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Baek SK, Aye WT, Htet AS, Stigum H, Gopinathan U, Bjertness E. Educational inequalities and self-reported health among men and women aged 18-49 years in Yangon Region, Myanmar: analysis of a population-based, cross-sectional study. BMJ Open 2024; 14:e074468. [PMID: 38890138 PMCID: PMC11191797 DOI: 10.1136/bmjopen-2023-074468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/18/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES To estimate the prevalence of good self-reported health (SRH) in subpopulations based on the social determinants of health and to investigate the association between education (measured in years of schooling) and good SRH among men and women aged 18-49 years in Yangon Region, Myanmar. DESIGN Analysis of data from a population-based, cross-sectional study conducted in Yangon, Myanmar, from October to November 2016. A multistage sampling procedure was employed, and structured face-to-face interviews were conducted with standardised questions adapted from the Myanmar Demographic and Health Survey. Prevalence ratios (PRs) with 95% CIs were estimated using Poisson regression analyses by sex. SETTING Urban and rural areas of Yangon Region, Myanmar. PARTICIPANTS The sample included 2,506 participants (91.8% response rate) aged 18-49 years and excluded nuns, monks, soldiers, institutionalised people and individuals deemed too ill physically and/or mentally to participate. RESULTS The prevalence of good SRH was 61.2% (95% CI 59.3 to 63.1), with higher rates among men (72.0%, 95% CI 69.3 to 74.5), younger individuals (69.2%, 95% CI 66.2 to 72.1), urban residents (63.6%, 95% CI 60.8 to 66.3), extended family dwellers (66.6%, 95% CI 63.7 to 69.4) and those with a higher level of education (66.0%, 95% CI 61.3 to 70.5). After adjusting for confounders (age and area of residence), the association between years of schooling and SRH (PR) was 1.01 (95% CI 1.01 to 1.02, p=0.002) in men and 1.01 (95% CI 0.99 to 1.02, p=0.415) in women. CONCLUSIONS Good SRH was more prevalent among men than among women. Additionally, a 1-year increase in education was associated with a 1% increase in the prevalence of good SRH among men, whereas the association was not statistically significant among women. In order to enhance the educational benefits of health in Myanmar, we recommend a higher focus on the length of education and addressing gender inequalities in wage return from education.
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Affiliation(s)
- Sel Ki Baek
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Win Thuzar Aye
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Aung Soe Htet
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Hein Stigum
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Gopinathan
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Espen Bjertness
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Fitzpatrick KM, Sjoblom E, Puinean G, Robson H, Campbell SM, Fayant B, Montesanti S. Examining global Indigenous community wellness worker models: a rapid review. Int J Equity Health 2024; 23:90. [PMID: 38698390 PMCID: PMC11065687 DOI: 10.1186/s12939-024-02185-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/22/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND There is a growing interest in employing community wellness worker models in Indigenous populations to address inequities in healthcare access and outcomes, concerns about shortage in health and mental health human resources, and escalating burden of chronic and complex diseases driving significant increase in health services demand and costs. A thorough review of Indigenous community wellness worker models has yet to be conducted. This rapid review sought to outline the characteristics of a community wellness worker model in Indigenous contexts across the globe, detailing factors shaping implementation challenges and success. METHODS A rapid review of the international peer-reviewed and grey literature of OVID Medline, Global Index Medicus, Google, and Google Scholar was conducted from January to June 2022 for Indigenous community wellness/mental health worker models and comparative models. Articles were screened and assessed for eligibility. From eligible articles, data pertaining to study design and sample; description of the program, service, or intervention; model development and implementation; terminology used to describe workers; training features; job roles; funding considerations; facilitators and barriers to success; key findings; outcomes measured; and models or frameworks utilized were extracted. Data were synthesized by descriptive and pattern coding. RESULTS Twenty academic and eight grey literature articles were examined. Our findings resulted in four overarching and interconnected themes: (1) worker roles and responsibilities; (2) worker training, education, and experience; (3) decolonized approaches; and (4) structural supports. CONCLUSION Community wellness worker models present a promising means to begin to address the disproportionately elevated demand for mental wellness support in Indigenous communities worldwide. This model of care acts as a critical link between Indigenous communities and mainstream health and social service providers and workers fulfill distinctive roles in delivering heightened mental wellness supports to community members by leveraging strong ties to community and knowledge of Indigenous culture. They employ innovative structural solutions to bolster their efficacy and cultivate positive outcomes for service delivery and mental wellness. Barriers to the success of community wellness worker models endure, including power imbalances, lack of role clarity, lack of recognition, mental wellness needs of workers and Indigenous communities, and more.
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Affiliation(s)
- Kayla M Fitzpatrick
- School of Public Health, University of Alberta, 3-300 Eddmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada
| | - Erynne Sjoblom
- School of Public Health, University of Alberta, 3-300 Eddmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada
| | - Giulia Puinean
- School of Public Health, University of Alberta, 3-300 Eddmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada
| | - Heath Robson
- School of Public Health, University of Alberta, 3-300 Eddmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada
| | - Sandra M Campbell
- John W. Scott Health Sciences Library, Mackenzie Health Science Centre, University of Alberta, 8440 - 112 St, Edmonton, AB, T6G 2B7, Canada
| | - Bryan Fayant
- McMurray Métis Local 1935, 441 Sakitawaw Trail, Fort McMurray, AB, AB T9H 4P3, Canada
| | - Stephanie Montesanti
- School of Public Health, University of Alberta, 3-300 Eddmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
- Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada.
