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2.
J Cancer Res Clin Oncol ; 146(1): 67-74, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786738

RESUMO

PURPOSE: Marital status has been demonstrated as an independent prognostic factor in many cancer types. The impact of marital status on non-small cell lung cancer (NSCLC) survival has not been assessed at the population level. Here, we used the surveillance, epidemiology and end results (SEER) database, a US national cancer registry, to address this issue. METHODS: All patients diagnosed with NSCLC from 2004 to 2009 were identified in the SEER database (version 8.3.2, updated at April 14, 2016). Those with incomplete clinicopathological information were excluded. The tumor, node, metastasis (TNM) staging was based on the criteria of the American Joint Committee on Cancer (AJCC) 6th edition. We used propensity-score matching analysis to balance baseline characteristics between the patients who were married and those who were not married. The impact of marital status on cancer-specific survival was analyzed with Cox proportional-hazards regression. RESULT: A total of 72, 984 NSCLC patients (41, 095 married patients, 56.3%) were enrolled in this study. After propensity-score matching, 25, 617 patients in the married group were 1:1 matched with patients in the unmarried group. Being unmarried was found to be associated with significantly decreased cancer-specific survival (hazard ratio (HR): 1.142, 95% CI: 1.119-1.166, p < 0.001). Among the unmarried group, patients who were single had worse cancer-specific survival (median survival 12 months, 95% CI: 11.37-12.63 months) than those who were divorced (median survival 15 months, 95% CI: 14.24-15.76 months, p < 0.001) or widowed (median survival 15 months, 95% CI: 14.25-15.76 months, p < 0.001). CONCLUSION: This study shows that marital status is an independent prognostic factor for cancer-specific survival in NSCLC patients. Patients who were married had better cancer-specific survival compared to the unmarried ones.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Neoplasias Pulmonares/mortalidade , Estado Civil/estatística & dados numéricos , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/terapia , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Pontuação de Propensão , Modelos de Riscos Proporcionais , Sistema de Registros , Programa de SEER , Estados Unidos/epidemiologia
3.
Tidsskr Nor Laegeforen ; 139(16)2019 Nov 05.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-31686490

RESUMO

BACKGROUND: The prevalence of depression among older people amounts to 1-5 % at the diagnostic level. Depression in older people may be chronic and is associated with an increased risk of dementia. No longitudinal studies have been conducted of depression in older people in Norway. MATERIAL AND METHOD: We have undertaken a multi-centre longitudinal observation study of 160 patients aged 60 years and above who had been treated for depression in departments of old-age psychiatry at specialist healthcare services in Norway. The patients were followed up on four occasions over a three-year period. RESULTS: Of the 131 patients who completed the study, 24 (18.3 %) were free from depression and depressive symptoms at the points of follow-up after discharge, while 55 (42.0 % showed depressive symptoms and 51 (38.9 %) had suffered at least one serious relapse or had remained continuously ill with a depressive condition. The proportion of persons with dementia increased from 14 out of 160 (8.8 %) at the start of the study period to 40 out of 131 (30.5 %) after three years. INTERPRETATION: Older people with depression who have been treated in departments of old-age psychiatry in specialist healthcare services have an unfavourable prognosis regarding the course of their depression and development of dementia over a three-year period.


Assuntos
Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Demência/epidemiologia , Escolaridade , Feminino , Seguimentos , Psiquiatria Geriátrica , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Estado Civil , Serviços de Saúde Mental , Testes de Estado Mental e Demência , Noruega/epidemiologia , Prognóstico , Recidiva , Resultado do Tratamento
4.
Nurs Res ; 68(6): 433-438, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693548

