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1.
Natl Vital Stat Rep ; 70(2): 1-51, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33814033

RESUMO

Objectives-This report presents 2019 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Methods-Descriptive tabulations of data reported on the birth certificates of the 3.75 million births that occurred in 2019 are presented. Data are presented for maternal age, livebirth order, race and Hispanic origin, marital status, tobacco use, prenatal care, source of payment for the delivery, method of delivery, gestational age, birthweight, and plurality. Selected data by mother's state of residence and birth rates by age are also shown. Trend data for 2010 through 2019 are presented for selected items. Trend data by race and Hispanic origin are shown for 2016-2019. Results-A total of 3,747,540 births were registered in the United States in 2019, down 1% from 2018. The general fertility rate declined from 2018 to 58.3 births per 1,000 women aged 15-44 in 2019. The birth rate for females aged 15-19 fell 4% between 2018 and 2019. Birth rates declined for women aged 20-34 and increased for women aged 35-44 for 2018-2019. The total fertility rate declined to 1,706.0 births per 1,000 women in 2019. Birth rates declined for both married and unmarried women from 2018 to 2019. The percentage of women who began prenatal care in the first trimester of pregnancy rose to 77.6% in 2019; the percentage of all women who smoked during pregnancy declined to 6.0%. The cesarean delivery rate decreased to 31.7% in 2019 (Figure 1). Medicaid was the source of payment for 42.1% of all births in 2019. The preterm birth rate rose for the fifth straight year to 10.23% in 2019; the rate of low birthweight was essentially unchanged from 2018 at 8.31%. Twin and triplet and higher-order multiple birth rates both declined in 2019 compared with 2018.


Assuntos
Coeficiente de Natalidade/tendências , Adolescente , Adulto , Declaração de Nascimento , Ordem de Nascimento , Coeficiente de Natalidade/etnologia , Peso ao Nascer , Grupos de Populações Continentais/estatística & dados numéricos , Parto Obstétrico/economia , Parto Obstétrico/métodos , Feminino , Idade Gestacional , Hispano-Americanos/estatística & dados numéricos , Humanos , Recém-Nascido , Masculino , Estado Civil/etnologia , Estado Civil/estatística & dados numéricos , Idade Materna , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Prole de Múltiplos Nascimentos/estatística & dados numéricos , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Uso de Tabaco/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
2.
Saudi Med J ; 42(4): 384-390, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33795493

RESUMO

OBJECTIVES: To measure the Saudi population's sleep quality during the lockdown of COVID-19. METHODS: An internet-based questionnaire that was performed during the lockdown of the COVID-19 pandemic among the Saudi population over 2 weeks from April 1 to April 15, 2020. We used the instant messaging application WhatsApp and Twitter to reach the targeted population. Saudi citizens and non-Saudi residents who can read and understand the questionnaire were recruited. Data were analyzed using Stata and SPSS. RESULTS: A total of 790 responses were included. The majority of participants were the Saudi population 735 (92.9%). The prevalence of insomnia and poor sleep quality were 54.4% and 55.5%, respectively. Saudi citizenship was associated with longer sleep duration (p=0.031). Female gender and being married were associated with worse global PSQI, sleep quality, sleep distribution, sleep latency, and daytime dysfunction. CONCLUSION: Our findings showed that during the COVID-19 pandemic, the Saudi population had a high prevalence of insomnia and poor sleep quality. Routine monitoring of the psychological impact of life-threatening outbreaks and the adoption of effective early mental health actions should be considered.


Assuntos
Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Sono , Adulto , Controle de Doenças Transmissíveis , Estudos Transversais , Escolaridade , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Política Pública , Fatores de Risco , Arábia Saudita/epidemiologia , Fatores Sexuais , Latência do Sono , Inquéritos e Questionários , Desemprego/estatística & dados numéricos
3.
J Aging Stud ; 56: 100907, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33712092

RESUMO

In this piece I argue that the pandemic with its emphasis on social distancing as a desirable civic norm can reconfigure popular understanding of mature female singlehood in India- a condition that is often described in the language of lacks and social failures. The pandemic, I argue, has reaffirmed the everyday practices of upper middle-class professional women (ages 50-60 years) lending them as positive agentic subjects who are invested in self-actualization and an appreciation of intimate solitude. Overall, by specifically focusing on subjectivities and social aspirations of my interlocutors during the pandemic, I illuminate ways in which middle aged selfhood is lived in all its fragility, ambivalence and emergent possibilities.


