1
|
Lim WB, Robertson FP, Nayar MK, Sharp L, Nandhra S, Pandanaboyana S. Social deprivation does not impact on acute pancreatitis severity and mortality: a single-centre study. BMJ Open Gastroenterol 2023; 10:bmjgast-2022-001035. [PMID: 36746520 PMCID: PMC9906294 DOI: 10.1136/bmjgast-2022-001035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/19/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND AIMS The incidence of acute pancreatitis (AP) is increasing in the UK. Patients with severe AP require a significant amount of resources to support them during their admission. The ability to predict which patients will develop multiorgan dysfunction remains poor leading to a delay in the identification of these patients and a window of opportunity for early intervention is missed. Social deprivation has been linked with increased mortality across surgical specialties. Its role in predicting mortality in patients with AP remains unclear but would allow high-risk patients to be identified early and to focus resources on high-risk populations. METHODS A prospectively collected single-centre database was analysed. English Index of Multiple Deprivation (IMD) was calculated based on postcode. Patients were grouped according to their English IMD quintile. Outcomes measured included all-cause mortality, Intestive care unit (ITU) admission, overall length of stay (LOS) and local pancreatitis-specific complications. RESULTS 398 patients with AP between 2018 and 2021 were identified. There were significantly more patients with AP in Q1 (IMD 1-2) compared with Q5 (IMD 9-10) (156 vs 38, p<0.001). Patients who were resident in the most deprived areas were significantly younger (52.4 in Q1 vs 65.2 in Q5, p<0.001), and more often smokers (39.1% in Q1 vs 23.7% in Q5, p=0.044) with IHD (95.0% vs 92.1% in Q5, p<0.001). In multivariate modelling, there was no significance difference in pancreatitis-related complications, number of ITU visits, number of organs supported and overall, LOS by IMD quintile. CONCLUSIONS Although there was a significantly higher number of patients admitted to our unit with AP from the most socially deprived quintiles, there was no correlation between social economic deprivation and mortality following AP.
Collapse
Affiliation(s)
- Wei Boon Lim
- Department of HPB and Transplant Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Francis P Robertson
- Department of HPB and Transplant Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Manu K Nayar
- Department of HPB and Transplant Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sandip Nandhra
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK,Department of Vascular surgery, Freeman Hospital, Newcastle upon Tyne, UK
| | - Sanjay Pandanaboyana
- Department of HPB and Transplant Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK .,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
2
|
Rujchanarong D, Scott D, Park Y, Brown S, Mehta AS, Drake R, Sandusky GE, Nakshatri H, Angel PM. Metabolic Links to Socioeconomic Stresses Uniquely Affecting Ancestry in Normal Breast Tissue at Risk for Breast Cancer. Front Oncol 2022; 12:876651. [PMID: 35832545 PMCID: PMC9273232 DOI: 10.3389/fonc.2022.876651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
A primary difference between black women (BW) and white women (WW) diagnosed with breast cancer is aggressiveness of the tumor. Black women have higher mortalities with similar incidence of breast cancer compared to other race/ethnicities, and they are diagnosed at a younger age with more advanced tumors with double the rate of lethal, triple negative breast cancers. One hypothesis is that chronic social and economic stressors result in ancestry-dependent molecular responses that create a tumor permissive tissue microenvironment in normal breast tissue. Altered regulation of N-glycosylation of proteins, a glucose metabolism-linked post-translational modification attached to an asparagine (N) residue, has been associated with two strong independent risk factors for breast cancer: increased breast density and body mass index (BMI). Interestingly, high body mass index (BMI) levels have been reported to associate with increases of cancer-associated N-glycan signatures. In this study, we used matrix assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) to investigate molecular pattern changes of N-glycosylation in ancestry defined normal breast tissue from BW and WW with significant 5-year risk of breast cancer by Gail score. N-glycosylation was tested against social stressors including marital status, single, education, economic status (income), personal reproductive history, the risk factors BMI and age. Normal breast tissue microarrays from the Susan G. Komen tissue bank (BW=43; WW= 43) were used to evaluate glycosylation against socioeconomic stress and risk factors. One specific N-glycan (2158 m/z) appeared dependent on ancestry with high sensitivity and specificity (AUC 0.77, Brown/Wilson p-value<0.0001). Application of a linear regression model with ancestry as group variable and socioeconomic covariates as predictors identified a specific N-glycan signature associated with different socioeconomic stresses. For WW, household income was strongly associated to certain N-glycans, while for BW, marital status (married and single) was strongly associated with the same N-glycan signature. Current work focuses on understanding if combined N-glycan biosignatures can further help understand normal breast tissue at risk. This study lays the foundation for understanding the complexities linking socioeconomic stresses and molecular factors to their role in ancestry dependent breast cancer risk.
