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1.
Epidemiol Prev ; 44(4): 304-307, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32921037

RESUMO

It has been hypothesized that bacille Calmette-Guerin (BCG), the anti-tuberculosis vaccine, can be protective against Covid-19. Using data of performed swabs and RT-PCR results for SARS-CoV-2 in the Reggio Emilia province (Emilia-Romagna Region, Northern Italy) from March 6th to March 26th, 2020, we computed age, gender, and place of birth (Italy or abroad) specific risk of being tested, prevalence of positive tests, and probability of testing positive given that a swab has been taken during the epidemic peak. We report that immigrants resident in Reggio Emilia province, mostly coming from Countries with high BCG vaccination coverage, and Italians had a similar prevalence of infection (odds ratio - OR 0.99; 95%CI 0.82-1.20) and similar probability of being tested (OR 0.93; 95%CI 0.81-1.10). Our data do not support the hypothesis that immigrants from Countries where BCG vaccination is recommended have a lower risk of Covid-19 infection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Emigrantes e Imigrantes/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Adulto , África/etnologia , Idoso , Ásia/etnologia , Vacina BCG , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/etnologia , Pneumonia Viral/prevenção & controle , Polônia/etnologia , Prevalência , Utilização de Procedimentos e Técnicas , Cobertura Vacinal
2.
J Food Sci ; 85(9): 2896-2901, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32794204

RESUMO

Although different cultural groups are known to vary in their tolerance for hot chili peppers, the influence of factors such as cultural background and upbringing on sensitivity to compounds in spicy food is unclear. A study was designed to investigate sensitivity differences to capsaicin between Caucasian American and South Asian Indian cultural groups while controlling for general chili pepper affinity. The two cultural groups were selected to match on metrics related to chili pepper use and liking. Subjects were exposed to a capsaicin (100 ppm) stimulus on the tongue, cheek, hard palate, and lip and rated the intensity of irritation every 30 s, over a 10-min period. Overall sensitivity to capsaicin in the oral cavity did not differ between the groups, nor were responses different between the groups depending on the oral cavity area stimulated. These data suggest a limited role of cultural attributes on capsaicin sensitivity between Caucasian Americans and South Asian Indians. The methods and findings here provide subject recruitment insight and guidance on effectively designing a sensory study to answer perceptual questions regarding specific subject groups. PRACTICAL APPLICATION: This study design provides a model for researchers interested in utilizing sensory testing to answer questions about subject groups. Although the objective of this study regarded sensitivity differences across two cultural groups, alterations in the subject matching process used presently could be easily implemented to investigate sensitivity across other differing subject characteristics of interest.


Assuntos
Capsaicina/metabolismo , Capsicum/metabolismo , Ásia/etnologia , Capsaicina/análise , Capsicum/química , Humanos , América do Sul/etnologia , Paladar , Língua/metabolismo
3.
Gene ; 758: 144944, 2020 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-32628976

RESUMO

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19). The relentless spread and pathogenicity of the virus have become a global public health emergency. One of the striking features of this pandemic is the pronounced impact on specific regions and ethnic groups. In particular, compared with East Asia, where the virus first emerged, SARS-CoV-2 has caused high rates of morbidity and mortality in Europe. This has not been experienced in past global viral infections, such as influenza, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) and is unique to SARS-CoV-2. For this reason, we investigated the involvement of genetic factors associated with SARS-CoV-2 infection with a focus on angiotensin-converting enzyme (ACE)-related genes, because ACE2 is a receptor for SARS-CoV-2. We found that the ACE1 II genotype frequency in a population was significantly negatively correlated with the number of SARS-CoV-2 cases. Similarly, the ACE1 II genotype was negatively correlated with the number of deaths due to SARS-CoV-2 infection. These data suggest that the ACE1 II genotype may influence the prevalence and clinical outcome of COVID-19 and serve as a predictive marker for COVID-19 risk and severity.


