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2.
Rev Saude Publica ; 53: 92, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644723

RESUMO

OBJECTIVE: To estimate the use of the first dose of antibiotics in the health care unit in children from the 2015 Pelotas Birth Cohort at 24 months. METHODS: A total of 4,014 children were monitored. We used descriptive statistics and Poisson regression to analyze the association between socioeconomic and demographic variables, participation in daycare units, in the activities of the Pastoral da Criança and in the Primeira Infância Melhor program, low birth weight, hospitalization between 12 and 24 months, place of medical appointment, prevalence of medical appointment in the last 30 days, prescription of antibiotics, and administration of the first dose in the health care unit. RESULTS: A total of 1,044 children had medical appointments in the last 30 days, of which 45% were prescribed antibiotics and only 10.5% were administered the first dose of this medication in the health care unit. Children with brown, yellow or indigenous skin color were administered 2.5 times more antibiotics than white children. Children whose mothers had 12 years or more of education were administered 83.0% fewer antibiotics than those whose mothers had up to 4 years of education. Among those who were hospitalized for 12 to 24 months, the use of antibiotics was almost four times higher than among those who were not. Among the children served by the Brazilian Unified Health System (SUS), only 15.3% were administered the first dose of antibiotic in the health care unit. When compared with children served by private health care or health plan, administration of the first dose in the SUS was 76.0% higher. CONCLUSIONS: Despite the efforts related to the Pastoral da Criança campaign "Antibiotic: first dose immediately," adherence to the provision of antibiotics in the health care unit is still low. Strategies are necessary and urgent so children have access to the first dose of antibiotics in the health care unit.


Assuntos
Antibacterianos/administração & dosagem , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Adulto , Agendamento de Consultas , Brasil/epidemiologia , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Estudos de Coortes , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Masculino , Mães , Programas Nacionais de Saúde , Prevalência , Fatores Socioeconômicos , Fatores de Tempo , Adulto Jovem
3.
BMC Public Health ; 19(1): 1256, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510978

RESUMO

BACKGROUND: Human capital (the knowledge, skills, and health that accumulate over life) can be optimized by investments in early childhood to promote cognitive and language development. Parents and caregivers play a crucial role in the promotion and support of cognitive development in their children. Thus, understanding caregiver perceptions of a child's capabilities and attributes, including intelligence, may enhance investments early in life. To explore this question, we asked caregivers to rank their child's intelligence in comparison with other children in the community, and compared this ranking with children's scores on an assessment of developmental abilities across multiple domains. METHODS: Our study examined cross-sectional data of 3361 children aged 16-42 months in rural Madagascar. Child intelligence, as perceived by their caregiver, was captured using a ladder ranking scale based on the MacArthur Scale for Subjective Social Status. Children's developmental abilities were assessed using scores from the Ages and Stages Questionnaire: Inventory (ASQ-I), which measures cognitive, language, and socio-emotional development. Ranked percentiles of the ASQ-I were generated within communities and across the whole sample. We created categories of under-estimation, matched, and over-estimation by taking the differences in rankings between caregiver-perceived child intelligence and ASQ-I. Child nutritional status, caregiver belief of their influence on child intelligence, and sociodemographic factors were examined as potential correlates of discordance between the measures using multinomial logistic regressions. RESULTS: We found caregiver perceptions of intelligence in Madagascar did not align consistently with the ASQ-I, with approximately 8% of caregivers under-estimating and almost 50% over-estimating their children's developmental abilities. Child nutritional status, caregiver belief of their influence on child intelligence, caregiver education, and wealth were associated with under- or over-estimation of children's developmental abilities. CONCLUSIONS: Our findings suggest parents may not always have an accurate perception of their child's intelligence or abilities compared with other children. The results are consistent with the limited literature on parental perceptions of child nutrition, which documents a discordance between caregiver perceptions and objective measures. Further research is needed to understand the common cues caregivers that use to identify child development milestones and how these may differ from researcher-observed measures in low-income settings. TRIAL REGISTRATION: Current Controlled Trials ISRCTN14393738 . Registered June 23, 2015.


