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1.
Ann Agric Environ Med ; 27(3): 448-455, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955229

RESUMO

INTRODUCTION: Cerebrovascular diseases in Poland constitute a bigger threat to life in men than in women, especially after the age of 60. Death rates indicate higher stroke over-mortality in the rural population rather than the urban. At the same time, stroke is the main cause of long-term disability, since half of the patients are unable to independently perform daily activities, which makes them dependent on other people. MATERIAL AND METHODS: The study was conducted in the Independent Public Healthcare Institution in Krasnik, eastern Poland. It covered the medical records of 1,500 patients, 780 women (52%) and 720 men (48%), aged 20-100, diagnosed with cerebral infarction. The patients were hospitalised between 2011-2016 in the Neurology Ward with a Stroke Unit, the Internal Medicine Ward, and the Anaesthetics and Intensive Care Ward. RESULTS: The stroke patients hospitalised in the Independent Public Healthcare Institution in Krasnik were residents of urban communes (59.1% of subjects) and rural communes (40.9%). The most often diagnosed type of stroke was due to embolism of the cerebral arteries (I63.4) in women (63.48%). In men, the most most often diagnosed type was cerebral infarction due to thrombosis of the cerebral arteries (I63.3; 51.33%). Stroke in 36.15% of the female subjects resulted in death. In male subjects, death occurred in 26.11% of the cases. CONCLUSIONS: Women aged around 78-years-old were the most likely to suffer a stroke. In men, it occurred eight years earlier. Despite residents of urban areas being hospitalised due to stroke more often, deaths caused by this disease were recorded the most frequently among rural residents. It can be concluded that primary stroke prevention is the only effective measure for reducing morbidity and premature mortality in the population.


Assuntos
População Rural/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , População Urbana/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Prevalência , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/etiologia , Adulto Jovem
2.
Ann Agric Environ Med ; 27(3): 469-475, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955231

RESUMO

INTRODUCTION: Currently, malignancies are the most severe medical problems worldwide. Numerous, already known risk factors in carcinogenesis could be potentially avoided. Some cancer risk factors have been recognized and have become the targets of primary prophylaxis. OBJECTIVE: The aim of the study was to ascertain the state of knowledge about risk factors, primary prevention and early detection of malignancies of gastrointestinal tract (GIT) in the urban and rural population of the Lublin province in Eastern Poland. MATERIAL AND METHODS: The study was cross-sectional. The originally designed questionnaire was applied to the group of 1,352 patients, representatives of both the rural and urban environments of the Lublin province during random appointments with their general practitioner (GP). RESULTS: The study showed low awareness of the issues connected with GIT malignancies within the studied group. The problem was particulary apparent in the rural population. CONCLUSIONS: In order to raise general awareness of cancer, different means should be applied in urban and rural populations. GPs and the media were found to have the leading rols in the promotion of primary prevention.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias Gastrointestinais/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Prevenção Primária/estatística & dados numéricos , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/prevenção & controle , Polônia , Fatores de Risco , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos
3.
BMC Public Health ; 20(1): 1442, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967642

RESUMO

BACKGROUND: There has been an increase in older rural-to-urban migrant workers (aged 50 and above) in mainland China, little known about their depressive symptoms. The aim of this study was to identify depressive symptoms among older rural-to-urban migrant workers, as well as explored the factors leading to differences in depressive symptoms between older rural-to-urban migrant workers and their rural counterparts (older rural dwellers) and urban counterparts (older urban residents) in mainland China. The results provided a comprehensive understanding of the depressive symptoms of older rural-to-urban migrant workers, and had great significance for improving the depressive symptoms for this vulnerable group. METHODS: Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015, and coarsened exact matching (CEM) method was employed to control confounding factors. This study employed a Chinese version 10-item short form of the Center for Epidemiologic Studies-Depression Scale (CES-D 10) to measure depressive symptoms, and used the Social-Ecological Model as a framework to explore influential factors related to depressive symptoms. Specifically, the approach of Fairlie's decomposition was used to parse out differences into observed and unobserved components. RESULTS: After matching, our findings indicated that the prevalence of depressive symptoms in older rural-to-urban migrant workers was lower than older rural dwellers; and the prevalence of depressive symptoms in older rural-to-urban migrant workers was higher than older urban residents. Fairlie's decomposition analysis indicated that type of in-house shower, sleeping time at night and ill in the last month were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older rural dwellers; self-reported health and sleeping time at night were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older urban residents. CONCLUSIONS: Differences in depressive symptoms between older rural-to-urban migrant workers and their rural and urban counterparts did exist. Our findings contributed to a more reliable understanding in depressive symptoms among older rural-to-urban migrant workers. Our findings would be of referential significance for improving older rural-to-urban migrant workers' depressive symptoms.