Assuntos
Infecções por Coronavirus/mortalidade , Peptidil Dipeptidase A/genética , Pneumonia Viral/mortalidade , Ásia/epidemiologia , Ásia/etnologia , Betacoronavirus/metabolismo , Infecções por Coronavirus/epidemiologia , Europa (Continente)/epidemiologia , Europa (Continente)/etnologia , Frequência do Gene/genética , Genótipo , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Polimorfismo de Nucleotídeo Único/genética , Risco , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
4.
Biochem Biophys Res Commun ; 529(2): 263-269, 2020 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-32703421

RESUMO

The World Health Organization recently announced that pandemic status has been achieved for coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Exponential increases in patient numbers have been reported around the world, along with proportional increases in the number of COVID-19-related deaths. The SARS-CoV-2 infection rate in a population is expected to be influenced by social practices, availability of vaccines or prophylactics, and the prevalence of susceptibility genes in the population. Previous work revealed that cellular uptake of SARS-CoV-2 requires Angiotensin Converting Enzyme 2 (ACE-2) and a cellular protease. The spike (S) protein on SARS-CoV-2 binds ACE-2, which functions as an entry receptor. Following receptor binding, transmembrane protease serine 2 (encoded by TMPRSS2) primes the S protein to allow cellular uptake. Therefore, individual expression of TMPRSS2 may be a crucial determinant of SARS-CoV-2 infection susceptibility. Here, we utilized multiple large genome databases, including the GTEx portal, SNP nexus, and Ensembl genome project, to identify gene expression profiles for TMPRSS2 and its important expression quantitative trait loci. Our results show that four variants (rs464397, rs469390, rs2070788 and rs383510) affect expression of TMPRSS2 in lung tissue. The allele frequency of each variant was then assessed in regional populations, including African, American, European, and three Asian cohorts (China, Japan and Taiwan). Interestingly, our data shows that TMPRSS2-upregulating variants are at higher frequencies in European and American populations than in the Asian populations, which implies that these populations might be relatively susceptible to SARS-CoV-2 infection.


Assuntos
Betacoronavirus/metabolismo , Regulação da Expressão Gênica/genética , Internacionalidade , Pulmão/metabolismo , Receptores Virais/genética , Serina Endopeptidases/genética , Ásia/etnologia , Estudos de Coortes , Europa (Continente)/etnologia , Frequência do Gene , Genética Populacional , Mapeamento Geográfico , Humanos , Especificidade de Órgãos/genética , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas/genética , Estados Unidos/etnologia , Regulação para Cima/genética
6.
N Z Med J ; 133(1514): 41-48, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32379738

RESUMO

AIMS: The purpose of this study is to audit the numbers of non-residents requiring orthopaedic admission to Dunedin and Southland Hospitals and determine the effects of increasing tourist numbers on healthcare resources. METHOD: All non-resident orthopaedic admissions to Dunedin Hospital from January 2005 to December 2017 and Invercargill Hospital from January 2011 to December 2017 were analysed with respect to country of residence, mechanism of injury, primary diagnosis and case weights consumed. The results were combined with figures from 1997-2004 to give a 21-year series for Dunedin Hospital. RESULTS: There has been a significant increase in the number of admissions and case weights (CW) over the past 21 years at Dunedin Hospital (p<0.001). The most common mechanisms of injury were snow sports at Dunedin Hospital and falls for Southland Hospital. Between 2011 and 2017 there were on average 50 non-resident admissions per year (92.9 CW/year) to Dunedin Hospital and 74 admissions (120.7 CW/year) in Southland. CONCLUSION: Increasing tourist numbers have resulted in an increase number of orthopaedic admissions to Dunedin Hospital over the last two decades although it remains a small proportion of the total workload. Southland Hospital is relatively more affected. These patients represent an annual cost in excess of $1,000,000 to Southern DHB.


Assuntos
Hospitais/estatística & dados numéricos , Ortopedia/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Admissão do Paciente/tendências , Ferimentos e Lesões/epidemiologia , Ásia/etnologia , Austrália/etnologia , Economia Hospitalar/estatística & dados numéricos , Fraturas Ósseas/epidemiologia , Humanos , Luxações Articulares/epidemiologia , Auditoria Médica , Nova Zelândia/epidemiologia , Ortopedia/organização & administração , Ortopedia/tendências , Traumatismos da Coluna Vertebral/epidemiologia , Viagem/estatística & dados numéricos , Reino Unido/etnologia , Ferimentos e Lesões/economia , Ferimentos e Lesões/etiologia
7.
CMAJ ; 192(11): E266-E274, 2020 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-32179535