Assuntos
Cuidadores/psicologia , Desenvolvimento Infantil , Saúde da Criança/estatística & dados numéricos , População Rural/estatística & dados numéricos , Criança , Pré-Escolar , Cognição/fisiologia , Estudos Transversais , Feminino , Humanos , Lactente , Madagáscar , Masculino , Pais/psicologia , Inquéritos e Questionários
4.
Artigo em Alemão | MEDLINE | ID: mdl-31529190

RESUMO

BACKGROUND: Even though 36.5% of children and adolescents living in Germany have a migration background (MB), data on the health of this population is scarce. With population-based data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017), reliable statements can be given. METHODS: Data from KiGGS Wave 2 is used in order to report on general health status, mental health, and the distribution of allergic diseases among children and adolescents aged 3-17 years (n = 13,568). To determine overweight, standardized measurements of body weight and height (n = 3463) were used. In addition to the MB (none/one-sided/two-sided), the socioeconomic status (SES) is considered. In multivariate analyses among children and adolescents with MB, SES and the parents' duration of stay in Germany were included. RESULTS: Participants with a two-sided MB show lower prevalence of neurodermatitis (3.5% vs. 6.9%) and ADHS (2.0% vs. 5.1%) than those without a migration background and higher prevalence of fair to poor general health status (6.1% vs. 3.9%). Children and adolescents with a two-sided migration background are more often affected by overweight than those without migration background (22.1% vs. 12.2%). After considering SES, the chances of a diagnosed neurodermatitis and ADHS remain higher and the chances for overweight are lower in children and adolescents with a migration background than among those without migration background. If only children with MB are considered, SES and partially the parents' duration of stay in Germany are associated with health outcomes. CONCLUSION: Differences in the general health status of children and adolescents with and without MB vary depending on the observed indicators. The heterogeneity of children and adolescents with MB, e.g. regarding SES and parents' duration of stay, should be considered when planning and implementing measures of health promotion.


Assuntos
Nível de Saúde , Classe Social , Adolescente , Saúde do Adolescente , Criança , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Alemanha , Inquéritos Epidemiológicos , Humanos , Prevalência , Fatores Socioeconômicos
5.
Artigo em Inglês | MEDLINE | ID: mdl-31295932

RESUMO

Globalization and urbanization in Nepal have driven a nutritional transition from an agricultural-based diet to an ultra-processed, sugary diet. This study assessed the nutrition and oral health of 836 children age 6 months to 6 years and their families in rural and urban Nepal. Mothers were interviewed about maternal-child oral health and nutrition, and children received dental exams and height and weight measurements. Analyses utilized SPSS statistical software. Most families lived within a 5-minute walk to a store selling ultra-processed snacks and sugary drinks. While most mothers knew sweets caused tooth decay, half of the children were given sweets daily, and 58.2% of children had dental caries. Caries began in the first 2 years and increased in prevalence and severity to age 6, when 74.3% had caries and 20% experienced mouth pain. Despite greater health knowledge and resources among urban mothers, urban children's increased access to junk food and frequency of consumption was associated with higher prevalence and severity of caries compared to rural children. Severe caries was associated with malnutrition, especially in rural children. Preventive strategies are needed in early childhood to incorporate nutrition and oral health education and dental care into maternal-child health services, and develop policies to prohibit the sale of junk food around schools.


Assuntos
Saúde da Criança/estatística & dados numéricos , Cárie Dentária/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Saúde Bucal/estatística & dados numéricos , Saúde da População Rural/estatística & dados numéricos , Saúde da População Urbana/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Cárie Dentária/etiologia , Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Lactente , Masculino , Desnutrição/etiologia , Nepal/epidemiologia , Pobreza , Prevalência , Fatores de Risco
6.
Rocz Panstw Zakl Hig ; 70(2): 147-153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31215779

