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1.
Braz. j. oral sci ; 20: e219638, jan.-dez. 2021. tab
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254752

RESUMEN

Diagnosis of oral and oropharyngeal cancer in advanced stages may be associated with social nature factors, access to health care, education, occupation, and behavioral/ cultural factors. Aim: To determine the factors related to high clinical-staging in patients diagnosed with squamous cell carcinoma in the oral and oropharyngeal region in a Cancer Center in Brazil between 2009 and 2015. Methods: It is an epidemiological, retrospective, and exploratory study. Patients diagnosed with squamous cell carcinoma had their medical records analyzed. The variables considered were sociodemographic, lifestyle, and disease characteristics. Descriptive and exploratory tests (Pearson's, chi-square test and, Student's t-test) were realized. Results: We analyzed 365 patient records, among which 289 (79.17%) were male, and 73 (20.0%) were female. Age ranged from 16 to 101 years, with a mean of 61.13. Regarding education, 157 (43.01%) studied < 8 years, 103 (28.21%) were illiterate and 102 (27.94%) studied > 8 years. 305 (83.56%) patients live in urban areas. There was an association between high clinical-staging and low educational level. For high clinical-staging, symptomatology, tobacco, and alcohol intake as well. Conclusion: Patients with low educational levels tend to report the disease later, and their diagnostics occurred in advanced stages. Thus, specific public health policies for this population, including access to dental care to recognize the clinical signs and early diagnosis, are necessary


Asunto(s)
Factores Socioeconómicos , Neoplasias de la Boca/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Registros Médicos
2.
Rev. enferm. UERJ ; 29: e51932, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1224598

RESUMEN

Objetivo: analisar a produção do conhecimento sobre a experiência da família acerca dos cuidados paliativos da criança com câncer hospitalizada na unidade de terapia intensiva e discutir o papel da enfermagem no atendimento à família da criança com câncer frente aos cuidados paliativos. Método: revisão integrativa realizada na PUBMED, LILACS, SCOPUS, SCIELO e CINAHL entre janeiro e março de 2020. Resultados: a amostra foi composta por 13 artigos, originando duas categorias: O impacto do cuidado paliativo da criança com câncer na dinâmica familiar e o cuidado multiprofissional, em especial dos enfermeiros, à família da criança com câncer. Conclusão: os estudos revelaram o panorama nacional e internacional dos cuidados paliativos à criança com câncer e a desestruturação da dinâmica familiar nos aspectos físicos, sociais, psicológicos, e financeiros, caracterizando o período como estressante e doloroso. Os enfermeiros estabelecem condutas terapêuticas objetivando promover qualidade de vida para crianças em cuidados paliativos e seus familiares.


Objective: to examine production of knowledge on families' experience of palliative care for children with cancer hospitalized in an intensive care center and discuss the role of nursing in assisting the family of the child in palliative cancer care. Method: this integrative review was conducted on PubMed, LILACS, Scopus, SciELO and CINAHL between January and March 2020. Results: from the sample of 13 articles, two categories originated: The impact of palliative cancer care for children on family dynamics and multiprofessional care, especially by nurses, for the family of the child with cancer. Conclusion: the studies revealed the national and international panorama of palliative care for children with cancer and the breakdown of physical, social, psychological, and financial family dynamics, characterizing the period as stressful and painful. Nurses establish therapeutic approaches aimed at promoting quality of life for children in palliative care and their families.


Objetivo: analizar la producción de conocimiento sobre la experiencia familiar en los cuidados paliativos de niños con cáncer, hospitalizados en la unidad de cuidados intensivos, y discutir el papel de la enfermería en la asistencia a la familia del niño con cáncer frente a los cuidados paliativos. Método: Revisión integradora realizada en PUBMED, LILACS, SCOPUS, SCIELO y CINAHL entre enero y marzo de 2020. Resultados: La muestra estuvo conformada por 13 artículos, originando dos categorías: El impacto de los cuidados paliativos para niños con cáncer en la dinámica familiar y los cuidados multiprofesionales, especialmente de las enfermeras, a la familia del niño con cáncer. Conclusión: Los estudios revelaron el panorama nacional e internacional de los cuidados paliativos para niños con cáncer y la ruptura de la dinámica familiar en aspectos físicos, sociales, psicológicos y económicos, caracterizándolo como un período estresante y doloroso. Las enfermeras establecen enfoques terapéuticos dirigidos a promover la calidad de vida de los niños en cuidados paliativos y sus familias.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Cuidados Paliativos , Familia/psicología , Niño Hospitalizado , Conocimientos, Actitudes y Práctica en Salud , Unidades de Cuidados Intensivos , Neoplasias/terapia , Rol de la Enfermera , Neoplasias/enfermería , Relaciones Enfermero-Paciente
3.
Rev. enferm. UERJ ; 29: e56956, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1224594