RESUMO

BACKGROUND: Ethnicity may be associated with important aspects of end-of-life care, such as what treatments are received, access to palliative care and where people die. However, most studies have focused on end-of-life care of white, Hispanic and black patients. We sought to compare end-of-life care delivered to people of Chinese and South Asian ethnicity with that delivered to others from the general population, in Ontario, Canada. METHODS: In this population-based cohort study, we included all people who died in Ontario, Canada, between Apr. 1, 2004, and Mar. 31, 2015. People were identified as having Chinese or South Asian ethnicity on the basis of a validated surname algorithm. We used modified Poisson regression analyses to assess location of death and care received in the last 6 months of life. RESULTS: We analyzed 967 339 decedents, including 18 959 (2.0%) of Chinese and 11 406 (1.2%) of South Asian ethnicity. Chinese (13.6%) and South Asian (18.5%) decedents were more likely than decedents from the general population (10.1%) to die in the intensive care unit (ICU). The adjusted relative risk of dying in intensive care was 1.21 (95% confidence interval [CI] 1.15 to 1.27) for Chinese and 1.25 (95% CI 1.20 to 1.30) for South Asian decedents. In their last 6 months of life, decedents of Chinese and South Asian ethnicity experienced significantly more ICU admission, hospital admission, mechanical ventilation, dialysis, percutaneous feeding tube placement, tracheostomy and cardiopulmonary resuscitation than the general population. INTERPRETATION: Decedents of Chinese and South Asian ethnicity in Ontario were more likely than decedents from the general population to receive aggressive care and to die in an ICU. These findings may be due to communication difficulties between patients and clinicians, differences in preferences about end-of-life care or differences in access to palliative care services.


Assuntos
Grupo com Ancestrais do Continente Asiático/etnologia , Assistência Terminal/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Ásia/etnologia , Reanimação Cardiopulmonar/estatística & dados numéricos , Cuidados Críticos/estatística & dados numéricos , Emigração e Imigração , Nutrição Enteral/estatística & dados numéricos , Utilização de Instalações e Serviços , Acesso aos Serviços de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Ontário/epidemiologia , Cuidados Paliativos/psicologia , Cuidados Paliativos/estatística & dados numéricos , Preferência do Paciente , Diálise Renal/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Estudos Retrospectivos , Assistência Terminal/psicologia , Traqueostomia/estatística & dados numéricos
9.
J Nutr ; 150(6): 1509-1515, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32133497

RESUMO

BACKGROUND: Diet quality is an important risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). Little is known about the diet quality of South Asians in the United States, a group with higher rates of T2D and CVD compared with other racial/ethnic groups. OBJECTIVE: This study determined whether diet quality differs between South Asian adults in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and whites, Chinese Americans, African Americans, and Hispanics in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS: Cross-sectional data from 3926 participants free of CVD from MESA visit 5 (2010-2011) and 889 South Asian participants from MASALA visit 1 (2010-2013) were pooled. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI-2010) derived using FFQs. Multivariable linear regression models adjusted for age, sex, and total energy intake were used to compare mean differences in diet quality between the racial/ethnic groups. RESULTS: MESA participants were, on average, 14 y older than MASALA participants. The adjusted mean (95% CI) scores for the AHEI-2010 were 70.2 (69.5, 70.9) among South Asians, 66.2 (66.3, 68.2) among Chinese Americans, 61.1 (60.7, 61.6) among whites, 59.0 (58.4, 59.7) among Hispanics, and 57.5 (56.9, 58.1) among African Americans. The mean AHEI scores among South Asians were 3.1 (1.8, 4.3), 9.2 (8.3, 10.1), 11.2 (10.2, 12.3), and 12.8 (11.8, 13.7) points higher compared with Chinese Americans, whites, Hispanics, and African Americans, respectively. CONCLUSIONS: South Asian adults in the United States have a higher diet quality compared with other racial/ethnic groups. This paradoxical finding is not consistent with the observed higher rates of T2D and CVD compared with other groups. This is further evidence of the importance of studying the South Asian population to better understand the causes of chronic disease not explained by diet quality.