RESUMO

Background: Body height and weight are somatic qualities largely determined by genetic factors. These qualities are also modified by the factors of external environment which have a higher impact on body mass rather than height. Objective: The aim of the research was to identify the prevalence of disorders related to body mass / height ratio in children residing in areas of diverse population numbers. A reconnaissance of cross-environmental diversification of the BMI value was also conducted. Material and Methods: The sample consisted of 593 healthy children (314 boys; 279 girls) aged 7 from large city (Wroclaw), small city (Polkowice) and rural environment (villages in the Lower Silesia) in Poland. Body height and weight were measured using standard procedures and body mass index (BMI) was calculated. Children's BMI categories were defined using IOTF cutoff points. Statistical analysis was carried out using ANOVA. Differences were considered significant at p < 0.05. Results: The data analysis showed a general lack of significant cross-environmental and cross-gender differences in mean values of BMI among the studies girls and boys. Prevalence of children with abnormal body mass residing in areas of diverse degree of urbanisation varies from 20% to 28%. Prevalence of underweight in 7-year-old children is intensified particularly in urban environment where it occurs in a degree comparable to overweight (9.4% vs 10.7%). Conclusions: The observed not significant differences in BMI means in the 7-year-old children, indicate the disappearing of disproportions in basic somatic parameters between children from environments of different urbanisation degree. Underweight is found in 6%-12% children, which is particularly intensified in urban environment where it occurs with prevalence comparable to the phenomenon of overweight. This suggests the need to introduce intervention measures aimed at increasing the consciousness of parents in terms of effects of malnutrition in the contexts of health risks for a developing child.


Assuntos
Índice de Massa Corporal , Saúde da Criança/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Peso Corporal , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Polônia/epidemiologia , Prevalência , Razão Cintura-Estatura
7.
Matern Child Health J ; 23(9): 1271-1280, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31228141

RESUMO

OBJECTIVES: To characterize the health and health care experiences of children in the U.S. Virgin Islands (USVI), assess differences by household poverty status, and provide comparisons to the general U.S. child population. METHODS: Data are from the 2011-2012 National Survey of Children's Health, which included 2342 USVI children, aged 0-17 years. Parent-reported measures of health status and health conditions, behavioral characteristics, and health care access and utilization were assessed. Weighted prevalence estimates were calculated and compared by household poverty status using Chi square tests. RESULTS: Overall, 31.3% of USVI children lived in households below 100% of the federal poverty level (FPL). Children in these low-income households were more likely to have public insurance (33.0% vs. 8.4%) and unmet health needs (11.6% vs. 6.3%) as compared to those in households with incomes ≥ 100% FPL (all p < 0.01). They were also less likely to have a medical home (22.5% vs. 42.2%), including a usual source of sick care (p < 0.01). Compared with U.S. children in general, USVI children had lower rates of preventive medical visits, preventive dental visits, and care received in a medical home. CONCLUSIONS: USVI children experience challenges in accessing and utilizing health care services, particularly those in low-income households, and fare worse than U.S. children on many of these measures. These findings will serve as a baseline comparison for an upcoming survey of maternal and child health to be conducted in eight U.S. territories including the USVI.


Assuntos
Saúde da Criança/normas , Nível de Saúde , Qualidade da Assistência à Saúde/normas , Adolescente , Distribuição de Qui-Quadrado , Criança , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Feminino , Comportamentos Relacionados com a Saúde , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Lactente , Masculino , Qualidade da Assistência à Saúde/estatística & dados numéricos , Classe Social , Inquéritos e Questionários , Ilhas Virgens Americanas
8.
BMC Health Serv Res ; 19(1): 267, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035985

RESUMO

BACKGROUND: The child health record booklet (CHRB) is a powerful tool for screening children under five and for education of caregivers by health workers. The objective of the present study was to assess the knowledge and utilization of CHRB by mothers and health workers in child growth monitoring and promotion (GMP) in the East Mamprusi Municipal, Northern region, Ghana. METHODS: A descriptive cross-sectional study was conducted among mothers attending child welfare clinics (CWC) and health workers providing GMP at CWC. Observational checklists were used to assess 73 CHRB on the completeness and correctness of growth charts. Mothers and health workers' knowledge on essential components of CHRB were assessed with a questionnaire. RESULTS: Weight measurements were correctly recorded in all booklets analyzed. Even though a greater proportion (70.7%) of health workers exhibited high knowledge scores on the interpretation of the essential components of the CHRB,most of the charts analyzed were not completely filled (72.6%) but rather correctly filled (74.0%). Mean knowedge score (3.4 ± 1.3) on growth charting was low among mothers who attend GMP. Work overload (26.1%), inadequate supply of CHRB (26.1%) and vaccine shortages (18.7%) were concerns raised by health workers on the effective usage of the CHRB. CONCLUSION: Knowledge scores on the child health record booklets among health workers and mothers in this part of northern Ghana were high but charting of growth of children was sub-optimal among health workers.


