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1.
rev.cuid. (Bucaramanga.2010) ; 13(1): 1-14, 20221213.
Artigo em Português | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1369166

RESUMO

Introdução: O sedentarismo em adolescentes contribui para a ocorrência de diferentes doenças, sendo relevante investigar sobre fatores associados. Objetivo: Analisar a associação entre sedentarismo e nível socioeconômico em adolescentes de escolas públicas. Materiais e métodos: Estudo transversal, realizado com 347 adolescentes matriculados em escolas públicas do ensino médio do município de Divinópolis, Minas Gerais. A coleta de dados ocorreu no ano de 2017. O sedentarismo foi avaliado utilizando-se o International Physical Activity Questionnaire e o nível socioeconômico pelo critério da Associação Brasileira de Empresas de Pesquisa. Foi realizada estatística descritiva e analítica através de modelo de regressão logística multivariada. Resultados: Participaram da investigação 347 adolescentes. A média de idade do grupo foi de 16,4 ± 1,0 anos. Os indivíduos caracterizados como sedentários constituíram 38,9% da amostra, sendo que, destes, 66,7% eram do sexo feminino. Possuir maior nível socioeconômico diminui a probabilidade de ser sedentário (OR=0,235; p=0,021), assim como ser estudante das escolas públicas da região sudoeste aumenta essa chance(OR=2,680; p=0,04). Discussão: Os motivos pelos quais as condições socioeconômicas podem influenciar o sedentarismo são variados. A ausência de espaços públicos pode contribuir para a elevação do sedentarismo em adolescentes com menor nível socioeconômico. Conclusão: Esta investigação sinaliza a importância de investimentos públicos em políticas de estímulo à prática de atividade física para os adolescentes, em especial para os do sexo feminino e de menor nível socioeconômico.


Introduction: A sedentary lifestyle in adolescents contributes to the occurrence of different diseases, making it relevant to investigate associated factors. Objective: To analyze the association between sedentary lifestyle and socioeconomic status in adolescents from public schools. Materials and methods: Cross-sectional study, carried out with 347 adolescents enrolled in public high schools in the city of Divinópolis, Minas Gerais. Data collection took place in 2017. Sedentary lifestyle was assessed using the International Physical Activity Questionnaire and socioeconomic status using the criteria of the Brazilian Association of Research Companies. Descriptive and analytical statistics were performed using a multivariate logistic regression model. Results: 347 adolescents participated in the investigation. The mean age of the group was 16.4 ± 1.0 years. Individuals characterized as sedentary constituted 38.9% of the sample, of which 66.7% were female. Having a higher socioeconomic level decreases the probability of being sedentary (OR = 0,235; p = 0.021), just as being a student in public schools in the southwest region increases this chance (OR = 2,680; p = 0.04). Discussion: The reasons why socioeconomic conditions can influence a sedentary lifestyle are varied. The absence of public spaces can contribute to the increase in sedentary lifestyles in adolescents with lower socioeconomic status. Conclusion: This investigation highlights the importance of public investments in policies to encourage the practice of physical activity for adolescents, especially for females and lower socioeconomic status.


Introducción: El sedentarismo en los adolescentes contribuye a la ocurrencia de diferentes enfermedades, por lo que es relevante investigar los factores asociados. Objetivo: Analizar la asociación entre sedentarismo y nivel socioeconómico en adolescentes de escuelas públicas. Materiales y métodos: Estudio transversal, realizado con 347 adolescentes matriculados en escuelas secundarias públicas de la ciudad de Divinópolis, Minas Gerais. La recolección de datos tuvo lugar en 2017. El estilo de vida sedentario se evaluó mediante el Cuestionario Internacional de Actividad Física y el nivel socioeconómico según los criterios de la Asociación Brasileña de Empresas de Investigación. La estadística descriptiva y analítica se realizó mediante un modelo de regresión logística multivariante. Resultados: 347 adolescentes participaron en la investigación. La edad media del grupo fue de 16,4 ± 1,0 años. Los individuos caracterizados como sedentarios constituyeron el 38,9% de la muestra, de los cuales el 66,7% eran mujeres. Tener un nivel socioeconómico más alto disminuye la probabilidad de ser sedentario (OR = 0,235; p = 0,021), al igual que ser alumno de escuelas públicas de la región suroeste aumenta esta posibilidad (OR = 2,680; p = 0,04). Discusión: Las razones por las que las condiciones socioeconómicas pueden influir en un estilo de vida sedentario son variadas. La ausencia de espacios públicos puede contribuir al aumento de estilos de vida sedentarios en adolescentes de menor nivel socioeconómico. Conclusión: Esta investigación destaca la importancia de la inversión pública en políticas para incentivar la práctica de actividad física en adolescentes, especialmente en mujeres y estrato socioeconómico más bajo.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Serviços de Saúde Escolar , Classe Social , Adolescente , Comportamento Sedentário
2.
Front Public Health ; 10: 880339, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35910895