Assuntos
Aterosclerose/etnologia , Dieta , Idoso , Ásia/etnologia , Estudos Transversais , Registros de Dieta , Emigração e Imigração , Grupos Étnicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos
10.
Lancet Psychiatry ; 7(4): 327-336, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32145763

RESUMO

BACKGROUND: Elevated risk of psychotic disorders in migrant groups is a public mental health priority. We investigated whether living in areas of high own-region migrant density was associated with reduced risk of psychotic disorders among migrants and their children, and whether generation status, probable visible minority status, or region-of-origin affected this relationship. METHODS: We used the Swedish registers to identify migrants and their children born between Jan 1, 1982, and Dec 31, 1996, and living in Sweden on or after their 15th birthday. We tracked all included participants from age 15 years or date of migration until emigration, death, or study end (Dec 31, 2016). The outcome was an ICD-10 diagnosis of non-affective psychosis (F20-29). We calculated own-region and generation-specific own-region density within the 9208 small areas for market statistics neighbourhoods in Sweden, and estimated the relationship between density and diagnosis of non-affective psychotic disorders using multilevel Cox proportional hazards models, adjusting for individual confounders (generation status, age, sex, calendar year, lone dwelling, and time since migration [migrants only]), family confounders (family income, family unemployment, and social welfare), and neighbourhood confounders (deprivation index, population density, and proportion of lone dwellings), and using the Akaike information criterion (AIC) to compare model fit. FINDINGS: Of 468 223 individuals included in the final cohort, 4582 (1·0%) had non-affective psychotic disorder. Lower own-region migrant density was associated with increased risk of psychotic disorders among migrants (hazard ratio [HR] 1·05, 95% CI 1·02-1·07 per 5% decrease) and children of migrants (1·03, 1·01-1·06), after adjustment. These effects were stronger for probable visible minority migrants (1·07, 1·04-1·11), including migrants from Asia (1·42, 1·15-1·76) and sub-Saharan Africa (1·28, 1·15-1·44), but not migrants from probable non-visible minority backgrounds (0·99, 0·94-1·04). Among migrants, adding generation status to the measure of own-region density provided a better fit to the data than overall own-region migrant density (AIC 36 103 vs 36 106, respectively), with a 5% decrease in generation-specific migrant density corresponding to a HR of 1·07 (1·04-1·11). INTERPRETATION: Migrant density was associated with non-affective psychosis risk in migrants and their children. Stronger protective effects of migrant density were found for probable visible minority migrants and migrants from Asia and sub-Saharan Africa. For migrants, this risk intersected with generation status. Together, these results suggest that this health inequality is socially constructed. FUNDING: Wellcome Trust, Royal Society, Mental Health Research UK, University College London, National Institute for Health Research, Swedish Research Council, and FORTE.


Assuntos
Transtornos Psicóticos/etnologia , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Adolescente , Adulto , África ao Sul do Saara/etnologia , Idoso , Ásia/etnologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Densidade Demográfica , Modelos de Riscos Proporcionais , Sistema de Registros , Distribuição por Sexo , Fatores Socioeconômicos , Suécia/epidemiologia , Adulto Jovem
12.
J Infect Dis ; 221(3): 389-399, 2020 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-31550363

RESUMO

BACKGROUND: Patients on oral antiviral (OAV) therapy remain at hepatocellular carcinoma (HCC) risk. Risk prediction tools distinguishing treated patients with residual HCC risk are limited. The aim of this study was to develop an accurate, precise, simple-to-use HCC risk score using routine clinical variables among a treated Asian cohort. METHODS: Adult Asian chronic hepatitis B (CHB) patients on OAV were recruited from 25 centers in the United States and the Asia-Pacific region. Excluded persons were coinfected with hepatitis C, D, or human immunodeficiency virus, had HCC before or within 1 year of study entry, or their follow-up was <1 year. Patients were randomized to derivation and validation cohorts on a 2:1 ratio. Statistically significant predictors from multivariate modeling formed the Real-world Effectiveness from the Asia Pacific Rim Liver Consortium for HBV (REAL-B) score. RESULTS: A total of 8048 patients were randomized to the derivation (n = 5365) or validation group (n = 2683). The REAL-B model included 7 variables (male gender, age, alcohol use, diabetes, baseline cirrhosis, platelet count, and alpha fetoprotein), and scores were categorized as follows: 0-3 low risk, 4-7 moderate risk, and 8-13 high risk. Area under receiver operating characteristics were >0.80 for HCC risk at 3, 5, and 10 years, and these were significantly higher than other risk models (p < .001). CONCLUSIONS: The REAL-B score provides 3 distinct risk categories for HCC development in Asian CHB patients on OAV guiding HCC surveillance strategy.