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Jiang Y, Yang JG, Qian HY, Yang YJ. Association between living alone and all-cause mortality of young and middle-aged patients with acute myocardial infarction: analysis of the China Acute Myocardial Infarction (CAMI) registry. BMC Public Health 2024; 24:14. [PMID: 38166780 PMCID: PMC10759749 DOI: 10.1186/s12889-023-17486-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Lack of social support is a known predictor of the prognosis after acute myocardial infarction (AMI). Although as a common factor associated with social support, there are limited data on long-term prognostic impact of living status in young and middle-aged patients with AMI. METHODS We analyzed data from the China Acute Myocardial Infarction (CAMI) Registry, consecutive AMI young and middle-aged patients admitted at 108 hospitals in China between January 2013 and September 2014 were included. Eligible patients were assigned to living alone and not living alone groups based on their living status. The primary endpoint was 2-year all-cause mortality. The secondary endpoints included in-hospital mortality and 2-year major adverse cardiac and cerebrovascular events (MACCEs; a composite of all-cause mortality, MI, or stroke). Multilevel logistic and multilevel Cox regression models were used to evaluate the effect of living status on short-term and long-term outcomes. RESULTS A total of 8307 consecutive AMI young and middle-aged patients were included, 192 (2.3%) patients were living alone. Of the analyzed patients, living alone was associated with 2-year all-cause mortality and MACCEs among all analyzed patients after multivariate adjustment (adjusted hazard ratio [HR] = 2.171 [1.210-3.895], P = 0.009; adjusted HR = 2.169 [1.395-3.370], P = 0.001), but not with poorer in-hospital mortality. CONCLUSIONS The analysis suggested that living alone was associated with both 2-year all-cause mortality and MACCEs in AMI young and middle-aged patients but did not show an extra effect on the in-hospital mortality after covariate adjustment. TRIAL REGISTRATION Trial registration number: NCT01874691; Registered 31 October 2012.
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Affiliation(s)
- Yu Jiang
- Center for Coronary Heart Disease, Department of Cardiology, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Rd, Beijing, 100037, China
| | - Jin-Gang Yang
- Center for Coronary Heart Disease, Department of Cardiology, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Rd, Beijing, 100037, China
| | - Hai-Yan Qian
- Center for Coronary Heart Disease, Department of Cardiology, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Rd, Beijing, 100037, China.
| | - Yue-Jin Yang
- Center for Coronary Heart Disease, Department of Cardiology, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Rd, Beijing, 100037, China.
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Sempungu JK, Choi M, Lee EH, Lee YH. Changes in Household Size in the Republic of Korea and Depression: A Temporal Analysis. Asia Pac J Public Health 2023; 35:214-216. [PMID: 36872615 DOI: 10.1177/10105395231160340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Affiliation(s)
| | - Minjae Choi
- Institute for Future Public Health, Graduate School of Public Health, Korea University, Seoul, Republic of Korea.,Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eun Hae Lee
- Program in Public Health, Graduate School, Korea University, Seoul, Republic of Korea
| | - Yo Han Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Senee A, Bye Ishnoo Y, Jeewon R. An Analysis of the Contributors and Factors Influencing Dietary Patterns Among the Elderly Population. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2022. [DOI: 10.12944/crnfsj.10.3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The normal process of aging consists of numerous behavioral, social, physical, psychological, and socioeconomic factors which may negatively affect the nutritional status of a senior. Old people are susceptible to poor nutritional status as they are mostly affected by nutritional deficiencies compared to individuals that belong to other age groups. The poor dietary pattern among the elderly leads to chronic diseases such as coronary heart disease, atherosclerosis, type 2 diabetes, hypertension, or malnutrition. Factors such as socioeconomic indicators, price of food items, marital status, psychological factors, changes in sensory functioning, access to food commodities, nutrition knowledge and cooking skills, gastrointestinal problems, oral health, and medication factors may influence the dietary pattern of an elderly individual. This review focuses on the factors affecting the eating habits of the elderly.
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Affiliation(s)
- Anoushka Senee
- Department of Health Sciences, Faculty of Medicine and Health Sciences, University of Mauritius, Reduit, Mauritius
| | - Yashwinee Bye Ishnoo
- Department of Health Sciences, Faculty of Medicine and Health Sciences, University of Mauritius, Reduit, Mauritius
| | - Rajesh Jeewon
- Department of Health Sciences, Faculty of Medicine and Health Sciences, University of Mauritius, Reduit, Mauritius
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Social change and birth cohorts decreased resilience among college students in China: A cross-temporal meta-analysis, 2007–2020. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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7
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Hyer JM, Diaz A, Tsilimigras D, Pawlik TM. A novel machine learning approach to identify social risk factors associated with textbook outcomes after surgery. Surgery 2022; 172:955-961. [PMID: 35710534 DOI: 10.1016/j.surg.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/18/2021] [Accepted: 05/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Identifying social determinants of health has become a priority for many researchers, health care providers, and payers. The vast amount of patient and population-level data available on social determinants creates, however, both an opportunity and a challenge as these data can be difficult to synthesize and analyze. METHODS Medicare beneficiaries who underwent 1 of 4 common operations between 2013 and 2017 were identified. Using a machine learning algorithm, the primary independent variable, surgery social determinants of health index, was derived from 15 common, publicly available social determents of health measures. After development of a surgery social determinants of health index, multivariable logistic regression was used to estimate the association of this index with textbook outcomes, as well as the component metrics of textbook outcomes. RESULTS A novel surgery social determinants of health index was developed with factor component weights that varied relative to their impact on postoperative outcomes. Factors with the highest weight in the algorithm relative to postoperative outcomes were the proportion of noninstitutionalized civilians with a disability and persons without high school diploma, while components with the lowest weights were the proportion of households with more people than rooms and persons below poverty. Overall, an increase in surgery social determinants of health index was associated with 6% decreased odds (95% confidence interval: 0.93-0.94) of achieving a textbook outcome. In addition, an increase in surgery social determinants of health index was associated with increased odds of each of the individual components of textbook outcome; ranging from 3% increased odds (95% confidence interval: 1.03-1.04) for 90-day readmission to 10% increased odds (95% confidence interval: 1.09-1.11) for 90-day mortality. Further, there was 6% increased odds (95% confidence interval: 1.05-1.07) of experiencing a complication and 7% increased odds (95% confidence interval: 1.06-1.07) of having an extended length of stay. Minority patients from a high surgery social determinants of health index had 38% lower odds (95% confidence interval: 0.60-0.65) of achieving a textbook outcome compared with White/non-Hispanic patients from a low surgery social determinants of health index area. CONCLUSION Using a machine learning approach, we developed a novel social determents of health index to predict the probability of achieving a textbook outcome after surgery.
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Affiliation(s)
- J Madison Hyer
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Adrian Diaz
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH; National Clinician Scholars Program at the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI; Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI. https://twitter.com/DiazAdrian10
| | - Diamantis Tsilimigras
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH.