Assuntos
Depressão/epidemiologia , Disparidades nos Níveis de Saúde , População Rural/estatística & dados numéricos , Migrantes/psicologia , População Urbana/estatística & dados numéricos , Idoso , China/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Migrantes/estatística & dados numéricos
4.
BMC Public Health ; 20(1): 1472, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993592

RESUMO

BACKGROUND: Urban-rural disparity in mortality at older ages is well documented in China. However, surprisingly few studies have systemically investigated factors that contribute to such disparity. This study examined the extent to which individual-level socioeconomic conditions, family/social support, health behaviors, and baseline health status contributed to the urban-rural difference in mortality among older adults in China. METHODS: This research used the five waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014, a nationally representative sample of older adults aged 65 years or older in China (n = 28,235). A series of hazard regression models by gender and age group examined the association between urban-rural residence and mortality and how this association was modified by a wide range of individual-level factors. RESULTS: Older adults in urban areas had 11% (relative hazard ratio (HR) = 0.89, p < 0.01) lower risks of mortality than their rural counterparts when only demographic factors were taken into account. Further adjustments for family/social support, health behaviors, and health-related factors individually or jointly had a limited influence on the mortality differential between urban and rural older adults (HRs = 0.89-0.92, p < 0.05 to p < 0.01). However, we found no urban-rural difference in mortality (HR = 0.97, p > 0.10) after adjusting for individual socioeconomic factors. Similar results were found in women and men, and among the young-old and the oldest-old populations. CONCLUSIONS: The urban-rural disparity in mortality among older adults in China was largely attributable to differences in individual socioeconomic resources (i.e., education, income, and access to healthcare) regardless of gender and age group.


Assuntos
Comportamentos Relacionados com a Saúde , Nível de Saúde , Renda/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Longevidade , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Risco , Percepção Social , Apoio Social , Fatores Socioeconômicos , Adulto Jovem
5.
BMC Public Health ; 20(1): 1243, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32799833

RESUMO

BACKGROUND: In African countries, including Angola, antenatal care (ANC) coverage is suboptimal and maternal mortality is still high due to pregnancy and childbirth-related complications. There is evidence of disparities in the uptake of ANC services, however, little is known about both the socio-economic and geographic-based disparity in the use of ANC services in Angola. The aim of this study was to assess the extent of socio-economic, urban-rural and subnational inequality in ANC coverage in Angola. METHODS: We analyzed data from the 2015 Angola Demographic and Health Survey (ADHS) using the World Health Organization (WHO) Health Equity Assessment Toolkit (HEAT) software. The analysis consisted of disaggregated ANC coverage rates using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population Attributable Risk, Ratio and Population Attributable Fraction). To measure statistical significance, an uncertainty interval (UI) of 95% was constructed around point estimates. RESULTS: The study showed both absolute and relative inequalities in coverage of ANC services in Angola. More specifically, inequality favored women who were rich (D = 54.2, 95% UI; 49.59, 58.70, PAF = 43.5, 95% UI; 40.12, 46.92), educated (PAR = 19.9, 95% UI; 18.14, 21.64, R = 2.14, 95% UI; 1.96, 2.32), living in regions such as Luanda (D = 51.7, 95% UI; 43.56, 59.85, R = 2.64, 95% UI; 2.01, 3.26) and residing in urban dwellings (PAF = 20, 95% UI; 17.70, 22.38, PAR = 12.3, 95% UI; 10.88, 13.75). CONCLUSION: The uptake of ANC services were lower among poor, uneducated, and rural residents as well as women from the Cuanza Sul region. Government policy makers must consider vulnerable subpopulations when designing needed interventions to improve ANC coverage in Angola to achieve the 2030 Sustainable Development Goal of reducing global maternal mortality ratio to 70 deaths per 100,000 live births.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Angola , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Fatores Socioeconômicos , Adulto Jovem
6.
PLoS One ; 15(8): e0237578, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32797104