Assuntos
Antivirais/efeitos adversos , Antivirais/uso terapêutico , Carcinoma Hepatocelular/etiologia , Vírus da Hepatite B/genética , Hepatite B Crônica/tratamento farmacológico , Neoplasias Hepáticas/etiologia , Projetos de Pesquisa , Administração Oral , Adulto , Antivirais/administração & dosagem , Ásia/etnologia , Grupo com Ancestrais do Continente Asiático , Estudos de Coortes , DNA Viral/genética , Confiabilidade dos Dados , Feminino , Hepatite B Crônica/etnologia , Hepatite B Crônica/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Curva ROC , Distribuição Aleatória , Medição de Risco
13.
Br J Psychol ; 111(1): 17-35, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30868563

RESUMO

This research experimentally examined the effects of exposure to intergroup conspiracy theories on prejudice and discrimination. Study 1 (N = 166) demonstrated that exposure to conspiracy theories concerning immigrants to Britain from the European Union (vs. anti-conspiracy material or a control) exacerbated prejudice towards this group. Study 2 (N = 173) found the same effect in a different intergroup context - exposure to conspiracy theories about Jewish people (vs. anti-conspiracy material or a control) increased prejudice towards this group and reduced participants' willingness to vote for a Jewish political candidate. Finally, Study 3 (N = 114) demonstrated that exposure to conspiracy theories about Jewish people not only increased prejudice towards this group but was indirectly associated with increased prejudice towards a number of secondary outgroups (e.g., Asians, Arabs, Americans, Irish, Australians). The current research suggests that conspiracy theories may have potentially damaging and widespread consequences for intergroup relations.


Assuntos
Emigrantes e Imigrantes , Processos Grupais , Judeus , Política , Preconceito/psicologia , Adolescente , Árabes , Ásia/etnologia , Austrália/etnologia , Emigrantes e Imigrantes/psicologia , União Europeia , Feminino , Humanos , Irlanda/etnologia , Masculino , Reino Unido
14.
Soc Psychiatry Psychiatr Epidemiol ; 55(4): 477-486, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31811317

RESUMO

PURPOSE: To examine the national trends and mental health correlates of discrimination among Latin American and Asian immigrants in the United States. METHODS: We examine data from the National Epidemiologic Survey on Alcohol and Related Conditions collected between 2004 and 2013. Recurrent discrimination was measured by respondent reports of adverse experiences such as receiving poor treatment in restaurants or being called a racist name. RESULTS: Rates of perceived discrimination increased by more than 80 percent among immigrants from Latin America (from 14% in 2004 to 25% in 2013), but remained unchanged among Asian immigrants (20-22%). Large percentage point (pp) increases were observed among Latin American immigrants with less than a high school education (pp increase = 13.5) and residing in households earning $20-35,000 annually (pp increase = 14.0). CONCLUSIONS: Findings raise concern both because of the inherent iniquitousness of discrimination and because identity-based mistreatment is linked with mental health problems.


Assuntos
Americanos Asiáticos/psicologia , Emigrantes e Imigrantes/psicologia , Hispano-Americanos/psicologia , Saúde Mental/etnologia , Discriminação Social/etnologia , Adulto , Ásia/etnologia , Feminino , Humanos , América Latina/etnologia , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/etnologia , Pessoa de Meia-Idade , Estados Unidos/epidemiologia
15.
Hist Sci ; 58(1): 51-75, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30966814

RESUMO

This essay examines the relationship between slavery and plant knowledge for cultivational activities and medicinal purposes on Isle de France (Mauritius) in the second half of the eighteenth century. It builds on recent scholarship to argue for the significance of slaves in the acquisition of plant material and related knowledge in pharmaceutical, acclimatization, and private gardens on the French colonial island. I highlight the degree to which French colonial officials relied on slaves' ethnobotanical knowledge but neglected to include such information in their published works. Rather than seeking to explore the status of such knowledge within European frameworks of natural history as an endpoint of knowledge production, this essay calls upon us to think about the plant knowledge that slaves possessed for its practical implementations in the local island context. Both female and male slaves' plant-based knowledge enriched - even initiated - practices of cultivation and preparation techniques of plants for nourishment and medicinal uses. Here, cultivational knowledge and skills determined a slave's hierarchical rank. As the case of the slave gardener Rama and his family reveals, plant knowledge sometimes offered slaves opportunities for social mobility and, even though on extremely rare occasions, enabled them to become legally free.


