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1.
J Frailty Aging ; 8(4): 198-204, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637406

RESUMO

OBJECTIVES: Eating alone is related to depression, nutritional risk, and mortality. These effects are also influenced by living status. However, little is known about the relationship between eating alone despite living with family and frailty. This study explores the relationship of eating alone and living status with frailty in community-dwelling older adults. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Kashiwa city, Chiba prefecture, Japan; randomly selected community-dwelling older adults (aged 65 years and over). MEASUREMENTS: Eating status was assessed by the question, "Do you eat meals with anyone, at least once a day: yes or no?" Frailty was defined by Kihon Checklist (KCL) score 8 or over. Domains of frailty were divided into instrumental activities of daily living (IADL), physical strength, nutrition, eating, socialization, memory, and mood, based on KCL categories. Binary logistic regression analysis was used, adjusting for age, years of education, chronic diseases, number of teeth and cognitive function. RESULTS: Among the total of 1,914 participants, 49.8% were male, and the overall mean age was 72.9 ± 5.5 years. Of all participants, 56 (5.9%) of men and 112 (11.7%) of women were frail. Older adults who ate alone despite living with others were more likely to be frail (OR 2.49, 95%CI 1.1-5.5 for men and OR 2.16, 95%CI 1.0-4.5 for women). Of particular note, eating and living status were associated with lower physical strength and mood in men, whereas in women these statuses were associated with lower scores for IADL, socialization, memory, and mood. CONCLUSIONS: Eating alone despite living with others was associated with high frailty in both genders; however, the pathways were different between genders. These results might help yield a simple, fundamental intervention approach to multifaceted frailty, reflecting gender and associated high-risk domains.


Assuntos
Comportamento Alimentar , Fragilidade/epidemiologia , Características de Residência/estatística & dados numéricos , Idoso , Estudos Transversais , Feminino , Idoso Fragilizado , Humanos , Vida Independente , Japão/epidemiologia , Masculino
2.
Rev Saude Publica ; 53: 75, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553378

RESUMO

OBJECTIVE: To investigate the association between exposure to green areas in the surroundings of the residence and the presence of common mental disorders among adults, according to different income strata. METHODS: Cross-sectional study with 2,584 participants from the Pró-Saúde Study (2006), residing in the city of Rio de Janeiro. Common Mental Disorders were measured using the General Health Questionnaire (GHQ-12) and exposure to green areas was measured using the normalized difference vegetation index, in buffers with radiuses between 100 and 1,500 meters around the residence. We used the mean and maximum normalized difference vegetation index categorized into quartiles. The study population was divided into three subgroups, according to the income: low, intermediate, and high. Odds ratios and their 95% confidence intervals were estimated with logistic regression models. The models were adjusted by sex and age, with and without inclusion of physical activity practice. RESULTS: The proportion of common mental disorders was 30% and 39% among men and women, respectively. The results of the adjusted models showed an inverse association between the presence of green areas in the surroundings of the residence and the occurrence of common mental disorders, in the buffer of 200 meters in the intermediate-income group and in the buffers of 400 and 1,500 meters in the low-income group. The odds ratio ranged from 0.52 (buffer of 1,500 meters) to 0.68 (buffer of 200 meters). The association found was independent of physical activity practice. CONCLUSIONS: The evidence found suggests the existence of a beneficial effect of urban green areas on the mental health of lower-income individuals. These findings can help in understanding how the urban environment can affect the mental health of the population.


Assuntos
Jardins/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Saúde Mental/estatística & dados numéricos , Parques Recreativos/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Estudos Transversais , Exercício/psicologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Distribuição por Sexo , Fatores Socioeconômicos
3.
BMC Public Health ; 19(1): 1066, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391023

RESUMO

BACKGROUND: Soil-transmitted helminth infection (STH) is one of the neglected tropical disease that affects approximately 2 billion people globally. School children represent the age group that is most commonly infected with STHs, resulting in poor school performance, impaired cognitive function, and many other detrimental effects. The transmission of STH is determined by many factors, such as hygiene and sanitation. Understanding the factors that influence disease transmission in a particular area is key to effective STH control. The objective of this study was to determine the prevalence of STH in North Sumatera and to identify the associated risk factors among school children. METHODS: A cross-sectional study was carried out among primary school children in Suka village, Tigapanah subdistrict. Stool samples were processed using a single Kato-Katz method. The potential risk factors analyzed were parent education and occupation, hand washing habits, latrine usage, footwear usage and contact with soil. The Chi-square test was performed to identify an association between risk factors and parasitological results. Logistic regression analysis was used to measure the strength of association. RESULTS: We enrolled 468 school children between 6 and 12 years of age. Among those children, 268 children (57.24%) were positive for one or more STH infections. Approximately 62.39% of children played with soil/dirt every day, and only 50% regularly washed their hands after activities. Most of the children wore shoes/slippers when going outside (87.82%) and used a latrine for defecation (85.04%). Playing with soil/dirt have been shown to increase the risk of STH infections 7.53 times, while hand washing habits and latrine usage decreased the risk of STH infections 0.16 times each. CONCLUSION: The prevalence of STH infection in school children in Suka village, Tigapanah subdistrict is still high. Playing with soil/dirt increased the risk of infection, while hand washing habits and latrine usage decreased the risk of infection. The combined strategies of improving the personal hygiene of children and biannual deworming can reduce the risk of STH infection in school children in Suka village, Tigapanah subdistrict.