RESUMEN

Objetivo: avaliar o desempenho das atividades de vida diárias e identificar diagnósticos de enfermagem de pessoas em situação de rua. Métodos: estudo transversal, realizado de abril a julho de 2017, com 52 pessoas. Para coleta de dados, foi utilizado instrumento fundamentado no modelo teórico de Roper-Logan e Tierney. Foram consideradas dependentes as atividades de vida com frequência igual ou superior a 40%, para inferência dos diagnósticos utilizou-se referencial de Risner. Resultados: as atividades de vida dependentes foram: trabalho e distração (92,3%), morte (88,5%), sexualidade (76,9%), sono (71,2%), manter ambiente seguro (71,2%), respirar (61,5%), eliminar (53,8%) e alimentar-se (51,9%). Os diagnósticos mais frequentes: Disposição para comunicação melhorada (96%), Desobstrução ineficaz das vias aéreas (94%), Risco de contaminação (77%) e Controle de impulsos ineficaz (73%). Conclusão: evidenciou-se que pessoas em situação de rua possuem dependência de cuidados em atividades de vida diária relacionados a aspectos fisiológicos, sociais e emocionais.


Objective: to evaluate performance of activities of daily living (ADLs) and to identify nursing diagnoses for people living on the streets. Methods: in this cross-sectional study of 52 people, data were collected between April and July 2017 using an instrument based on the Roper-Logan-Tierney theoretical model. ADLs with frequency of 40% or more were considered to be care-dependent; diagnoses were inferred using a Risner framework. Results: dependent ADLs were: working and playing (92.3%), dying (88.5%), expressing sexuality (76.9%), sleeping (71.2%), maintaining a safe environment (71.2 %), breathing (61.5%), eliminating body wastes (53.8%), and eating (51.9%). The most frequent diagnoses were: improved communication disposition (96%), ineffective airway clearance (94%), contamination risk (77%), and ineffective impulse control (73%). Conclusion: people living on the streets were found to be dependent on care in physiological, social and emotional ADLs.


Objetivo: evaluar el desempeño de las actividades de la vida diaria e identificar diagnósticos de enfermería para personas que viven en la calle. Métodos: estudio transversal, realizado entre abril y julio de 2017, con 52 personas. Para la recolección de datos se utilizó un instrumento basado en el modelo teórico de Roper-Logan y Tierney. Se consideraron como dependientes las actividades de vida con una frecuencia igual o superior al 40%. Para inferir los diagnósticos se utilizó el modelo referencial de Risner. Resultados: las actividades de la vida dependientes fueron: trabajo y distracción (92,3%), muerte (88,5%), sexualidad (76,9%), sueño (71,2%), mantener un ambiente seguro (71,2%), respirar (61,5%), eliminar (53,8%) y alimentarse (51,9%). Los diagnósticos más frecuentes: Mejora de la disposición comunicativa (96%), Limpieza ineficaz de la vía aérea (94%), Riesgo de contaminación (77%) y Control ineficaz de los impulsos (73%). Conclusión: se evidenció que las personas que viven en la calle son dependientes de cuidados en las actividades de la vida diaria relacionadas con los aspectos fisiológicos, sociales y emocionales.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Diagnóstico de Enfermería , Personas sin Hogar , Actividades Cotidianas , Estudios Transversales , Atención de Enfermería
4.
Front Public Health ; 9: 675927, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34604151

RESUMEN

Background: The incidence of chronic diseases has increased dramatically due to rapid aging and lifestyle changes of China in recent decades. The population aged more than 45 years is an important participant in the labor force market, and the health status directly affects their labor force participation decision. This study aims to explore the relationship between chronic diseases and the labor force participation among the elderly Chinese population aged more than 45 years. Method: We employ a multivariate probit (MVP) model to construct five structural equations for an analysis. The advantage of this model is that it can deal with the endogeneity of chronic diseases. Results: Firstly, compared with the elderly, younger people are more likely to participate in the labor force market; the influence of chronic diseases is the largest for presenile women in the decision-making of labor force participation; the impact of psychological problems on labor force participation cannot be ignored, especially for men aged more than 45 years. In addition, sociodemographic factors such as geographical location and marital status also have direct effects on the probability of labor force participation while the impact of both family wealth and family number is much smaller. Finally, unhealthy lifestyles through chronic diseases have negative and indirect marginal effects on labor force participation. Conclusions: This article proves that chronic diseases have a negative impact on the labor force participation for Chinese aged more than 45 years. The public should give more tolerance and opportunities to these groups. The population aged more than 45 years are more vulnerable and face more psychological problems, which will lead to a decline in labor force participation. Psychological health counseling and services are urgently needed. As the urban areas enjoy more social welfare, Chinese welfare policy needs to be tilted toward the rural elderly. For individuals, maintaining healthy lifestyles can help you stay away from chronic diseases and stay in the labor force market.