Assuntos
/prevenção & controle , Estado Civil/estatística & dados numéricos , Quarentena/psicologia , Estigma Social , Mulheres/psicologia , Feminino , Humanos , Índia , Pessoa de Meia-Idade , Pandemias , Inquéritos e Questionários
4.
Asian J Psychiatr ; 58: 102626, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33721830

RESUMO

Mental health issues among health care workers (HCWs) in treatment settings during COVID-19 remains understudied in India. This study examines its prevalence and correlates among HCWs in Karnataka State, India. HCWs who attended a workshop to improve mental health well-being during COVID-19 completed an anonymous online questionnaire. In addition to socio-demographics, domains assessed include occupational characteristics, COVID-19 related concerns, anxiety/depression, substance use, suicidality, lifestyle and family functioning. Of the 3083 HCWs who completed the survey (response rate-51.4 %), anxiety disorder and depression was highest among those with frontline COVID-19 responsibilities (anxiety disorder-26.6 %, depression-23.8 %). Prevalence was significantly higher among those with clinical responsibilities compared to those with supportive responsibilities (anxiety disorder: 23.9 % vs 15.5 %), (depression: 20.0 % vs 14.2 %). In the backward step-wise logistic regression analysis, HCWs with anxiety disorder were more likely to be doctors/nurses/hospital assistants, older, female, unmarried, without a leisure activity, report increased alcohol use and suicidal thoughts after pandemic onset, and having a history of receiving mental health interventions. Participants with depression additionally had family distress and hardly ever exercised. To conclude, mental health issues are common among HCWs in India. Interventions need to ensure that HCWs are protected from mental health consequences of working in COVID-19 treatment settings.


Assuntos
/psicologia , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Adulto , Fatores Etários , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Estado Civil/estatística & dados numéricos , Fatores Sexuais
5.
Prax Kinderpsychol Kinderpsychiatr ; 70(2): 134-153, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33565952

RESUMO

The Role of Partnership Status and Relationship Satisfaction in Inpatient Mother-Child Treatment in Postpartum Mental Disorders The study examines the partnership status and satisfaction in connection with symptoms of postpartum mental disorders, mother-child attachment and outcome of inpatient mother-child treatment. Two sub-studies were carried out. In the first study, N = 126 mothers with postpartum mental disorders who went to a preliminary consultation for inpatient mother-child treatment stated their symptom burden (SCL-90), mother-child attachment (PBQ) and satisfaction with their partner relationship (PFB-K). Mothers with stressed relationships showed the highest level of symptom burden and impaired attachment. Mothers without a partner reported the least amount of impairment in mother-child attachment. In the second study, N = 41 mothers were examined over the course of inpatient treatment (within-subject design with a waiting-list). The initial relationship satisfaction was not predictive of symptom reduction or improvement in mother-child attachment. An increase in satisfaction during the treatment was though correlated with an improvement in mother-child attachment.


Assuntos
Pacientes Internados/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Apego ao Objeto , Satisfação Pessoal , Período Pós-Parto/psicologia , Parceiros Sexuais/psicologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Estado Civil/estatística & dados numéricos
6.
Arch Sex Behav ; 50(2): 683-694, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33469812

RESUMO

A growing body of research has demonstrated how the link between pornography use and various manifestations of psychological distress and dissatisfaction is explained by moral incongruence-the experience of violating one's deeply held moral values. The predictive power of moral incongruence, however, has yet to be applied to other sexual activities. Drawing on data from available waves of the General Social Surveys (1988-2018: nmen = 6590, nwomen = 7047; 1989-2018: nmen = 3558, nwomen = 4841), this study extended moral incongruence theory by testing whether engaging in same-sex or non-marital sexual activity when one rejects either as morally wrong is associated with a greater likelihood of reporting unhappiness. Analyses demonstrated that American men (but not women) who reported engaging in same-sex sex in the previous year were more likely than other men to say they were unhappy, but only if they viewed homosexuality as "always wrong." Analyses also showed that American women (not men) who reported higher frequencies of non-marital sex in the previous year were more likely than other women to report being unhappy, but only if they viewed non-marital sex as "always wrong." Though nuanced by gender, findings affirmed expectations from moral incongruence research: Sexual behavior per se is not associated with unhappiness, but moral inconsistency or conflict regarding one's sexual behavior is.


Assuntos
Relações Extramatrimoniais/psicologia , Tristeza/psicologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Adulto , Conflito Psicológico , Literatura Erótica/psicologia , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Princípios Morais , Fatores Sexuais , Adulto Jovem
7.
PLoS One ; 15(12): e0242352, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370291