Assuntos
Colonialismo/história , Pessoas Escravizadas/história , Etnobotânica , Jardins/história , Medicina Herbária/história , Plantas Medicinais , África/etnologia , Ásia/etnologia , Escravização/história , Grupos Étnicos/história , Feminino , França , História do Século XVIII , Humanos , Masculino , Maurício
16.
BMJ Open ; 9(12): e028757, 2019 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-31843819

RESUMO

OBJECTIVE: The first aim was to determine the extent of the relationship between place of birth and self-rated health (SRH) in primary healthcare patients born outside Sweden and those born in Sweden. The second aim was to investigate whether socioeconomic and lifestyle factors explained any differences. SETTING: Two academic primary healthcare centres in Stockholm County, Sweden. PARTICIPANTS: 825 patients at high risk of developing pre-diabetes and diabetes, aged 18-74 years, attending academic healthcare centres in areas with large numbers of immigrants, 56.8% born abroad and 43.2% born in Sweden. Patients with a diagnosis of diabetes were excluded. Inclusion criteria were based on previous research showing that people born in Middle Eastern and Asian countries who live in Sweden have a high prevalence of and risk for diabetes. OUTCOME: SRH was dichotomised as optimal (very good/good) and suboptimal (fair/bad/very bad) and compared in those born outside Sweden and in Sweden. RESULTS: There was a statistically significant difference in the SRH of the two groups (p=0.008). Logistic regression analysis showed a crude OR for reduced SRH of 1.46 (95% CI 1.10 to 1.92) in patients born outside Sweden. After controlling for education, employment and marital status, the OR increased to 1.50 (95% CI 1.11 to 2.02). After controlling for physical activity and smoking, it decreased to 1.36 (95% CI 1.00 to 1.85). CONCLUSION: Socioeconomic and lifestyle factors influenced SRH. It could therefore be useful for clinicians to consider these factors when providing care for patients born outside Sweden and resettled in areas with large numbers of immigrants.


Assuntos
Diabetes Mellitus/epidemiologia , Emigrantes e Imigrantes/estatística & dados numéricos , Nível de Saúde , Estado Pré-Diabético/epidemiologia , Adolescente , Adulto , Idoso , Ásia/etnologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Oriente Médio/etnologia , Fatores de Risco , Autorrelato , Fatores Socioeconômicos , Suécia/epidemiologia , Adulto Jovem
17.
PLoS One ; 14(12): e0225212, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31790443

RESUMO

OBJECTIVE: While prediction models can estimate an infant's risk of developing obesity at a later point in early childhood, caregiver receptiveness to such information is largely unknown. We aimed to assess the acceptability of these models to New Zealand caregivers. METHODS: An anonymous questionnaire was distributed online. The questionnaire consisted of multiple choice and Likert scale questions. Respondents were parents, caregivers, and grandparents of children aged ≤5 years. RESULTS: 1,934 questionnaires were analysed. Responses were received from caregivers of various ethnicities and levels of education. Nearly two-thirds (62.1%) of respondents would "definitely" or "probably" want to hear if their infant was at risk of early childhood obesity, although "worried" (77.0%) and "upset" (53.0%) were the most frequently anticipated responses to such information. With lower mean scores reflecting higher levels of acceptance, grandparents (mean score = 1.67) were more receptive than parents (2.10; p = 0.0002) and other caregivers (2.13; p = 0.021); males (1.83) were more receptive than females (2.11; p = 0.005); and Asian respondents (1.68) were more receptive than those of European (2.05; p = 0.003), Maori (2.11; p = 0.002), or Pacific (2.03; p = 0.042) ethnicities. There were no differences in acceptance according to socioeconomic status, levels of education, or other ethnicities. CONCLUSIONS: Almost two-thirds of respondents were receptive to communication regarding their infant's risk of childhood obesity. While our results must be interpreted with some caution due to their hypothetical nature, findings suggest that if delivered in a sensitive manner to minimise caregiver distress, early childhood obesity risk prediction could be a useful tool to inform interventions to reduce childhood obesity in New Zealand.