Asunto(s)
Envejecimiento , Empleo , Anciano , China/epidemiología , Enfermedad Crónica , Femenino , Humanos , Masculino , Factores Socioeconómicos
5.
Int J Public Health ; 66: 1604004, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34630005

RESUMEN

Objectives: To quantify the Black/Hispanic disparity in COVID-19 mortality in the United States (US). Methods: COVID-19 deaths in all US counties nationwide were analyzed to estimate COVID-19 mortality rate ratios by county-level proportions of Black/Hispanic residents, using mixed-effects Poisson regression. Excess COVID-19 mortality counts, relative to predicted under a counterfactual scenario of no racial/ethnic disparity gradient, were estimated. Results: County-level COVID-19 mortality rates increased monotonically with county-level proportions of Black and Hispanic residents, up to 5.4-fold (≥43% Black) and 11.6-fold (≥55% Hispanic) higher compared to counties with <5% Black and <15% Hispanic residents, respectively, controlling for county-level poverty, age, and urbanization level. Had this disparity gradient not existed, the US COVID-19 death count would have been 92.1% lower (177,672 fewer deaths), making the rate comparable to other high-income countries with substantially lower COVID-19 death counts. Conclusion: During the first 8 months of the SARS-CoV-2 pandemic, the US experienced the highest number of COVID-19 deaths. This COVID-19 mortality burden is strongly associated with county-level racial/ethnic diversity, explaining most US COVID-19 deaths.


Asunto(s)
Afroamericanos , COVID-19 , Disparidades en el Estado de Salud , Hispanoamericanos , Pandemias , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , COVID-19/etnología , COVID-19/mortalidad , Niño , Preescolar , Hispanoamericanos/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Factores Socioeconómicos , Estados Unidos/epidemiología , Adulto Joven
6.
Medicine (Baltimore) ; 100(39): e27315, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34596131

RESUMEN

ABSTRACT: Participation in volunteer activity has positive effects on health among elderly. Few studies have investigated the association between volunteer activity and depression among Chinese elderly. This study aimed to examine the association between volunteer activity and depression among the elderly in China regarding rural-urban differences.Totally 8255 subjects from the 2015 China Health and Retirement Longitudinal Study were selected in this study. Depression was assessed by 10-item Center for Epidemiologic Studies Depression Scale. Types and frequency of volunteer activity were measured in the questionnaire. Multiple linear regression analysis was used to explore the relationship between volunteer activity and depression of elderly.In our study, the urban elderly had lower depressive scores than rural elderly (6.7 ±â€Š5.8 vs. 9.1 ±â€Š6.7). After adjustment for all covariates, our results revealed that almost daily participation in formal volunteer activities was negatively associated with depression among urban elderly (B = -2.69, SE = 1.05, P = .010); almost daily caring for a sick or disabled adult was positively associated with depression among both urban and rural elderly (urban:B = 3.13, SE = 1.54, P = .043; rural:B = 2.56, SE = 1.18, P = .031).These findings suggested that there was a negative association between formal volunteer activity and depression among urban elderly, while there was a positive association between caring for a sick or disabled adult and depression among both urban and rural elderly. The government should take effective measures to encourage the elderly to participate in formal volunteer activities to prevent them from depression.


Asunto(s)
Depresión/epidemiología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Voluntarios/psicología , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/psicología , Cuidadores/psicología , China/epidemiología , Femenino , Conductas Relacionadas con la Salud , Humanos , Estilo de Vida , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Factores Sexuales , Factores Socioeconómicos
7.
Medicine (Baltimore) ; 100(39): e27339, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34596139

RESUMEN

ABSTRACT: The effect of hypothermia as a mortality risk factor at 30 days in the elderly who had hip fracture (HF) surgery is still controversial because it may be due to a set of poorly identified factors. In this study, we aim to determine if exposure to intra and immediate postoperative hypothermia increases the incidence of mortality at 30 days in elderly patients who had HF surgery.Survival study in the elderly who had HF surgery with and without exposure to hypothermia. Sociodemographic, anesthetic and surgical factors were collected. The temperature of the rectum was measured at the end of the surgery and in the recovery room. The effect of hypothermia was analyzed by the incidence of mortality at 30 days. Other results were considered, such as, surgical site infection (SSI), blood transfusions, and influence of implants used in the 30-day mortality.Three hundred eighty five subjects were eligible, to include 300. Inadvertent hypothermia was 12%, the 30-day overall mortality was 9% and in subjects with hypothermia it was 25% (P = .002). Subjects with hypothermia had a higher risk of SSI (relative risk 4.2, 95% confidence interval 1.3-13.6, P = .03) and receive more transfusions (relative risk 3.6, 95% confidence interval 2.0-6.5, P < .001).Elderly subjects with HF exposed to hypothermia who undergo hip hemiarthroplasty and who receive 2 or more blood transfusions during their treatment, are at greater risk of dying after 30 days of the surgery. Hypothermia, as a possible causative factor of mortality, should continue to be studied.


