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2.
Rev Chilena Infectol ; 36(3): 283-291, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31859746

RESUMO

INTRODUCTION: Condylomas or genital warts (GW) are the most frequently diagnosed sexually transmitted infection (STI) in STI centers in Chile, but there are no population statistics available. OBJECTIVES: To describe the prevalence of GW in patients from 18-60 years of age who attend outpatient dermatology, gynecology and urology practice; the demographic characteristics of the patients and the diagnostic and treatment tools. METHODS: A sample of Chilean specialists stratified by region, population and gender of patients was provided with a logbook and answered a questionnaire. RESULTS: The GW prevalence was 2.44% for the whole group; 3.76% for the 18-34 age group and 1.29% for the 35-60 years group (p = 0.0000). The average age of patients with GW was 29.4 years in women and 32.7 years in men (p = 0.019). The distribution by age was different according to gender and health system. Visual inspection was the most frequent diagnostic method used and imiquimod cream the most common treatment, however, there were differences in the use of diagnostic and therapeutic tools according to the patient's gender, specialty of the doctor and health system. CONCLUSIONS: The high prevalence of GW confirmed the need and importance of public health interventions to address this problem.


Assuntos
Condiloma Acuminado/epidemiologia , Pacientes Ambulatoriais/estatística & dados numéricos , Adolescente , Adulto , Antineoplásicos/uso terapêutico , Chile/epidemiologia , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/tratamento farmacológico , Demografia/estatística & dados numéricos , Dermatologistas/estatística & dados numéricos , Feminino , Ginecologia/estatística & dados numéricos , Instituições Privadas de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Imiquimode/uso terapêutico , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde/estatística & dados numéricos , Prática Profissional/estatística & dados numéricos , Urologistas/estatística & dados numéricos , Adulto Jovem
3.
Dokl Biol Sci ; 487(1): 108-111, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31571077

RESUMO

Progressive expansion of the most hazardous human parasitoses caused by trematodes, cestodes and nematodes has been found on the south of the Russian Far East. Decelerating expansion of the trematode Clonorchis sinensis, an agent of clonorchiasis towards the southern Primorye Territory from the Amur River basin, that began 10-15 years ago, was revealed. A prognosis was made on the activation of the natural foci of clonorchiasis and paragonimiasis. Circulation possibilities are discussed of the highly pathogenic trematode Pagonimus heterotremusar in the South Asian regional ecosystems. Our experiments showed that the freshwater gastropods of the Parajuga genus from the Amur River basin and those of Stenothyra genus from Primorsky Territory were resistant to this trematode infection. Nevertheless, this does not exclude the possibility of this parasite penetration into the Far East region via infection of the local gastropods of other genera.


Assuntos
Reservatórios de Doenças/parasitologia , Helmintíase/parasitologia , Animais , Canidae/parasitologia , Cestoides/patogenicidade , Clima , Demografia/estatística & dados numéricos , Felidae/parasitologia , Peixes/parasitologia , Helmintíase/epidemiologia , Helmintíase/transmissão , Humanos , Moluscos/parasitologia , Nematoides/patogenicidade , Sibéria , Trematódeos/patogenicidade
4.
Prensa méd. argent ; 105(10): 700-709, oct 2019. tab, graf
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1025979

RESUMO

Introduction: Achondroplasia (Ach) is the most frequent cause of dwarfism. The first therapeutic strategy offered to patients with Ach was. However, GH has played un important role in Ach and Hypochondroplasia (Hch), despite short-term and long-term effects. Purpose: The aim of this systematic review and meta-analysis was to assess the efficacy of GH in the height of patients with Ach and Hch in the short and long term. Methods: 12 studies were included selected from the Pubmed database (3 Randomized Clinical trials (RCTs) and 9 prospective studies) from 1993 to 2014. Comparing high and low doses of GH. The systematic review included 9 prospective studies and the high-dose GH arm of the 3 RCTs. Inclusion criteria was focused on paediatric patients with Ach and Hch treated with GH. Demographic variables were collected including age, gender, dose, height and follow-up. The height variables included height increase and height velocity. Finally, 363 patients with Ach and 41 patients with Hcb were included. A was performed with a follow-up from one to 3 years. Results: In patients with Ach the average height velocity at one, two and three years were 2.65, 1.07 and -0.87 cm/years respectively (p<0.05). The RCTs showed a significant increase in height velocity in patients treated with high dose of GH (MD= 1.38, 95% CI: 0.68-2.07, p=0.0001, I2=0%) . Height at one year increased 0.61 cm. The RCTs did not show significant differences (MD 0.11, 95% CI: 0.17-0.39, p=0.44, I2 = 0%). Finally, patients with Hch increased height velocity 4 cm/year at the first year (p<0.05). Conclusion: GH treatment is beneficial in the shor-term height of children with Ach and Hch. GH effect on different ages and subgroups is unknown, as well as its possible long--term consequences