Assuntos
Agricultura , Helmintíase/epidemiologia , Helmintíase/transmissão , Características de Residência/estatística & dados numéricos , Solo/parasitologia , Criança , Estudos Transversais , Fezes/parasitologia , Feminino , Humanos , Higiene/normas , Indonésia/epidemiologia , Masculino , Prevalência , Fatores de Risco , Toaletes/estatística & dados numéricos
4.
BMC Public Health ; 19(1): 1030, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370829

RESUMO

BACKGROUND: We examined the correlations between living arrangement and the physical activity (PA) levels of youth aged 9-19 years while accounting for demographic factors such as age, sex, and socioeconomic status in Shanghai, China. METHODS: Cross-sectional analyses of data from the 2014 Physical Activity and Fitness in Shanghai China-The Youth Study was conducted. Participants were 33,213 primary (9-11-year-olds; n = 13,237), junior middle (12-14-year-olds; n = 11,157), and junior high school students (15-19-year-olds; n = 8819). Youth (boys = 49%) and their guardians were randomly sampled from 17 districts in Shanghai, China. Youths' moderate-to-vigorous PA (MVPA) levels, information about living arrangement, and guardians' sociodemographic factors were collected via questionnaires. RESULTS: Only 17.8% of school-aged youths in Shanghai met MVPA recommendations, with significantly more boys (20.6%) meeting recommendations than girls (p < .001). Youths living in rural areas showed an overall significantly higher percentage of meeting MVPA recommendations (20.3%) than those living in urban areas (p < .001). Youths who lived with single parents showed an overall significantly lower percentage of meeting MVPA recommendations (15.3%) than those living with their grandparent(s) or with both parents (p < .001). A logistic regression analysis revealed that, among 9-11-year-olds, children who live with their grandparent(s) were less likely to meet MVPA recommendations than those who lived with both parents (boys: adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.61-0.84; girls: aOR = 0.84, 95%CI = 0.72-0.98). CONCLUSIONS: Type of living arrangement was associated with the PA of youth in Shanghai, with no significant gender difference. Youth aged 9-19 years who lived with single parents had the lowest percentage of meeting MVPA recommendations. The probability of achieving 60 min/day MVPA recommendations was significantly lower among 9-11-year-old children living with their grandparent(s) than children living with both parents; however, no such difference was observed among adolescents. Our findings suggest that living arrangement may be an important consideration for promotion of PA among youth in China.


Assuntos
Exercício/fisiologia , Características de Residência/estatística & dados numéricos , Adolescente , Fatores Etários , Criança , China , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
5.
BMC Public Health ; 19(1): 1036, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375090

RESUMO

BACKGROUND: This study aims to investigate the mechanisms through which neighborhood social reciprocity influences older adults' mental health in China. METHODS: This study used data from the 2011-2015 waves of the China Health and Retirement Longitudinal Study. It estimated the effects of neighborhood social reciprocity on older adults' mental health and tested the mediating effects of the frequencies of physical activity, social interaction with neighbors, and volunteering experience. RESULTS: The results indicated that more neighborhood social reciprocity related to better mental health. The effects of the three mediators were statistically significant and enhanced mental health. In addition, the effects of the mediators were strengthened by neighborhood social reciprocity, and vice versa. CONCLUSIONS: In China, neighborhood social reciprocity influenced older adults' mental health directly and through the mechanisms of the frequencies of physical activity, social interaction with neighbors, and volunteering experience.