RESUMO

Although rurality is often treated as an aspect of diversity, researchers disagree regarding whether the traditional rural values of self-reliance, distrust of outsiders, religiosity, centrality of family, and fatalism continue to differentiate rural versus urban undergraduates. The present study examined 1) whether differences in these values exist between rural and urban college students in the United States and 2) whether these rural values might mediate the association between geographic remoteness and posttraumatic stress symptom (PTSS) severity. College undergraduates in the United States who reported experiencing traumatic and/or stressful events (N = 213) completed measures of these constructs through an online survey. T-test results indicated that rural respondents had significantly higher levels of PTSS severity and distrust of outsiders and significantly lower levels of religiosity when compared with urban participants. After controlling for gender, distrust of outsiders and religiosity also emerged as significant mediators of the relationship between geographic remoteness and PTSS severity. Thus, despite research that highlights differences based on geographic location, similarities and differences exist for rural and urban undergraduates in the United States with regard to traditionally rural values. For rural undergraduate clients presenting with trauma symptoms, our results suggest that building trust and religious and/or spiritual self-care may be particularly critical.


Assuntos
População Rural/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estudantes/psicologia , População Urbana/estatística & dados numéricos , Adolescente , Características Culturais , Feminino , Humanos , Masculino , Religião , Autocuidado/psicologia , Índice de Gravidade de Doença , Estudantes/classificação , Estados Unidos/epidemiologia , Adulto Jovem
7.
J Registry Manag ; 47(1): 4-12, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32833378

RESUMO

OBJECTIVES: Researchers often approximate individual-level socioeconomic status (SES) from census tract and county data. However, area-level variables do not serve as accurate proxies for individual-level SES, particularly among some demographic subgroups. The present study aimed to analyze the potential bias introduced by this practice. METHODS: Data included (1) individual-level SES from the Mortality Disparities in American Communities study (n ≈ 3,471,000 collected in 2008), and (2) census tract- and county-level SES from the 2006-2010 American Community Survey. Analyses included correlations among SES indicators (eg, median household income, having a high school degree, unemployment) across individual versus census tract and county levels, stratified by sex, age, race/ethnicity, and urbanicity. Finally, generalized estimating equations evaluated demographic differences in whether area-level SES matched or underestimated individual-level SES. RESULTS: Low correlations were observed between individual- and area-level SES (census tract: Spearman's r range = 0.048 for unemployment to 0.232 for median household income; county: r range = 0.028 for unemployment to 0.157 for median household income; all P < .0001). SES indicators were more likely to match for males, older participants, and urban groups. Area-level SES indicators were more likely to underestimate individual-level SES for older participants and rural groups, indicating that individuals who are part of these groups may live in systematically lower-SES communities than their own SES might connote. CONCLUSIONS: In this population-based study of 3.5 million participants, area-level indicators were poor proxies for individual-level SES, particularly for participants living in rural areas.


Assuntos
Censos , Sistema de Registros/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Feminino , Humanos , Masculino , População Rural/estatística & dados numéricos , Classe Social , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
8.
BMC Public Health ; 20(1): 1291, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847504