Collapse
Affiliation(s)
- Denys Rujchanarong
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Bruker-MUSC Center of Excellence, Clinical Glycomics, Medical University of South Carolina, Charleston, SC, United States
| | - Danielle Scott
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Bruker-MUSC Center of Excellence, Clinical Glycomics, Medical University of South Carolina, Charleston, SC, United States
| | - Yeonhee Park
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, United States
| | - Sean Brown
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Bruker-MUSC Center of Excellence, Clinical Glycomics, Medical University of South Carolina, Charleston, SC, United States
| | - Anand S. Mehta
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Bruker-MUSC Center of Excellence, Clinical Glycomics, Medical University of South Carolina, Charleston, SC, United States
| | - Richard Drake
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Bruker-MUSC Center of Excellence, Clinical Glycomics, Medical University of South Carolina, Charleston, SC, United States
| | - George E. Sandusky
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Harikrishna Nakshatri
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Peggi M. Angel
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Bruker-MUSC Center of Excellence, Clinical Glycomics, Medical University of South Carolina, Charleston, SC, United States
| |
Collapse
|
3
|
Liu H, Wang M. Socioeconomic status and ADL disability of the older adults: Cumulative health effects, social outcomes and impact mechanisms. PLoS One 2022; 17:e0262808. [PMID: 35143499 PMCID: PMC8830695 DOI: 10.1371/journal.pone.0262808] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/06/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Socioeconomic status (SES) is one of the important indicators affecting individual's social participation and resource allocation, and it also plays an important role in the health shock of individuals. Faced by the trend of aging society, more and more nations across the world began to pay attention to prevent the risk of health shock of old adults. METHODS Based on the data of China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015 and 2018, this study uses path analysis and ologit model to empirically estimate the effects of SES and health shock on the activities of daily living (ADL) disability of old adults. RESULTS As a result, first, it was found that SES has significant impact on the disability of old adults. Specifically, economic conditions (income) plays dominant role. Economic status affects the risk of individual disability mainly through life security and health behavior. Secondly, SES significantly affecting health shock, with education and economic status showing remarkable impact, and there is an apparent group inequality. Furthermore, taking high education group as reference, the probability of good sight or hearing ability of the low education group was only 49.76% and 63.29% of the high education group, respectively, while the rates of no pain and severe illness were 155.50% and 54.69% of the high education group. At last, the estimation of path effect of SES on ADL disability indicates evident group inequality, with health shock plays critical mediating role. CONCLUSIONS SES is an important factor influencing residents' health shock, and health shocks like cerebral thrombosis and cerebral hemorrhage will indirectly lead to the risk of individual ADL disability. Furthermore, among the multi-dimensional indicators of SES, individual income and education are predominant factors affecting health shock and ADL disability, while occupation of pre-retirement have little impact.