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Exploring the Relationship between Household Structure and Utilisation of Maternal Health Care Services in India. J Biosoc Sci 2022; 55:438-448. [PMID: 35575104 DOI: 10.1017/s0021932022000219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The role of household structure, especially the mother-in-law (MIL) influencing daughter-in-law's maternal health care (MHC) seeking behaviour, has been a continuing debate due to the former's advantageous position in the household. This study assesses the association of household structure and particularly the presence of MIL with MHC utilisation in India using the National Family Health Survey-4 data (2015-16). The sample of women aged 15-49 years who have given birth during the last five years preceding the survey (n=184,641) was considered for analysis. The outcome variables were full-antenatal care, institutional delivery, and postnatal care. Binary logistic regression was used to check the adjusted effects of the household structure on MHC utilisation. The analyses were done with STATA (version 13) with a significance level of 5%. Adjusting the effects of socio-demographic and economic characteristics, women from non-nuclear households with MIL had higher odds of full-antenatal care (OR= 1.04, CI= 0.99-1.08) and institutional delivery (OR=1.05, CI=1.01- 1.10) than their counterparts from nuclear households. Women from non-nuclear households without MIL had lower chances of postnatal care (OR=0.98, CI=0.96-1.00) than those from nuclear households. The study unearths a very weak association between the presence of MIL in the household and MHC services utilisation of the daughter-in-law, a notable change from the earlier literature often portraying MIL as a barrier.
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Hammouri H, Almomani F, Abdel Muhsen R, Abughazzi A, Daghmash R, Abudayah A, Hasan I, Alzein E. Lifestyle Variations during and after the COVID-19 Pandemic: A Cross-Sectional Study of Diet, Physical Activities, and Weight Gain among the Jordanian Adult Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1346. [PMID: 35162368 PMCID: PMC8834702 DOI: 10.3390/ijerph19031346] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 02/01/2023]
Abstract
The way that COVID-19 has been handled since its inception in 2019 has had a significant impact on lifestyle-related behaviors, such as physical activities, diet, and sleep patterns. This study measures lifestyle-related behavior during the COVID-19 pandemic lockdown using a 22-item questionnaire. The responses were collected from March 2021 to September 2021. A total of four hundred and sixty-seven Jordanian participants were engaged in assessing the changes caused by the pandemic and their effect on BMI. The validity and reliability of the questionnaire were tested for 71 participants. Cronbach's alpha values for the questionnaire exceeded 0.7, demonstrating good reliability and internal consistency. The effect of each question regarding physical activity and dietary habits over the BMI difference was studied using ANOVA. The study shows that more than half of the participants reported snacking more between meals and increased their sitting and screen time, while 74% felt more stressed and anxious. BMI difference among the individuals throughout the lockdown was significantly associated with these variables. In contrast, 62% of the participants showed more awareness about their health by increasing the intake of immunity-boosting foods, and 56% of the participants showed an increase in the consumption of nutrition supplements. Females and married individuals tended to be healthier. Therefore, their BMI showed stability compared to others based on their gender and marital status. Exercise, sleep, and avoiding 'junk' food, which contributes to weight gain and COVID-19 vulnerability, are strongly recommended.
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Affiliation(s)
- Hanan Hammouri
- Department of Mathematics and Statistics, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Fidaa Almomani
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Ruwa Abdel Muhsen
- Department of Mathematics and Statistics, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Aysha Abughazzi
- Department of English Language and Linguistics, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Rawand Daghmash
- Department of Pharmaceutical Technology, Jordan University of Science and Technology, Irbid 22110, Jordan; (R.D.); (A.A.); (I.H.)
| | - Alaa Abudayah
- Department of Pharmaceutical Technology, Jordan University of Science and Technology, Irbid 22110, Jordan; (R.D.); (A.A.); (I.H.)
| | - Inas Hasan
- Department of Pharmaceutical Technology, Jordan University of Science and Technology, Irbid 22110, Jordan; (R.D.); (A.A.); (I.H.)
| | - Eva Alzein
- Department of Public Health, Jordan University of Science and Technology, Irbid 22110, Jordan;
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10
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Social vulnerability and fragmentation of postoperative surgical care among patients undergoing hepatopancreatic surgery. Surgery 2021; 171:1043-1050. [PMID: 34538339 DOI: 10.1016/j.surg.2021.08.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Regionalization of hepatopancreatic surgery to high-volume hospitals has been associated with fragmentation of postoperative care and, in turn, inferior outcomes after surgery. The objective of this study was to examine the association of social vulnerability with the likelihood of experiencing fragmentation of postoperative care (FPC) after hepatopancreatic surgery. METHODS Patients who underwent hepatopancreatic surgery and had at least 1 readmission within 90 days were identified using Medicare 100% Standard Analytical Files between 2013 and 2017. Fragmentation of postoperative care was defined as readmission at a hospital other than the index institution where the initial surgery was performed. The association of social vulnerability index and its components with fragmentation of postoperative care was examined. RESULTS Among 11,142 patients, 8,053 (72.3%) underwent pancreatectomy, and 3,089 (27.7%) underwent hepatectomy. The overall incidence of fragmentation of postoperative care was 32.9% (n = 3,667). Patients who experienced fragmentation of postoperative care were older (73 years [interquartile range: 69-77]FPC vs 72 years [interquartile range: 68-77]non-FPC) and had a higher Charlson comorbidity score (4 [interquartile range: 2-8]FPC vs 3 [interquartile range: 2-8]non-FPC) (both P < .001). Median overall social vulnerability index was higher among patients who experienced fragmentation of postoperative care (52.5 [interquartile range: 29.3-70.4]FPC vs 51.3 [interquartile range: 27.9-69.4]non-FPC, P = .02). On multivariable analysis, the odds of experiencing fragmentation of postoperative care was higher with increasing overall social vulnerability index (odds ratio: 1.14; 95% confidence interval 1.01-1.30). Additionally, the odds of experiencing fragmentation of postoperative care were higher among patients with high vulnerability owing to their socioeconomic status (odds ratio: 1.28; 95% confidence interval 1.12-1.45) or their household composition and disability (odds ratio: 1.35; 95% confidence interval 1.19-1.54), whereas high vulnerability owing to minority status and language was inversely associated with fragmentation of postoperative care (odds ratio: 0.73; 95% confidence interval 0.64-0.84). CONCLUSION Social vulnerability was strongly associated with the odds of experiencing fragmented postoperative care after hepatopancreatic surgery.