Assuntos
Exercício/psicologia , Relações Interpessoais , Saúde Mental/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Voluntários/psicologia , Idoso , China , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Voluntários/estatística & dados numéricos
6.
BMC Public Health ; 19(1): 1041, 2019 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-31376838

RESUMO

BACKGROUND: Adolescents engage in various combinations (typologies) of physical activity and sedentary behaviors, which impact their health and wellbeing in different ways. As such, there is a need to understand the factors that may inhibit or facilitate engagement in combinations of activity-related behaviors to help inform effective intervention strategies targeting those most in need. The aim of this study was to identify ecological correlates of adolescent physical activity and sedentary behavior typologies. METHODS: Cross-sectional study of 473 adolescents (15.0 ± 1.6 years, 41.4% boys) from 18 secondary schools in Melbourne, Australia. Intrapersonal, interpersonal and neighborhood-physical environmental factors were assessed via self-report surveys and Geographic Information Systems. Multinomial logistic regression models determined the relative risk ratio of membership of three homogenous activity-related behavior typologies based on the potential correlates. RESULTS: Higher levels of self-efficacy for physical activity, parental screen-time restriction rules, parental support for physical activity, sibling screen-time co-participation and perceptions of neighborhood pedestrian/traffic safety were associated with greater likelihood of adolescents being in the typology defined as highly active and low sedentary compared to the physically inactive, highly sedentary typology. Higher frequency of co-participation in screen-time with friends was associated with greater likelihood of adolescents being in the typology defined as moderately active, high screen-time compared to physically inactive, highly sedentary. CONCLUSIONS: A range of intrapersonal, interpersonal and environmental correlates appear to play a role in adolescent activity-related typology membership. The findings may inform public health interventions targeting unique adolescent subgroups most at risk of poor health outcomes based on their engagement in combinations of activity-related behaviors.


Assuntos
Comportamento do Adolescente , Fenômenos Ecológicos e Ambientais , Exercício/psicologia , Adolescente , Austrália , Estudos Transversais , Feminino , Amigos/psicologia , Humanos , Masculino , Pais/psicologia , Características de Residência/estatística & dados numéricos , Tempo de Tela , Comportamento Sedentário , Autorrelato
7.
BMC Public Health ; 19(1): 853, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262276

RESUMO

BACKGROUND: The presence of urban rats in the neighbourhood environment may negatively impact the physical and mental health of residents. Our study sought to describe the experiences with, perceptions of, and feelings towards rats and rat control efforts among a group of disadvantaged urban residents in Vancouver, Canada. METHODS: Semi-structured interviews were held with 20 members of the Vancouver Area Network of Drug Users (VANDU) recruited by VANDU staff. Interviews were audio recorded, transcribed, and analyzed using thematic analysis. RESULTS: Participants reported daily sightings of rats and close contact during encounters. Participants generally disliked encountering rats, raising issues of health and safety for themselves and the community due to the belief that rats carry disease. Fear of rats was common, and in some cases resulted in avoidance of rats. Effects of rats on participants were particularly pronounced for those living with rats in the home or for homeless participants who described impacts on sleep due to the sounds made by rats. Although rats were viewed as more problematic in their neighbourhood than elsewhere in Vancouver, participants believed there to be a lack of neighbourhood-level control initiatives that angered and disheartened participants. In combination with other community-level concerns (e.g., housing quality and availability), the presence of rats was viewed by some to align with a general disregard for the community and its residents. CONCLUSIONS: This study suggests that the presence of rats in urban centres may have several consequences on the physical and mental health of residents living in close contact with them. These effects may be exacerbated with continued contact with rats and when residents perceive a lack of initiative to control rats in their neighbourhood. As such, research and policies aimed at mitigating the health risks posed by rats should extend beyond disease-related risk and incorporate diverse health outcomes.


Assuntos
Áreas de Pobreza , Ratos/psicologia , Características de Residência/estatística & dados numéricos , População Urbana , Populações Vulneráveis/psicologia , Adulto , Idoso , Animais , Canadá , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , População Urbana/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos
8.
BMC Public Health ; 19(1): 887, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277619

RESUMO

BACKGROUND: Depression has become a severe societal problem in China. Although many studies have analyzed how environmental characteristics within neighborhoods affect depression, only a few have dealt with developing countries, and even fewer have considered built, natural, and social environments concurrently. METHODS: Based on a sample of 20,533 Chinese residents assessed in 2016, the present study examined associations between depressive symptoms and respondents' built, natural, and social environments. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D), and multilevel regression models were fitted accounting for potential covariates. RESULTS: Results indicated that living in neighborhoods with more green spaces and a higher population density were negatively associated with CES-D scores. Living in neighborhoods with more social capital was protective against depression. Furthermore, results showed that the social environment moderated the association between the built environment and depression. CONCLUSIONS: Social environments moderate the relationship between the built environment and depression. As environments seem to interact with each other, we advise against relying on a single environment when examining associations with depressive symptoms.