RESUMO

BACKGROUND: The relationship between an increasing elderly population and wide-ranging neurological conditions has led to heightened rates of cognitive function impairment. Some researchers have found that health literacy risk may be associated with cognitive impairment in older adults. OBJECTIVES: The purpose of this study was to delineate the difference in health literacy risk between older adults with mild cognitive impairment and those with normal cognitive function. METHODS: We conducted a survey study to explore the health literacy risk in older adults with and without mild cognitive impairment. Data were collected from 412 subjects between 60 and 91 years of age (260 without and 152 with mild cognitive impairment) between June and December 2016 in China. Cognitive function was measured using the Mini-Mental Status Examination, Montreal Cognitive Assessment, Global Deterioration Scale, Activities of Daily Living, and Hamilton Depression Rating Scale. Health literacy was measured using the Chinese Citizen Health Literacy Questionnaire. RESULTS: The scores of total health literacy and its three dimensions (basic health knowledge and mind, basic skills, and health lifestyle and behavior) were lower in those with mild cognitive impairment. Older adults with normal cognitive function had adequate or marginal health literacy levels, whereas those with mild cognitive impairment had marginal or inadequate health literacy levels. Using multiple logistic regression analysis, we found that health literacy risk, education level, age, marital status, and body mass index were independent risk factors for mild cognitive impairment. DISCUSSION: These results suggest that low health literacy may be a predictor of mild cognitive impairment. Screening for lower health literacy risk should be included in multidimensional geriatric evaluation.


Assuntos
Disfunção Cognitiva/psicologia , Alfabetização em Saúde , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Casos e Controles , China , Escolaridade , Feminino , Humanos , Modelos Logísticos , Masculino , Estado Civil , Pessoa de Meia-Idade , Fatores de Risco
5.
N Engl J Med ; 381(18): 1741-1752, 2019 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-31657887

RESUMO

BACKGROUND: Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. METHODS: A cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. We used multivariable logistic-regression models to assess the association of mistreatment with burnout and suicidal thoughts. The survey asked residents to report their gender. RESULTS: Among 7409 residents (99.3% of the eligible residents) from all 262 surgical residency programs, 31.9% reported discrimination based on their self-identified gender, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse (or both), and 10.3% reported sexual harassment. Rates of all mistreatment measures were higher among women; 65.1% of the women reported gender discrimination and 19.9% reported sexual harassment. Patients and patients' families were the most frequent sources of gender discrimination (as reported by 43.6% of residents) and racial discrimination (47.4%), whereas attending surgeons were the most frequent sources of sexual harassment (27.2%) and abuse (51.9%). Proportion of residents reporting mistreatment varied considerably among residency programs (e.g., ranging from 0 to 66.7% for verbal abuse). Weekly burnout symptoms were reported by 38.5% of residents, and 4.5% reported having had suicidal thoughts during the past year. Residents who reported exposure to discrimination, abuse, or harassment at least a few times per month were more likely than residents with no reported mistreatment exposures to have symptoms of burnout (odds ratio, 2.94; 95% confidence interval [CI], 2.58 to 3.36) and suicidal thoughts (odds ratio, 3.07; 95% CI, 2.25 to 4.19). Although models that were not adjusted for mistreatment showed that women were more likely than men to report burnout symptoms (42.4% vs. 35.9%; odds ratio, 1.33; 95% CI, 1.20 to 1.48), the difference was no longer evident after the models were adjusted for mistreatment (odds ratio, 0.90; 95% CI, 0.80 to 1.00). CONCLUSIONS: Mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.


Assuntos
Esgotamento Profissional/epidemiologia , Cirurgia Geral/educação , Internato e Residência , Abuso Físico/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Discriminação Social/estatística & dados numéricos , Esgotamento Profissional/psicologia , Feminino , Humanos , Masculino , Estado Civil , Corpo Clínico Hospitalar , Recursos Humanos em Hospital , Abuso Físico/psicologia , Relações Médico-Paciente , Relações Profissional-Família , Fatores Sexuais , Assédio Sexual/psicologia , Discriminação Social/psicologia , Ideação Suicida , Inquéritos e Questionários , Estados Unidos/epidemiologia
6.
BMC Public Health ; 19(1): 1410, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664963

RESUMO

BACKGROUND: The Woman's Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman's Condom and influencing factors among internal migrants. METHODS: A longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects. RESULTS: Three-level model analysis revealed statistically higher short-term acceptability of the Woman's Condom among subjects who lived in Shanghai (ß = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (ß = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (ß = - 1.69, t = - 7.55, p < 0.01) and lower educational attainment (ß = - 2.30, t = - 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (ß = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants' acceptability of the Woman's Condom would significantly increase over time (ß = 1.09, t = 5.54, p < 0.01). CONCLUSIONS: The findings indicate that the Woman's Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women's Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.