RESUMO

Background: One in four women of childbearing age has some degree of mental disorders and are, therefore, prone to both pregnancy complications and adverse health outcomes in their offspring. We aimed to evaluate the impact of preconception severe mental disorders on pregnancy outcomes in primiparous women. Methods: The study cohort was composed of 6,189 Finnish primiparous women without previously diagnosed diabetes, who delivered between 2009 and 2015, living in the city of Vantaa, Finland. Women were classified to have a preconception severe mental disorder if they had one or more outpatient visits to a psychiatrist or hospitalization with a psychiatric diagnosis 1 year before conception. Data on pregnancies, diagnoses, and pregnancy outcomes were obtained from national registers at an individual level. Results: Primiparous women with preconception severe psychiatric diagnosis were younger, more often living alone, smokers, and had lower educational attainment and lower taxable income than women without psychiatric diagnosis (for all p < 0.001). Of all women, 3.4% had at least one psychiatric diagnosis. The most common psychiatric diagnoses were depression and anxiety disorders. The most common comorbidity was the combination of depression and anxiety disorders. There were no differences in the need for respiratory treatments, admissions to the neonatal intensive care unit, or antibiotic treatments between the offspring's groups. Conclusion: Although primiparous women had severe mental disorders, the well-being of newborns was good. The most common severe mental health disorders were depression and anxiety disorders, and psychiatric comorbidity was common. Women with severe mental disorders more often belonged to lower socioeconomic groups.


Assuntos
Saúde Mental , Complicações na Gravidez , Transtornos de Ansiedade , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Classe Social
3.
BMC Psychiatry ; 22(1): 519, 2022 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918664

RESUMO

BACKGROUND: Bullying, being a victim of violent behaviors, life satisfaction (LS) and self-rated health (SRH) in children and adolescents, all have consistently been recognized as vital factors in school performance and future individual life. METHODS: This cross-sectional data secondary study was a part of the fifth Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-V) in 2015. A total of 14,400 students 7-18 years and their parents living in 30 provinces in Iran were studied. A validated questionnaire of the World Health Organization on Global School-based Health Survey (WHO-GSHS) was used to measure the outcomes and socioeconomic variables. Family's socioeconomic status (SES) was determined using principal component analysis (PCA). The crude and adjusted odds ratios (95% confidence interval (CI)) were estimated using multiple logistic regressions for each outcome. RESULTS: A total of 14,274 students completed the study, of whom 50.6% were boys. Overall, the prevalence of bullying, being a victim, life dissatisfaction (LDS), and poor SRH among students was 35.6, 21.4, 21.1, and 19.0%, respectively. In multiple-logistic regression analysis (Adjusted OR, (95%CI), students with an illiterate father and mother (1.60, (1.25-2.04), 1.28, (1.03-1.61), unemployed father (1.58, (1.29-1.81)), and one-parent family (1.32, (1.05 - 1.64) had a higher odd of Poor-SRH. Besides, a family size larger than four members (1.14, (1.03-1.25), and low-SES (1.35, (1.15-1.56), and illiteracy of the mother (1.64, (1.30-2.08) had a direct association with LDS. Mother illiteracy also increased the odds of bullying (1.77, (1.45-2.16) and being a victim (1.58, (1.26-1.98). CONCLUSIONS: Some socioeconomic variables can be proposed as the statistically significant attribution of bullying and being a victim, LDS, and Poor-SRH in children and adolescents.