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Lee D, Kim Y, Devine B. Spillover Effects of Mental Health Disorders on Family Members' Health-Related Quality of Life: Evidence from a US Sample. Med Decis Making 2021; 42:80-93. [PMID: 34378438 DOI: 10.1177/0272989x211027146] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aims to characterize the spillover effects of selected mental health disorders (episodic mood disorder (EMD), anxiety, substance use disorder (SUD), schizophrenia, attention-deficit/hyperactivity disorder (ADHD), and dementia) on family members' health-related quality of life and to compare the magnitude of spillover effects across these types. METHODS Using the 2000-2015 Medical Expenditure Panel Survey, households having individuals with mental health disorders were identified. The SF-12 and EQ-5D surveys were used to acquire utility and health status scores for household members. The outcomes in households including an individual with a mental health disorder were compared to those of the control group (absence of individuals with mental health disorders in the household). We also compared a total of 15 pairs of diseases based on the SF-6D scores. A beta generalized estimating equation model was employed. RESULTS Average scores of utility and health status among individuals living with a member with a mental health disorder in the household were statistically lower than those of the control group and; for the SF-6D, met the minimally important difference for SUD, schizophrenia, and dementia. Differences in the SF-6D scores were statistically significant for 5 pairs of the mental health disorders: EMD-anxiety, EMD-ADHD, dementia-anxiety, dementia-ADHD, and schizophrenia-ADHD. CONCLUSIONS This study provides evidence of family spillover effects in mental illness using both utility and health status measures from a US representative sample. Integrating this evidence into clinical and policy decision making as well as economic evaluations would allow for a more comprehensive valuation of the societal benefits of mental and behavioral health interventions.
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Affiliation(s)
- Donghoon Lee
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Yeonil Kim
- Merck Research Laboratories, Merck & Co Inc, Rahway, NJ, USA
| | - Beth Devine
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
- The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, WA, USA
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Brijnath B, Gartoulla P, Joosten M, Feldman P, Temple J, Dow B. A 7-year trend analysis of the types, characteristics, risk factors, and outcomes of elder abuse in community settings. J Elder Abuse Negl 2021; 33:270-287. [PMID: 34278978 DOI: 10.1080/08946566.2021.1954574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Bianca Brijnath
- National Ageing Research Institute, Melbourne, Australia.,School of Allied Health, Curtin University, Perth, Australia
| | - Pragya Gartoulla
- Division of Social Gerontology, National Ageing Research Institute, Melbourne, Australia
| | - Melanie Joosten
- Seniors Rights Victoria at Council of the Ageing Victoria, Melbourne, Australia
| | - Peter Feldman
- Division of Social Gerontology, National Ageing Research Institute, Melbourne, Australia
| | - Jeromey Temple
- ARC Centre of Excellence in Population Ageing Research, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Briony Dow
- National Ageing Research Institute, School of Population and Global Health, The University of Melbourne, School of Nursing and Midwifery, Deakin University, Melbourne, Australia
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Miranda R, Meeks KAC, Snijder MB, van den Born BJ, Fransen MP, Peters RJ, Stronks K, Agyemang C. Health literacy and hypertension outcomes in a multi-ethnic population: the HELIUS study. Eur J Public Health 2021; 30:545-550. [PMID: 31578555 DOI: 10.1093/eurpub/ckz174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hypertension disproportionately affects ethnic minority groups. Although health literacy may play role in these ethnic inequalities, little is known about the extent to which health literacy affects hypertension prevalence, awareness, treatment and control in different ethnic groups. Therefore, we assessed these associations in a multi-ethnic population. METHODS Baseline data from the HELIUS study were used including participants of Dutch (n = 1948), South-Asian Surinamese (n = 2054) and African Surinamese (n = 1932) origin aged 18-70 years, who lived in Amsterdam, the Netherlands, were fluent in Dutch and underwent health literacy assessment through the Rapid Estimate of Adult Literacy in Medicine-Dutch (REALM-D). The REALM-D was categorized either as low (<60 sumscore) or adequate (≥60 sumscore) health literacy. Participants completed questionnaires and underwent physical examination. RESULTS After adjusting for confounding variables, Dutch [odds ratio (OR) 2.02; 95% confidence interval (CI), 1.11-3.64] and African Surinamese (OR 1.36; 1.03-1.79) with low health literacy were more likely than those with adequate health literacy to have hypertension, whereas in South-Asian Surinamese this association was not significant. No significant associations were found between health literacy and hypertension awareness, treatment and control in any of the ethnic groups. CONCLUSION Findings indicate that health literacy is associated with hypertension prevalence in selected ethnic groups, but not with hypertension awareness, treatment and control. Targeting health literacy might be an entry point for tackling ethnic inequalities in hypertension prevalence. To substantially reduce these inequalities, further research is needed to explore other factors and pathways through which health literacy may impact hypertension outcomes in different ethnic groups.
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Affiliation(s)
- R Miranda
- Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - K A C Meeks
- Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.,Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - M B Snijder
- Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam Public Health research institute, University of Amsterdam, Amsterdam, the Netherlands
| | - B J van den Born
- Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.,Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M P Fransen
- Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - R J Peters
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - K Stronks
- Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - C Agyemang
- Department of Public Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
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Beutel ME, Brähler E, Ernst M, Klein E, Reiner I, Wiltink J, Michal M, Wild PS, Schulz A, Münzel T, Hahad O, König J, Lackner KJ, Pfeiffer N, Tibubos AN. Noise annoyance predicts symptoms of depression, anxiety and sleep disturbance 5 years later. Findings from the Gutenberg Health Study. Eur J Public Health 2021; 30:516-521. [PMID: 32034913 DOI: 10.1093/eurpub/ckaa015] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cross-sectional studies have shown that noise annoyance is strongly associated with mental distress, however, its long-term effects on mental health is unknown. We therefore investigated whether noise annoyance predicts depression, anxiety and sleep disturbance in a large, representative sample 5 years later. METHODS We investigated longitudinal data of N = 11 905 participants of the Gutenberg Health Study, a population-based, prospective, single-centre cohort study in mid-Germany (age at baseline 35-74 years). Noise annoyance was assessed at baseline and 5-year follow-up (sources: road traffic, aircraft, railways, industrial, neighbourhood indoor and outdoor noise; and day vs. nighttime). Depression, anxiety and sleep disturbance were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-2. Participants suffering from depression, anxiety or sleep disturbance at baseline were excluded from the respective multivariate analyses of new onset at follow-up. RESULTS General noise annoyance remained stable. Daytime noise annoyance predicted new onset of depressive, anxiety symptoms (also nighttime annoyance) and sleep disturbance (beyond respective baseline scores). Additional predictors were female sex, lower age and low socioeconomic status (SES). Regarding specific sources, daytime baseline aircraft annoyance predicted depression and anxiety. Sleep disturbance was most consistently predicted by neighbourhood annoyance (baseline and follow-up) and follow-up annoyance by aircraft (night) and road traffic (day and night). CONCLUSIONS We identified current and past noise annoyances as risk factors for mental distress and sleep disturbance. Furthermore, women, younger adults and those with lower SES are particularly susceptible to noise annoyance. Our results indicate the need to provide regulatory measures in affected areas to prevent mental health problems.