Assuntos
Preservativos Femininos/estatística & dados numéricos , Comportamento Sexual/psicologia , Migrantes/psicologia , Adulto , Pequim , China , Feminino , Humanos , Relações Interpessoais , Estudos Longitudinais , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto Jovem
7.
BMC Public Health ; 19(1): 1415, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664981

RESUMO

BACKGROUND: Appropriate contraceptive use remains a major health challenge in rural Jordan. The Japan International Cooperation Agency implemented a project aimed at enhancing the capacity of village health centers (VHCs) to improve the quality and quantity of family planning (FP) services in rural Jordan in 2016-2018. Facility- and community-based approaches were integrated into the interventions. We evaluated the project's impacts on contraceptive behaviors and the effectiveness of the two approaches. METHODS: We used a difference-in-differences analysis based on the project baseline and endline surveys, and logistic regression analysis to assess associations between eight primary outcomes and three secondary outcomes (impacts). The unit of intervention was five target VHCs; the unit of analysis was currently married women of reproductive age (15-49 years) in five intervention and five control villages. RESULTS: Overall, 2061 married women participated; 83.8% were in need of FP. Compared with the control villages, significant effects, ranging from + 0.4% points (pp) to + 11.5 pp., were observed in the intervention villages for six primary outcomes in these categories: increasing the use of FP services at VHCs, participation in health promotion activities, and changing the sources of reproductive health information. There was a trend toward improved secondary outcomes in the intervention villages, but no significant differences were observed between the intervention and control villages regarding modern contraceptive use (mCU; + 4.3 pp), traditional contraceptive use (tCU; - 0.5 pp), and spousal agreement on contraception (+ 5.1 pp). mCU was positively associated with five primary outcomes: obtaining contraceptives at VHCs [adjusted odds ratio (AOR) 3.44, 95% confidence interval (CI) 1.26-9.40], education sessions at VHC (AOR 7.41, 95% CI 1.60-34.39), health activities in communities (AOR 7.41, 95% CI 3.28-16.78), counseling by private doctor/clinic (AOR 0.62, 95% CI 0.40-0.97), and information gained through TV (AOR 0.50, 95% CI 0.32-0.76). Spousal agreement on contraception showed similar positive trends. tCU was associated only with TV. CONCLUSIONS: The project had impacts on increased mCU and husbands' perception of contraception in rural Jordan. The integration of facility- and community-based approaches may be effective in shifting from tCU to mCU in other rural areas.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Serviços de Planejamento Familiar/organização & administração , Serviços de Saúde Rural/organização & administração , População Rural , Adolescente , Adulto , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Jordânia , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Adulto Jovem
8.
J Surg Oncol ; 120(8): 1486-1496, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31602661

RESUMO

BACKGROUND AND OBJECTIVES: To investigate non-lung cancer specific mortality between stage IA non-small cell lung cancer (NSCLC) tumors less than and equal to 2 cm treated with lobectomy and sublobectomy. METHODS: Surveillance, epidemiology, and end results database was queried for patients who underwent lobectomy and sublobectomy. Propensity score matching (PSM) was used to achieve balance in clinicopathological characteristics. We used Fine-and-Gray hazard functions to analyze cause-specific mortality and risk factors. Standardized mortality ratios were calculated to describe cause specific mortality relative to the general population. RESULTS: After PSM, 3,844 patients underwent lobectomy and 1,922 patients underwent sublobectomy. Three leading causes of non-lung cancer mortality were cardiovascular disease (CVD), chronic obstructive pulmonary diseases (COPD), and other cancers. The 5-year cumulative non-lung cancer mortality of lobectomy and sublobectomy groups were 11.4% and 14.0%, respectively (P = .090). Multivariate analyses revealed that age, sex, histology, tumor size, and marital status (P < .01) were independent predictors of non-lung cancer specific mortality. In both groups, risks of CVD specific mortality were comparable to that in the general population, whereas the risk of COPD specific mortality was higher relative to the general population. CONCLUSIONS: As a significant competing event, non-lung cancer specific mortality is comparable between stage IA NSCLC tumors less than equal to 2 cm treated with lobectomy and sublobectomy.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/cirurgia , Doenças Cardiovasculares/mortalidade , Causas de Morte , Neoplasias Pulmonares/cirurgia , Pneumonectomia/métodos , Doença Pulmonar Obstrutiva Crônica/mortalidade , Adulto , Fatores Etários , Idoso , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Estado Civil , Análise por Pareamento , Pessoa de Meia-Idade , Análise Multivariada , Pontuação de Propensão , Programa de SEER , Fatores Sexuais , Estados Unidos/epidemiologia , Adulto Jovem
10.
Med Oral Patol Oral Cir Bucal ; 24(6): e759-e763, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31655836