RESUMO

BACKGROUND: Job loss in patient with chronic illness like schizophrenia is the most serious public concern in the clinical and socio-economic terms worldwide. Patients with schizophrenia usually have unsatisfactory job termination like quitting or getting fired which results well-established negative outcomes. The complex interplay between one another has made job and mental illness the focus areas. In the developing nations, there is limited study on these areas in spite of higher rates of job loss. OBJECTIVES: This study aimed to assess the prevalence and correlates of job loss among schizophrenia outpatient units in Addis Ababa, Ethiopia. METHODS: Institutional based cross-sectional study was conducted at Saint Amanuel Mental Specialized Hospital among schizophrenia outpatient units in Addis Ababa from May to June 2018. A total of 421 study subjects were interviewed using Positive and Negative Syndrome Scale and Perceived devaluation and discrimination scale. Out of the total study participants, female populations were slightly higher (50.4%) and the majorities (38.6%) were orthodox religion followers. Study characteristics was summarized using descriptive statistics and bi-variable and multivariable analysis was performed using Statistical Package for Social Science version 24. Furthermore, those factors at p value ≤ 0.05 were considered as statistically significant. RESULTS: The prevalence of job loss among patients with schizophrenia was 37.3%. Factors including unmarried [AOR = 2.42:95% CI (1.28, 4.54)], divorced [AOR = 2.34: 95% CI (1.16, 4.71)], severe positive symptoms [AOR = 2.03: 95% CI (1.15, 3.60)], severe general psychopathology [AOR = 1.76: 95% CI (1.01, 3.08)], and poor level of social and occupational functioning [AOR = 5.05: 95% CI (2.81, 9.09)] were significantly associated with job loss among schizophrenia people. CONCLUSION: This study suggested that job loss among schizophrenia outpatients was high. There was significant association among people with unmarried, divorced, severe positive symptoms, poor functionality and higher general psychopathology. Therefore, clinical and psychosocial factors were responsible for job loss which warrant further attention and investigation.


Assuntos
Pacientes Ambulatoriais/estatística & dados numéricos , Esquizofrenia/complicações , Desemprego/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Etiópia , Feminino , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pacientes Ambulatoriais/psicologia , Fatores de Risco , Índice de Gravidade de Doença , Estigma Social , Apoio Social , Desemprego/psicologia , Adulto Jovem
8.
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 191-198, dic. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1145493

RESUMO

Introducción: el siguiente estudio tuvo como finalidad explorar algunas características demográficas asociadas al dolor crónico y el desarrollo de ideas de suicidio en una población de pacientes mayores de 65 años. Método: se realizó un estudio observacional y analítico de corte transversal mediante el relevamiento de datos a partir historias clínicas de pacientes mayores de 65 años que concurrieron a los consultorios externos del equipo de geriatría del Servicio de Psiquiatría del Hospital Italiano de Buenos Aires, entre junio de 2018 y diciembre de 2018. Resultados: se incluyó en el estudio un total de 222 pacientes, de los cuales 50 (23%) presentaron indicadores de dolor crónico y 33 pacientes (14,6%) lo hicieron de ideación suicida. Mediante estudio de correlación se estableció que estar ocupado, padecer dolor crónico y haber tenido más de una internación psiquiátrica son factores que incrementan el riesgo de presentar ideación suicida. Las variables ideación suicida, edad, y el estado civil ‒separado o divorciado en comparación con estar casado‒ son factores asociados a la presencia de dolor crónico. Conclusiones: el dolor crónico y la ideación suicida son factores que contribuyen a aumentar la fragilidad en personas mayores y deben ser estudiados en mayor profundidad para comprender los distintos modos de expresión de la patología psiquiátrica en esta población. (AU)


Introduction: the following study aimed to explore some demographic characteristics associated with chronic pain and the development of suicidal ideas in a population of patients over 65 years. Method: an cross-sectional observational and analytical study was carried out by collecting data from clinical histories of patients over 65 years of age who attended the external offices of the geriatrics team of the Psychiatry service of the Italian Hospital of Buenos Aires between June 2018 and December 2018. Results: a total of 222 patients were included in the study, of which 50 (23%) presented indicators of chronic pain and 33 patients (14.6%) had suicidal ideation. A correlation study established that being employed, suffering from chronic pain and having had more than one psychiatric hospitalization are factors that increase the risk of presenting suicidal ideation. The variables suicidal ideation, age, and separated or divorced marital status compared to being married are factors associated with the presence of chronic pain. Conclusions: chronic pain and suicidal ideation are factors that contribute to increasing frailty in elderly patients and should be studied in greater depth to understand the different modes of expression of psychiatric pathology in this population. (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Ideação Suicida , Dor Crônica/epidemiologia , Argentina/epidemiologia , Psicotrópicos/uso terapêutico , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Pesar , Estudos Transversais , Fatores de Risco , Fatores Etários , Estado Civil/estatística & dados numéricos , Demência/psicologia , Dor Crônica/psicologia , Disfunção Cognitiva/psicologia , Fragilidade/psicologia , Psiquiatria Geriátrica/estatística & dados numéricos
9.
PLoS One ; 15(9): e0238348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32936820

RESUMO

We examined family isolation, economic hardship, and long-distance migration as potential patterns of an extreme outcome of a lonely death: bodily remains that remain unclaimed and are left to the state. This paper combines a unique dataset-Los Angeles County's records of unclaimed deaths-with the Vital Statistics' Mortality data and the Annual Social and Economic Survey (ASEC) to examine 1) whose remains are more likely to become unclaimed after death and, 2) whether population-level differences and trends in family isolation, economic hardship, and long-distance migration explain the differences in the rates of unclaimed deaths. We employ multivariate Poisson models to estimate relative rates of unclaimed deaths by social and demographic characteristics. We find that increases in never married, divorced/separated, and living without family were positively associated with rates of unclaimed deaths. Unemployment among men and poverty among women was associated with higher unclaimed deaths. Long-distance migration was not associated with more unclaimed bodies.