Collapse
Affiliation(s)
- Huan Liu
- School of Public Administration, Zhejiang University of Finance & Economics, Hang Zhou, Zhejiang Province, China
| | - Meng Wang
- School of Public Administration, Zhejiang University of Finance & Economics, Hang Zhou, Zhejiang Province, China
| |
Collapse
|
4
|
Liang YL, Tsai MC, Lin YC, Strong C, Lin CY. Poverty and the prediction of health status in adolescents from low-income families in Taiwan. J Public Health (Oxf) 2021; 42:44-52. [PMID: 30977812 DOI: 10.1093/pubmed/fdy220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 04/10/2018] [Accepted: 12/06/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A comparison of the performance between monetary and an asset-based socioeconomic position (SEP) index in predicting adolescents' health outcomes was conducted only in low-income countries. Our study aims to compare these two indices among adolescents from low-income families in a high-income country. METHODS Data of adolescents aged 12-18 years was used from the Taiwan Database of Children and Youth in Poverty (n = 2529). The asset-based index was based on a set of weighted self-reported household conditions using principal components analysis. Multivariable logistic regression was conducted to examine the association between these two indices and the mental and physical health outcomes among adolescents. RESULTS Health outcomes were significantly associated with the asset-based SEP index but not with the monetary index. An increased trend was shown in mental illness symptoms, infections, injuries, allergies and dental problems when the regression was performed in the asset-based SEP index (P < 0.05) but not in the monetary SEP index. CONCLUSIONS An asset-based SEP index serves as a better index associated with a social gradient in health inequality. To prioritize giving care to people in need, healthcare policymakers should consider including an assessment of household assets and resources, supplementary to the conventional monetary index.
Collapse
Affiliation(s)
- Ya-Lun Liang
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Lin
- Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Department of Rehabilitation Science, Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| |
Collapse
|
5
|
Mair FS, Jani BD. Emerging trends and future research on the role of socioeconomic status in chronic illness and multimorbidity. LANCET PUBLIC HEALTH 2020; 5:e128-e129. [PMID: 32007133 DOI: 10.1016/s2468-2667(20)30001-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Frances S Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK.
| | - Bhautesh Dinesh Jani
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK
| |
Collapse
|
6
|
Surveillance Recommendations after Thoracic Endovascular Aortic Repair Should Be Based on Initial Indication for Repair. Ann Vasc Surg 2019; 57:51-59. [DOI: 10.1016/j.avsg.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/22/2018] [Accepted: 11/08/2018] [Indexed: 11/22/2022]
|
7
|
Influence of Socioeconomic and Anthropometric Factors on Respiratory Function in Female University Students. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 968:41-48. [PMID: 28181198 DOI: 10.1007/5584_2016_194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The purpose of this study was to evaluate lung function in healthy young female university students and to seek the relation of lung function to socioeconomic and anthropometric indices. The methodology consisted of spirometry tests, anthropometric measures and a questionnaire conducted in November of 2015 among 152 female university students. At first, lung function was analyzed for any relationship with socioeconomic factors and smoking. The results of a multi-factor analysis of variance demonstrate significant differences in the FEV1/FVC ratio depending on the general socioeconomic status. Then, anthropometric and spirometric parameters were tested for correlations. A comparison of underweight, normal weigh, overweight, and obese subjects revealed statistically significant differences for FVC% and FEV1/FVC, with the highest values noted in the subjects of normal weight. Individuals with abdominal obesity had lower FVC% and FEV1% and a higher FEV1/FVC ratio. The findings of our study confirm that both general obesity and abdominal obesity are related to a reduced lung function.
Collapse
|
8
|
Myrick JG, Willoughby JF. Educated but anxious: How emotional states and education levels combine to influence online health information seeking. Health Informatics J 2017; 25:649-660. [DOI: 10.1177/1460458217719561] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study combined conceptual frameworks from health information seeking, appraisal theory of emotions, and social determinants of health literatures to examine how emotional states and education predict online health information seeking. Nationally representative data from the Health Information National Trends Survey (HINTS 4, Cycle 3) were used to test the roles of education, anxiety, anger, sadness, hope, happiness, and an education by anxiety interaction in predicting online health information seeking. Results suggest that women, tablet owners, smartphone owners, the college educated, those who are sad some or all of the time, and those who are anxious most of the time were significantly more likely to seek online health information. Conversely, being angry all of the time decreased the likelihood of seeking. Furthermore, two significant interactions emerged between anxiety and education levels. Discrete psychological states and demographic factors (gender and education) individually and jointly impact information seeking tendencies.