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Acondroplasia/terapia , Demografia/estatística & dados numéricos , Avaliação de Resultados (Cuidados de Saúde) , Hormônio do Crescimento Humano/administração & dosagem , Hormônio do Crescimento Humano/uso terapêutico
5.
Complement Ther Med ; 46: 202-209, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31519280

RESUMO

OBJECTIVES: Growing interest in integrative medicine motivates examination of who seeks integrative care, and why. By examining differences in demographics and complementary and alternative medicine (CAM) use between patients recruited from Japanese Kampo (traditional herbal medicine) versus biomedical clinics, this study aimed to identify whether integrative medicine options might attract different patients. DESIGN AND SETTING: In this cross-sectional, observational study we administered the International Complementary and Alternative Medicine-Questionnaire (I-CAM-Q) to 209 patients recruited from four hospital clinics. Demographics, use of different types of CAM (self-help CAM, CAM practitioners, CAM products), and motivations were compared between Kampo and Non-Kampo patients and by gender. Factors influencing attendance at the Kampo clinic and CAM use were identified using logistic regression. RESULTS: While some demographic characteristics, CAM provider and total CAM use differed between Kampo and non-Kampo patients, self-help CAM use did not. Motivations (for acute, long-term, health maintenance, or other reasons) differed between Kampo and non-Kampo clinic patients for going to non-Kampo physicians (P = 0.02) and Kampo physicians (P = 0.1). Logistic regression results for 'any CAM' use showed odds ratio of 0.32 (95%CI 0.15-0.67) for self-rated health, and 1.60 (95%CI 1.10-2.32) for Macarthur subjective social status scale. Attendance at the Kampo clinic showed odds ratios of 1.50 (95%CI 1.11-2.02) for education and 0.56 (95%CI 0.39-0.80) for employment status. CONCLUSIONS: Better understanding of factors such as motivation, self-rated health, and socioeconomic conditions that influence patients' CAM use and integrative clinic attendance may enable more effective targeting of populations and integration of CAM into biomedical settings.


Assuntos
Terapias Complementares/estatística & dados numéricos , Demografia/estatística & dados numéricos , Medicina Integrativa/estatística & dados numéricos , Medicina Kampo/estatística & dados numéricos , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde/fisiologia , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Médicos/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
6.
PLoS One ; 14(8): e0220062, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398208

RESUMO

BACKGROUND: Undernutrition, an important indicator for monitoring progress of development goals, is a matter of concern in many developing countries, including Bangladesh. Despite regional differences in chronic undernutrition in Bangladesh, regional determinants among children under the age of five were not extensively explored. DATA AND METHODS: Using combined repeated cross-sectional nationwide Bangladesh Demographic and Health Surveys (BDHS 2011 and 2014) and employing bivariate and logistic regression analyses, we estimated prevalence, changes and variations in regional determinants of stunting among children aged 6-59 months over two time periods 2011 and 2014. RESULTS: Our benchmark results suggested that the children from Rajshahi, Khulna, Rangpur, Chittagong and Dhaka tend to be significantly less stunted by 51% (p = 0.000; CI = [0.38, 0.63]), 44% (p = 0.000; CI = [0.44, 0.71]), 26% (p = 0.012; CI = [0.58, 0.93]), 23% (p = 0.012; CI = [0.62, 0.95]) and 22% (p = 0.033; [0.63, 0.97]) respectively, against Sylhet in 2011. With the exception of Dhaka, no region showed significant differences in the odds of stunting over two time periods 2011 and 2014, i.e. only Dhaka revealed significant difference by 30% reductions in the odds of stunting in 2014. Also, rural children were less likely to be stunted (by 19%) of the urban counterparts. Regional covariates of stunting differ. However, children's age, household wealth, mother's height, and parental education were important determinants of stunting in Bangladesh. CONCLUSION: Dhaka made an impressive improvement in child nutrition, thus contributed largely to the reduction of stunting levels in Bangladesh for 2014 over 2011. Sylhet and Barisal require strong push to improve nutritional status of children. Further decline is possible through region-specific multipronged interventions that can address area-specific covariates to break the cycle of undernutrition like strengthening economic and educational status, emphasizing the role of father to augment their knowledge in varying aspects like family planning, reduction of fertility and by improving mother's health.