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Affiliation(s)
- Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Eva Klein
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Iris Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,DZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany
| | - Philipp S Wild
- DZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany.,Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- DZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany.,Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Omar Hahad
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jochem König
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ana N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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15
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Lodhi FS, Rabbani U, Khan AA, Raza O, Holakouie-Naieni K, Yaseri M, Farooq U, Montazeri A. Factors associated with quality of life among joint and nuclear families: a population-based study. BMC Public Health 2021; 21:234. [PMID: 33509153 PMCID: PMC7845136 DOI: 10.1186/s12889-021-10265-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/19/2021] [Indexed: 11/11/2022] Open
Abstract
Background Advantages and disadvantages associated with joint and nuclear family systems can affect quality of life (QOL). However, there is scarcity of literature about QOL among joint and nuclear family systems. This study aimed to assess the factors associated with QOL in joint and nuclear family systems. Methods We conducted a population based cross sectional study in all 52 Union Councils (UCs) of District Abbottabad, Khyber Pakhtunkhwa province, Pakistan from March 2015 to August 2015. Multistage cluster sampling technique was used to select participants from both nuclear and joint family houses. The validated Urdu version of World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF) was used to assess quality of life among participants. Univariate and multivariate analyses were performed to explore the associations of different socio demographic variables with QOL among both family systems. Also a multilevel linear regression using backward analysis to obtain final model for each domain was performed to find out the variables that are associated with QOL score in each of family systems. Results A total of 2063 participants were included in this study (51.0% joint family, 49.0% nuclear family) with the response rate of 97.4%. In multiple linear regression analysis of each domain for joint and nuclear family systems, rural residence compared to urban (p < 0.001), being female (p < 0.001), older age (p < 0.001), having comorbidity (p < 0.001) and lower socioeconomic status (p < 0.001) were found to be a strong predictor of poorer QOL. Furthermore, social capital (p < 0.001) had a positive effect on joint and nuclear family QOL scores. Conclusion This study was the first of its kind which determined the factors of QOL in joint and nuclear families using the validated Urdu version of WHOQOL-BREF in Pakistan. Male gender, urban residence, younger age, higher socioeconomic status and social capital were positive predictors of QOL score while older age and presence of illness were associated with lower QOL scores among both family systems.
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Affiliation(s)
- Fahad Saqib Lodhi
- Department of Community Medicine, Women Medical and Dental College, Abbottabad, Pakistan.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Unaib Rabbani
- Family Medicine Academy, Qassim, Kingdom of Saudi Arabia
| | - Adeel Ahmed Khan
- Saudi Board Program of Preventive Medicine, Ministry of Health, Mecca, Kingdom of Saudi Arabia
| | - Owais Raza
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Kourosh Holakouie-Naieni
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Umer Farooq
- Community Medicine Department, Ayub Medical College, Abbottabad, Pakistan
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. .,Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran.
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16
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Biney E, Amoateng AY, Ewemooje OS. Inequalities in morbidity in South Africa: A family perspective. SSM Popul Health 2020; 12:100653. [PMID: 32939393 PMCID: PMC7476866 DOI: 10.1016/j.ssmph.2020.100653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 11/30/2022] Open
Abstract
South Africa is struggling to achieve sustainable development targets as the country faces a quadruple burden of diseases. Concerted efforts to realise good health for all people require evidence-based targeted interventions. This study aimed to investigate the relationship between living arrangements and self-reported ill-health among adults aged 15 years and older in South Africa. Analyses were based on a sample of 49,962 individuals drawn from the 2017 South African General Household Survey, using a multivariate regression technique to assess the distribution and predictors of ill-health. Composite indices of disease burdens were created using several related morbidities in each disease category. The findings confirm that health outcomes in South Africa vary by living arrangements of individuals, their socioeconomic status, and by the level of urbanisation or residence. It was found that women who are black, younger and less-educated, irrespective of their living arrangement, are particularly vulnerable to illhealth. Policy implications are discussed.
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Affiliation(s)
- Elizabeth Biney
- Population and Health Research Entity, Faculty of Humanities, North-West University (Mafikeng Campus), North West, South Africa
| | - Acheampong Yaw Amoateng
- Population and Health Research Entity, Faculty of Humanities, North-West University (Mafikeng Campus), North West, South Africa
| | - Olusegun Sunday Ewemooje
- Population and Health Research Entity, Faculty of Humanities, North-West University (Mafikeng Campus), North West, South Africa
- Department of Statistics, Federal University of Technology, Akure, Nigeria
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17
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Relationship between household composition and intergenerational post-disaster mental health in two-parent families: Evidence from Japan. J Affect Disord 2020; 270:22-29. [PMID: 32275216 DOI: 10.1016/j.jad.2020.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/13/2020] [Accepted: 03/20/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Previous literature has neglected the effect of household composition on mental health, especially in the context of post-disaster recovery. METHODS Open access data from the 2015 Social Survey on Living and Disaster Recovery (SSLDR) in Japan are used. A total of 689 respondents (346 from Fukushima and 343 from Sendai) made up of people living in two-parent families are examined in the current study. Pearson's Chi-square Test and ANOVA are applied to assess the differences between four groups: Fukushima parent generation, Fukushima child generation, Sendai parent generation, and Sendai child generation. The method of multiple linear regression is used to explore the association factors of intergenerational mental health in two city sites, respectively. RESULTS Fukushima child generation tended to have the worst mental health status. In two city sites, the child generation tended to have a less degree of neighborhood connectedness than those in the parent generation. Variables of household composition, daily worries, and gender have significant associations with mental health in either two cities or one of them. LIMITATIONS The 2015 SSLDR datasets were collected by means of investigation through a series of questionnaires. Errors may exist if the respondents did not honestly or fully report their household composition. And there is some complexity in some attempted analysis models that is not fully included in the imputation model. CONCLUSION Household composition has significant association with intergenerational mental health in the context of post-disaster recovery. Our results highlight the need to look for appropriate and targeted supporting mechanisms.