Collapse
|
9
|
Gonorrhea infection increases the risk of prostate cancer in Asian population: a nationwide population-based cohort study. Eur J Clin Microbiol Infect Dis 2016; 36:813-821. [PMID: 28013414 DOI: 10.1007/s10096-016-2866-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/06/2016] [Indexed: 12/27/2022]
Abstract
This nationwide population-based retrospective cohort study evaluated the risk of developing prostate cancer among patients with gonorrhea. We identified cases of newly diagnosed gonorrhea in men between 2000 and 2010 from the Taiwan National Health Insurance Research Database. Each patient with gonorrhea was matched to four controls, based on age and index year. All subjects were followed up from the index date to December 31, 2010. The Cox proportional hazards regression model was used to assess the risk of prostate cancer. A total of 355 men were included in the study group, and 1,420 age-matched subjects without gonorrhea were included in the control group. After adjusting for age, comorbidities, urbanization level, hospital level, and monthly income, gonorrhea was significantly associated with an increased risk of prostate cancer (adjusted hazard ratio = 5.66, 95% confidence interval = 1.36-23.52). Men aged 45-70 years and those with lower monthly income were more strongly associated with prostate cancer in the study group than the control group. The higher risk for developing prostate cancer were also found in those without syphilis, without genital warts, without diabetes mellitus, without chronic obstructive pulmonary disease, without benign prostatic hypertrophy, without chronic prostatitis, and without alcoholism. The Kaplan-Meier analysis showed the risk of prostate cancer was significantly higher in the study group than in the control group. Gonorrhea may be involved in the development of prostate cancer. More intensive screening and prevention interventions for prostate cancer should be recommended in men with gonorrhea.
Collapse
|
10
|
Abdou CM, Fingerhut AW, Jackson JS, Wheaton F. Healthcare Stereotype Threat in Older Adults in the Health and Retirement Study. Am J Prev Med 2016; 50:191-8. [PMID: 26497263 PMCID: PMC4755717 DOI: 10.1016/j.amepre.2015.07.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 06/25/2015] [Accepted: 07/27/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Healthcare stereotype threat is the threat of being personally reduced to group stereotypes that commonly operate within the healthcare domain, including stereotypes regarding unhealthy lifestyles and inferior intelligence. The objective of this study was to assess the extent to which people fear being judged in healthcare contexts on several characteristics, including race/ethnicity and age, and to test predictions that experience of such threats would be connected with poorer health and negative perceptions of health care. METHODS Data were collected as part of the 2012 Health and Retirement Study (HRS). A module on healthcare stereotype threat, designed by the research team, was administered to a random subset (n=2,048 of the total 20,555) of HRS participants. The final sample for the present healthcare stereotype threat experiment consists of 1,479 individuals. Logistic regression was used to test whether healthcare stereotype threat was associated with self-rated health, reported hypertension, and depressive symptoms, as well as with healthcare-related outcomes, including physician distrust, dissatisfaction with health care, and preventative care use. RESULTS Seventeen percent of respondents reported healthcare stereotype threat with respect to one or more aspects of their identities. As predicted, healthcare stereotype threat was associated with higher physician distrust and dissatisfaction with health care, poorer mental and physical health (i.e., self-rated health, hypertension, and depressive symptoms), and lower odds of receiving the influenza vaccine. CONCLUSIONS The first of its kind, this study demonstrates that people can experience healthcare stereotype threat on the basis of various stigmatized aspects of social identity, and that these experiences can be linked with larger health and healthcare-related outcomes, thereby contributing to disparities among minority groups.
Collapse
Affiliation(s)
- Cleopatra M Abdou
- Davis School of Gerontology and Department of Psychology, University of Southern California, Los Angeles, California.
| | - Adam W Fingerhut
- Department of Psychology, Loyola Marymount University, Los Angeles, California
| | - James S Jackson
- Institute for Social Research, Department of Psychology, and School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Felicia Wheaton
- Davis School of Gerontology, University of Southern California, Los Angeles, California
| |
Collapse
|