Assuntos
Demografia/estatística & dados numéricos , Inquéritos Epidemiológicos , Desnutrição/epidemiologia , Bangladesh/epidemiologia , Pré-Escolar , Doença Crônica/epidemiologia , Doença Crônica/tendências , Feminino , Humanos , Lactente , Masculino , Prevalência
7.
Rev Bras Enferm ; 72(4): 1007-1012, 2019 Aug 19.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31432959

RESUMO

OBJECTIVE: To verify the association between sex (male and female) and sociodemographic, reproductive and sexual variables in teenagers and identify the highest rates of social and health issues among them. METHOD: This was a cross-sectional study conducted with 239 adolescents enrolled in a public school of Salvador, Bahia, Brazil, whose data were produced by applying a structured form processed in Stata. RESULTS: The research indicated an association between females and higher education level (p = 0.02), living with both parents (p = 0.02) and a higher rate of mental, social and behavioral issues. Being a man was associated with sexual initiation (p = 0.00), which occurred before they turned 14 years old (p = 0.05). CONCLUSION: The study variables behave, depending on sex, with smaller or greater chances of experiencing harmful situations, this understanding being essential for subsidizing educational activities that promote the quality of life of teenagers.


Assuntos
Demografia/estatística & dados numéricos , Nível de Saúde , Fatores Sexuais , Classe Social , Adolescente , Comportamento do Adolescente/psicologia , Brasil/epidemiologia , Criança , Estudos Transversais , Demografia/métodos , Feminino , Humanos , Masculino , Gravidez , Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/psicologia , Enfermagem em Saúde Pública/métodos , Assunção de Riscos , Educação Sexual/métodos , Comportamento Sexual/psicologia , Adulto Jovem
8.
Geriatr Gerontol Int ; 19(9): 945-949, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31332921

RESUMO

AIM: This study aimed to investigate the association between daily sleep duration and incident disability among younger elderly individuals in Japan. METHODS: We carried out a prospective cohort study, the New Integrated Suburban Seniority Investigation Project, including 1895 (962 men and 933 women) Japanese physically and socially independent individuals aged ≥65 years. Information on daily sleep duration, demographic, lifestyle characteristics and medical status were collected by questionnaire and health checkup every year from 1996 through 2005. Dates of incident disability were confirmed using the certification for the long-term care insurance in Japan. We treated censored cases due to death as competing events. A competing risk model was used to calculate the hazard ratio and 95% confidence interval for incident disability. RESULTS: During a median of 12.7 years of follow up, 256 participants (114 men and 142 women) reported incident disability. Compared with a sleep duration of 7-7.9 h/day, sleeping <6 h/day showed an increased risk of incident disability (hazard ratio 1.64, 95% confidence interval 1.13-2.38 for total; hazard ratio 1.90, 95% confidence interval 1.19-3.03 for women). CONCLUSIONS: The present findings suggest that shorter sleep duration was associated with a higher risk of incident disability among older Japanese people. Geriatr Gerontol Int 2019; 19: 945-949.


Assuntos
Vida Independente/estatística & dados numéricos , Estilo de Vida , Transtornos do Sono-Vigília , Sono , Idoso , Estudos de Coortes , Demografia/estatística & dados numéricos , Avaliação da Deficiência , Feminino , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Nível de Saúde , Humanos , Incidência , Seguro de Assistência de Longo Prazo , Japão/epidemiologia , Masculino , Estudos Prospectivos , Fatores de Risco , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/epidemiologia
10.
Nat Biotechnol ; 37(6): 571, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31164745

RESUMO

Systematic gathering of detailed demographic data on the workforce is needed to ensure continued progress in diversifying biotech.