RESUMO

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality worldwide. The effect of socioeconomic factors on cause-specific mortality and burden of CVD is rarely evaluated in low- and middle-income countries, especially in a rapidly changing society. METHODS: Original data were derived from the vital registration system in Yangpu, a representative, population-stable district of urban Shanghai, China, during 1974-2015. Temporal trends for the mortality rates and burden of CVD during 1974-2015 were evaluated using Joinpoint Regression Software. The burden was evaluated using age-standardized person years of life loss per 100,000 persons (SPYLLs). Age-sex-specific CVD mortality rates were predicted by using age-period-cohort Poisson regression model. RESULTS: A total of 101,822 CVD death occurred during 1974-2015, accounting for 36.95% of total death. Hemorrhagic stroke, ischemic heart disease, and ischemic stroke were the 3 leading causes of CVD death. The age-standardized CVD mortality decreased from 144.5/100,000 to 100.7/100,000 in the residents (average annual percentage change [AAPC] -1.0, 95% confidence interval [CI] -1.7 to - 0.2), which was mainly contributed by women (AAPC -1.3, 95% CI - 2.0 to - 0.7), not by men. Hemorrhagic stroke, the major CVD death in the mid-aged population, decreased dramatically after 1991. The crude mortality of ischemic heart disease kept increasing but its age-adjusted mortality decreased continually after 1997. SPYLLs of CVD death increased from 1974 to 1986 (AAPC 2.1, 95% CI 0.4 to 3.8) and decreased after 1986 (AAPC 1.8, 95% CI - 2.3 to - 1.3). These changes were in concert with the implementation of policies including extended medical insurance coverage, pollution control, active prophylaxis of CVD including lifestyle promotion, and national health programs. The mortality of CVD increased in those born during 1937-1945, a period of the Japanese military occupation, and during 1958-1965, a period including the Chinese Famine. Sequelae of CVD and ischemic heart disease are predicted to be the leading causes of CVD death in 2029. CONCLUSIONS: Exposure to serious malnutrition in early life might increase CVD mortality in later life. Improvements in medical services, pollution control, and lifestyle could decrease CVD death. New strategy is needed to prevent the aging-related CVD death and burden in the future.


Assuntos
Doenças Cardiovasculares/epidemiologia , Causas de Morte/tendências , Disparidades nos Níveis de Saúde , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estatísticas Vitais , Adulto Jovem
10.
Public Health Rep ; 135(5): 691-699, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32791034

RESUMO

OBJECTIVES: Although many people who use drugs meet criteria for vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV), estimates of susceptibility (ie, lack of immunity) are not well established. This study sought to identify the prevalence of and characteristics associated with HAV and HBV susceptibility among people who use drugs attending an urban syringe services program. METHODS: We initiated this seroprevalence study in 2018 among 438 clients of a syringe services program who met study criteria, including provision of a blood specimen and a self-reported history of drug use. We assessed HAV and HBV susceptibility and infection via serological testing. We examined associations between participant characteristics and serology status by using descriptive statistics and multivariable logistic regression models. RESULTS: Of the initial 438 clients identified, 353 (80.6%) met study criteria. Of 352 participants with conclusive HAV test results, 48.6% (n = 171) were HAV susceptible; of 337 participants with conclusive HBV test results, 32.6% (n = 110) were HBV susceptible, 24.3% (n = 82) showed evidence of past or present HBV infection, and 43.0% (n = 145) had vaccine-derived immunity. Compared with participants born before 1970, participants born during 1980-1989 had 5.90 (95% CI, 2.42-14.40) times the odds of HAV susceptibility and 0.18 (95% CI, 0.06-0.53) times the odds of HBV susceptibility, and participants born during 1990-1999 had 6.31 (95% CI, 2.34-17.00) times the odds of HAV susceptibility. Decreased odds of HAV susceptibility were associated with homelessness (adjusted odds ratio = 0.48; 95% CI, 0.28-0.82). CONCLUSION: Despite applicable HAV and HBV vaccination recommendations, substantial gaps exist in HAV and HBV susceptibility among a population of people who use drugs. These findings highlight the need for increased HAV and HBV vaccination efforts among people who use drugs.


Assuntos
Suscetibilidade a Doenças , Usuários de Drogas/estatística & dados numéricos , Hepatite A/epidemiologia , Hepatite B/epidemiologia , Programas de Troca de Agulhas/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Philadelphia/epidemiologia , Fatores de Risco , População Urbana/estatística & dados numéricos , Adulto Jovem
11.
Health Place ; 64: 102378, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32738578