RESUMO

BACKGROUND: Social determinants may be associated with the onset and progression of the clinical stage of oral cancer. AIM: To evaluate the impact of socio-demographic characteristics on the prevalence of advanced clinical stage of oral cancer. MATERIAL AND METHODS: Information about 51,116 cases of oral cancer, from all Brazilian states, between 2000 and 2012, was obtained from the Cancer Registry Information System. The clinical stage of oral cancer (dependent variable) was classified as initial (stages I and II) or advanced (stages III and IV). The relationship between the clinical stage of oral cancer and the following independent variables was analyzed: sex, age, schooling, marital status, family history of cancer, and origin of referral. Analyses on frequency distribution and multivariate binary logistic regression model were performed (α<0.05). RESULTS: Compared to individuals with no schooling, those who attended elementary to high school (OR=2.461) and college education (OR = 3.050) had a higher prevalence of advanced cases of oral cancer. Individuals without a partner (OR = 14,209) demonstrated a higher prevalence compared to married individuals. Subjects aged 20-44 years (OR = 4.081) and 45-64 years (OR = 14.875) had a higher prevalence compared to those aged 15-19 years. The variables gender, family history of cancer and origin of referral integrated the binary model of logistic regression, but did not present statistical significance. CONCLUSIONS: Socioeconomic factors may be related to the advanced clinical stage of oral cancer.


Assuntos
Neoplasias Bucais , Adolescente , Adulto , Brasil , Humanos , Estado Civil , Prevalência , Fatores Socioeconômicos , Adulto Jovem
11.
World Neurosurg ; 132: e14-e20, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31521753

RESUMO

OBJECTIVE: Age and comorbidity burden of patients going anterior cervical discectomy and fusion (ACDF) have increased significantly over the past 2 decades, resulting in increased expenditures. Non-home discharge after ACDF contributes to increased direct and indirect costs of postoperative care. The purpose of this study was to identify independent prognostic factors for discharge disposition in patients undergoing ACDF. METHODS: A retrospective review was conducted at 5 medical centers to identify patients undergoing ACDF for degenerative conditions. The primary outcome was non-home discharge. Additional outcomes considered included discharge to rehabilitation and home discharge with services. Bivariate and multivariable analyses were used to identify independent prognostic factors for non-home discharge. RESULTS: Of 2070 patients undergoing ACDF, 114 (5.5%) had non-home discharge and 63 (3.0%) had discharge to inpatient rehabilitation. Factors independently associated with non-home discharge included older age, marital status, Medicare insurance, Medicaid insurance, previous spine surgery, myelopathy, preoperative comorbidities (hemiplegia/paraplegia, congestive heart failure, cerebrovascular accident), anemia, and leukocytosis. C-statistic for the overall model was 0.85. Results were relatively similar for patients younger than the age of 65 years as well as for discharge to inpatient rehabilitation and discharge home with services. CONCLUSIONS: Numerous sociodemographic and clinical characteristics influence the risk of non-home discharge and discharge to inpatient rehabilitation in patients undergoing ACDF. Policy makers and payers should consider these factors when determining appropriate preoperative adjustment for risk-based reimbursements.