Asunto(s)
Hemiartroplastia/mortalidad , Hemiartroplastia/métodos , Fracturas de Cadera/mortalidad , Fracturas de Cadera/cirugía , Hipotermia/mortalidad , Factores de Edad , Anciano , Anciano de 80 o más Años , Transfusión Sanguínea/estadística & datos numéricos , Temperatura Corporal , Femenino , Humanos , Masculino , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Infección de la Herida Quirúrgica/epidemiología
8.
Medicine (Baltimore) ; 100(39): e27350, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34596141

RESUMEN

ABSTRACT: A community-based cross-sectional study was undertaken by the Cardiology Society of India (Kerala Chapter) to determine the prevalence of coronary artery disease (CAD) and its risk factors. The periodontal health status of the rural and urban participants in the Thiruvananthapuram district of Kerala was evaluated to document any association between periodontal disease (PD) and CAD and to describe any shared risk factors.The participants were selected using a multistage cluster random sampling method. Socio-demographic data and personal histories were collected using a structured interview schedule and validated tools. Body mass index, blood pressure, electrocardiogram, and biochemical investigations were recorded and analyzed using standard protocols. A modification of the Ramfjord periodontal disease index was used to assess periodontal health.PD was more frequent among rural (61.4%) than in the urban population (35.5%). The frequencies of CAD associated with PD in the rural and urban populations were 82.6% and 40.5%, respectively. PD was not found to be a significant risk factor for CAD in the univariate regression analysis of urban populations. In the rural population, the odds of PD as a risk factor for CAD were found to be 3.08 (95% CI [1.38-8.38]) and significant (P = .043) in univariate regression analysis and 1.54 (95% CI: 0.44-5.4) and non-significant (P = .503) in the multivariate regression analysis.In rural areas, male sex and dyslipidemia demonstrated borderline significance as risk factors for CAD. PD was not found to be an independent risk factor after adjusting for age, sex, tobacco use, hypertension, sedentary lifestyle, and dyslipidemia. Male sex and dyslipidemia were identified as shared risk factors between PD and CAD, which could have confounded the significant association between the latter. In urban areas, age, male sex, and dyslipidemia demonstrated an independent association with CAD. This study could not establish an independent association between PD and CAD in either community. Future epidemiological studies should identify and recruit novel environmental factors to understand the interrelationships between PD and CAD and focus on the role of effect modifiers that may have a protective role against PD colluding with CAD.


Asunto(s)
Enfermedad de la Arteria Coronaria/epidemiología , Enfermedades Periodontales/epidemiología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto , Anciano , Presión Sanguínea , Índice de Masa Corporal , Comorbilidad , Estudios Transversales , Dislipidemias/epidemiología , Electrocardiografía , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Adulto Joven
9.
Pan Afr Med J ; 39: 195, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34603576

RESUMEN

Introduction: active ageing is the process of optimizing opportunities for health in order to enhance quality of life and wellbeing. It is influenced by physical activity, social participation and social network, cognitive and continuous learning and socio-economic factors. It involves disease prevention and promotion of healthy behaviours that can reduce the risk and occurrence of non-communicable diseases in middle age and also at old age. The study aimed to determine and compare the active ageing process and its determinants among middle-aged men in rural and urban areas in Nigeria. Methods: this was a comparative cross-sectional study among middle-aged men 40-60 years using mixed methods. A multi-stage sampling technique was used to select 720 respondents. A structured interviewer administered questionnaire and Key informant interviews were used to collect data. Results: respondents in the rural area were a little older compared to the respondents in the urban area with a mean age of 49.6 ± 6.3 years and 48.6 ± 6.2 years respectively. A higher proportion of the respondents in the rural area (83.2%) than the respondents in the urban area (73.8%) practice good active ageing processes in their lives. There was a significant association between education of respondent and the practice of active ageing among respondents in the urban and rural areas. Multivariate logistic regression showed that physical activity (aOR 7.62, 95% CI: 243-23.94, P = 0.001), life-long learning (aOR 51.73, 95% CI: 12.14-220.49, P = 0.000) and community participation (aOR 3.46, 95% CI: 2.51-4.77, P=0.000) are predictors of active ageing. Conclusion: the study showed that respondents in the rural area practice good active ageing compared to the respondents in the urban area and hence engaged more in sufficient active life in their daily activities, reducing the risk of non-communicable diseases.