Assuntos
Biotecnologia/tendências , Demografia/estatística & dados numéricos , Recursos Humanos/estatística & dados numéricos , Humanos
11.
BMC Infect Dis ; 19(1): 496, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170921

RESUMO

BACKGROUND: HIV testing serves as a critical gateway for linkage and retention to care services, particularly in sub-Saharan African countries with high burden of HIV infections. However, the current progress towards addressing the first cascade of the 90-90-90 programme is largely contributed by women. This study aimed to map evidence on the intervention strategies to improve HIV uptake among men in sub-Saharan Africa. METHODS: We conducted a scoping review guided by Arksey and O'Malley's (2005) framework and Levac et al. (2010) recommendation for methodological enhancement for scoping review studies. We searched for eligible articles from electronic databases such as PubMed/MEDLINE; American Doctoral Dissertations via EBSCO host; Union Catalogue of Theses and Dissertations (UCTD); SA ePublications via SABINET Online; World Cat Dissertations; Theses via OCLC; and Google Scholar. We included studies from January 1990 to August 2018. We used the PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. The Mixed Method Appraisal Tool version 2018 was used to determine the methodological quality of the included studies. We further used NVivo version 11 to aid with content thematic analysis. RESULTS: This study revealed that teaching men about HIV; Community-Based HIV testing; Home-Based HIV testing; Antenatal Care HIV testing; HIV testing incentives and HIV Self-testing are important strategies to improving HIV testing among men in sub-Saharan Africa. The need for improving programmes aimed at giving more information to men about HIV that are specifically tailored for men, especially given their poor uptake of HIV testing services was also found. This study further revealed the need for implementing Universal Test and Treat among HIV positive men found through community-based testing strategies, while suggesting the importance of restructuring home-based HIV testing visits to address the gap posed by mobile populations. CONCLUSION: The community HIV testing, as well as, HIV self-testing strategies showed great potential to increase HIV uptake among men in sub-Saharan Africa. However, to address poor linkage to care, ART should be initiated soon after HIV diagnosis is concluded during community testing services. We also recommend more research aimed at addressing the quality of HIV self-testing kits, as well as, improving the monitoring systems of the distributed HIV self-testing kits.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Programas de Rastreamento , Participação do Paciente/estatística & dados numéricos , Adulto , África ao Sul do Saara/epidemiologia , Atitude Frente a Saúde , Demografia/estatística & dados numéricos , Prática Clínica Baseada em Evidências , Feminino , Geografia , HIV , Infecções por HIV/transmissão , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/organização & administração , Programas de Rastreamento/estatística & dados numéricos , Programas Nacionais de Saúde/organização & administração , Programas Nacionais de Saúde/normas , Programas Nacionais de Saúde/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Testes Sorológicos
12.
PLoS One ; 14(5): e0216742, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31141515

RESUMO

The causes of disappearance of the Neanderthals, the only human population living in Europe before the arrival of Homo sapiens, have been debated for decades by the scientific community. Different hypotheses have been advanced to explain this demise, such as cognitive, adaptive and cultural inferiority of Neanderthals. Here, we investigate the disappearance of Neanderthals by examining the extent of demographic changes needed over a period of 10,000 years (yrs) to lead to their extinction. In regard to such fossil populations, we inferred demographic parameters from present day and past hunter-gatherer populations, and from bio-anthropological rules. We used demographic modeling and simulations to identify the set of plausible demographic parameters of the Neanderthal population compatible with the observed dynamics, and to explore the circumstances under which they might have led to the disappearance of Neanderthals. A slight (<4%) but continuous decrease in the fertility rate of younger Neanderthal women could have had a significant impact on these dynamics, and could have precipitated their demise. Our results open the way to non-catastrophic events as plausible explanations for Neanderthal extinction.