Assuntos
Causas de Morte , Solidão/psicologia , Estado Civil/estatística & dados numéricos , Pobreza , Desemprego/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
JAMA Netw Open ; 3(9): e2019686, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32876685

RESUMO

Importance: The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms. Objective: To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic. Design, Setting, and Participants: This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020. Exposures: The COVID-19 pandemic and outcomes associated with the measures to mitigate it. Main Outcomes and Measures: Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20). Results: A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during-COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre-COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]). Conclusions and Relevance: These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post-COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.


Assuntos
Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Renda/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Betacoronavirus , Depressão/psicologia , Escolaridade , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias , Questionário de Saúde do Paciente , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Estresse Psicológico/psicologia , Estados Unidos/epidemiologia , Adulto Jovem
11.
PLoS One ; 15(8): e0237349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776957

RESUMO

BACKGROUND: Dimensions of social location such as socioeconomic position or sex/gender are often associated with low response rates in epidemiological studies. We applied an intersectionality-informed approach to analyze non-response among population strata defined by combinations of multiple dimensions of social location and subjective health in a health survey in Germany. METHODS: We used data from the cross-sectional sample of the German Health Interview and Examination Survey for Adults (DEGS1) conducted between 2008 and 2011. Information about non-responders was available from a mailed non-responder questionnaire. Intersectional strata were constructed by combining all categories of age, sex/gender, marital status, and level of education in scenario 1. Subjective health was additionally used to construct intersectional strata in scenario 2. We applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to calculate measures of discriminatory accuracy, proportions of non-responders among intersectional strata, as well as stratum-specific total interaction effects (intersectional effects). Markov chain Monte Carlo methods were used to estimate multilevel logistic regression models. RESULTS: Data was available for 6,534 individuals of whom 36% were non-responders. In scenario 2, we found weak discriminatory accuracy (variance partition coefficient = 3.6%) of intersectional strata, while predicted proportions of non-response ranged from 20.6% (95% credible interval (CI) 17.0%-24.9%) to 57.5% (95% CI 48.8%-66.5%) among intersectional strata. No evidence for intersectional effects was found. These results did not differ substantially between scenarios 1 and 2. CONCLUSIONS: MAIHDA revealed that proportions of non-response varied widely between intersectional strata. However, poor discriminatory accuracy of intersectional strata and no evidence for intersectional effects indicate that there is no justification to exclusively target specific intersectional strata in order to increase response, but that a combination of targeted and population-based measures might be appropriate to achieve more equal representation.


Assuntos
Inquéritos Epidemiológicos/estatística & dados numéricos , Recusa de Participação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Escolaridade , Feminino , Alemanha , Nível de Saúde , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Análise Multinível , Fatores Sexuais , Adulto Jovem
12.
PLoS One ; 15(8): e0237333, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776993

RESUMO

Hypertension is the leading risk factor for mortality and it is also one of the major risk factors for other non-communicable diseases (NCDs). The objective of the study was to assess the prevalence of hypertension and its associated factors among adults residing in Arba Minch health and demographic surveillance site (HDSS), Southern Ethiopia. A community-based cross-sectional survey was conducted in 2017 on the estimated sample size of 3,368 adults at Arba Minch Health and Demographic Surveillance site (HDSS). Data were collected using the WHO STEPS survey tools. Bivariate analysis was done to detect candidate variables at P-value less than 0.25 and entered into the final model to identify the independent predictors of hypertension. The prevalence of hypertension was 18.92% (95% CI: 17.63-20.28). The magnitude increase among respondents in the older age group [AOR 1.39 (95%CI: 1.05-1.84), 1.68 (95% CI: 1.26-2.23) and 2.67 (95%CI: 2.01-3.56) for age group 35-44, 45-54 and 55-64, respectively, compared to 25-34 years old group] and those with the higher wealth index [AOR 1.86 (95%CI: 1.33-2.59), 2.68 (95% CI: 1.91-3.75) and 2.97 (95%CI: 2.08-4.25) for 3rd quantile, 4th quantile and 5th quantile, respectively, compared to 1st quantile]. The odds of hypertension reduce among married participants (AOR 0.66, 95%CI: 0.51-0.85). Respondents with overweight (AOR 1.44, 95%CI: 1.02-2.02), khat chewing (AOR3.31, 95%CI: 1.94-5.64), low fruit and/or vegetable consumption (AOR 1.27, 95%CI: 1.05-1.53) and those who do not use coffee and tea (AOR 1.52, 95%CI: 1.03-2.24) had significantly higher likelihood of hypertension. Nearly one out of five participants have hypertension in this population. As hypertension is one of the silent killers, it is advisable to develop a system for enabling early detection and monitoring in the older age groups and overweight individuals.