Assuntos
Desenvolvimento Infantil , Saúde da Criança/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Mães/educação , Folhetos , Adulto , Lista de Checagem , Saúde da Criança/normas , Pré-Escolar , Estudos Transversais , Feminino , Gana , Humanos , Lactente , Masculino , Programas de Rastreamento , Inquéritos e Questionários
9.
Fam Syst Health ; 37(2): 167-172, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31058528

RESUMO

INTRODUCTION: Asthma is the most common pediatric chronic disease and disproportionately affects urban, minority, and disadvantaged youth. This study explored the relationship between parent and child psychosocial functioning and asthma-related health outcomes in a sample of at-risk children with asthma. We hypothesized that greater parent resilience would be associated with better parent mood, more symptom-free days (SFDs), better child mood, and less child anxiety. Further, we hypothesized that parent resilience would moderate the relationship between parent mood and SFDs. METHOD: We performed a secondary analysis of baseline cross-sectional enrollment data. Parents of African American children on Medicaid with persistent asthma reported their children's asthma SFDs and their own measures of parent quality of life, mood, and resilience, and child mood and anxiety. RESULTS: Baseline data from 217 parents (92.2% female, Mage = 33.8 years ± 9.5) of children (Mage = 6.6 years ± 2.3) were available. Parent resilience was significantly associated with parent mood. Better parent-reported quality of life (QOL) and mood were significantly associated with more child asthma SFDs. In contrast to our hypothesis, parent resilience did not moderate the relationship between parent mood and SFDs. DISCUSSION: Higher parent-reported QOL and mood were significantly associated with better parent report of child asthma SFDs. Although parent resilience was associated with parent mood, it did not moderate the relationship to child SFDs. Future research is warranted to better understand the unique contribution of resilience in families with children with asthma. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Afeto , Asma/psicologia , Saúde da Criança/normas , Pais/psicologia , Estresse Psicológico/complicações , Adulto , Asma/terapia , Criança , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais , Pessoa de Meia-Idade , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , /estatística & dados numéricos , Relações Pais-Filho , Pediatria/métodos , Psicometria/instrumentação , Psicometria/métodos , Qualidade de Vida/psicologia , Estresse Psicológico/psicologia
10.
PLoS One ; 14(5): e0217342, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31125387

RESUMO

BACKGROUND: This study aimed to assess how maternal mental health mediates the association between childhood socio-economic conditions at birth and subsequent child behavioural and emotional problem scores. METHODS: Analysis of the Wirral Child Health and Development Study (WCHADS), a prospective epidemiological longitudinal study of the early origins of child mental health (n = 664). Household income at 20-weeks gestation, a measure of socio-economic conditions (SECs) in pregnancy, was the main exposure. The outcome measure was externalising and internalising problems, as measured by the Child Behaviour Checklist at 5 years. We assessed the association of household income with child behavioural outcomes in sequential linear models adjusting for maternal mental health in the pre- and post- natal period. RESULTS: Children of mothers in more disadvantaged households had higher scores for externalising behaviour with a difference of 3.6 points comparing the most affluent to the most disadvantaged families (the socio-economic (SEC) gap). In our regression model adjusting for baseline confounders, comparing children of mothers in the most disadvantaged households to the least disadvantaged, we found that most disadvantaged children scored 45 percentage points (95% CI 9, 93) higher for externalising problems, and 42% of this difference was explained in the fully adjusted model. Adjusting for prenatal maternal depressive symptomology attenuated the SEC gap in externalising problems by about a third, rendering the association non-significant, whilst adjusting for pre- and post-natal maternal mental health attenuated the SEC gap by 42%. There was no significant relationship between household income and internalising problems. CONCLUSION: Social disadvantage is associated with higher child externalising behaviour problems score at age 5, and about 40% of this was explained by maternal perinatal mental health. Policies supporting maternal mental health in pregnancy are important to address the early emergence of inequalities in child mental health.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Saúde da Criança , Saúde Materna , Saúde Mental , Adolescente , Adulto , Sintomas Afetivos/epidemiologia , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Estudos de Coortes , Inglaterra/epidemiologia , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Saúde Materna/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Gravidez , Estudos Prospectivos , Fatores Socioeconômicos , Adulto Jovem
11.
Int J Equity Health ; 18(1): 67, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088473