Asunto(s)
Envejecimiento Saludable/fisiología , Calidad de Vida , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto , Envejecimiento/fisiología , Estudios Transversales , Conductas Relacionadas con la Salud , Promoción de la Salud , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Factores Socioeconómicos , Encuestas y Cuestionarios
10.
Int J Public Health ; 66: 584916, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34616240

RESUMEN

Objective: Much of the extensive quantitative research linking socio-economic position (SEP) and health utilizes three common indicators: income, occupation and education. Existing survey data may enable researchers to include indicators of additional forms of capital in their analyses, permitting more nuanced consideration of the relationship between SEP and health. Our objective was to identify the breadth of survey questions related to economic, cultural, and social capital available through Statistics Canada surveys, and the extent to which those surveys also include health measures. Methods: We compiled a list of all population-based Statistics Canada surveys, and developed a broad list of potential indicators of forms of capital. We systematically searched the surveys for those indicators and health measures, analyzing their co-occurrence. Results: Traditional SEP indicators were present in 73% of surveys containing health measures, while additional indicators of social and cultural capital were available in 57%. Conclusion: Existing national survey data represent an under-exploited opportunity for research examining the relationship between various forms of capital and health in Canada. Future empirical explorations of these data could enrich our theoretical understanding of health inequities.


Asunto(s)
Disparidades en el Estado de Salud , Canadá , Conjuntos de Datos como Asunto , Humanos , Capital Social , Factores Socioeconómicos , Encuestas y Cuestionarios
11.
Infect Dis Poverty ; 10(1): 122, 2021 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-34620243

RESUMEN

BACKGROUND: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.


Asunto(s)
Vacunas contra la COVID-19 , Intención , Vacunación , Adolescente , Adulto , Anciano , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/administración & dosificación , Estudios Transversales , Femenino , Salud Global , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Encuestas y Cuestionarios , Vacunación/psicología , Vacunación/estadística & datos numéricos , Adulto Joven
12.
Pan Afr Med J ; 39: 197, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34603578

RESUMEN

The COVID-19 pandemic has changed the world in so many ways since 2019 when the first case was recorded. COVID-19 pandemic has impacted negatively on economy, health, education and infrastructure globally. COVID-19 vaccine was developed with the aim of stopping the pandemic and allowing the rebuilding of our societies and economies. The vaccine was rolled out in December 2020 and the distribution plan appears to be skewed in favour of high income countries. This paper highlights the need for consideration of the principles of equity and universal health coverage in the distribution plan of the vaccine. It emphasizes the need to ensure that the interests of citizens of developing and low income countries are well protected. The paper concludes that issues of disparity in economic status of countries entering agreement with the vaccine manufacturing companies, absence of logistic support among others should not be a barrier to ensuring equitable access to vaccine for all consistent with the sustainable development goal 3.7.


Asunto(s)
Vacunas contra la COVID-19/provisión & distribución , COVID-19/prevención & control , Disparidades en Atención de Salud/economía , Cobertura Universal del Seguro de Salud/economía , Vacunas contra la COVID-19/economía , Países en Desarrollo , Industria Farmacéutica/economía , Salud Global , Equidad en Salud , Accesibilidad a los Servicios de Salud/economía , Humanos , Factores Socioeconómicos
13.
Global Health ; 17(1): 117, 2021 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-34598720

RESUMEN

BACKGROUND: The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. OBJECTIVES: We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping. METHODS: We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. RESULTS: A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). CONCLUSIONS: The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements.


Asunto(s)
Adaptación Psicológica , COVID-19/psicología , Miedo , Salud Global/estadística & datos numéricos , Distrés Psicológico , Adulto , COVID-19/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Socioeconómicos , Adulto Joven
14.
BMC Womens Health ; 21(1): 346, 2021 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-34600521