Assuntos
Comportamento Alimentar , Hipertensão/epidemiologia , Sobrepeso/epidemiologia , Adulto , Fatores Etários , Catha/efeitos adversos , Café , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Hipertensão/prevenção & controle , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Fatores de Risco , Chá , Verduras
13.
BMC Public Health ; 20(1): 1228, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787807

RESUMO

BACKGROUND: Vasectomy is one of the highly effective and non-reversible types of long-term family planning methods for men. Ethiopia has a limited number of studies on the use of vasectomy, and they are focused on men rather than married men. The current study was aimed to identify the intention to use vasectomy as a method of contraception among married men in the study setting. METHODS: A community-based cross-sectional study was conducted from February 1 - April 30, 2018. A sample of 422 married men was recruited using a systematic random sampling method. We conducted face to face interviews with a structured questionnaire (i.e. closed-ended questions). Data were entered into Epi data version 3.1 and SPSS version 23 used for data analysis. The statistical association between the outcome variable (Intention to use vasectomy) and the explanatory variables were first tested with binary logistic regression. Multivariable logistic regression was used to control for confounding effect of each predictor. RESULTS: The study findings showed that the intention to use vasectomy as a method of family planning was reported as high (24%). About 34.8% of the respondents had good knowledge and nearly a quarter (23.2%) of them had a positive attitude toward the acceptance of vasectomy use. In multivariate analysis, age range between 30 and 39 years [AOR = 2.4, 95% CI = (1.16-4.82)], having good knowledge about vasectomy use [AOR = 6.22, 95% CI = (3.17-12.21)], and having a positive attitude toward vasectomy use [AOR = 7.81, 95% CI = (4.25-14.38)] were factors significantly associated to use vasectomy as compared to their counterparts. CONCLUSION: The level of acceptance of vasectomy (24%) was high compared to the level of its use in developing countries (i.e. if acceptability translates to use). The study revealed that age, good knowledge, and a positive attitude towards the use of vasectomy were important predictors of the intention to accept vasectomy. To further promote the use of vasectomy effective communication strategies in family planning programs are needed.


Assuntos
Intenção , Estado Civil/estatística & dados numéricos , Vasectomia/psicologia , Adulto , Estudos Transversais , Etiópia , Serviços de Planejamento Familiar/métodos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Inquéritos e Questionários
14.
PLoS One ; 15(8): e0236352, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760153

RESUMO

INTRODUCTION: Despite the desire of adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) to use contraceptives, the majority of them have challenges with access to contraceptive services. This is more evident in high fertility countries in SSA. The purpose of this study was to examine the predictors of unmet need for contraception among AGYW in selected high fertility countries in SSA. MATERIALS AND METHODS: Data from current Demographic and Health Surveys (DHS) carried out between 2010 and 2018 in 10 countries in SSA were analysed. A sample size of 24,898 AGYW who were either married or cohabiting was used. Unmet need for contraception was the outcome variable in this study. The explanatory variables were age, marital status, occupation, educational level, frequency of reading newspaper/magazine, frequency of listening to radio, frequency of watching television and parity (individual level variables) and wealth quintile, sex of household head, place of residence and decision-maker in healthcare (household/community level variables). Descriptive and multilevel logistic regression analyses were carried out. The results of the multilevel logistic regression analyses were reported using adjusted odds ratios at 95% confidence interval. RESULTS: The prevalence of unmet need for contraception in all the countries considered in this study was 24.9%, with Angola, recording the highest prevalence of 42.6% while Niger had the lowest prevalence of 17.8%. In terms of the individual level predictors, the likelihood of unmet need for contraception was low among AGYW aged 20-24 [aOR = 0.82; 95% CI = 0.76-0.88], those with primary [aOR = 1.22; 95% CI = 1.13-1.31] and secondary/higher levels of formal education [aOR = 1.18; 95% CI = 1.08-1.28, p < 0.001], cohabiting AGYW [aOR = 1.52; 95% CI = 1.42-1.63] and AGYW with three or more births [aOR = 3.41; 95% CI = 3.02-3.85]. At the household/community level, the odds of unmet need for contraception was highest among poorer AGYW [aOR = 1.36; 95% CI = 1.21-1.53], AGYW in female-headed households [aOR = 1.22; 95% CI = 1.13-1.33], urban AGYW [aOR = 1.21; 95% CI = 1.11-1.32] and AGYW who took healthcare decisions alone [aOR = 1.10; 95% CI = 1.01-1.21]. CONCLUSION: This study has identified disparities in unmet need for contraception among AGYW in high fertility countries in SSA, with AGYW in Angola having the highest prevalence. Both individual and household/community level factors predicted unmet need for contraception among AGYW in this study. However, based on the ICC values, household/community level factors prevailed the individual level factors. Enhancing access to contraception among poorer AGYW, those in female-headed households, those in urban areas and those who take healthcare decisions alone by both governmental and non-governmental organisations in high fertility countries is recommended.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Anticoncepcionais/provisão & distribução , Dispositivos Anticoncepcionais/provisão & distribução , Serviços de Planejamento Familiar/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Adolescente , África ao Sul do Saara , Feminino , Inquéritos Epidemiológicos , Humanos , Estado Civil/estatística & dados numéricos , Análise Multinível/métodos , Fatores Socioeconômicos , Adulto Jovem
15.
PLoS One ; 15(7): e0235211, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645010