RESUMO

BACKGROUND: A growing number of women in Cambodia are seeking support from health facilities during delivery, up from 8% in 2000 to 82% in 2014. This growth may be attributed to increased national level attention to incentivize hospital births and reduce potential barriers. This paper address three related questions regarding the impact of increased utilization of health care in Cambodia. First, did increasing health facility deliveries occur most among disadvantaged women? Second, as health facility utilization increased, did the benefit of delivery location on child health outcomes weaken? Finally, did socioeconomic disparities in child outcomes decline as a result of increased health facility deliveries? METHODS: Data is from the 2010 and 2014 Cambodian Demographic and health surveys. Regression models include logistic regression to predict utilization of a health facility, linear regression to predict child nutritional status and Cox regression to measure child survival. Propensity score matching was used to account for selectivity. RESULTS: Analysis shows that health facility delivery is associated with better nutritional status and survival and the effectiveness of a health center delivery remains with this rapidly increasing care. However, the largest increases in delivery at a health facility did not occur among less educated, less wealthy, and rural Cambodian women, and inequalities in child health outcomes remain. CONCLUSIONS: Cambodian women have participated in a rapid increase in health center deliveries and those health facility deliveries remain beneficial for future child outcomes. However, initiatives to increase care are not addressing inequity in access to care among disadvantaged women. Additionally, disparities in children's health outcomes remain, suggesting that health facility births are not sufficient in reducing disparities among children of disadvantaged mothers. Moving forward, current initiatives are rapidly increasing facility deliveries and maintaining their efficacy, but further efforts need to be placed on targeting disadvantaged women and their children.


Assuntos
Saúde da Criança/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Instalações de Saúde/estatística & dados numéricos , Camboja , Criança , Feminino , Humanos , Gravidez
12.
Artigo em Inglês | MEDLINE | ID: mdl-31121878

RESUMO

BACKGROUND: Improvements in child health are a key indicator of progress towards the third goal of the United Nations' Sustainable Development Goals. Poor nutritional outcomes of Indian children are occurring in the context of high economic growth rates. The aim of this paper is to conduct a comprehensive analysis of the demographic and socio-economic factors contributing to changes in the nutritional status of children aged 0-5 years in India using data from the 2004-2005 and 2011-2012 Indian Human Development Survey. METHODS: To identify how much the different socio-economic conditions of households contribute to the changes observed in stunting, underweight and the Composite Index of Anthropometric Failure (CIAF), we employ both linear and non-linear decompositions, as well as the unconditional quantile technique. RESULTS: We find the incidence of stunting and underweight dropping by 7 and 6 percentage points, respectively. Much of this remarkable improvement is encountered in the Central and Western regions. A household's economic situation, as well as maternal body mass index and education, account for much of the change in child nutrition. The same holds for CIAF in the non-linear decomposition. Although higher maternal autonomy is associated with a decrease in stunting and underweight, the contribution of maternal autonomy to improvements is relatively small. CONCLUSIONS: Household wealth consistently makes the largest contribution to improvements in undernutrition. Nevertheless, maternal autonomy and education also play a relatively important role.


Assuntos
Saúde da Criança/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição Infantil , Transtornos do Crescimento/epidemiologia , Estado Nutricional , Magreza/epidemiologia , Antropometria , Pré-Escolar , Feminino , Humanos , Incidência , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Prevalência , Fatores Socioeconômicos
13.
N Z Med J ; 132(1493): 15-24, 2019 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-30973856

