]. Objective. Assess the association between social and economic conditions and homicide rates in young people between 10 and 24 years of age in Mexico in 2017. Methods. This ecological study looked at the social inequalities associated with homicides in the population 10-24-year-old population in 2017 in Mexico, using secondary data sources for deaths by homicide in each Mexican state. Social inequalities in health were studied by measuring absolute and relative inequality gaps. Mortality rates were estimated using Poisson regression models. Results. In 2017, there were 8,094 homicides in the target population, predominantly in men (86.7%). There was high variance in inequality between states. Unemployment in the population over 12 years of age, households composed of people who are not family members, low school attendance rates, and income below the poverty line showed significant association with homicide rates. Conclusions. There is a strong association between social determinants and homicides in the study population. Policies and intersectoral actions should be implemented to help bridge inequality gaps and achieve better living conditions and higher levels of well-being and health for people and their communities.

[RESUMO]. Objetivo. Descrever a associação entre as condições socioeconômicas e as taxas de homicídios em jovens entre 10 e 24 anos no México em 2017. Métodos. Neste estudo ecológico foram examinadas as desigualdades sociais associadas aos homicídios na população entre 10 e 24 anos no México em 2017 com base em dados obtidos de fontes de informação secundárias relativos a mortes por homicídio por entidade federativa. As desigualdades sociais em saúde foram avaliadas com a mensuração absoluta e relativa das lacunas de desigualdade. As razões de prevalências de mortalidade foram estimadas com modelos de regressão de Poisson. Resultados. Em 2017, houve 8.094 homicídios na população jovem, com predomínio no sexo masculino (86,7%). As lacunas de desigualdade entre os estados foram significativas. Ociosidade juvenil (em maiores de 12 anos), domicílios constituídos por pessoas sem laços de parentesco, baixa frequência escolar e renda abaixo da linha do bem-estar foram fatores que tiveram uma associação significativa com as taxas de homicídios. Conclusões. Observou-se uma forte associação entre os determinantes sociais e os homicídios na população estudada. Políticas e ações intersetoriais devem ser implementadas para ajudar a reduzir as lacunas de desigualdade e melhorar as condições de vida, o nível de bem-estar e a saúde das pessoas e suas comunidades.

[Homicides in young people and social inequalities in Mexico, 2017Homicídios em jovens e desigualdades sociais no México, 2017]. / Homicidios en jóvenes y desigualdades sociales en México, 2017.

OBJECTIVE: Assess the association between social and economic conditions and homicide rates in young people between 10 and 24 years of age in Mexico in 2017. METHODS: This ecological study looked at the social inequalities associated with homicides in the population 10-24-year-old population in 2017 in Mexico, using secondary data sources for deaths by homicide in each Mexican state. Social inequalities in health were studied by measuring absolute and relative inequality gaps. Mortality rates were estimated using Poisson regression models. RESULTS: In 2017, there were 8,094 homicides in the target population, predominantly in men (86.7%). There was high variance in inequality between states. Unemployment in the population over 12 years of age, households composed of people who are not family members, low school attendance rates, and income below the poverty line showed significant association with homicide rates. CONCLUSIONS: There is a strong association between social determinants and homicides in the study population. Policies and intersectoral actions should be implemented to help bridge inequality gaps and achieve better living conditions and higher levels of well-being and health for people and their communities.

OBJETIVO: Descrever a associação entre as condições socioeconômicas e as taxas de homicídios em jovens entre 10 e 24 anos no México em 2017. MÉTODOS: Neste estudo ecológico foram examinadas as desigualdades sociais associadas aos homicídios na população entre 10 e 24 anos no México em 2017 com base em dados obtidos de fontes de informação secundárias relativos a mortes por homicídio por entidade federativa. As desigualdades sociais em saúde foram avaliadas com a mensuração absoluta e relativa das lacunas de desigualdade. As razões de prevalências de mortalidade foram estimadas com modelos de regressão de Poisson. RESULTADOS: Em 2017, houve 8.094 homicídios na população jovem, com predomínio no sexo masculino (86,7%). As lacunas de desigualdade entre os estados foram significativas. Ociosidade juvenil (em maiores de 12 anos), domicílios constituídos por pessoas sem laços de parentesco, baixa frequência escolar e renda abaixo da linha do bem-estar foram fatores que tiveram uma associação significativa com as taxas de homicídios. CONCLUSÕES: Observou-se uma forte associação entre os determinantes sociais e os homicídios na população estudada. Políticas e ações intersetoriais devem ser implementadas para ajudar a reduzir as lacunas de desigualdade e melhorar as condições de vida, o nível de bem-estar e a saúde das pessoas e suas comunidades.