Assuntos
Comunicação , Obesidade Pediátrica/epidemiologia , Adolescente , Adulto , Ásia/etnologia , Atitude Frente a Saúde/etnologia , Cuidadores/psicologia , Pré-Escolar , Europa (Continente)/etnologia , Retroalimentação , Feminino , Previsões , Avós/psicologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Nova Zelândia/etnologia , Pais/psicologia , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/prevenção & controle , Risco , Inquéritos e Questionários , Adulto Jovem
18.
Popul Health Metr ; 17(1): 14, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675961

RESUMO

BACKGROUND: Many studies on migrant health have focused on aspects of morbidity and mortality, but very few approach the relevant issues of migrants' health considering behavioral risk factors. Previous studies have often been limited methodologically because of sample size or lack of information on migrant country of origin. Information about risk factors is fundamental to direct any intervention, particularly with regard to non-communicable diseases that are leading causes of death and disease. Thus, the main focus of our analysis is the influence of country of origin and the assimilation process. METHOD: Utilizing a surveillance system that has been collecting over 30,000 interviews a year in Italy since 2008, we have studied migrants' attitudes and behaviors by country of origin and by length of stay. Given 6 years of observation, we have obtained and analyzed 228,201 interviews of which over 9000 were migrants. RESULTS: While migrants overall present similar conditions to native-born Italians, major differences appear when country of origin or length of stay is considered. Subgroups of migrants present substantially different behaviors, some much better than native-born Italians, some worse. However, integration processes generally produce a convergence towards the behavioral prevalence observed for native-born Italians. CONCLUSIONS: Health programs should consider the diversity of the growing migrant population: data and analyses are needed to support appropriate policies. Many migrants' subgroups arrive with healthier behaviors than those of their adopted country. However, they are likely to have a less favorable social position in their destination countries that could lead to a change towards less healthy behaviors. Interventions capable of identifying this tendency could produce significant better health for this important part of the future (multicultural) populations.


Assuntos
Aculturação , Emigrantes e Imigrantes , Comportamentos Relacionados com a Saúde , Nível de Saúde , Adolescente , Adulto , África ao Sul do Saara/etnologia , África do Norte/etnologia , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Ásia/etnologia , Bebedeira/epidemiologia , Fumar Cigarros/epidemiologia , Depressão/epidemiologia , Detecção Precoce de Câncer/estatística & dados numéricos , Europa (Continente)/etnologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Questionário de Saúde do Paciente , Refugiados , Fatores de Risco , Fatores de Tempo , Neoplasias do Colo do Útero/diagnóstico , Adulto Jovem
20.
Hum Resour Health ; 17(1): 88, 2019 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752896

RESUMO

BACKGROUND: In recent years, the number of students from Asian and African countries to study medicine in China has been on the rise. This study investigated the migration intentions of China-educated international medical students (IMSs) after graduation and the factors that influence the migration intentions. METHODS: The cross-sectional, questionnaire-based study involved the IMSs from the 2nd to the 6th year of degree course at Xuzhou Medical University, China, conducted from April to July of 2018. The self-administrated questionnaire asked questions on students' migration destinations for short-term stay and permanent stay. The influence of gender, continent of origin, academic performance, and family socioeconomic background on the migration intentions was analyzed. Chi-square tests were used for statistical analysis. RESULTS: Among 266 valid responses, 124 (46.62%) students intended to return to their home countries. This intention to return was associated with Asian citizenship, lower academic performance, and middle/lower family socioeconomic status. The remaining 142 students desired to stay temporarily or permanently outside their home countries. The starting time for them to stay outside home countries was immediately after graduation or some time later. Among them, 88 (61.97%) expected to migrate to a high-income country. The intention to migrate to high-income countries was associated with female gender and higher academic grades. For students who intended to stay outside their home countries, the most popular destination for short-term stay was China, and that for permanent stay was the USA. CONCLUSION: IMSs with characteristics of Asian citizenship, lower academic performance, or middle/lower family socioeconomic status are more likely to return to their home countries after graduation, and those with characteristics of female gender or higher academic grades are more likely to migrate to high-income countries. These results suggest that China-educated IMSs constitute a potential resource of healthcare workforce not only for their home countries, but also for the recipient countries. Our findings provide important information on healthcare workforce planning for the governments of the relevant countries.


Assuntos
Educação Médica , Emigração e Imigração/estatística & dados numéricos , Intenção , Área de Atuação Profissional/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , África/etnologia , Ásia/etnologia , China , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários
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