RESUMEN

BACKGROUND: Fertility decline characterised by inter-birth intervals remains rather slow or stall in many countries of sub-Saharan African (SSA). Non-adherence to optimal inter-birth intervals often occasioned by low prevalence of contraceptive use and high fertility desires often lead to poor maternal and child health outcomes. Additionally, information on the influence of contraception and fertility desire on interval between first and second births (SBI) is rarely available. This study therefore aimed to examine the influence of fertility desire and contraception on SBI among women in four SSA countries. METHODS: We analysed cross-sectional data on women aged 15-49 years who participated in the recent Demographic and Health Surveys in DR Congo, Ethiopia, Nigeria and South Africa. Semi-parametric Cox proportional hazards regression was employed for the analysis at 5% significance level. RESULTS: The median time to second birth was 34 months in DR Congo; 35 months, Nigeria; 42 months, Ethiopia; and 71 months, South Africa. About 70% of the women desired additional child(ren) and two-thirds have never used contraceptive in both Nigeria and DR Congo. The hazard of second birth was significantly lower among women who desired additional child(ren) compared to desired for no more child in DR Congo (aHR = 0.93; CI: 0.89-0.97), Ethiopia (aHR = 0.64; CI: 0.61-0.67) and South Africa (aHR = 0.51; CI: 0.47-0.55). Women who had never used contraceptive were 12%, 20% and 24% more likely to lengthen SBI than those who were current users in DR Congo, Nigeria and South Africa respectively. DR Congo and Nigerian women were about two times more likely to shorten SBI compared with their South African counterparts. Other significant determinants of SBI include ethnicity, rural residential, age and marital status at first birth, wealth and employment status. CONCLUSION: Findings showed differentials in the linkage between second birth interval and the desired fertility and contraception by country, demonstrating the importance of context. The contribution of these factors to second birth interval requires country context-specific attention if further decline in fertility and poor health outcomes associated with sub-optimal inter-birth interval is to be attained in SSA.


Asunto(s)
Intervalo entre Nacimientos , Anticonceptivos , Niño , Estudios Transversales , Femenino , Fertilidad , Humanos , Factores Socioeconómicos , Sudáfrica
15.
PLoS One ; 16(10): e0257757, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34606508

RESUMEN

CONTEXT: The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing structural factors facilitated better outcomes despite different starting points, as understanding of the relative impact of structural aspects should facilitate achieving optimal forward progress. METHODS: Desk study, based on selecting and collecting a range of measures for 48 representative characteristics of 42 countries' demography, society, health system, and policy-making profiles, matched to three pandemic time points. Different analytic approaches were employed including correlation, multiple regression, and cluster analysis in order to seek triangulation. FINDINGS: Population structure (except country size), and volume and nature of health resources, had only minor links to Covid impact. Depth of social inequality, poverty, population age structure, and strength of preventive health measures unexpectedly had no moderating effect. Strongest measured influences were population current enrolment in tertiary education, and country leaders' strength of seeking scientific evidence. The representativeness, and by interpretation the empathy, of government leadership also had positive effects. CONCLUSION: Strength of therapeutic health system, and indeed of preventive health services, surprisingly had little correlation with impact of the pandemic in the first nine months measured in death- or case-rates. However, specific political system features, including proportional representation electoral systems, and absence of a strong single party majority, were consistent features of the most successful national responses, as was being of a small or moderate population size, and with tertiary education facilitated. It can be interpreted that the way a country was lead, and whether leadership sought evidence and shared the reasoning behind resultant policies, had notable effects. This has significant implications within health system development and in promoting the population's health.


Asunto(s)
COVID-19/patología , Democracia , COVID-19/epidemiología , COVID-19/mortalidad , COVID-19/virología , Servicios Médicos de Urgencia , Política de Salud , Humanos , Pandemias , Salud Pública , Resiliencia Psicológica , SARS-CoV-2/aislamiento & purificación , Factores Socioeconómicos
16.
Front Public Health ; 9: 717747, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34595148

RESUMEN

Background: The lockdowns associated with the COVID-19 pandemic has been called a crisis in mental health, and adolescents may have been among the most affected. Comparing the first period of societal lockdown in spring 2020 to periods going back to 2014 using a rich cross-sectional dataset based on repeated surveys, we explore the potential changes in self-reported mental well-being across sociodemographic groups among Norway's adolescents. Methods: Norway closed schools and implemented strict restrictions in March 2020; an electronic questionnaire survey was distributed to lower secondary school students in Trøndelag county (N = 2,443) in May 2020. Results were compared with similar surveys conducted annually in the same county dating back to 2014. Logistic regression models were applied to investigate potential changes in depressive symptoms, loneliness, and quality of life and life satisfaction, and to detect possible differences in the impact of lockdown between the genders and socioeconomic groups. Results: The prevalence of boys and girls reporting high quality of life (43-34%; 23-16%) and life satisfaction (91-80%; 82-69%) decreased significantly compared to the pre-pandemic. For girls only, lockdown was associated with higher odds for reporting high depressive symptoms. As expected, the least privileged socioeconomic groups showed the greatest psychological distress. However, our trend analyses provided no evidence that the socioeconomic inequalities in psychological distress (according to prevalence of high depressive symptoms or loneliness) changed substantial in any direction during the first wave of the pandemic [between the pre-pandemic and inter-pandemic periods]. Conclusion: Adolescents are vulnerable, and interventions should provide them with mental health support during crises such as societal lockdown. In particular, the social and health policy, public health, and further research should target these least privileged groups.