Assuntos
Extinção Biológica , Homem de Neandertal , Animais , Simulação por Computador , Demografia/estatística & dados numéricos , Europa (Continente) , Feminino , Fósseis , História Antiga , Humanos , Masculino , Modelos Biológicos , Homem de Neandertal/classificação , Homem de Neandertal/genética , Dinâmica Populacional/história , Processos Estocásticos
13.
Glob Health Action ; 12(1): 1608013, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31092155

RESUMO

BACKGROUND: Understanding socioeconomic disparities in all-cause and cause-specific mortality can help inform prevention and treatment strategies. OBJECTIVES: To quantify cause-specific mortality rates by socioeconomic status across seven health and demographic surveillance systems (HDSS) in five countries (Ethiopia, Kenya, Malawi, Mozambique, and Nigeria) in the INDEPTH Network in sub-Saharan Africa. METHODS: We linked demographic residence data with household survey data containing living standards and education information we used to create a poverty index. Person-years lived and deaths between 2003 and 2016 (periods varied by HDSS) were stratified in each HDSS by age, sex, year, and number of deprivations on the poverty index (0-8). Causes of death were assigned to each death using the InterVA-4 model based on responses to verbal autopsy questionnaires. We estimated rate ratios between socioeconomic groups (2-4 and 5-8 deprivations on our poverty index compared to 0-2 deprivations) for specific causes of death and calculated life expectancy for the deprivation groups. RESULTS: Our pooled data contained almost 3.5 million person-years of observation and 25,038 deaths. All-cause mortality rates were higher among people in households with 5-8 deprivations on our poverty index compared to 0-2 deprivations, controlling for age, sex, and year (rate ratios ranged 1.42 to 2.06 across HDSS sites). The poorest group had consistently higher death rates in communicable, maternal, neonatal, and nutritional conditions (rate ratios ranged 1.34-4.05) and for non-communicable diseases in several sites (1.14-1.93). The disparities in mortality between 5-8 deprivation groups and 0-2 deprivation groups led to lower life expectancy in the higher-deprivation groups by six years in all sites and more than 10 years in five sites. CONCLUSIONS: We show large disparities in mortality on the basis of socioeconomic status across seven HDSS in sub-Saharan Africa due to disparities in communicable disease mortality and from non-communicable diseases in some sites. Life expectancy gaps between socioeconomic groups within sites were similar to the gaps between high-income and lower-middle-income countries. Prevention and treatment efforts can benefit from understanding subpopulations facing higher mortality from specific conditions.


Assuntos
Causas de Morte , Demografia/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Expectativa de Vida , Pobreza/estatística & dados numéricos , Classe Social , Fatores Socioeconômicos , Adolescente , Adulto , Etiópia , Feminino , Humanos , Quênia , Malaui , Masculino , Pessoa de Meia-Idade , Moçambique , Nigéria , Vigilância da População , Inquéritos e Questionários
14.
PLoS One ; 14(5): e0216061, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31075119

RESUMO

BACKGROUND: The consequences of armed conflicts impose considerable burdens on the economy and health care services, particularly in countries that are not equipped to deal with them, such as in the Middle-East, and North African countries. Little is known about the burden of mortality and injury resulting from the Libyan armed conflict. This study aimed to determine the trends and patterns of mortality, injury and disabilities directly associated with the Libyan armed conflict and analyze the geographic variation within the country during 2012-2107. METHODS: Data on conflict-related deaths, injuries, and disabilities were obtained from the national registry offices. The information included date, place, and demographic information. A questionnaire was also used to obtain information from the affected individuals and their families. National and regional trends of mortality, injury and disabilities were calculated. Spatial analysis was performed using geographic data available on all documented cases to analyze clustering of mortality and injury. RESULTS: A total of 16,126 deaths and 42,633 injuries were recorded with complete information during the Libyan conflict from 2012 till 2017. The overall mortality rate was 2.7/1000 population and injury rate was 7.1/1000. The overall male-to-female ratio of mortality and injury was 4.4:1; 42.3% were single and aged 20-30 years old, and 26.4% were aged 31-40 years. Moreover, injuries resulted in death in 20.1% of cases and disability in 33.5% of the cases. Most of the disabilities were caused by blasts, while gun shots resulted in more deaths. The overall mortality and injury rates were highest during 2015-2017. These rates were highest in the eastern region. Injuries were most concentrated in Benghazi and Derna in the east, followed by Sert and Musrata in the central region. CONCLUSIONS: Conflict-related mortality, injury and disability has inflicted a heavy burden on the Libyan society that may persist for a long time. The rates of these casualties varied in time and place. National, well-planned efforts are needed to address this serious situation and its consequences.