Assuntos
Agressão , Bullying , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Classe Social , Estudantes
4.
Health Qual Life Outcomes ; 20(1): 121, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918765

RESUMO

BACKGROUND: Socioeconomic status is a key predictor of lifetime health: poorer people can expect to live shorter lives with lower average health-related quality-of-life (HRQoL) than richer people. In this study, we aimed to improve understanding of the socioeconomic gradient in HRQoL by exploring how inequalities in different dimensions of HRQoL differ by age. METHODS: Data were derived from the Health Survey for England for 2017 and 2018 (14,412 participants). HRQoL was measured using the EQ-5D-5L instrument. We estimated mean EQ-5D utility scores and reported problems on five HRQoL dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) for ages 16 to 90+ and stratified by neighbourhood deprivation quintiles. Relative and absolute measures of inequality were assessed. RESULTS: Mean EQ-5D utility scores declined with age and followed a socioeconomic gradient, with the lowest scores in the most deprived areas. Gaps between the most and least deprived quintiles emerged around the age of 35, reached their greatest extent at age 60 to 64 (relative HRQoL of most deprived compared to least deprived quintile: females = 0.77 (95% CI: 0.68-0.85); males = 0.78 (95% CI: 0.69-0.87)) before closing again in older age groups. Gaps were apparent for all five EQ-5D dimensions but were greatest for mobility and self-care. CONCLUSION: There are stark socioeconomic inequalities in all dimensions of HRQoL in England. These inequalities start to develop from early adulthood and increase with age but reduce again around retirement age.


Assuntos
Depressão , Qualidade de Vida , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Dor , Classe Social , Inquéritos e Questionários , Adulto Jovem
5.
Chron Respir Dis ; 19: 14799731221117297, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938497

RESUMO

INTRODUCTION: Specialist management of asthma has been shown to associate with socioeconomic status (SES). However, little is known about the influence of SES on care burden in universal healthcare settings. METHODS: Patients aged 18-45 years using inhaled corticosteroids (ICS) were followed in national databases. Impact of asthma was investigated using negative binomial regression adjusted for age, sex, comorbidity, and GINA 2020 Step. Uncontrolled asthma was defined as >600 annual SABA puffs, ≥2 prednisolone courses and/or ≥1 hospitalization. RESULTS: A total of 60,534 (55% female, median age 33 (IQR 25-39)) patients were followed for 10.1 years (IQR 5.2-14.3)). Uncontrolled asthma resulted in 6.5 and 0.51 additional annual contacts to primary care and pulmonologists, respectively.Unscheduled and primary care burden was dependent on SES, increasing with rural residence, lower education, income and receiving welfare. Differences in planned respiratory care were slight, only seen among divorced, low income- or welfare recipients. Lower SES was consistently associated with an increased utilization of SABA and prednisolone. No dose-response relationship between ICS use and SES could be identified. CONCLUSION: Lower SES in asthma is a risk factor for a predominance of unscheduled care and adverse outcomes, warranting further attention to patients' background when assessing asthma care.


Assuntos
Antiasmáticos , Asma , Administração por Inalação , Corticosteroides/uso terapêutico , Adulto , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Asma/epidemiologia , Estudos de Coortes , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Prednisolona/uso terapêutico , Classe Social , Adulto Jovem
6.
Nature ; 608(7921): 122-134, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35915343

RESUMO

Low levels of social interaction across class lines have generated widespread concern1-4 and are associated with worse outcomes, such as lower rates of upward income mobility4-7. Here we analyse the determinants of cross-class interaction using data from Facebook, building on the analysis in our companion paper7. We show that about half of the social disconnection across socioeconomic lines-measured as the difference in the share of high-socioeconomic status (SES) friends between people with low and high SES-is explained by differences in exposure to people with high SES in groups such as schools and religious organizations. The other half is explained by friending bias-the tendency for people with low SES to befriend people with high SES at lower rates even conditional on exposure. Friending bias is shaped by the structure of the groups in which people interact. For example, friending bias is higher in larger and more diverse groups and lower in religious organizations than in schools and workplaces. Distinguishing exposure from friending bias is helpful for identifying interventions to increase cross-SES friendships (economic connectedness). Using fluctuations in the share of students with high SES across high school cohorts, we show that increases in high-SES exposure lead low-SES people to form more friendships with high-SES people in schools that exhibit low levels of friending bias. Thus, socioeconomic integration can increase economic connectedness in communities in which friending bias is low. By contrast, when friending bias is high, increasing cross-SES interactions among existing members may be necessary to increase economic connectedness. To support such efforts, we release privacy-protected statistics on economic connectedness, exposure and friending bias for each ZIP (postal) code, high school and college in the United States at https://www.socialcapital.org .