RESUMO

This longitudinal study aims to investigative the impacts of development density on the spread and mortality rates of COVID-19 in metropolitan counties in the United States. Multilevel Linear Modeling (MLM) is employed to model the infection rate and the mortality rate of COVID-19, accounting for the hierarchical (two-level) and longitudinal structure of the data. This study finds that large metropolitan size (measured in terms of population) leads to significantly higher COVID-19 infection rates and higher mortality rates. After controlling for metropolitan size and other confounding variables, county density leads to significantly lower infection rates and lower death rates. These findings recommend that urban planners and health professionals continue to advocate for compact development and continue to oppose urban sprawl for this and many other reasons documented in the literature, including the positive relationship between compact development and fitness and general health.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Planejamento Ambiental , Morbidade , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , População Urbana/estatística & dados numéricos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/etnologia , Humanos , Estudos Longitudinais , Pandemias , Pneumonia Viral/etnologia , Estados Unidos
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1076-1080, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741174

RESUMO

Objective: To evaluate the compliance of low-dose computed tomography (LDCT) screening for high-risk groups of lung cancer and influencing factors in urban area of Henan province during 2013-2017. Methods: Cluster sampling method was used to select the residents of 40-74 years old in Henan for cancer risk factor investigation and lung cancer risk assessment. Subjects with high risk of lung cancer received LDCT screening. The differences of LDCT receiving rates between groups were compared with χ(2) tests, and the time trend of rates were tested with the Cochran- Armitage trend test. The potential factors correlating to the compliance of LDCT screening were identified with multivariate logistic regression models. Results: Overall, 35 672 participants who met the inclusion criteria were included in this analysis, and 13 383 of them received LDCT screening, the receiving rate was 37.52%. The receiving rate varied greatly across cities, ranging from 38.47% to 26.73% (P<0.05). Moreover, the receiving rate varied greatly across periods, ranging from 29.22% during 2013-2014 to 43.30% during 2014-2015, and the receiving rate increases gradually as the screening year increases (P<0.001). The multivariate logistic regression analyses showed that: being female, age 45-69 years, with education level of junior high school/high school, previous smoking, drinking or previous drinking, infrequent physical exercise, history of tuberculosis, history of chronic bronchitis, history of emphysema, history of asthma bronchiectasis and family history of lung cancer were positive factors for receiving LDCT screening (All P<0.05). Conclusions: The overall compliance of LDCT screening in high-risk population of lung cancer was still not high in urban area of Henan. Implementation of effective interventions targeting the specific high-risk populations might improve the overall compliance of LDCT screening in the future.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias Pulmonares/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Tomografia Computadorizada por Raios X/métodos , População Urbana , Adulto , Idoso , China/epidemiologia , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
13.
MMWR Morb Mortal Wkly Rep ; 69(33): 1127-1132, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32817606

RESUMO

The geographic areas in the United States most affected by the coronavirus disease 2019 (COVID-19) pandemic have changed over time. On May 7, 2020, CDC, with other federal agencies, began identifying counties with increasing COVID-19 incidence (hotspots) to better understand transmission dynamics and offer targeted support to health departments in affected communities. Data for January 22-July 15, 2020, were analyzed retrospectively (January 22-May 6) and prospectively (May 7-July 15) to detect hotspot counties. No counties met hotspot criteria during January 22-March 7, 2020. During March 8-July 15, 2020, 818 counties met hotspot criteria for ≥1 day; these counties included 80% of the U.S. population. The daily number of counties meeting hotspot criteria peaked in early April, decreased and stabilized during mid-April-early June, then increased again during late June-early July. The percentage of counties in the South and West Census regions* meeting hotspot criteria increased from 10% and 13%, respectively, during March-April to 28% and 22%, respectively, during June-July. Identification of community transmission as a contributing factor increased over time, whereas identification of outbreaks in long-term care facilities, food processing facilities, correctional facilities, or other workplaces as contributing factors decreased. Identification of hotspot counties and understanding how they change over time can help prioritize and target implementation of U.S. public health response activities.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Humanos , Incidência , Estados Unidos/epidemiologia
14.
Anticancer Res ; 40(7): 3897-3903, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620630

RESUMO

BACKGROUND/AIM: Previous studies have shown discrepancies between patient's desired and actual death place. As planning of family support and involvement of palliative home care teams seem to improve the chance to meet patients preferences, geographical availability of specialized palliative home care could influence place of death. PATIENTS AND METHODS: Data of patients diagnosed and deceased between January 2011 until December 2014 with lung, brain, colorectal, breast and prostate cancer was collected from Swedish national registers and multiple regression analyses were performed. RESULTS: Patients with lung, brain, colorectal, and prostate cancer who resided in rural municipalities had a higher likelihood of dying at home than dying in hospital settings, compared to those who lived in urban areas. CONCLUSION: Patients in Sweden, with the exception of breast cancer patients, have a higher likelihood of home death than inpatient hospital death when residing in rural areas compared to when residing in urban areas.