Assuntos
Conflitos Armados/estatística & dados numéricos , Conflitos Armados/tendências , Causas de Morte/tendências , Pessoas com Deficiência/estatística & dados numéricos , Mortalidade/tendências , Adolescente , Adulto , África do Norte , Análise por Conglomerados , Morte , Demografia/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio , Registros/estatística & dados numéricos , Inquéritos e Questionários , Ferimentos e Lesões , Adulto Jovem
15.
PLoS One ; 14(4): e0215733, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31022237

RESUMO

BACKGROUND: Early initiation of breastfeeding (EIBF) is associated with better health of the mothers and reduced risk of neonatal mortality. The objective of this study was to determine the prevalence of EIBF and associated factors among Bangladeshi mothers. METHODS: The data was extracted from the Bangladesh Demographic and Health Survey (BDHS)-2014. A total of 4,092 married non-pregnant Bangladeshi mothers who had at least one child aged 2 years or younger were included in this study. A two-level logistic regression model was used to remove the clustering effect for finding the impact of socio-economic and demographic factors on EIBF. RESULTS: The prevalence of EIBF among Bangladeshi mothers was 51.4% (urban: 47.1% and rural: 53.4%). A two -level logistic regression model showed that mothers living in the Sylhet division (p<0.01) and rural environment (p<0.05) were more likely to practice EIBF. Mothers who were obese or overweight (p<0.01), had secondary (p<0.05) or higher education (p<0.01) were less likely to provide early breastfeeding to their newborn babies compared to their counterparts. Those who delivered by caesarian-section (p<0.01) were less likely to perform EIBF while those who attended an antenatal care clinic more than 3 times (p<0.05) were more likely to do so. CONCLUSIONS: About half of the Bangladeshi mothers did not start breast-feeding within one hour after birth. This study identified several geographical and socio-demographic factors that were associated with EIBF, and hope that this information will help the government to focus their resources to promote early breastfeeding.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Demografia/estatística & dados numéricos , Mães/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Bangladesh , Pré-Escolar , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Prevalência , População Rural/estatística & dados numéricos , Fatores de Tempo , População Urbana/estatística & dados numéricos , Adulto Jovem
16.
Midwifery ; 75: 72-79, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31030061

RESUMO

BACKGROUND: International migration is an increasing public health concern, particularly regard to maternal and neonatal health. OBJECTIVE: To compare obstetric and neonatal variables among native and immigrant childbearing women in a clinical hospital in Santiago, Chile. METHOD: A cross-sectional, analytic study with 2598 childbearing women and their newborn examined between January and July 2015. Data were collected from clinical records by students who had previously been trained. Ethical approval was obtained from the local Ethics Committee at the hospital. All participants signed an informed consent form. A descriptive and comparative analysis was performed. For comparison, a Chi-square test was used for categorical variables, and Student t-test was used for quantitative variables. RESULTS: Among the included women, 41.5% (n = 1078) were immigrants. The immigrants' mean age was 28.1 ±â€¯6.4 years, and that of natives was 26.8 ±â€¯6.9 (p < 0.001). Among natives, the obesity rate was 38.3%, as compared to 19.3% among immigrants (p < 0.001). A significantly higher rate of caesarean section was seen among natives (36.8%) than among immigrants (31.7%). Obstetric morbidity, pre-eclampsia, gestational diabetes and prematurity were significantly higher among natives. There was no difference regarding low birth weights. CONCLUSION: In general, immigrants present better maternal and neonatal indicators than native women. Controversially, this is known as the 'healthy immigrant' phenomenon in the literature.