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18
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Ge Z, Li L, Lohfeld L, Lu C, Congdon N, Lin S, Deng Y, Lan Y, Zhang S, Hou L, Zhou W, Cui L, Qu J, Liang Y. Validity and feasibility of a self-administered home vision examination in Yueqing, China: a cross-sectional study. BMJ Open 2020; 10:e030956. [PMID: 32303511 PMCID: PMC7199938 DOI: 10.1136/bmjopen-2019-030956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the validity and feasibility of a self-administered home vision examination programme in China. DESIGN Cross-sectional study. SETTING Yueqing, China. PARTICIPANTS A two-stage convenience sampling procedure was used to randomly select 600 households from 30 communities participating in the Yueqing Eye Study (YES). The aim of YES is to encourage home-based vision screening, reporting of visual acuity (VA) annually through social media and encouraging people to attend follow-up clinic appointments as a way to improve eye care access for adults with VA ≤+0.5 log of the minimum angle of resolution (logMAR). INTERVENTIONS Household screeners (one per household) who tested other family members' VA completed a questionnaire on family structure, demographic information and knowledge about screening procedures. Other family members then underwent confirmatory VA testing by researchers. OUTCOME MEASURES The completion rate of home-based VA screening, its sensitivity and specificity were used to evaluate validity. Factors that determined whether families participated in the self-VA screening were used to evaluate feasibility. RESULTS 345 (66%) of the 523 (87.2%) households with valid data form their home-based vision examinations also were retested by researchers. There was no statistically significant difference in scores on the family-administerd or researcher-administerd VA test (VA≤+0.5 logMAR, p=0.607; VA >+0.5 logMAR, p=0.612). The sensitivity and specificity of home-based vision screening were 80.5% (95% CI 70.2% to 86.9%) and 95.1% (95% CI 92.6% to 96.8%), respectively. 14.7% (77/523) of tested respondents had VA ≤+0.5 logMAR. Predictors of performing home screening for VA remaining in regression models included higher economic status ('fair and above' vs 'poor': OR 1.74; 95% CI 1.08 to 2.76; p=0.022), age (<45 years vs ≥45 years: OR 0.46; 95% CI 0.25 to 0.85; p=0.014) and living in a nuclear (OR 5.17; 95% CI 2.86 to 9.36; p<0.001) or extended family (OR 8.37; 95% CI 4.93 to 14.20; p<0.001). CONCLUSION Self-administered home vision screening is reliable and highly accepted by Chinese adults.
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Affiliation(s)
- Zhengyan Ge
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Linshan Li
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Lynne Lohfeld
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Centre for Public Health, Queen's University Belfast, Belfast, Belfast, UK
| | - Chunjie Lu
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, Belfast, UK
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Sigeng Lin
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Yuxuan Deng
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Yuan Lan
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Shaodan Zhang
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Laurence Hou
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Weihe Zhou
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Lele Cui
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jia Qu
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Yuanbo Liang
- The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
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Lodhi FS, Montazeri A, Nedjat S, Mahmoodi M, Farooq U, Yaseri M, Kasaeian A, Holakouie-Naieni K. Assessing the quality of life among Pakistani general population and their associated factors by using the World Health Organization's quality of life instrument (WHOQOL-BREF): a population based cross-sectional study. Health Qual Life Outcomes 2019; 17:9. [PMID: 30642360 PMCID: PMC6332637 DOI: 10.1186/s12955-018-1065-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 12/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measuring quality of life (QOL) in a population is important for the predictions of health and social care needs. In Pakistan, health related quality of life data exist but there are no quality of life data of general population. In this study, quality of life was assessed among the Pakistani general population and their associated factors by using the World Health Organization's quality of life instrument (WHOQOL-BREF). METHODOLOGY A population-based cross-sectional study was carried out in all 52 Union Councils of District Abbottabad, Khaber Pkutunkhua province, Pakistan from March 2015 to August 2015. Multi-stage cluster sampling technique was employed in this study. Quality of life was measured by using the validated WHOQOL-BREF instrument, along with socioeconomic, demographic, and World Bank social capital questions in this population- based study. The data were collected through households, utilizing face to face interviews. The association between socio-demographic variables and quality of life domains were determined by using both univariate and multivariate analysis. Descriptive statistics were derived, and a multilevel linear regression using backward analysis allowing to obtain final model for each domain was achieved to recognize the variables that affect quality of life score. RESULTS A total of 2063 participants were included in this study (51.2% male, 48.2% female). Mean age of participants was 37.9, SD = 13.2; ranging from 18 to 90. Mean score of quality of life domains (physical, psychological, social relationship and environmental domains) were 65.0 (SD = 15.2), 67.4 (SD = 15.0), 72.0 (SD = 16.5), 55.5 (SD = 15.0), respectively. Overall, socioeconomic status was established to be the strongest predictor of poorer quality of life for all domains as a change in SES from high to low results in reduction about (β = - 5.85, β = - 9.03, β = - 8.33, β = - 9.98, p < 0.001). Similarly, type of residency was negatively associated with physical, psychological and environmental domains while age and sex were negatively associated with physical, psychological and relationship domains in final model. Furthermore social capital (β = 0.09, β = 0.13, β =0.14, β =0.15, p < 0.001) had a positive effect on Pakistani quality of life. Overall, subjective quality of life was found to be low in our population and extremely varied by socio-demographic variables. CONCLUSIONS Increasing age, having average and lower socioeconomic status and living in the rural area were found to be the strong predictor of poorer quality of life in all domains, while total social capital score had a positive effect on Pakistani quality of life scores.