Assuntos
Vértebras Cervicais/cirurgia , Discotomia Percutânea/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Fusão Vertebral/estatística & dados numéricos , Adulto , Fatores Etários , Comorbidade , Feminino , Humanos , Degeneração do Disco Intervertebral/reabilitação , Degeneração do Disco Intervertebral/cirurgia , Masculino , Estado Civil , Medicaid/estatística & dados numéricos , Medicare/estatística & dados numéricos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia
13.
Transplant Proc ; 51(7): 2245-2249, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400979

RESUMO

BACKGROUND: The aim of this study was to determine the social support perceptions and hope levels of patients waiting for organ transplantation. METHOD: A sample of the descriptive study consisted of a total of 136 patients who attended to the dialysis unit of a university hospital in Istanbul between January and May 2017. Data were collected using the Patient Information Form, the Multidimensional Scale of Perceived Social Support, and the Herth Hope Scale. RESULTS: The mean age of the participants was 49.0 ± 1.15; 55.9% were male, 67.6% were married, and 41.2% were primary school graduates. A statistically significant difference was found between total perceived social support scores and age ratios. There was a statistically significant difference between participants' marital status and income level with total hope scores. There was a statistically significant difference between total hope scores and having chronic illness. There was a statistically significant difference between total perceived social support scores and having organ transplantation in the family or relatives. A statistically significant difference was found between total perceived social support and total hope scores with feelings perceived by family or relatives. A significant weak positive correlation between total perceived social support scores and total hope scores was found. CONCLUSION: According to this study, the sociodemographic characteristics of individuals waiting for transplantation affected their social support perceptions and hope levels. It seems that hope levels increased as family or relatives social support increased.


Assuntos
Esperança , Transplante de Órgãos/psicologia , Apoio Social , Adulto , Fatores Etários , Emoções , Feminino , Humanos , Renda , Masculino , Estado Civil , Pessoa de Meia-Idade , Inquéritos e Questionários , Listas de Espera
14.
Niger J Clin Pract ; 22(8): 1147-1156, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417060

RESUMO

Background: Social support, acknowledged as a protective factor against diseases, produces positive results in the prognosis of cancer patients. Objective: There is no relevant studies on perceived social support and factors related to Turkish cancer patients. Hence, the present study aimed to determine the demographic characteristics that affect the perceived social support in cancer patients undergoing chemotherapy in Turkey. Patients and Methods: This study was designed as a descriptive cross-sectional study. The sample included 423 adult cancer patients who admitted to the Outpatient Chemotherapy Unit of three hospitals in Turkey between March 2014 and August 2014. The data were collected through Demographic Characteristics Form and Cancer-Specific Social Support Scale (CPSSS). Results: Patients were between 19 and 85 years of age with a mean 51.75 years. Almost half of them (40.7%) were primary school graduates, 53.2% were female, 84.6% were married and 85.8% had children. It was found that the patients generally received a high score (127.86 ± 17.44) from the CPSSS scale. The highest scores were obtained on the Confidence Support sub dimension. It was revealed that women and married patients needed more confidence support and general social support (P < 0.05). Social support perceived by primary school graduates was statistically significant to a great extent (P < 0.05). In spite of the difference between the patients with metastasis and their perceived social support grade averages (P > 0.05), it was seen that patients with multiple children utilized more confidence support and general social support in social support reception (P < 0.05). Conclusion: The study showed that study participants received a high amount of social support. Age, gender, marital status, number of children, and educational status were determined to affect perceived social support. It is recommended to support the patients who do not receive sufficient social.