Assuntos
Ambiente Construído/estatística & dados numéricos , Depressão/epidemiologia , Características de Residência/estatística & dados numéricos , Meio Social , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multinível , Fatores de Risco
9.
BMC Public Health ; 19(1): 926, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291914

RESUMO

BACKGROUND: Open drains are common methods of transporting solid waste and excreta in low-income urban neighborhoods. Open drains can overflow due to blockages with solid waste and during rainfall, posing exposure risks. The goal of this study was to evaluate whether pediatric enteric infection was associated with open drains and flooding in a dense, low-income, urban neighborhood. METHODS: As part of the MAL-ED study in Vellore, India, a cohort of 230 children provided stool specimens at 14-17 scheduled home visits and during diarrheal episodes in the first two years of life. All specimens were analyzed for enteric pathogens. Caregivers in 100 households reported on flooding of drains and households and monthly frequency of contact with open drains and flood water. Household GPS points were collected. Monthly rainfall totals for the Vellore district were collected from the Indian Meteorological Department. Clustering of reported drain and house flooding were identified by Kulldorff's Bernoulli Spatial Scan. Differences in enteric infection were assessed for household responses and spatial clusters, with interactions between reported flooding and rainfall to approximate monthly drain flooding retrospectively, using multivariable, mixed-effects logistic regression models. RESULTS: Coverage of household toilets was low (33%), and most toilets (82%) discharged directly into open drains, suggesting poor neighborhood fecal sludge management. Odds of enteric infection increased significantly with total monthly rainfall for children who lived in households that reported that the nearby drain flooded (4% increase per cm of rain: OR: 1.04, 95% CI: 1.00-1.08) and for children in households in a downstream spatial cluster of reported drain flooding (5% increase per cm of rain: OR: 1.05, 95% CI: 1.01-1.09). There was no association between odds of enteric infection and frequency of reported contact with drain or floodwater. CONCLUSIONS: Children in areas susceptible to open drain flooding had increased odds of enteric infection as rainfall increased. Results suggested that infection increased with rainfall due to neighborhood infrastructure (including poor fecal sludge management) and not frequency of contact. Thus, these exposures may not be mitigated by changes in personal behaviors alone. These results underscore the importance of improving the neighborhood environment to improve children's health in low-income, urban settings.


Assuntos
Infecções Bacterianas/epidemiologia , Inundações , Áreas de Pobreza , Características de Residência/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Criança , Estudos de Coortes , Fezes/microbiologia , Humanos , Índia/epidemiologia , Chuva , Saneamento , Esgotos
10.
BMC Public Health ; 19(1): 949, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307422

RESUMO

BACKGROUND: Community-driven projects that aim to address public concerns about health risks from H. pylori infection in Indigenous Arctic communities (estimated H. pylori prevalence = 64%) show frequent failure of treatment to eliminate the bacterium. Among project participants, treatment effectiveness is reduced by antibiotic resistance of infecting H. pylori strains, which in turn, is associated with frequent exposure to antibiotics used to treat other infections. This analysis compares antibiotic dispensation rates in Canadian Arctic communities to rates in urban and rural populations in Alberta, a southern Canadian province. METHODS: Project staff collected antibiotic exposure histories for 297 participants enrolled during 2007-2012 in Aklavik, Tuktoyaktuk, and Fort McPherson in the Northwest Territories, and Old Crow, Yukon. Medical chart reviews collected data on systemic antibiotic dispensations for the 5-year period before enrolment for each participant. Antibiotic dispensation data for urban Edmonton, Alberta (average population ~ 860,000) and rural northern Alberta (average population ~ 450,000) during 2010-2013 were obtained from the Alberta Government Interactive Health Data Application. RESULTS: Antibiotic dispensation rates, estimated as dispensations/person-years (95% confidence interval) were: in Arctic communities, 0.89 (0.84, 0.94); in Edmonton, 0.55 (0.55, 0.56); in rural northern Alberta, 0.63 (0.62, 0.63). Antibiotic dispensation rates were higher in women and older age groups in all regions. In all regions, the highest dispensation rates occurred for ß-lactam and macrolide antibiotic classes. CONCLUSIONS: These results show more frequent antibiotic dispensation in Arctic communities relative to an urban and rural southern Canadian population.