Assuntos
Status Econômico , Amigos , Mapeamento Geográfico , Instituições Acadêmicas , Capital Social , Classe Social , Estudantes , Conjuntos de Dados como Assunto , Status Econômico/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Preconceito/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Mídias Sociais/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Estados Unidos , Universidades/estatística & dados numéricos
7.
BMC Public Health ; 22(1): 1522, 2022 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948969

RESUMO

BACKGROUND: Overweight and obesity rates are increasing worldwide, particularly among people with a low socioeconomic status (SES). Care-physical activity (care-PA) initiatives may improve participants' lifestyles and thereby lower overweight and obesity rates. A two-year care-PA initiative specifically developed for citizens with a low SES, X-Fittt 2.0, was offered free of charge to participants, and included 12 weeks of intensive guidance and sports sessions, and 21 months of aftercare. Here, we study the impact of X-Fittt 2.0 on health, quality of life (QoL) and societal participation using a mixed-methods design. METHODS: Questionnaires and body measurements were taken from 208 participants at the start of X-Fittt 2.0 (t0) and after 12 weeks (t1), one year (t2) and two to three years (t3). We also held 17 group discussions (t1, n = 71) and 68 semi-structured interviews (t2 and t3). Continuous variables were analysed using a linear mixed-model analysis (corrected for gender, age at t0, height, education level and employment status at the different time points), while we used descriptive statistics for the categorical variables. Qualitative data were analysed using a thematic analysis. RESULTS: Body weight was significantly lower at all three post-initiative time points compared with the baseline, with a maximum of 3.8 kg difference at t2. Body Mass Index, waist circumference, blood pressure and self-perceived health only significantly improved during the first 12 weeks. A positive trend regarding paid work was observed, while social visits decreased. The latter might be explained by the COVID-19 pandemic, as lockdowns limited social life. Furthermore, participants reported increased PA (including sports) and a few stopped smoking or drinking alcohol. Participants mentioned feeling healthier, fitter and more energetic. Additionally, participants' self-esteem and stress levels improved, stimulating them to become more socially active. However, the participants also mentioned barriers to being physically active, such as a lack of money or time, or physical or mental health problems. CONCLUSIONS: X-Fittt 2.0 improved the health, QoL and societal participation of the participants. Future initiatives should take into account the aforementioned barriers, and consider a longer intervention period for more sustainable results. More complete data are needed to confirm the findings.


Assuntos
COVID-19 , Qualidade de Vida , Controle de Doenças Transmissíveis , Exercício Físico/psicologia , Humanos , Obesidade , Sobrepeso , Pandemias , Qualidade de Vida/psicologia , Classe Social
8.
Indian J Dent Res ; 33(1): 105-109, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35946255

RESUMO

Objectives: The aim of the study was to assess the effect of life course factors on dental fear among adult dental patients attending out-reach clinics in a rural area of South India. The objectives were to measure dental fear and changes in socio-economic status during the life course among the study population and to know whether social mobility reduced/increased dental fear. Methods: Dental fear scale and life course data were collected from 403 respondents. The improvement status of individual life course criteria was categorised into "less/minimal", "stable", or "upwardly mobile". Results: The odds of dental fear in the group showing less or minimal upward social mobility was two times that of the stable group [p = 0.022; 95% confidence interval (C.I): 1.104-3.598], whereas the odds of dental fear in the group showing more or good upward social mobility were 4.5 times that of the stable group [p = 0.001; 95% C.I: 1.928-10.515] when adjusted for covariates, that is, participant age, gender, and education and past history of dental avoidance. Conclusion: Social mobility was found to be a risk indicator for dental fear. Dental services may have been affected even with increased standards of living because of psychological factors such as dental fear.


Assuntos
Ansiedade ao Tratamento Odontológico , Acontecimentos que Mudam a Vida , Adulto , Ansiedade ao Tratamento Odontológico/etiologia , Escolaridade , Humanos , Índia , Classe Social
9.
PLoS One ; 17(8): e0270990, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35917333

RESUMO

Different methodologies rely on names, by assuming that people clearly and solely perceive signals of ethnic-national origin from names. This study examines the perception of names from an intersectional perspective in a West-European context. Firstly, we analyze whether people perceive signals of ethnic-national origin in names. Secondly, we test the excludability assumption by analyzing whether names signal also other factors. Thirdly, we distinguish between homogenous and mixed names. For these purposes, we collected data on the perception of 180 names in Belgium of Belgian, Moroccan, Turkish, Polish and Congolese origin. It appears that respondents distinguish Belgian from non-Belgian names rather than perceiving a specific ethnic-national origin. Besides, people perceive signals about a person's gender, religiosity, social class and educational level. This implies that scholars should be precautious with comparing discrimination against ethnic groups, if ethnic-national origin is only signaled through names. Moreover, the question arises as to what we are measuring exactly, since names contain complex signals.