Asunto(s)
COVID-19 , Pandemias , Adolescente , Control de Enfermedades Transmisibles , Estudios Transversales , Femenino , Humanos , Masculino , Salud Mental , Noruega/epidemiología , Calidad de Vida , SARS-CoV-2 , Autoinforme , Factores Sexuales , Factores Socioeconómicos
17.
J Nepal Health Res Counc ; 19(2): 252-258, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34601512

RESUMEN

BACKGROUND: Information on trends in the prevalence of overweight and obesity and the high-risk groups helps plan health promotion programmes and health policy. This study examined trends in overweight and obesity from 2006 to 2016 and the associated socio-demographic factors in 2016 among 20 to 49-year-old women in Nepal. METHODS: Nationally representative cross-sectional data were used from three Demographic and Health Surveys conducted in 2006 (n=7809), 2011 (n=4561), and 2016 (n=4904) in Nepal. Bodyweight and height were measured by trained personnel. Overweight was defined as 23.0 to 27.5 kg/m2 and obesity as >27.5 kg/m2 based on Asian-specific criteria in the main analyses. Multinomial logistic regression models were adjusted for age, parity, education, and wealth index. RESULTS: The prevalence of overweight increased from 16.6% to 26.8% and obesity from 3.9% to 14.3% between 2006 and 2016. The adjusted odds ratios and 95% confidence intervals were 2.26 (2.06 to 2.49) for overweight and 5.26 (4.48 to 6.18) for obesity in 2016 compared with 2006. Age 30 to 49 years, higher wealth index, parity 1 to 3 and education were associated with a higher prevalence of overweight and obesity, whereas the association between the area of residence (urban/rural) and prevalence of overweight or obesity was not statistically significant. CONCLUSIONS: The prevalence of overweight and obesity increased among Nepalese women of reproductive age between 2006 and 2016. More research is needed on how to prevent overweight and obesity among women, especially women aged 30 to 49 years or with higher wealth, in Nepal.


Asunto(s)
Obesidad , Sobrepeso , Adulto , Índice de Masa Corporal , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Persona de Mediana Edad , Nepal/epidemiología , Obesidad/epidemiología , Sobrepeso/epidemiología , Embarazo , Prevalencia , Factores Socioeconómicos , Adulto Joven
18.
Washington, D.C.; PAHO; 2021-10-14.
en Inglés | PAHO-IRIS | ID: phr-54991

RESUMEN

The Economic Commission for Latin America and the Caribbean (ECLAC) and the Pan American Health Organization (PAHO) have produced this second joint report to update the situation on the evolution of the COVID-19 pandemic and its implications for health, society and the economy. This report defines potential scenarios for control of the pandemic in the short term as well as long-term action recommended to strengthen the response capacity of countries with regard to the health needs of their populations and determinants in the context of a transformative recovery.


Asunto(s)
COVID-19 , Coronavirus , Infecciones por Coronavirus , Pandemias , Salud Pública , Economía , Economía y Organizaciones para la Atención de la Salud , Problemas Sociales , Bienestar Social , Capital Social
19.
Washington, D.C.; OPS; 2021-10-14.
en Español | PAHO-IRIS | ID: phr-54990

RESUMEN

Más de un año después del inicio de la pandemia de COVID-19, América Latina y el Caribe acumula un número desproporcionado de casos y muertes respecto de otras regiones del mundo y sufre la mayor contracción económica de los últimos 120 años. En este segundo informe conjunto de la Comisión Económica para América Latina y el Caribe y la Organización Panamericana de la Salud se actualizan la situación de la evolución de la pandemia y sus implicaciones sociales, económicas y para la salud. Para ello se abordan los principales impactos económicos y sociales de la pandemia en la región, junto con el papel central de la protección social y el Estado, y la necesidad de incrementar la inversión pública en salud y fortalecer la institucionalidad del sector de la salud. Por último, se analizan los posibles escenarios de supresión de la pandemia en el corto plazo y un conjunto de condiciones contextuales que inciden de forma directa en este objetivo. El informe se cierra con un apartado de recomendaciones que enfatizan la importancia de adoptar un abordaje integral para poner fin a la crisis de salud en el corto plazo, avanzar hacia una recuperación económica sostenible y con igualdad, y promover la salud universal mediante sistemas de salud resilientes.