RESUMO

BACKGROUND: The current international physical activity guidelines for health recommend children to engage in at least 60 minutes of moderate-to-vigorous physical activity (MVPA) daily. Yet, accurate prevalence estimates of physical activity levels of children are unavailable in many African countries due to the dearth of accelerometer-measured physical activity data. The aim of this study was to describe the prevalence and examine the socio-demographic correlates of accelerometer-measured physical activity among school-going children in Kampala city, Uganda. METHODS: A cross-sectional study design was used to recruit a sample of 10-12 years old school-going children (n = 256) from 7 primary schools (3 public schools and 4 private schools) in Kampala city, Uganda. Sedentary time, light-intensity physical activity (LPA), moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA) were measured by accelerometers (ActiGraph GT3X+ [Pensacola, Florida, USA]) over a seven-day period. Socio-demographic factors were assessed by a parent/guardian questionnaire. Weight status was generated from objectively measured height and weight and computed as body mass index (BMI). Multi-level logistic regressions identified socio-demographic factors that were associated with meeting physical activity guidelines. RESULTS: Children's sedentary time was 9.8±2.1 hours/day and MVPA was 56±25.7 minutes/day. Only 36.3% of the children (38.9% boys, 34.3% girls) met the physical activity guidelines. Boys, thin/normal weight and public school children had significantly higher mean daily MVPA levels. Socio-demographic factors associated with odds of meeting physical activity guidelines were younger age (OR = 0.68; 95% CI = 0.55-0.84), thin/normal weight status (OR = 4.08; 95% CI = 1.42-11.76), and socioeconomic status (SES) indicators such as lower maternal level of education (OR = 2.43; 95% CI = 1.84-3.21) and no family car (OR = 0.31; 95% CI = 0.17-0.55). CONCLUSION: Children spent a substantial amount of time sedentary and in LPA and less time in MVPA. Few children met the physical activity guidelines. Lower weight status, lower maternal education level and no family car were associated with meeting physical activity guidelines. Effective interventions and policies to increase physical activity among school-going children in Kampala, are urgently needed.


Assuntos
Acelerometria/estatística & dados numéricos , Exercício Físico , Instituições Acadêmicas/estatística & dados numéricos , Comportamento Sedentário , Fatores Socioeconômicos , Adulto , Idoso , Índice de Massa Corporal , Peso Corporal , Criança , Cidades/estatística & dados numéricos , Estudos Transversais , Feminino , Guias como Assunto , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Instituições Acadêmicas/normas , Fatores de Tempo , Uganda , Adulto Jovem
16.
BMC Public Health ; 20(1): 1085, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32650747

RESUMO

BACKGROUND: We examined the association between family-related life events (cohabitation/marriage and becoming a parent) and change in physical activity. METHODS: Longitudinal data (n = 8045) from the 1970 British Cohort Study (30 and 34 years) were included. Life events (beginning cohabitation/marriage and becoming a parent) were reported and coded: 0 no, 1 yes, for each event occurring between 30 and 34 years. Participants reported frequency of participation in leisure-time physical activity at 30 and 34 years (Likert scale: mean change calculated ranging between - 4 and 4). Linear regression models were used to examine the association between life events and physical activity change (comparing individuals experiencing events between 30 and 34 years versus never experiencing the event - excluding participants that experienced previous events - with a final analysis sample of n = 3833 in parenthood analysis; n = 1137 in cohabitation analysis). Interaction terms were used to analyse combined parenthood and cohabitation status. Analyses were adjusted for level of education achieved, ethnicity, country of origin and other life events. ANCOVA was used to examine associations between change in physical activity and child age. RESULTS: Compared to remaining without children, becoming a parent was associated with a greater reduction in physical activity among men [ß:-0.234(95%CI:-0.396 to - 0.072)] but not women [0.126(- 0.048;0.301)]. No associations were found between cohabitation and physical activity. Men who became fathers both while cohabitating [- 0.201(- 0.383;-0.020)] and without cohabiting [- 0.937(- 1.623;-0.250)] experienced greater physical activity declines than those remaining single and without children; the decline was greatest among non-cohabiting fathers. These associations did not differ by child age. CONCLUSIONS: Parenthood appears to differentially impact physical activity for men and women; this association also differs by cohabitation status. Parenthood appears to be most detrimental to physical activity levels among men. Interventions for physical activity could target new or soon-to-be parents, especially fathers. Further analyses with device-measured physical activity data would be valuable to advance understanding of these associations.