Assuntos
Etnicidade , Nomes , Escolaridade , Humanos , Percepção , Classe Social
10.
Longit Life Course Stud ; 13(3): 380-411, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35920633

RESUMO

There has been much debate over the micro-level relationship between employment situations and fertility in Europe and Northern America. However, related research in East Asia is scant, although countries in this region have some of the lowest fertility rates in the world. Moreover, most studies analyse the employment-fertility relationship from a static perspective and only for women, which underemphasises life course dynamics and gender heterogeneity of employment careers and their fertility implications. Drawing on retrospective data from the 2017 Taiwan Social Change Survey (TSCS), this study explores women's and men's career trajectories between ages 18 and 40 in Taiwan using sequence cluster analyses. It also examines how career variations associate with different timing and quantum of birth. Empirical results show that economically inactive women experience faster motherhood transitions and have more children by age 40 than women with stable full-time careers. For men, having an unstable career associates with slower fatherhood transitions and a lower number of children. For both genders, self-employed people are the earliest in parenthood transitions and have the highest number of children by midlife. Our findings demonstrate sharp gender contrasts in employment careers and their diversified fertility implications in low-fertility Taiwan.


Assuntos
Fertilidade , Classe Social , Adolescente , Adulto , Criança , Demografia , Feminino , Humanos , Masculino , Dinâmica Populacional , Estudos Retrospectivos , Fatores Socioeconômicos , Taiwan , Adulto Jovem
11.
J Nutr Sci ; 11: e61, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35912305

RESUMO

Vitamin D is essential for bone and muscle health with adequate status in childhood crucial for normal skeletal development. We aimed to investigate vitamin D status in a convenience sample (n = 1226) of Irish children (aged 1-17 years) who had serum 25-hydroxyvitamin D (25(OH)D) tested by request of their GP at a Dublin Hospital between 2014 and 2020. We examined predictors including age, sex, season and socioeconomic status (SES). Vitamin D deficiency (<30 nmol/l) was prevalent affecting 23 % and was more common in disadvantaged areas (34 %) and in those aged >12 v. ≤12 years (24 % v. 16 %, P = 0⋅033). The greatest predictor was SES (disadvantaged v. affluent, OR 2⋅18, CI 1⋅34, 3⋅53, P = 0⋅002), followed by female sex (OR 1⋅57, CI 1⋅15, 2⋅14, P = 0⋅005) and winter season (October to February, OR 1⋅40, CI 1⋅07, 1⋅84, P = 0⋅015). A quarter of our sample of children were deficient, rising to one-third in those in disadvantaged areas. Females and those aged over 12 years had a higher prevalence of deficiency. Public health strategies to improve vitamin D status in Irish children, including systematic food fortification may need to be considered to address this issue.


Assuntos
Suplementos Nutricionais , Deficiência de Vitamina D , Criança , Feminino , Humanos , Classe Social , Vitamina D , Deficiência de Vitamina D/epidemiologia , Vitaminas
12.
BMC Prim Care ; 23(1): 205, 2022 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-35948866

RESUMO

BACKGROUND: Depression is a major public health concern, which is most pronounced in population segments with a lower social-economic status (SES). E-health interventions for depressive complaints are proven to be effective, but their reach needs to be improved, especially among people with a lower socioeconomic status (SES). Implementing e-health interventions in the primary care setting with SES-sensitive guidance from General Practice nurses (GP nurses) may be a useful strategy to increase the reach of e-health in lower SES groups. We implemented an evidence-based online intervention that targets depressive complaints in primary care. METHODS: A pragmatic cluster-randomised trial was conducted in two parallel groups where a SES sensitive (SES-sens) implementation strategy with additional face-to-face guidance by GP nurses was compared to an all-SES implementation strategy. The primary outcome was the percentage of lower SES participants in either condition. Participation was defined as completing at least 1 face-to-face session and 2 online exercises. Participation rates were evaluated using logistic mixed modelling. RESULTS: In both conditions, the participation rates of lower SES participants were quite high, but were notably lower in the SES-sens implementation condition (44%) than in the all-SES implementation condition (58%). This unexpected outcome remained statistically significant even after adjusting for potential confounders between the conditions (Odds Ratio 0.43, 95%-CI 0.22 to 0.81). Less guidance was provided by the GP nurses in the SES-sens group, contrary to the implementation instructions. CONCLUSIONS: From a public health point of view, it is good news that a substantial number of primary care patients with a lower SES level used the implemented e-health intervention. It is also positive that an all-SES implementation strategy performed well, and even outperformed a SES-sensitive strategy. However, this was an unexpected finding, warranting further research into tailoring implementation strategies of e-health interventions towards specific target groups in the primary care setting. TRIAL REGISTRATION: Netherlands Trial Register, identifier: NL6595 , registered on 12 November 2017.