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Affiliation(s)
- Fahad Saqib Lodhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Academic Center for Education, Culture and Research, Institute for health Sciences Research, Tehran, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Mahmoodi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Umer Farooq
- Community Medicine Department, Ayub Medical College, Abbottabad, Pakistan
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kourosh Holakouie-Naieni
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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20
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Moncatar TJR, Nakamura K, Rahman M, Seino K. Health Status and Health Facility Utilization of Community-Dwelling Elderly Living Alone in the Philippines: A Nationwide Cross-Sectional Study. Health (London) 2019. [DOI: 10.4236/health.2019.1111117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Permyakova NV, Billingsley S. Men's health and co-residence with older generations in Russia: better or worse? J Epidemiol Community Health 2017; 72:179-184. [PMID: 29263180 PMCID: PMC5868530 DOI: 10.1136/jech-2017-209896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/06/2017] [Accepted: 11/26/2017] [Indexed: 12/05/2022]
Abstract
Background Previous studies show contradictory findings on the relationship between health and intergenerational living arrangements (ILAs), which may be due to variation in who selects themselves into and out of ILA. Addressing the selectivity into ILA and the health of the older generation, we assess whether there is a health-protective or health-damaging effect of ILA. We locate our study in the Russian context, where ILA is prevalent and men’s health has become a public health issue. Methods We apply a fixed-effects logistic regression to self-rated health status of 11 546 men aged 25 years or older who participated in at least two waves in the Russian Longitudinal Monitoring Survey from 1994 to 2015. To further isolate the health effect of ILA, we observe only associations after transitioning into or out of ILA. Results A transition into co-residence with an unhealthy older generation increases men’s odds of reporting poor health (OR=0.64, CI 0.44 to 0.93). A transition out of co-residence with a healthy older generation decreases men’s odds of reporting fine health by 63% (OR=0.37, CI 0.28 to 0.50), whereas continuing to live with an unhealthy older generation decreases the odds by half (OR=0.49, CI 0.38 to 0.63). Conclusions We reveal a health interlinkage between co-residing generations by finding a detrimental health effect of co-residence with an unhealthy older generation. No longer living with an older generation who was in fine health also negatively affects men’s health. Future studies should address heterogeneity related to the health of older generations, unobserved time-constant characteristics of younger generations and selectivity into/out of ILA.
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Lu C, Yuan L, Lin W, Zhou Y, Pan S. Depression and resilience mediates the effect of family function on quality of life of the elderly. Arch Gerontol Geriatr 2017; 71:34-42. [DOI: 10.1016/j.archger.2017.02.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 02/07/2017] [Accepted: 02/21/2017] [Indexed: 01/09/2023]
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23
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Pereira MG, Ponte M, Ferreira G, Machado JC. Quality of life in patients with skin tumors: the mediator role of body image and social support. Psychooncology 2016; 26:815-821. [DOI: 10.1002/pon.4236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 07/24/2016] [Accepted: 07/26/2016] [Indexed: 11/11/2022]
Affiliation(s)
| | - Mafalda Ponte
- School of Psychology; University of Minho; Braga Portugal
| | | | - José C. Machado
- Institute of Social Sciences; University of Minho; Braga Portugal
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Ali S, Malik JA. Consistency of prediction across generation: explaining quality of life by family functioning and health-promoting behaviors. Qual Life Res 2015; 24:2105-12. [PMID: 25724696 DOI: 10.1007/s11136-015-0942-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE The study aimed to investigate the consistency of relationship between family functioning, health-promoting behaviors, and quality of life across generations in joint families. METHOD The sample comprises of 79 joint families (N = 316 members, n = 79 grandparents (grandfathers = 27, grandmothers = 52) n = 158 parents (fathers = 79, mothers = 79), and n = 79 grandchildren (girls = 61, boys = 18)). Data were collected on Self-Report Family Inventory, SFI, Health-Promoting Lifestyle Profile II, HPLP-II, and World Health Organization Quality of Life Scale BREF WHO QOL BREF. All three variables, i.e., family functioning, health-promoting behaviors, and quality of life, were modeled as latent variables. Analyses were conducted separately for each group. RESULTS Results showed that in grandparents, family functioning predicted (β = .44, p < .01,) health-promoting behaviors (R (2) = .20), which in turn predicted (β = .26, p < .05) quality of life (R (2) = .85). Family functioning appears to have significant indirect effects (β = .34, p < .01) through health-promoting behaviors on quality of life. The model fit indices showed a good fit (IFI = .917, CFI = .910, RMSEA = .078) of the model of the data. For all other groups, i.e., fathers, mothers, and grandchildren, family functioning and health-promoting behaviors independently predicted quality of life (R (2) = .55, .67, and .54, respectively). CONCLUSION Our results showed that family functioning and health-promoting behaviors are consistent predictors of quality of life across generations.
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Affiliation(s)
- Sehrish Ali
- Center of Excellence, National Institute of Psychology, Quaid-i-Azam University, Room No. 142, Islamabad, Pakistan,
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Abstract
This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.
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Affiliation(s)
- Elisabete Alves
- Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Susana Silva
- Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | | | - Henrique Barros
- Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Roncon J, Lima S, Pereira MDG. Qualidade de Vida, Morbilidade Psicológica e StressFamiliar em Idosos Residentes na Comunidade. PSICOLOGIA: TEORIA E PESQUISA 2015. [DOI: 10.1590/0102-37722015011637087096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo procurou investigar as relações existentes entre morbilidade psicológica, stress familiar e qualidade de vida (QV) da pessoa idosa. A amostra foi constituída por 126 idosos. Os instrumentos utilizados foram: The Lawton Instrumental Activities of Daily Living (IADL), Quality of Life (WHOQOL-Bref), Geriatric Anxiety Inventory (GSI), Geriatric Depression Scale (GDS); e Index of Family Relations (IFR). Os resultados revelaram a importância da idade, estado civil, escolaridade e número de patologias assim como o género na capacidade funcional, morbilidade, stress familiar e QV. Ao nível dos preditores, a depressão foi a variável que mais contribuiu para a QV. Não foram encontradas variáveis moderadoras no modelo. A discussão e implicações dos resultados são abordadas bem como a intervenção psicológica nesta população.
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Kibusi SM, Ohnishi M, Outwater A, Seino K, Kizuki M, Takano T. Sociocultural factors that reduce risks of homicide in Dar es Salaam: a case control study. Inj Prev 2013; 19:320-5. [PMID: 23322260 PMCID: PMC3786652 DOI: 10.1136/injuryprev-2012-040492] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 11/09/2012] [Accepted: 11/27/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study was performed to examine the potential contributions of sociocultural activities to reduce risks of death by homicide. METHODS This study was designed as a case control study. Relatives of 90 adult homicide victims in Dar es Salaam Region, Tanzania, in 2005 were interviewed. As controls, 211 participants matched for sex and 5-year age group were randomly selected from the same region and interviewed regarding the same contents. RESULTS Bivariate analysis revealed significant differences between victims and controls regarding educational status, occupation, family structure, frequent heavy drinking, hard drug use and religious attendance. Conditional logistic regression analysis indicated that the following factors were significantly related to not becoming victims of homicide: being in employment (unskilled labour: OR=0.04, skilled labour: OR=0.07, others: OR=0.04), higher educational status (OR=0.02), residence in Dar es Salaam after becoming an adult (compared with those who have resided in Dar es Salaam since birth: OR=3.95), living with another person (OR=0.07), not drinking alcohol frequently (OR=0.15) and frequent religious service attendance (OR=0.12). CONCLUSIONS Frequent religious service attendance, living in the same place for a long time and living with another person were shown to be factors that contribute to preventing death by homicide, regardless of place of residence and neighbourhood environment. Existing non-structural community resources and social cohesive networks strengthen individual and community resilience against violence.