Assuntos
Antibacterianos/uso terapêutico , Características de Residência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Regiões Árticas , Canadá , Criança , Pré-Escolar , Feminino , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Falha de Tratamento , População Urbana/estatística & dados numéricos , Adulto Jovem
11.
BMC Public Health ; 19(1): 983, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337383

RESUMO

BACKGROUND: Many studies have focused on risky sexual behaviour among adolescents and young adults; however, literature on protective sexual practices among this age cohort is still evolving. Since young adults are disproportionately burdened by sexually transmissible infections, including HIV, understanding factors that influence protective sexual behaviour among the age group is crucial in developing age-appropriate interventions. Drawing from a cross-sectional survey conducted among adolescents and young adults in two Nigerian universities, we examined gender differences in protective sexual behaviours and the influence of family support and living with both parents on these behaviours. METHODS: A total of 800 male and female university students in two Nigerian universities were recruited using stratified random sampling between February and April 2018. Analysis was, however, based on 599 participants aged between 15 and 24 . Adjusted and unadjusted multinomial logistic regression models were used to examine the influence of family support, and living with both parents on protective sexual behaviours at a 95% confidence interval. RESULTS: Findings show that the largest proportion of our participants engaged in protective sexual behaviours. We found no gender differences in protective sexual behaviours, including sexual abstinence, consistent condom use, and sexual fidelity. Family support and living with both parents were positively associated with protective sexual behaviours among adolescents and young adults. CONCLUSION: This study found that a majority of adolescents and young adults in Nigerian Universities engage in protective sexual behaviours. Adequate family support and living with both parents are positively associated with protective sexual behaviours. The study however revealed that about one-fifth of our participants engaged in high-risk sexual behaviour. This suggests a need for behavioural change interventions, provision of sexual health services and empowerment of students who receive inadequate family support.


Assuntos
Família/psicologia , Características de Residência/estatística & dados numéricos , Comportamento Sexual/psicologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
12.
BMC Public Health ; 19(1): 920, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288774

RESUMO

BACKGROUND: Neighbourhood safety has repeatedly been shown to be associated with the health and well-being of the residents. Criminality is often seen as one of the key factors affecting neighbourhood safety. However, the relationship between crime, fear of crime and feelings of safety remains underexplored. METHODS: Data on socio-demographic, health and safety perceptions was extracted from the Maastricht municipality survey (the Netherlands) (n = 9656 adults) and merged with data on official neighbourhood crime rates from the Police Registry. Pearson correlation coefficients and multilevel logistic regression models were computed to assess the association between aspects of objective and perceived criminality, individuals' feelings of safety and health. RESULTS: The correlation between the police recorded crime and residents' perceptions of the neighbourhood crime rates was weak (0.14-0.38), with the exception of violent crime (0.59), which indicates that other factors contribute to the perceptions of safety. In turn, the perception of higher rates of violent crime and more nuisance (on the scale 0-10) but not other types of crime or nuisance was positively associated with feeling unsafe (OR 1.27 [1.22;1.32] and 1.39 [1.33;1.46], respectively). Lower general feelings of safety at both the individual and neighbourhood level were consistently associated with worse self-rated health. Among different indicators of safety, the general feelings of safety had the most pronounced association with health, while subjective or objective measures of crime showed limited to no direct relationship with health. CONCLUSIONS: Public health policies targeting safety as a social determinant of health should consider prioritizing areas of violent crime and nuisance to improve general feelings of safety. Further research is needed to understand which factors aside from criminality are driving residents' feelings of safety.


Assuntos
Crime/estatística & dados numéricos , Autoavaliação Diagnóstica , Emoções , Características de Residência/estatística & dados numéricos , Segurança , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cidades , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Fatores Socioeconômicos , Adulto Jovem
13.
BMC Public Health ; 19(1): 1017, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357982

RESUMO

BACKGROUND: Depression is regarded as a major public health concern in our society. While living arrangements as a structural factor of social support may contribute to older adults' depression. Our study aims to investigate the association between living arrangements and depressive symptoms among older adults in the whole China, and to explore whether such influences differ by genders. METHODS: Data were obtained from the 2015 China Health and Retirement Longitudinal Study. The sample was comprised of 6001 individuals aged ≥60 years. Depressive symptoms were measured by the 10-item Short-Form Center for Epidemiological Studies Depression. Independent variables were divided into 4 groups, considering living with/without a spouse and living with/without a child. The multivariate logistic regression was used to estimate the relationship between living arrangements and depressive symptoms in four models. RESULTS: Compared with living only with a spouse, people living with a spouse and child, or living alone were more likely to have depressive symptoms (odds ratio = 1.23 95% CI 1.06-1.42 and 1.40 95% CI 1.03-1.92, respectively). Women were more associated with depressive symptoms (odds ratio = 2.13), but there were no significant associations between living arrangements and depressive symptoms among women. Men living with a spouse and a child had stronger positively depressive symptoms (odds ratio = 1.37). CONCLUSIONS: Older adults living alone, or living with both a child and spouse were more likely to have depressive symptoms. It is important to provide more social services for those older adult, particularly for men living with a spouse and child.