Assuntos
Intervenção Baseada em Internet , Exercício Físico , Humanos , Países Baixos/epidemiologia , Atenção Primária à Saúde , Classe Social
13.
Eur J Cardiothorac Surg ; 62(2)2022 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-35809067

RESUMO

OBJECTIVES: Pulmonary thromboendarterectomy (PTE) is a definitive treatment for chronic thromboembolic pulmonary hypertension. Demographic-based disparities in PTE outcomes have not been well-studied. METHODS: We reviewed all patients who underwent PTE for chronic thromboembolic pulmonary hypertension between 2009 and 2019 at our institution, tracking demographic information including self-identified race, preoperative characteristics and 2-year survival. Socioeconomic status was assessed using the zip code-linked Distressed Communities Index, a validated holistic measure of community well-being. Survival was estimated using Kaplan-Meier method and factors associated with mortality were estimated using Cox regression. RESULTS: Of 235 PTE patients, 101 (42.9%) were white and 87 (37.0%) were black. White patients had a higher median age at surgery (57 vs 51 years, P = 0.035) and a lower degree of economic distress (33.6 vs 61.2 percentile, P < 0.001). Regarding sex, 106 (45.1%) patients were male and 129 (53.6%) were female. Male patients had a higher median age (59 vs 50 years, P = 0.004), greater rates of dyslipidaemia (34% vs 20.2%, P = 0.025), a lower ejection fraction (55% vs 57%, P = 0.046) and longer cross-clamp (77 vs 67.50 min, P = 0.004) and circulatory arrest times (42 vs 37.50 min, P = 0.007). No difference was observed in unadjusted 2-year survival after PTE between patients stratified by race and sex (P = 0.35). After adjustment for clinically relevant variables, neither socioeconomic status, sex nor race were associated with mortality in Cox proportional hazard analysis. CONCLUSIONS: Sex, socioeconomic status and race were not associated with adverse outcomes after PTE in our single-centre experience.


Assuntos
Hipertensão Pulmonar , Embolia Pulmonar , Doença Crônica , Endarterectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/complicações , Classe Social , Resultado do Tratamento
14.
Age Ageing ; 51(7)2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35796136

RESUMO

BACKGROUND: socioeconomic inequity in mortality and life expectancy remains inconclusive in low- and middle-income countries, and to what extent the associations are mediated or modified by lifestyles remains debatable. METHODS: we included 21,133 adults from China Health and Nutrition Survey (1991-2011) and constructed three parameters to reflect participants' overall individual- (synthesising income, education and occupation) and area-level (urbanisation index) socioeconomic status (SES) and lifestyles (counting the number of smoking, physical inactivity and unhealthy diet and bodyweight). HRs for mortality and life expectancy were estimated by time-dependent Cox model and life table method, respectively. RESULTS: during a median follow-up of 15.2 years, 1,352 deaths were recorded. HRs (95% CIs) for mortality comparing low versus high individual- and area-level SES were 2.38 (1.75-3.24) and 1.84 (1.51-2.24), respectively, corresponding to 5.7 (2.7-8.6) and 5.0 (3.6-6.3) life-year lost at age 50. Lifestyles explained ≤11.5% of socioeconomic disparity in mortality. Higher lifestyle risk scores were associated with higher mortality across all socioeconomic groups. HR (95% CI) for mortality comparing adults with low individual-level SES and 3-4 lifestyle risk factors versus those with high SES and 0-1 lifestyle risk factors was 7.06 (3.47-14.36), corresponding to 19.1 (2.6-35.7) life-year lost at age 50. CONCLUSION: this is the first nationwide cohort study reporting that disadvantaged SES was associated with higher mortality and shorter life expectancy in China, which was slightly mediated by lifestyles. Risk lifestyles were related to higher mortality across all socioeconomic groups, and those with risk lifestyles and disadvantaged SES had much higher mortality risks.