Asunto(s)
COVID-19 , Coronavirus , Infecciones por Coronavirus , Pandemias , Sistemas de Salud , Salud Pública , Economía , Economía y Organizaciones para la Atención de la Salud , Problemas Sociales , Bienestar Social , Capital Social
20.
Artículo en Español | PAHO-IRIS | ID: phr-54981

RESUMEN

[RESUMEN]. Con millones de personas en el mundo en situación de distanciamiento físico por el COVID-19, las tecnologías de la información y comunicaciones (TICs) se han posicionado como uno de los medios principales de interacción y colaboración. Ya al inicio de este milenio se empezaban a mencionar las siguientes ventajas: mayor acceso a la información y a la prestación de servicios; fortalecimiento educativo; control de calidad de los programas de detección y reducción de los costos de la atención de en salud. Sin embargo, entre las principales barreras de adopción de la telemedicina se encuentran las de índole: tecnológicas; humanas y sociales; psicosociales y antropológicas; de Gobernanza y económicas. En estos 20 años se logró un aumento en los recursos y capacidad técnica, una mejora en la educación digital, un empoderamiento del paciente en su tratamiento y un mayor interés público en esta área. En especial se considera exitosa la conformación de equipos interdisciplinarios, las redes académicas y profesionales y las consultas médicas virtuales. Después de revisar el estado de la telemedicina en la Región de las Américas, los autores recomiendan adoptar medidas urgentes para poner en práctica políticas y programas nacionales de telemedicina, incluyendo el marco normativo y presupuesto necesario, cuya implementación se realice de manera integral e interoperable y que se sustente de redes académicas, de colaboración e instituciones especializadas. Dichas políticas deben generar un contexto habilitante que den sostenibilidad al avance logrado, considerando los aspectos mencionados en las posibles barreras.


[ABSTRACT]. With millions of people in the world in situations of physical distancing because of COVID-19, information and communication technology (ICT) has become as one of the principal means of interaction and collaboration. The following advantages of ICT have been cited since the start of the new millennium: increased access to information and service delivery, educational strengthening, quality control of screening programs, and reduction of health care costs. In the case of telemedicine, however, a number of barriers—especially technological, human and social, psychosocial, anthropological, economic, and governance-related—have stood in the way of its adoption. The past 20 years have seen an increase in the availability of resources and technical capacity, improvements in digital education, empowerment of patients regarding their treatment, and increased public interest in this area. Successes have included the use of interdisciplinary teams, academic and professional networking, and virtual medical consultations. After reviewing the state of telemedicine in the Region of the Americas, the authors recommend the urgent adoption of measures aimed at implementing national telemedicine policies and programs, including a regulatory framework and adequate funding. Implementation of the measures should be integrated and interoperable and include the support of academic networks and the collaboration of specialized institutions. The policies should generate an enabling context that ensures sustainability of the progress achieved, bearing in mind the possible barriers mentioned.


[RESUMO]. Com milhões de pessoas no mundo em situação de distanciamento físico devido à COVID-19, as tecnologias da informação e comunicação (TICs) se enquadraram como um dos meios principais de interação e colaboração. Já no início deste milênio, começaram a ser mencionadas as seguintes vantagens: maior acesso à informação e à prestação de serviços; fortalecimento da educação; controle de qualidade dos programas de detecção e redução dos custos na atenção à saúde. No entanto, entre as principais barreiras de adoção da telemedicina se encontram as de caráter: tecnológico; humano e social; psicossocial e antropológico; de governança e econômico. Nestes 20 anos, houve um aumento nos recursos e na capacidade técnica, uma melhora na educação digital, um empoderamento do paciente em seu tratamento e um maior interesse público nessa área. Em especial, são consideradas bem-sucedidas a constituição de equipes interdisciplinares e as redes acadêmicas e profissionais, e as consultas médicas virtuais. Após revisar o estado da telemedicina na Região das Américas, os autores recomendam a adoção de medidas urgentes para implementar políticas e programas nacionais de telemedicina, incluindo o marco normativo e o orçamento necessário. Essa implementação deve ser realizada de maneira integral e interoperável e sustentada por redes acadêmicas, de parceria e instituições especializadas. Tais políticas devem gerar um contexto favorável, dando sustentabilidade ao avanço obtido e considerando os aspectos mencionados nas possíveis barreiras.


Asunto(s)
Acceso a la Información , Comunicación , Práctica de Salud Pública , Salud Pública , Planificación en Salud , Telemedicina , Acceso a la Información , Comunicación , Salud Pública , Práctica de Salud Pública , Planificación en Salud , Telemedicina , Acceso a la Información , Comunicación , Salud Pública , Práctica de Salud Pública , Planificación en Salud
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