Assuntos
Neoplasias/psicologia , Qualidade de Vida/psicologia , Apoio Social , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demografia , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Neoplasias/etnologia , Neoplasias/terapia , Fatores Socioeconômicos , Inquéritos e Questionários , Turquia/epidemiologia
15.
BMC Oral Health ; 19(1): 195, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455271

RESUMO

BACKGROUND: The aim of this study is to use data representative of the U.S. population to determine if households (HHs) age, birth country, and marital status, are strong predictors as HHs education for dental sealants, restorations, and caries in children 5 to 19 years of age. METHODS: A cross sectional analysis was performed with oral health data from three waves of the National Health and Nutrition Examination Survey (NHANES 2005 to 2010). The sample size consisted of children 5 to 19 years of age (n = 9151) and households > 18 years of age (n = 31,034). Dependent variables included the number of children with dental sealants, restorations, and caries. HHs independent variables consisted of gender, age, race, country of birth, HHs education level, marital status, and HHs spouse education. Multivariate regression analysis models were adjusted for HHs citizenship, health insurance, family size, and children age categories. RESULTS: The prevalence of children 5-19 years of age with dental sealants, restorations, and caries was 31.3, 43, and 15.8% respectively. The odds of children having sealants were higher among HHs with a college education or above OR 2.05 [1.54.-2.73] vs. HHs with a < 9th grade, in HHs ages 39-49 (OR 1.78 [1.41-2.24) vs. 18-29 years of age, and in HHs spouses with a college education and above OR 1.71 [1.14-2.56] vs. HHs with a < 9th grade. The odds of having at least one restored tooth were higher in children from HHs born in Mexico 1.74 [1.44-2.10] vs. US born. The highest odds for caries were among children from HHs that were never married 1.91 [1.47-2.48] vs. married HHs. In HHs with a college education the odds for caries in children were 0.31 (0.22-0.43) for college and above, and 0.78 (0.60-1.01) for some college. CONCLUSIONS: The odds of children having dental sealants were higher in HHs with a college education, however, HHs ages 30-49 provided higher odds for sealants than spouses with college education. HHs birth place increased the odds of children with restorations more than HHs education. Children from HHs that never married had higher odds of experiencing dental caries. Recognizing the impact of these HHs characteristics could augment efforts in the prevention of adverse oral health outcomes in U.S. children. Households' age, country of birth, and marital status, stronger predictor variables than education in the prevalence of dental sealants, restorations, and caries among US children 5-19 years of age, NHANES 2005-2010.


Assuntos
Cárie Dentária , Características da Família , Selantes de Fossas e Fissuras , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Estado Civil , México , Pessoa de Meia-Idade , Inquéritos Nutricionais , Parto , Gravidez , Prevalência , Adulto Jovem
16.
Ethiop J Health Sci ; 29(3): 299-308, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31447498

RESUMO

Background: Adherence is the most important factor in determining Antiretroviral Therapy (ART) treatment success and long-term viral suppression. Nonadherence to ART led to the human Immunodeficiency Virus (HIV) related morbidity and mortality. Moreover, it intensifies the risk of the emerging drug resistant HIV strains. This study aimed to assess the level of ART adherence and to identify its predictive associated factors among people living with HIV/AIDS in Hara Town and its surroundings, North-Eastern Ethiopia. Methods: An institutional facility based cross-sectional study was conducted from April-May 2017. A total of 454 individuals were on ART follow-up in the selected ART-clinic, and only 418 patients were recruited. Bivariate and multivariate logistic regression analyses were carried out to identify associated factors. Odds ratio and 95% Confidence Interval (CI) were calculated to determine the level of significance. Results: The level of ART adherence in the study setting was 300 (71.8%). Participants who had not disclosed their HIV status to their families were 88% less likely to adhere to their ART medication than those who had disclosed their HIV status ((Odds ratio (OR): 0.12, 95%CI:0.05-0.58; p<0.001). On the other hand, participants who had not encountered drug side effects were 2.69 times more likely to adhere to their ART medication than those who had ever encountered drug side effects (OR: 2.69, 95%CI:1.27-5.05; p<0.001). Conclusion: A very low level of ART adherence was shown in the study population. It was below the recommended good adherence standard. Therefore, patients should get adequate and comprehensive ART adherence counselling before initiation ART treatment and during the follow-up time.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adolescente , Adulto , Fármacos Anti-HIV/efeitos adversos , Contagem de Linfócito CD4/estatística & dados numéricos , Estudos Transversais , Escolaridade , Etiópia/epidemiologia , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Estado Civil , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Adulto Jovem
17.
Tidsskr Nor Laegeforen ; 139(11)2019 Aug 20.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-31429227