Assuntos
Depressão/epidemiologia , Características de Residência/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
14.
BMC Public Health ; 19(1): 1011, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357984

RESUMO

BACKGROUND: Previous research has shown that certain living arrangements, such as living alone, are associated with worse health at older ages. We assessed the association between living arrangements and hospital care use among middle-aged and older adults, and investigated to what extent observed and unobserved individual characteristics explain this association. METHODS: Longitudinal Finnish registry data for men and women aged 50-89 years were used for the period 1987-2007. The relationship between living arrangements (based on whether an individual lived with a partner, other adults or alone, and whether they lived with minor/adult children) and heavy hospital care use (i.e., having been in hospital for 8 or more days in a year) was studied. First, we applied logistic regression models and linear probability models controlling for observed time-invariant factors (socioeconomic status measured by education, labour force status, and household income; and marital status), and then individual linear probability models with fixed-effects to further account for unobserved time-invariant individual characteristics in the measurement period. Analyses were done separately for 10 year age-groups. RESULTS: In the logistic regression models, men and women who lived alone had higher crude odds of heavy hospital care use than those living only with their partner. These odds ratios were highest for men and women in the youngest age category (50-59 years, 1.72 and 1.36 respectively) and decreased with age. Adjusting for observed time-invariant socioeconomic status attenuated these odds by 14-40%, but adjusting for marital status did not affect the results. Lower odds were observed among adults aged 50-59 years who lived with their partner and (minor or adult) children. But odds were higher for individuals aged 60-79 years who co-resided with their adult children, regardless of whether they lived with a partner. Adjusting for observed time-invariant factors generally did not change these results. After further adjusting for unobserved time-invariant individual characteristics in the individual fixed-effects models, most of these associations largely attenuated or disappeared, particularly for ages 80-89 years. CONCLUSIONS: The association between living arrangements and higher use of hospital care at middle and older ages is largely explained by socioeconomic disadvantage and unobserved time-invariant individual characteristics.


Assuntos
Hospitalização/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Finlândia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores Socioeconômicos
15.
BMC Public Health ; 19(1): 861, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31269940

RESUMO

BACKGROUND: Considering the lack of studies that examine built environmental factors associated with life satisfaction among old people in developing countries, particularly those focused on Brazil, the aim of this study was to estimate the prevalence of life satisfaction among old adults residents in a Brazilian urban center and to investigate its association with individual characteristics and objective measures of the built environment. METHODS: A household survey (N = 832) in Belo Horizonte, Minas Gerais, Brazil (2008-2009) and a Systematic Social Observation (SSO) was used in this study. Life satisfaction was assessed through Self-Anchoring Ladder Scale, developed by Cantril, in 1965. Participants' answers were categorized as satisfied (rungs 6-10) and dissatisfied (rungs 0-5). A Multilevel Poisson regression analysis with robust variance was performed. RESULTS: The prevalence of satisfaction with life was approximately 82%. Higher prevalence of life satisfaction was significantly associated with old people who reported higher incomes, higher religious participation, who practice physical activity and who perceive their health as good and very good. In contextual level, results showed that when the contextual features were adjusted separately by the individual characteristics they were no longer significant. The results also showed a lower prevalence of life satisfaction among those living in neighborhoods with higher physical disorder, even after adjusting for individual and other contextual characteristics. CONCLUSIONS: The present findings suggest that life satisfaction should be assessed whenever evaluating urban redevelopment programs designed to improve neighborhood characteristics, reducing physical disorder, especially among old adults.


Assuntos
Ambiente Construído/estatística & dados numéricos , Satisfação Pessoal , Características de Residência/estatística & dados numéricos , População Urbana , Idoso , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Análise Multinível , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
16.
BMC Health Serv Res ; 19(1): 343, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146790

RESUMO

BACKGROUND: Health care on equal terms is a cornerstone of the Swedish health care system. Total hip arthroplasty (THA) is considered a success story in Sweden with low frequency of reoperations and restored health-related quality of life (HRQoL). Administratively, health care in Sweden is locally self-governed by 21 counties. In this longitudinal nation-wide observational study we assessed the possible geographical variations in 1-year follow-up patient-reported outcomes (PROs): EQ-5D index, EQ VAS, Pain VAS and Satisfaction VAS. METHODS: Study population consisted of 36,235 Swedish THA patients, operated during 2008 to 2012 due to hip osteoarthritis. Individual data came from Swedish Hip Arthroplasty Register, Statistics Sweden and National Board of Health and Welfare. We used descriptive statistics together with multivariable regression analysis to analyse the data. RESULTS: We observed county level differences in both preoperative and postoperative PROs. The results showed that the differences observed in preoperative PROs could not fully explain the differences observed in postoperative PROs, even after adjustment for patient demographics (age, sex, BMI, Elixhauser comorbidity index, marital status, educational level and disposable income). This indicates that other factors might influence the outcome after THA. CONCLUSION: Likely, structural and process differences such as indication for surgery have an influence on PROs after surgery. Standardization of care at hospital levels may decrease geographical variations in postoperative HRQoL. Remaining differences will then possibly be associated to patient demographics.