RESUMO

AIM: The Center for Disease Control's (CDC) Adverse Childhood Experiences (ACEs) have been associated with adverse health consequences in adults and children, but less is known about any association between ACE and early learning skills. We investigated the relationship between ACEs and objective preschool measures of skills using the Growing up In New Zealand (GUiNZ) cohort study (n=5,562; 2009-2015). METHODS: We mapped standard ACE definitions to GUiNZ to determine the prevalence of ACEs. We performed regression analysis to investigate the association between ACEs and a range of outcome measures, including counting up to 10, counting down from 10, letter recognition, affective knowledge, name writing, number writing and delayed gratification. RESULTS: Before entering primary school, 52.8% of GUiNZ children experienced at least one ACE. We found a dose-response relationship with seven of the eight tests. For example, after statistically adjusting for multiple potential confounders, for each one additional ACE, children were 1.12 times more likely to be unable to count up from 1-10 (95% Confidence Interval 1.04-1.19). CONCLUSIONS: Awareness of the negative impact of ACEs on school readiness should aid in the development and prioritisation of prevention strategies to reduce the occurrence and impact of ACEs in children.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Comportamento Infantil/psicologia , Saúde da Criança/estatística & dados numéricos , Escolaridade , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Prevalência , Medição de Risco/estatística & dados numéricos , População Rural/estatística & dados numéricos , Instituições Acadêmicas , População Urbana/estatística & dados numéricos
14.
Ethiop J Health Sci ; 29(2): 215-222, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31011269

RESUMO

Background: Inequality in the access to health services is a major cause of health problemsamong children under five old. The aim of this analysis is to measure the inequality among children under-5 years in relation to main health indicators in Uganda. Methods: Main child health indicators data in Uganda were obtained from WHO inequity data set for the years 1995, 2000, 2001 and 2011. Indicators such as under-5 years mortality rate, underweight prevalence and full vaccination converge and child with infection access to health facilities were included in the analysis. For simple indicators, inequality difference was calculated, and relative concentration index for complex order indicators was used. Four different inequality dimensions were used to work as stratifies for these indicators. Results: Inequality regarding child health indicators was observed in different dimensions. It was clear that inequality among people living in rural areas were more than urban areas. Femaleshad high inequality than males. Poor and uneducated people are more likely to have inequality than rich and educated people. Conclusion: Great effort should be made to decrease inequality among children less than five years through access to health services for all groups in different areas.


Assuntos
Saúde da Criança/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Indicadores Básicos de Saúde , Pré-Escolar , Feminino , Disparidades em Assistência à Saúde , Humanos , Lactente , Recém-Nascido , Masculino , População Rural/estatística & dados numéricos , Fatores Sexuais , Fatores Socioeconômicos , Uganda , População Urbana/estatística & dados numéricos
15.
Rev Paul Pediatr ; 37(2): 166-172, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30970047

RESUMO

OBJECTIVE: Identify the association between exposure to fine particulate matter and hospitalizations due to respiratory diseases in children up to ten years of age in the city of Cuiabá, Mato Grosso, stratifying the analysis by sex and calculating excess costs. METHODS: Ecological study of time series. The dependent variable was daily hospitalizations according to the 10th Revision of the International Classification of Diseases (ICD10): J04.0, J12.0 to J18.9, J20.0 to J21.9 and J45.0 to J45.0. The independent variables were the concentration of fine particulate, estimated by a mathematical model, temperature and relative air humidity, controlled by short and long-term trends. Generalized additive model of Poisson regression was used. Relative risks, proportional attributable risk (PAR) and excess hospitalizations and their respective costs by the population attributable fraction (PAF) were calculated. RESULTS: 1,165 children were hospitalized, 640 males and 525 females. The mean concentration, estimated by the mathematical model, was 15.1±2.9 mcg/m3 for PM2.5. For boys, there was no significant association; for girls a relative risk of up to 1.04 of daily hospitalizations due to respiratory diseases was observed for exposure to PM 2.5 in lags 1, 2 and 6. Increase of 5 µg/m3 in these concentrations increased the percentage of the risk in 18%; with an excess 95 hospital admissions and with excess expenses in the order of US$ 35 thousand. CONCLUSIONS: Significant effect in daily hospitalizations due to respiratory diseases related to exposure to fine particulate matter was noted for girls, suggesting the need for stratification by sex in further studies.