Assuntos
Serviços de Assistência Domiciliar/estatística & dados numéricos , Neoplasias/mortalidade , Neoplasias/terapia , Cuidados Paliativos/estatística & dados numéricos , Humanos , Cuidados Paliativos/métodos , Preferência do Paciente , Sistema de Registros , População Rural/estatística & dados numéricos , Suécia/epidemiologia , Assistência Terminal/métodos , Assistência Terminal/estatística & dados numéricos , População Urbana/estatística & dados numéricos
15.
J Rural Health ; 36(4): 591-601, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32602983

RESUMO

PURPOSE: There are growing signs that the COVID-19 virus has started to spread to rural areas and can impact the rural health care system that is already stretched and lacks resources. To aid in the legislative decision process and proper channelizing of resources, we estimated and compared the county-level change in prevalence rates of COVID-19 by rural-urban status over 3 weeks. Additionally, we identified hotspots based on estimated prevalence rates. METHODS: We used crowdsourced data on COVID-19 and linked them to county-level demographics, smoking rates, and chronic diseases. We fitted a Bayesian hierarchical spatiotemporal model using the Markov Chain Monte Carlo algorithm in R-studio. We mapped the estimated prevalence rates using ArcGIS 10.8, and identified hotspots using Gettis-Ord local statistics. FINDINGS: In the rural counties, the mean prevalence of COVID-19 increased from 3.6 per 100,000 population to 43.6 per 100,000 within 3 weeks from April 3 to April 22, 2020. In the urban counties, the median prevalence of COVID-19 increased from 10.1 per 100,000 population to 107.6 per 100,000 within the same period. The COVID-19 adjusted prevalence rates in rural counties were substantially elevated in counties with higher black populations, smoking rates, and obesity rates. Counties with high rates of people aged 25-49 years had increased COVID-19 prevalence rates. CONCLUSIONS: Our findings show a rapid spread of COVID-19 across urban and rural areas in 21 days. Studies based on quality data are needed to explain further the role of social determinants of health on COVID-19 prevalence.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Disparidades nos Níveis de Saúde , Pneumonia Viral/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Teorema de Bayes , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Vigilância da População , Prevalência , Prognóstico , Fatores de Risco , Estados Unidos
16.
PLoS One ; 15(7): e0232998, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32609719

RESUMO

OBJECTIVES: The study tried to determine if malnutrition (underweight, stunting, wasting, overweight) and enamel defects (enamel hypoplasia, hypomineralized second molar, amelogenesis imperfecta, fluorosis) were associated with early childhood caries (ECC). The study also examined whether malnutrition was associated with the presence of enamel defects in 0-5-year-old children. METHODS: The study was a secondary analysis of primary data of a cross-sectional study assessing the association between maternal psychosocial health and ECC in sub-urban Nigerian population collected in December 2018 and January 2019. One hundred and fifty nine children were recruited. Exploratory variables were malnutrition and enamel defects. The outcome variables were the prevalence of ECC in 0-2-year-old, 3-5-year-old, and 0-5-year-old children. Multivariable Poisson regression analysis was used to determine the associations, and socioeconomic status, oral hygiene status, and frequency of in-between-meals sugar consumption were adjusted for. The adjusted prevalence ratios, 95% confidence intervals, and p values were calculated. RESULTS: The prevalence of ECC was 2.1% in 0-2-year-old children and 4.9% in 3-5-year-old children. In adjusted models, underweight, stunting, and wasting/overweight were not significant risk indicators for ECC in either age group. 0-2-year-old children who had amelogenesis imperfecta (p<0.001) and fluorosis (p<0.001) were more likely to have ECC than were children who did not have these lesions. 3-5-year-old children who had hypoplasia (p = 0.004), amelogenesis imperfecta (p<0.001) and fluorosis (p<0.001) were more likely to have ECC than were children who did not have these lesions. 0-5-year-old children with hypoplasia (p<0.001) and fluorosis (p<0.001) were more likely to have ECC than were children who did not have these lesions. There were significant associations between various types of malnutrition and various types of enamel defects. CONCLUSION: Although different types of malnutrition were associated with enamel defects, and enamel defects were associated with ECC, malnutrition was not associated with ECC. Further studies are needed to clarify the association between malnutrition and genetically and toxin-induced enamel defects.