Assuntos
Demografia/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Distribuição de Qui-Quadrado , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Recém-Nascido de Baixo Peso , Gravidez , Complicações na Gravidez/epidemiologia
18.
Rural Policy Brief ; 2019(1): 1-4, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30995707

RESUMO

Purpose: The Medicare Advantage (MA) program allows Medicare beneficiaries to receive benefits from private plans rather than from traditional fee-for-service (FFS) Medicare. Little is known about the rural and urban differences in the populations that enroll in the MA program, and these differences may be important for setting policy. This brief uses data from the 2012-13 Medicare Current Beneficiary Survey (MCBS) to describe these differences, and combined with county-level data on MA issuer participation, this dataset also allows us to assess the degree to which issuers may engage in selective MA market entry on the basis of demographic characteristics. Key Findings: (1) Rural and urban MA and FFS populations did not differ much on average by any characteristics reported in the data, including age, self-reported health status, cancer diagnosis, smoking status, Medicaid status, or by other variables assessing frailty and presence of chronic conditions. (2) Most measures of access were similar across rural and urban respondents. However, in terms of cost, urban enrollees were less likely to pay an additional premium (beyond Medicare Part A and B) to obtain MA coverage: 42 percent reported doing so in urban places, while 54 percent did so in rural places. (3) While rurality on its own was often a significant predictor of lower issuer participation in a county's MA market, the addition of other demographic characteristics did not influence the prediction. In other words, we found no evidence, based upon MCBS data, that issuers exclude rural counties due to other demographics.


Assuntos
Utilização de Instalações e Serviços/estatística & dados numéricos , Medicare Part C/estatística & dados numéricos , População Rural , População Urbana , Idoso , Idoso de 80 Anos ou mais , Comportamento do Consumidor , Demografia/estatística & dados numéricos , Planos de Pagamento por Serviço Prestado , Acesso aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Estados Unidos
19.
Biometrics ; 75(3): 799-809, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31004437

RESUMO

Over the past decade, there has been much methodological development for the estimation of abundance and related demographic parameters using mark-resight data. Often viewed as a less-invasive and less-expensive alternative to conventional mark recapture, mark-resight methods jointly model marked individual encounters and counts of unmarked individuals, and recent extensions accommodate common challenges associated with imperfect detection. When these challenges include both individual detection heterogeneity and an unknown marked sample size, we demonstrate several deficiencies associated with the most widely used mark-resight models currently implemented in the popular capture-recapture freeware Program MARK. We propose a composite likelihood solution based on a zero-inflated Poisson log-normal model and find the performance of this new estimator to be superior in terms of bias and confidence interval coverage. Under Pollock's robust design, we also extend the models to accommodate individual-level random effects across sampling occasions as a potentially more realistic alternative to models that assume independence. As a motivating example, we revisit a previous analysis of mark-resight data for the New Zealand Robin (Petroica australis) and compare inferences from the proposed estimators. For the all-too-common situation where encounter rates are low, individual detection heterogeneity is non-negligible, and the number of marked individuals is unknown, we recommend practitioners use the zero-inflated Poisson log-normal mark-resight estimator as now implemented in Program MARK.


Assuntos
Demografia/estatística & dados numéricos , Modelos Biológicos , Modelos Estatísticos , Animais , Densidade Demográfica , Tamanho da Amostra , Aves Canoras
20.
Nat Commun ; 10(1): 1633, 2019 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-30967543

RESUMO

The success of vaccination programs depends largely on the mechanisms used in vaccine delivery. National immunization programs offer childhood vaccines through fixed and outreach services within the health system and often, additional supplementary immunization activities (SIAs) are undertaken to fill gaps and boost coverage. Here, we map predicted coverage at 1 × 1 km spatial resolution in five low- and middle-income countries to identify areas that are under-vaccinated via each delivery method using Demographic and Health Surveys data. We compare estimates of the coverage of the third dose of diphtheria-tetanus-pertussis-containing vaccine (DTP3), which is typically delivered through routine immunization (RI), with those of measles-containing vaccine (MCV) for which SIAs are also undertaken. We find that SIAs have boosted MCV coverage in some places, but not in others, particularly where RI had been deficient, as depicted by DTP coverage. The modelling approaches outlined here can help to guide geographical prioritization and strategy design.


Assuntos
Demografia/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Vacinação em Massa/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Camboja , Pré-Escolar , Conjuntos de Dados como Assunto , República Democrática do Congo , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Etiópia , Humanos , Renda , Lactente , Recém-Nascido , Vacinação em Massa/métodos , Vacinação em Massa/organização & administração , Vacina contra Sarampo/administração & dosagem , Modelos Estatísticos , Moçambique , Análise Multivariada , Nigéria , Planejamento Estratégico
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