Assuntos
Poluentes Atmosféricos , Hospitalização/estatística & dados numéricos , Exposição por Inalação , Doenças Respiratórias , Fatores Sexuais , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Brasil/epidemiologia , Criança , Saúde da Criança/estatística & dados numéricos , Fenômenos Ecológicos e Ambientais , Feminino , Hospitalização/economia , Humanos , Exposição por Inalação/efeitos adversos , Exposição por Inalação/prevenção & controle , Exposição por Inalação/estatística & dados numéricos , Masculino , Material Particulado/efeitos adversos , Material Particulado/análise , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/etiologia , Doenças Respiratórias/terapia , Medição de Risco , Fatores de Risco
18.
N C Med J ; 80(2): 122-123, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30877165
19.
Artigo em Inglês | MEDLINE | ID: mdl-30813530

RESUMO

The familial social background of a child can significantly impact their behavior and health. We investigated associations between socio-economic status (SES) and health parameters and behaviors in German children and adolescents. Data were collected between 2011 and 2018 in the framework of the LIFE Child study. Participants included 2998 children aged 3⁻18 years. SES was represented by an index combining information on parental education, occupation, and income. Associations between SES and health outcomes were estimated using linear and logistic regression analyses. In a moderator analysis, all associations were checked for interactions between SES and age or sex. A higher SES composite score was associated with better health (lower body mass index (ß = -0.26), fewer behavioral difficulties (ß = -0.18), higher quality of life (ß = 0.21), fewer critical life events (odds ratio (OR) = 0.93); all p < 0.05) and a healthier lifestyle (healthier nutrition (ß = 0.16), less excessive television use (OR = 0.87), less nicotine consumption (OR = 0.93), and more physical activity (OR = 1.18); all p < 0.05). However, SES was not associated with alcohol consumption (OR = 1.02) or sleep problems (ß = -0.04). The strengths of the associations between SES and child health did not differ depending on SES indicator (education, occupation, income). The associations between SES and parent-reported behavioral difficulties and physical activity were stronger in older vs. younger children. In contrast, none of the observed associations were moderated by sex. This study highlights the strong association between socio-economic status and child health, even in modern Western societies.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Saúde da Criança/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Alemanha , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Razão de Chances , Pais
20.
Rev Bras Ginecol Obstet ; 41(3): 147-154, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30873565

RESUMO

OBJECTIVE: The objective of the present study was to explore obstetric management in relation to clinical, maternal and child health outcomes by using the Robson classification system. METHODS: Data was collected from obstetrics registries in tertiary care hospitals in Dubai, United Arab Emirates (UAE). RESULTS: The analysis of > 5,400 deliveries (60% of all the deliveries in 2016) in major maternity hospitals in Dubai showed that groups 5, 8 and 9 of Robson's classification were the largest contributors to the overall cesarean section (CS) rate and accounted for 30% of the total CS rate. The results indicate that labor was spontaneous in 2,221 (45%) of the women and was augmented or induced in almost 1,634 cases (33%). The birth indication rate was of 64% for normal vaginal delivery, of 24% for emergency CS, and of 9% for elective CS. The rate of vaginal birth after cesarean was 261 (6%), the rate of external cephalic version was 28 (0.7%), and the rate of induction was 1,168 (21.4%). The prevalence of the overall Cesarean section was 33%; with majority (53.5%) of it being repeated Cesarean section. CONCLUSION: The CS rate in the United Arab Emirates (UAE) is higher than the global average rate and than the average rate in Asia, which highlights the need for more education of pregnant women and of their physicians in order to promote vaginal birth. A proper planning is needed to reduce the number of CSs in nulliparous women in order to prevent repeated CSs in the future. Monitoring both CS rates and outcomes is essential to ensure that policies, practices, and actions for the optimization of the utilization of CS lead to improved maternal and infant outcomes.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Analgesia Obstétrica/estatística & dados numéricos , Anestesia Epidural/estatística & dados numéricos , Cesárea/estatística & dados numéricos , Saúde da Criança/estatística & dados numéricos , Feminino , Humanos , Trabalho de Parto Induzido/estatística & dados numéricos , Forceps Obstétrico/estatística & dados numéricos , Ocitócicos , Ocitocina , Gravidez , Resultado da Gravidez , Gravidez Múltipla/estatística & dados numéricos , Estudos Prospectivos , Nascimento a Termo , Emirados Árabes Unidos , Procedimentos Desnecessários/estatística & dados numéricos , Adulto Jovem
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