Assuntos
Artroplastia de Quadril/estatística & dados numéricos , Osteoartrite do Quadril/cirurgia , Idoso , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Osteoartrite do Quadril/epidemiologia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Reoperação/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Suécia/epidemiologia , Escala Visual Analógica
17.
Int J Equity Health ; 18(1): 81, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159820

RESUMO

BACKGROUND: Health equity is a priority in the global sustainable development agenda. Available health equity indicators often focus on health outcomes, access to healthcare, risk factors and determinants such as income, education, and gender. Less attention has been given to other social determinants, including those related to place and ethnicity. Measures such as income, education, and gender, however, may not provide policy-makers with sufficient information to redress inequities. In this paper, we begin to develop health equity indicators for young Pasifika peoples in Logan, Queensland, Australia. While health data on Pasifika young people in Queensland is scant, available data suggests significant inequalities. The purpose of the study was to develop an understanding of the drivers of these disparities through the lens of the social determinants of health, to create health equity indicators. METHODS: Following meetings with community stakeholders to develop respectful and collaborative partnership processes, we took a youth participatory action research approach. Six peer researchers (3 male, 3 female) were recruited from the Logan area for the project. Following training, the peer researchers undertook 31 qualitative interviews with young Pasifika (16-24 years old). Data was manually analysed, coded and grouped into themes to develop the draft indicators. Interviews used the culturally appropriate Talanoa storytelling approach. RESULTS: Six key themes were identified from the interviews and were used to develop example indicators related to: spiritual and socio-cultural dimensions, place, access to culturally responsive services, economic and material dimensions and political dimensions. The results demonstrate health inequities experienced by Pasifika populations are strongly linked to place and their economic, social and cultural position. CONCLUSIONS: This study emphasises the need to understand the multiplicity of place-based factors that interact in complex ways to shape health inequities for young Pasifika peoples. It highlights health equity indicators must go beyond healthcare services, outcomes and a limited number of objective determinants, to include a more holistic focus. Starting to measure health and wellbeing via the lens of the social determinants of health will help to identify where policy-makers and programmes can intervene to begin to more adequately address inequities.


Assuntos
Equidade em Saúde , Indicadores Básicos de Saúde , Características de Residência/estatística & dados numéricos , Determinantes Sociais da Saúde , Adolescente , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Queensland , Adulto Jovem
18.
BMC Public Health ; 19(1): 752, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196039

RESUMO

BACKGROUND: Globally, alcohol use is responsible for 320 deaths every hour, and the impact is more among those in the younger age group. Despite the adverse health and social challenges associated with alcohol use, alcohol remains the most used and abused psychoactive substance among young adults. Our study aimed at determining the prevalence, correlates and frequency of alcohol use among young adults in two Nigerian universities. We further explored the role of family structure, family support and religion/religiosity on alcohol use in this study setting. Such findings could help to inform public health policy formulation in the country. METHODS: This was a cross-sectional study conducted in two selected universities in the North Central region of Nigeria. The study was conducted among a final sample of 784 students selected using stratified random sampling. An interviewer-administered questionnaire was used to collect data on ever and current alcohol use and frequency of alcohol use between February and April 2018. The data were analysed using descriptive and inferential statistics. RESULTS: The level of ever and current use of alcohol was 43.5 and 31.1%, respectively. The mean frequency of alcohol use among the study participants was three days, but ten days among current alcohol users. In the adjusted model, male sex, age above 19 years, infrequent attendance of religious rituals, and belonging to rich/middle-class family were significantly associated with a higher likelihood of ever use and current use of alcohol, while living in the same household as one's father was associated with lower odds of current and ever use of alcohol. CONCLUSION: There is a high rate of lifetime and current use of alcohol among university students in the study setting. Alcohol use was significantly associated with living with parents, religion and religiosity. Both high and low socioeconomic status were associated with alcohol use. There is a need to implement measures in controlling alcohol manufacturing and marketing as well as policies regulating alcohol outlets establishment around educational institutions as well as the working hours in such outlets. Finally, there is a need to organise interventions aimed at reducing this unhealthy social norm among students in this setting.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Consumo de Bebidas Alcoólicas/epidemiologia , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Religião , Características de Residência/estatística & dados numéricos , Fatores de Risco , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
19.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 643-647, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238612