RESUMO

BACKGROUND: Many questionnaires for measuring the quality of life for patients with obesity require comprehensive calculation before they are used. There is a need for questionnaires that permit simple assessment of the responses during a patient consultation. We have developed the questionnaire Patient-Reported Outcomes in Obesity (PROS). The objective of the study was to test the reliability and validity of the questionnaire. MATERIAL AND METHOD: The questionnaire was used to ask patients about the extent to which they perceived their weight or body shape as bothersome. A group of patients with an average body mass index (BMI) of 42 (n = 109) completed the PROS questionnaire and The Impact of Weight Quality of Life questionnaire (IWQOL-Lite) before undergoing obesity surgery. Another group with an average body mass index of 29 (n = 95) completed the PROS questionnaire 1-5 years after having undergone obesity surgery. 67,7 % of the patients were > 40 years and 79 % were women. For the statistical analysis we used Cronbach's alpha, factor analysis, Spearman's rank test and independent t-test. RESULTS: Cronbach's alpha for the total PROS score was 0.90, and the factor analysis showed a significant factor (eigenvalue = 4.7) that explained 58.4 % of the variance. The test-retest correlation was 0.93 (p < 0.001). The correlation coefficients between the PROS score, the total IWQOL-Lite score (rs = -0.91) and body mass index (rs = 0.60) were all significant (p < 0.001). The t-test showed an effect size (difference in standard deviation) between the non-surgery and the surgery groups of 1.9 (95 % CI 1.6-2.5) for the PROS questionnaire and 2.1 (95 % CI 1.7-2.5 for the total IWQOL-Lite score. INTERPRETATION: The PROS questionnaire is a reliable and valid questionnaire for measurement of obesity-specific quality of life.


Assuntos
Obesidade/psicologia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Adulto , Cirurgia Bariátrica , Índice de Massa Corporal , Estudos Transversais , Escolaridade , Exercício/psicologia , Feminino , Humanos , Relações Interpessoais , Masculino , Estado Civil , Pessoa de Meia-Idade , Dor/psicologia , Reprodutibilidade dos Testes , Autoimagem , Comportamento Sexual/psicologia , Sono , Discriminação Social/psicologia , Trabalho/psicologia
18.
Niger Postgrad Med J ; 26(3): 182-188, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31441457

RESUMO

Background: Despite women's adequate knowledge and the obvious unmet need for family planning (FP), contraceptive prevalence in Nigeria is low. A greater understanding of the barriers to FP that informs service utilisation and preferences is needed to improve service delivery. Aim: This study was aimed at assessing the use and preferences of FP services among women. Subjects and Methods: A community-based, descriptive, cross-sectional survey was carried out among 367 women (15-49 years of age) residing in Ikosi-Isheri, Kosofe local government area, who were selected by multistage sampling method. Data were collected using a pre-tested, semi-structured, interviewer-administered questionnaire and were analysed using SPSS software version 20. Frequency distributions and cross tabulations were generated. The Chi-square and Fisher's exact tests were used to determine associations, and the level of significance was set at P ≤ 0.05. Results: Although 64.0% were aware of FP, only 26.4% had ever used FP services. The contraceptive prevalence was 17.9%. Traditional or religious restrictions were given as the reasons for not using FP (40.9%). The preferred FP services were those offered at primary healthcare centres (45.2%) and teaching hospitals (33.9%) because of proximity (38.7%), privacy (14.5%) and health workers being female (22.6%). Age, level of education and marital status were associated with the utilisation of FP services (P < 0.001, P = 0.020 and P < 0.001, respectively). Conclusion: Although awareness was high, uptake was low. Government health facilities were preferred. Primary healthcare should be strengthened, and FP services should be scaled up to make FP more accessible. Services should be closer to where people live while providing the privacy they desire.