Assuntos
Exercício Físico , Características da Família , Pai/estatística & dados numéricos , Estado Civil/estatística & dados numéricos , Mães/estatística & dados numéricos , Adulto , Feminino , Humanos , Ilegitimidade/estatística & dados numéricos , Modelos Lineares , Estudos Longitudinais , Masculino , Casamento/estatística & dados numéricos , Reino Unido
17.
South Med J ; 113(6): 285-291, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32483638

RESUMO

OBJECTIVE: The purpose of this study was to evaluate factors associated with postpartum contraceptive use among women with short and moderate-to-long birth intervals using population-based data from the Pregnancy Risk Assessment and Monitoring System. METHODS: Because only Mississippi and Tennessee include a question about birth interval length on their Pregnancy Risk Assessment and Monitoring System survey, this analysis was limited to women from those states who reported information on this variable (N = 2198). Demographic, lifestyle, and reproductive data, including information on postpartum contraceptive use, were obtained from surveys and birth certificates. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Nearly 90% of women reported currently using a form of contraception during the postpartum period. In the unadjusted model, among women with short birth intervals, there was no association between alcohol consumption during pregnancy and postpartum contraceptive use (OR 1.03, 95% CI 0.15-7.31); however, smoking during pregnancy was associated with a decreased odds of postpartum contraceptive use (OR 0.70, 95% CI 0.25-1.96). Among women with moderate-to-long birth intervals, alcohol use during pregnancy was associated with a decreased odds (OR 0.71, 95% CI 0.28-1.80) and smoking during pregnancy was associated with an increased odds (OR 1.18, 95% CI 0.60-2.30) of postpartum contraceptive use. Regardless of birth interval length, women with no health insurance had a decreased odds of postpartum contraceptive use when compared with women with health insurance (short birth interval: OR 0.89, 95% CI 0.32-2.49 and moderate-to-long birth interval: OR 0.85, 95% CI 0.52-1.39). Among women with short birth intervals, non-Hispanic black women had a decreased odds of postpartum contraceptive use (OR 0.14, 95% CI 0.03-0.64) and women who were unmarried or had a history of preterm delivery had an increased odds of postpartum contraceptive use (unmarried: OR 5.81, 95% CI 1.26-26.69 and preterm delivery: OR 4.19, 95% CI 1.42-12.37, respectively) after adjustment for confounders. Among women with moderate-to-long birth intervals, individuals who identified as Hispanic/mixed race/other had a statistically significant decreased odds of postpartum contraceptive use after adjustment (OR 0.43, 95% CI 0.18-0.99). CONCLUSIONS: Findings underscore the importance of postpartum medical visits for all women, regardless of birth interval length. Certain groups of women may need additional counseling regarding the importance of using contraceptives to prevent another closely spaced or unintended pregnancy.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Intervalo entre Nascimentos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde , Período Pós-Parto , Fumar/epidemiologia , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Modelos Logísticos , Estado Civil/estatística & dados numéricos , Mississippi/epidemiologia , Razão de Chances , Nascimento Prematuro/epidemiologia , Tennessee/epidemiologia , Adulto Jovem
18.
Am J Obstet Gynecol ; 223(5): 735.e1-735.e14, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32433998

RESUMO

BACKGROUND: Social determinants of health are known to contribute to disparities in health outcomes. Routine screening for basic social needs is not a part of standard care; however, the association of those needs with increased healthcare utilization and poor compliance with guideline-directed care is well established. OBJECTIVE: In this study, we aimed to assess the prevalence of basic social resource needs identified through a quality improvement initiative in a gynecologic oncology outpatient clinic. In addition, we aimed to identify clinical and demographic factors associated with having basic social resource needs. STUDY DESIGN: We performed a prospective cohort study of women presenting to a gynecologic oncology clinic at an urban academic institution who were screened for basic social resource needs as part of a quality improvement initiative from July 2017 to May 2018. The following 8 domains of resource needs were assessed: food insecurity, housing insecurity, utility needs, financial strain, transportation, childcare, household items, and difficulty reading hospital materials. Women with needs were referred to resources to address those needs. Demographic and clinical information were collected for each patient. The prevalence of needs and successful follow-up interventions were calculated. Patient factors independently associated with having at least 1 basic social resource need were identified using multivariable Poisson regression. RESULTS: A total of 752 women were screened in the study period, of whom 274 (36%) reported 1 or more basic social resource need, with a median of 1 (range, 1-7) need. Financial strain was the most commonly reported need (171 of 752, 23%), followed by transportation (119 of 752, 16%), difficulty reading hospital materials (54 of 752, 7%), housing insecurity (31 of 752, 4%), food insecurity (28 of 752, 4%), household items (22 of 752, 3%), childcare (15 of 752, 2%), and utility needs (13 of 752, 2%). On multivariable analysis, independent factors associated with having at least 1 basic social resource need were being single, divorced or widowed, nonwhite race, current smoker, nonprivate insurance, and a history of anxiety or depression. A total of 36 of 274 (13%) women who screened positive requested assistance and were referred to resources to address those needs. Of the 36 women, 25 (69%) successfully accessed a resource or felt equipped to address their needs, 9 (25%) could not be reached despite repeated attempts, and 2 (6%) declined assistance. CONCLUSION: Basic social resource needs are prevalent in women presenting to an urban academic gynecologic oncology clinic and can be identified and addressed through routine screening. To help mitigate ongoing disparities in this population, screening for and addressing basic social resource needs should be incorporated into routine comprehensive care in gynecologic oncology clinics.