Assuntos
Cárie Dentária/epidemiologia , Esmalte Dentário/patologia , Desnutrição/epidemiologia , Criança , Pré-Escolar , Cárie Dentária/complicações , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Desnutrição/complicações , Nigéria , Prevalência , Fatores de Risco , População Urbana/estatística & dados numéricos
18.
Biomed Environ Sci ; 33(6): 396-402, 2020 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-32641202

RESUMO

Objectives: To evaluate the distribution by age and sex of serum high-sensitivity C-reactive protein (hsCRP) in an urban Chinese population and to provide a profile prediction for the risk of bacterial infection, inflammatory diseases, or tissue damages in the body. Methods: Serum hsCRP was determined using the Roche Tina-quant immuno-turbidimetric assay on a Hitachi 7600-010 automatic biochemical analyzer (Roche Diagnostics) in 1,572 males and 1,800 females, including 78 pregnant women, who were derived from the National Health and Nutrition Survey in 2010-2012. Results: The average hsCRP concentration in urban China was 0.68 mg/L for males and 0.65 mg/L for females. Significant differences in hsCRP were found among different age groups ( P < 0.05). Monitoring results showed no significant differences among the 6-11, 45-59, and ≥ 60-year-old groups in the comparison of hsCRP between males and females in large cities. However, hsCRP concentration was significantly higher in men aged 12-17 and 18-44 years than in women. Conclusion: The distribution of the hsCRP status of residents in large cities in China was influenced by age and gender, and the hsCRP levels of both sexes increased gradually with age. In addition, hsCRP concentration was higher in healthy pregnant women than in non-pregnant women. Basing on our results, we recommend that this parameter be included in future national and international screening for early detection of various illnesses.


Assuntos
Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/epidemiologia , Inflamação/epidemiologia , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Prevalência , População Urbana/estatística & dados numéricos , Adulto Jovem
20.
Rev Bras Epidemiol ; 23: e200067, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32667464

RESUMO

INTRODUCTION: Cephalalgia is one of the most common somatic complaints related to health problems in childhood and adolescence. OBJECTIVE: To measure the cephalalgia prevalence in adolescents from the city of São Paulo, Brazil, and associated factors. METHODS: This is a cross-sectional population-based study, carried out in 2015, with 539 adolescents of both sexes, aged between 15 and 19 years. The information was collected in a household survey, and the participants were selected from probabilistic sampling. Frequencies, χ2 test and logistic regression analysis were used in the study, and significance level was 5%. RESULTS: the estimated prevalence of cephalalgia was 38.2% (95%CI 33.8 - 42.7), and 7.8% (95%CI 5.6 - 10.7), migraine. The associated factors for cephalalgia were: female sex (OR = 2.2; 95%CI 1.4 - 3.4), Common Mental Disorder (OR = 2.8; 95%CI 1.7 - 4.9), vision impairment (OR = 2.6; 95%CI 1.6 - 4.2), besides back pain (OR = 2.2; 95%CI 1.3 - 3.5), sinusitis (OR = 2.0; 95%CI 1.2 - 3.4) and incomplete elementary education (OR = 3.0; 95%CI 1.6 - 5.6). CONCLUSION: The prevalence of headache among adolescents in the city of São Paulo represented more than 1/3 (one third) of this population. The main associated factors were sex, low schooling and the following comorbidities: common mental disorder and vision impairment.


Assuntos
Cefaleia/epidemiologia , Vigilância da População/métodos , População Urbana/estatística & dados numéricos , Adolescente , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Distribuição por Sexo , Fatores Socioeconômicos
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