Assuntos
Comportamento Contraceptivo , Anticoncepção/psicologia , Serviços de Planejamento Familiar/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Preferência do Paciente , Adolescente , Adulto , Atitude do Pessoal de Saúde , Comportamento de Escolha , Anticoncepção/estatística & dados numéricos , Estudos Transversais , Escolaridade , Feminino , Humanos , Governo Local , Estado Civil , Pessoa de Meia-Idade , Nigéria , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Inquéritos e Questionários , Adulto Jovem
19.
J Clin Neurosci ; 69: 109-113, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31466904

RESUMO

Little is known on factors influencing cognitive decline in rural communities. Using the Atahualpa Project cohort, we aimed to assess whether the marital status or living arrangements influenced cognitive decline in community-dwelling adults living in an Ecuadorian rural village. The study included 629 Atahualpa residents aged ≥40 years who had a follow-up Montreal Cognitive Assessment (MoCA) repeated at least one year after baseline. Multivariate longitudinal linear models were fitted to assess differences between the marital status and living arrangements and cognitive decline (as the outcome). A total of 411 participants were married. The remaining 218 were either single, divorced or widowed (191 of them lived with family members and the others lived alone). Enrolled individuals contributed 2088.4 person-years of follow-up (mean: 3.3 ±â€¯1.1 years). The mean baseline MoCA was 22.1 ±â€¯4.5 points and the follow-up MoCA was 20.6 ±â€¯4.8 points (p = 0.001). Overall, 394 (63%) individuals had lower MoCA scores at follow-up. A fully-adjusted longitudinal linear model showed no differences in MoCA decline across married and non-married individuals (ß: -0.15; 95% C.I.: -0.55 - 0.26; p = 0.477). When the subset of non-married individuals was taken into account for analyses, multivariate longitudinal linear models showed no differences in the severity of cognitive decline across individuals living alone versus those living with family members (ß: 0.28; 95% C.I.: -0.68 - 1.24; p = 0.572). In this study, the marital status or living arrangements had no influence on cognitive decline in the follow-up.


Assuntos
Disfunção Cognitiva , Apoio Social , Adulto , Idoso , Equador , Feminino , Humanos , Vida Independente , Modelos Lineares , Masculino , Estado Civil , Pessoa de Meia-Idade , Estudos Prospectivos , População Rural
20.
Pan Afr Med J ; 32: 182, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31404268

RESUMO

Introduction: Unintended pregnancies and adolescent childbearing are on the increase in Sub-Saharan Africa. In Ghana, 14% of adolescents aged 15-19 are already mothers or pregnant with their first child. Most of these pregnancies are associated with poor outcomes such as miscarriages, stillbirths, unsafe abortions and other complications that might result in infant or mortality. In addition, sexually-active adolescents (16-19 years) are at higher risk of contracting STIs. Evidence suggest that contraceptive use help reduce fertility rate and adolescent reproductive health. This study therefore sought to understand the magnitude and associated factors that influence female adolescents' use of contraceptive in the Atwima Kwanwoma District, Ghana. Methods: A descriptive and analytic cross-sectional study design was used for this study. Using a structured questionnaire, data were collected from randomly sampled 200 sexually active female adolescents; aged 16-19 for a three month period; June to September 2017. The questionnaire elicited data on the socio-demographic characteristics of respondents, their knowledge and perception, use of contraceptives and factors influencing their contraceptive use. Data were analyzed using STATA version 12.1 software. Results: Ninety-five percent of the respondents exhibited some knowledge about contraceptives, but this high knowledge did not translate into its use as the prevalence rate was 18%. Condom was the most widely used contraceptive (33%) and perceived side effects of contraceptives was found to be the main reason for not using the contraceptives (53.66%). Marital status and the participants who were staying with both parents were found to be associated with contraceptive use with their p-values of 0.023 and 0.002 respectively. Conclusion: Considering the fact that contraceptive knowledge does not necessarily translate into use, further studies (qualitative), are needed to understand why high knowledge levels are not associated with high usage patterns.


Assuntos
Preservativos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Anticoncepcionais/administração & dosagem , Estudos Transversais , Feminino , Gana , Humanos , Estado Civil/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
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