RESUMO

Objective: To analyze the epidemiological characteristics, trend and related factors of tuberculosis patients that delayed for care, in Wuhan from 2008 to 2017. Methods: Data regarding tuberculosis (TB) patients was collected from the tuberculosis management information system (TMIS), a part of the China information system for disease control and prevention from 2008 to 2017. A total of 64 208 tuberculosis patients, aged 0 to 95 years were included for the analysis. Unconditional logistic regression method was used to estimate those factors that associated with this study. Results: Days of delay among TB patients appeared as M=10 (P(25)-P(75): 3-28) day, in Wuhan, 2008-2017. The prevalence of the delay was 52.5% (33 703/64 208), presenting a downward trend from 2008 to 2017 (trend χ(2)=10.64, P<0.001), but the proportions of women and ≥65 year-olds were gradually increasing. Results from the multivariate logistic regression analysis showed that factors as: patients living far away from the city vs. near the city (OR=1.29, 95%CI: 1.25-1.35), and age above 45 years vs. younger than 25 years (the age 45-64 years group vs. aged less than 25 years group, OR=1.22, 95%CI: 1.15-1.29; the age 65 or above group vs. aged less than 25 years group, the OR=1.30, 95%CI: 1.22-1.39) were under higher risk on the delay of seeking care. Occupation, way of case-finding and classification of tuberculosis patients also appeared as influencing factors on this issue. Conclusions: Prevalence on the delay of care was 52.5% among tuberculosis patients in Wuhan, 2008-2017, but with an annual decrease. Attention should be paid to female, wrinkly or elderly tuberculosis patients regarding the delay of care on TB, in Wuhan.


Assuntos
Antituberculosos/uso terapêutico , Diagnóstico Tardio , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Características de Residência/estatística & dados numéricos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Assistência à Saúde/organização & administração , Feminino , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Prevalência , Distribuição por Sexo , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/microbiologia , Adulto Jovem
20.
BMC Public Health ; 19(1): 619, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31113396

RESUMO

BACKGROUND: With studies around the world suggesting a large proportion of people do not recognise that they are overweight (or feel satisfied with being overweight), this fuels the view that such 'misperceptions' need to be 'corrected'. However, few longitudinal studies have examined the consequences of under-perceived weight status, nor over-perceived weight status (when a person feels overweight when they are not) and weight-related satisfaction on trajectories in body mass index (BMI). METHODS: Five-year BMI trajectories were examined among 8174 participants in an Australian nationally representative cohort. Each person was classified into groups according to their neighbourhood socioeconomic circumstances, baseline BMI and answers to "how satisfied are you with your current weight?" and "do you consider yourself to be… acceptable weight / underweight / overweight?" Gender-specific multilevel linear regressions were used to examine five-year BMI trajectories for people in each group, adjusting for potential confounders. RESULTS: At baseline, weight-related dissatisfaction and perceived overweight were generally associated with higher mean BMI for men and women, regardless of whether they were classified as 'normal' or overweight by World Health Organization (WHO) criteria. Mean BMI did not decrease among people classified as overweight who perceived themselves as overweight, or expressed weight-related dissatisfaction, regardless of where they lived. Among men and women with 'normal' BMI at baseline but expressing weight-related dissatisfaction, mean BMI increased disproportionately among those living in disadvantaged areas compared to their counterparts in affluent areas. Similarly, mean BMI rose disproportionately among people in disadvantaged areas who felt they were overweight despite having a 'normal' BMI by WHO criteria, compared to people with the same over-perceptions living in affluent areas. These differences exacerbated pre-existing socioeconomic inequities in mean BMI. CONCLUSIONS: No evidence was found to suggest accurate recognition of overweight or expressing weight-related dissatisfaction leads to a lower BMI. However, there was evidence of an increase in mean BMI among people who felt dissatisfied with, or over-perceived their 'normal' weight, especially in socioeconomically disadvantaged areas. Correction of under-perceptions may not drive weight loss, but circumstances contributing to over-perception and dissatisfaction with weight status may contribute to increased weight gain and exacerbate socioeconomic inequities in BMI.


Assuntos
Imagem Corporal/psicologia , Sobrepeso/psicologia , Percepção , Satisfação Pessoal , Perda de Peso , Adulto , Austrália , Índice de Massa Corporal , Feminino , Humanos , Estudos Longitudinais , Masculino , Áreas de Pobreza , Características de Residência/estatística & dados numéricos
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