Assuntos
Expectativa de Vida , Estilo de Vida , China/epidemiologia , Estudos de Coortes , Humanos , Inquéritos Nutricionais , Classe Social
15.
Int J Equity Health ; 21(1): 94, 2022 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-35821147

RESUMO

BACKGROUND: Evidence suggests that the socioeconomic status (SES) affects individuals' health service utilization. Spinal cord injury is a condition that often leads to physical impairments and enhanced health care needs. It therefore presents an informative and yet under-researched case in point to investigate social inequalities in health service utilization. This study aims to describe associations between SES and health service utilization in adults with spinal cord injury from Switzerland. METHODS: We use cross-sectional data from 1,294 participants of the Swiss Spinal Cord Injury Cohort Study community survey 2017. SES was operationalized with education, household income, perceived financial hardship, subjective status, and granting of supplementary financial benefits. Health service utilization was assessed with information on visits to 13 different health care providers and four health care institutions (inpatient stays, outpatient clinics, emergency departments, specialized spinal cord centers) during the past 12 months. The dichotomized outcomes on service utilization (visited vs. not visited) were regressed on SES indicators, including adjustments for sociodemographics, lesion characteristics, and health status. RESULTS: Persons with higher SES reported higher likelihood for specialist, dentist, and dental hygienist visits and reported utilizing a larger number of different care providers. Further, specific SES indicators were associated with certain care provider visits (i.e., higher education and subjective status: higher odds for pharmacist visits; higher income: higher odds for natural healer visits; higher subjective status: higher odds for chiropractor visits; supplementary benefit granting: higher odds for general practitioner and home care service visits). We found statistically non-significant trends towards lower likelihood for inpatient stays, outpatient clinic and emergency department visits and enhanced likelihood for specialized spinal cord-center visits in higher SES groups. CONCLUSIONS: This study generally supports the claim that basic health care provision is guaranteed for all patients with spinal cord injury in Switzerland, independently of their SES. However, social inequalities were still observed for the utilization of specific providers, such as oral health care providers. Given that oral health is key for health maintenance in persons with spinal cord injury, specific interventions to enhance regular dental check-ups in lower SES groups are highly recommended.


Assuntos
Serviços de Assistência Domiciliar , Traumatismos da Medula Espinal , Adulto , Estudos de Coortes , Estudos Transversais , Atenção à Saúde , Humanos , Classe Social , Suíça
16.
PLoS One ; 17(7): e0269118, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35802577

RESUMO

Socioeconomic inequalities in the detection and treatment of non-communicable diseases represent a challenge for healthcare systems in middle-income countries (MICs) in the context of population ageing. This challenge is particularly pressing regarding hypertension due to its increasing prevalence among older individuals in MICs, especially among those with lower socioeconomic status (SES). Using comparative data for China, Colombia, Ghana, India, Mexico, Russia and South Africa, we systematically assess the association between SES, measured in the form of a wealth index, and hypertension detection and control around the years 2007-15. Furthermore, we determine what observable factors, such as socio-demographic and health characteristics, explain existing SES-related inequalities in hypertension detection and control using a Blinder-Oaxaca decomposition. Results show that the prevalence of undetected hypertension is significantly associated with lower SES. For uncontrolled hypertension, there is evidence of a significant gradient in three of the six countries at the time the data were collected. Differences between rural and urban areas as well as lower and higher educated individuals account for the largest proportion of SES-inequalities in hypertension detection and control at the time. Improved access to primary healthcare in MICs since then may have contributed to a reduction in health inequalities in detection and treatment of hypertension. However, whether this indeed has been the case remains to be investigated.