Assuntos
Status Econômico/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Ginecologia , Habitação/estatística & dados numéricos , Oncologia , Determinação de Necessidades de Cuidados de Saúde , Melhoria de Qualidade , Determinantes Sociais da Saúde , Centros Médicos Acadêmicos , Adulto , Idoso , Assistência Ambulatorial , Criança , Cuidado da Criança/estatística & dados numéricos , Vestuário/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/terapia , Hospitais Urbanos , Utensílios Domésticos/estatística & dados numéricos , Humanos , Seguro Saúde/estatística & dados numéricos , Alfabetização/estatística & dados numéricos , Estado Civil/estatística & dados numéricos , Programas de Rastreamento , Pessoa de Meia-Idade , Estudos Prospectivos , Fumar/epidemiologia , Transportes/estatística & dados numéricos
19.
PLoS One ; 15(4): e0232624, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353069

RESUMO

BACKGROUND: A global epidemic of obesity has been documented, particularly among African countries. While central obesity and overweight have been reported for many countries, very limited information exists about the prevalence of these health problems in Sudan, and these data are nonexistent for Eastern Sudan. The present study aimed to determine the prevalence of obesity and central obesity, as well as the factors associated with both, among adults in Gadarif, Eastern Sudan. METHODS: A cross-sectional study was conducted in Gadarif, Eastern Sudan, during the period of January through May 2018. Sociodemographic and health characteristics data were collected through a questionnaire. Body mass index (BMI) and waist circumference (WC) were measured using the standard methods. Both descriptive and inferential statics were applied to analyze the data. RESULTS: A total of 594 adults participated in the study; 70.4% of them were female. The mean (standard deviation) age was 44.98 (16.64) years. Of the 594 enrolled participants, 33.7%, 7.4%, 26.8%, and 32.2% were normal weight, underweight, overweight, and obese, respectively. The prevalence of central obesity was (67.8%). Approximately, one-third of the participants (29.29%) were obese and had central obesity. In the multinomial regression, being married was the main risk factor associated with overweight, and older age, female sex, being married and hypertension were significantly associated with obesity. In the binary regression, the main risk factors associated with central obesity were female sex and being married. CONCLUSION: The prevalence rates of both obesity and central obesity among the study participants were high. Older age and hypertension were only associated with obesity. Obesity and central obesity were significantly associated with female sex and being married. This study provided valuable baseline information to develop appropriate strategies for the prevention and control of obesity in Eastern Sudan.


Assuntos
Obesidade Abdominal/epidemiologia , Sobrepeso/epidemiologia , Adulto , Fatores Etários , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/prevenção & controle , Sobrepeso/diagnóstico , Sobrepeso/prevenção & controle , Prevalência , Fatores de Risco , Fatores Sexuais , Sudão/epidemiologia , Circunferência da Cintura
20.
Int J Public Health ; 65(5): 627-636, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32350551

RESUMO

OBJECTIVES: We study the role of marital status and living arrangements in mortality among a 50+ population living in Europe by gender and welfare states. METHODS: Using data from waves 4, 5, and 6 of the Survey of Health Age and Retirement in Europe (n = 54,171), we implemented Cox proportional hazard models by gender and age groups (50-64 and 65-84). We estimated pooled models and separated models for two regions representing different welfare states (South-East and North-West). RESULTS: Among people aged 50-64, nonpartnered individuals (except never-married women) showed a higher mortality risk as compared with those partnered. Among the older population (65-84), divorce was associated with higher mortality among men, but not among women, and living with someone other than a partner was associated with higher mortality risk as compared to those partnered. In the South-East region living with a partner at ages 50-64 was associated with lower mortality. CONCLUSIONS: Partnership and residential status are complementary for understanding the role of family dimensions in mortality. The presence of a partner is mortality protective, especially among 50-64-year-old men in South-East Europe.


Assuntos
Divórcio/estatística & dados numéricos , Estado Civil/estatística & dados numéricos , Mortalidade , Características de Residência/estatística & dados numéricos , Pessoa Solteira/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
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