Assuntos
Hipertensão , Renda , Idoso , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Índia/epidemiologia , Prevalência , Classe Social , Fatores Socioeconômicos
17.
J Bone Joint Surg Am ; 104(14): 1244-1249, 2022 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-35856928

RESUMO

BACKGROUND: Although there have been calls for the routine reporting of patient demographics associated with health disparities, including race, ethnicity, and socioeconomic status (SES), in published research, the extent to which these variables are reported in orthopaedic journals remains unclear. METHODS: We identified and examined all research articles with human cohorts published in 2019 in the 2 highest-ranked U.S. general orthopaedics journals, Clinical Orthopaedics and Related Research and The Journal of Bone & Joint Surgery. Excluded from analysis were studies with no U.S.-based institution and those that did not report any demographic data. Articles were reviewed to determine study type; reporting of race, ethnicity, and any of 3 SES variables (i.e., income, education, and health-care insurance); and the inclusion of these demographics in multivariable analyses. RESULTS: A total of 156 articles met the inclusion criteria. Of these, 56 (35.9%) reported patient race and 24 (15.4%) reported patient ethnicity. Income was reported in 13 (8.3%) of the articles, education in 23 (14.7%), and health insurance in 18 (11.5%). Of the 97 papers that reported results of multivariable analyses, 30 (30.9%) included race in the analysis and 21 (21.6%) reported significance associated with race. Income, education, and health insurance were included in multivariable analyses in 7 (7.2%), 11 (11.3%), and 10 (10.3%) of the articles, respectively. CONCLUSIONS: Race, ethnicity, and SES were infrequently reported and analyzed within articles published in 2 of the top orthopaedic journals. This problem may be remedied if orthopaedic journals impose standards for the reporting and analysis of patient demographics in studies with human cohorts. CLINICAL RELEVANCE: Failure to report key demographics makes it difficult for practitioners to determine whether study results apply to their patient populations. In addition, when orthopaedic interventions are evaluated without accounting for potential disparities by demographics, clinicians may incorrectly assume that the overall benefits and risks reported in studies apply equally to all patients.


Assuntos
Ortopedia , Publicações Periódicas como Assunto , Bibliometria , Etnicidade , Humanos , Classe Social
19.
Child Abuse Negl ; 131: 105785, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35839567

RESUMO

BACKGROUND: Child marriage is a breach of the basic fundamental rights of a child and is a major concern for policy makers in many countries. OBJECTIVE: The present study intended to identify the direct and indirect socio-demographic factors associated with child marriage among 15-17 years old girls in India. PARTICIPANTS AND SETTING: The study used National Family Health Survey-4 data. The sample comprised of 1459 married girls and an equal number of unmarried girls aged 15-17 years at the time of the survey. METHODS: Multivariable logistic regression was performed to identify the factors associated with child marriage. A hypothetical path model was constructed and tested. The path models were refitted after removing the insignificant path coefficients, and finally, the significance of direct as well as indirect effects were obtained. RESULTS: Path analysis revealed that mother's education was the only factor that had both significant direct and indirect effects on child marriage (p < 0.001). Religion had only significant indirect effect (p = 0.047) through girls' education. Besides mother's education, the factors that showed significant direct effects on child marriage were wealth index (p = 0.012), caste (p = 0.009) and education of the girl (p = 0.009). CONCLUSIONS: Education of both mothers and the girls, wealth index and caste had significant direct effects on child marriage whereas significant indirect effect was exerted by mothers' education and religion. Therefore, these factors should be given primary focus while formulating strategies to curb child marriage in countries like India.


Assuntos
Família , Casamento , Adolescente , Criança , Escolaridade , Feminino , Humanos , Índia/epidemiologia , Religião , Classe Social , Fatores Socioeconômicos
20.
Open Biol ; 12(7): 220047, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35857972

RESUMO

The reproductive castes of eusocial insects are often characterized by extreme lifespans and reproductive output, indicating an absence of the fecundity/longevity trade-off. The role of DNA methylation in the regulation of caste- and age-specific gene expression in eusocial insects is controversial. While some studies find a clear link to caste formation in honeybees and ants, others find no correlation when replication is increased across independent colonies. Although recent studies have identified transcription patterns involved in the maintenance of high reproduction throughout the long lives of queens, the role of DNA methylation in the regulation of these genes is unknown. We carried out a comparative analysis of DNA methylation in the regulation of caste-specific transcription and its importance for the regulation of fertility and longevity in queens of the higher termite Macrotermes natalensis. We found evidence for significant, well-regulated changes in DNA methylation in mature compared to young queens, especially in several genes related to ageing and fecundity in mature queens. We also found a strong link between methylation and caste-specific alternative splicing. This study reveals a complex regulatory role of fat body DNA methylation both in the division of labour in termites, and during the reproductive maturation of queens.


Assuntos
Formigas , Isópteros , Fatores Etários , Animais , Formigas/genética , Abelhas , Metilação de DNA , Insetos , Isópteros/genética , Classe Social
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