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Affiliation(s)
- Stephen Matthew Kibusi
- Health Promotion Section, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mayumi Ohnishi
- Department of Nursing, School of Health Sciences, Nagasaki University, Nagasaki, Japan
| | - Anne Outwater
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Kaoruko Seino
- International Health Section, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
| | - Masashi Kizuki
- Health Promotion Section, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
| | - Takehito Takano
- Health Promotion Section, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
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A Scientific Assessment of Sociodemographic Factors, Physical Activity Level, and Nutritional Knowledge as Determinants of Dietary Quality among Indo-Mauritian Women. J Nutr Metab 2013; 2013:572132. [PMID: 23762543 PMCID: PMC3677610 DOI: 10.1155/2013/572132] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 05/10/2013] [Accepted: 05/10/2013] [Indexed: 11/17/2022] Open
Abstract
A healthy diet is of particular concern throughout the life of women to avoid many chronic illnesses especially during their 30s to 50s. There are published data on dietary quality and its determinants among women, but there is a lack of similar data regarding women in Mauritius. This study aimed to investigate the association between age and dietary quality in relation to sociodemographic factors, physical activity level (PAL) and nutritional knowledge (NK). A survey-based study was conducted in 2012 among Indo-Mauritian women including 117 young (21.35 ± 1.98), 160 reaching middle age (34.02 ± 5.09) and 50 middle-aged (37.85 ± 8.32). Validated questionnaires were used to elicit information on the determinants. A food frequency table consisting of 18 food items was used to assess dietary quality. Univariate and multivariate analyses were used to determine the association between various factors and dietary quality. The mean dietary score of middle-aged women (18.70 ± 2.67) was closer to recommended dietary guidelines compared to young women (17.22 ± 3.40), and women reaching middle age (17.55 ± 3.29). Educational level, PAL, NK, and age were main determinants of dietary quality among Indo-Mauritian women (P < 0.05). Younger women with low educational level, PAL, and NK are at risk of poor dietary quality.
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Melchiorre MG, Chiatti C, Lamura G, Torres-Gonzales F, Stankunas M, Lindert J, Ioannidi-Kapolou E, Barros H, Macassa G, Soares JFJ. Social support, socio-economic status, health and abuse among older people in seven European countries. PLoS One 2013; 8:e54856. [PMID: 23382989 PMCID: PMC3559777 DOI: 10.1371/journal.pone.0054856] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 12/17/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Social support has a strong impact on individuals, not least on older individuals with health problems. A lack of support network and poor family or social relations may be crucial in later life, and represent risk factors for elder abuse. This study focused on the associations between social support, demographics/socio-economics, health variables and elder mistreatment. METHODS The cross-sectional data was collected by means of interviews or interviews/self-response during January-July 2009, among a sample of 4,467 not demented individuals aged 60-84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden). RESULTS Multivariate analyses showed that women and persons living in large households and with a spouse/partner or other persons were more likely to experience high levels of social support. Moreover, frequent use of health care services and low scores on depression or discomfort due to physical complaints were indicators of high social support. Low levels of social support were related to older age and abuse, particularly psychological abuse. CONCLUSIONS High levels of social support may represent a protective factor in reducing both the vulnerability of older people and risk of elder mistreatment. On the basis of these results, policy makers, clinicians and researchers could act by developing intervention programmes that facilitate friendships and social activities in old age.
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Affiliation(s)
- Maria Gabriella Melchiorre
- Centre of Socio-Economic Research on Ageing, Italian National Institute of Health and Science on Aging, I.N.R.C.A., Ancona, Italy.
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Abstract
Abstract
Scholars traditionally argued that industrialization, urbanization, and educational expansion lead to a decline in extended families and complementary rise in nuclear families. Some have suggested that such transitions are good for young married women because living in nuclear families benefits their health. However, extended families may also present advantages for young women’s health that outweigh any disadvantages. Using the Indian National Family Health Survey, this article examines whether young married women living in nuclear families have better health than those in patrilocal extended families. It also examines whether young married women’s living arrangements are changing over time and, if so, how such changes will affect their health. Results show that young married women living in nuclear families do not have better health than those in patrilocal extended families. Of eight health outcomes examined, only five differ significantly by family structure. Further, of the five outcomes that differ, four are patrilocal extended-family advantages and only one is a nuclear-family advantage. From 1992 to 2006, the percentage of young married women residing in nuclear families increased, although the majority remained in patrilocal extended families. This trend toward nuclear families will not benefit young women’s health.
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Affiliation(s)
- Keera Allendorf
- Department of Sociology, University of Illinois at Urbana-Champaign, 702 S. Wright St., Urbana, IL 61801, USA
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Li CY, Han HR, Kim J, Kim MT. Factors related to risk of cardiovascular disease among older korean chinese with hypertension. Asian Nurs Res (Korean Soc Nurs Sci) 2011; 5:164-9. [PMID: 25030365 DOI: 10.1016/j.anr.2011.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 08/24/2011] [Accepted: 08/29/2011] [Indexed: 10/17/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the prevalence of cardiovascular disease (CVD) risk factors among older Korean Chinese with hypertension-one of the most underserved and understudied ethnic minority groups in China. In addition, factors underlying the risk of CVD were examined. METHODS A total of 334 participants were recruited at the Community Health Service Center in Yanji, China. Data regarding socioeconomic, health-related, psychosocial, and other CVD risk factors were collected between June and October 2009. In this cross-sectional study, factors related to the risk of CVD were assessed by multivariate logistic regression; the Framingham Risk Score was used to measure the risk of CVD. RESULTS The prevalence of dyslipidemia, diabetes, and current smoking were 75.4%, 6.6%, and 23.1% respectively. Participants who lived alone were twice as likely to have a high risk of CVD (10-year risk of CVD ≥15%; odds ratio [OR], 2.00; 95% confidence interval [CI], 1.13-3.54). Those with a higher education level and greater knowledge about hypertension were at 57% and 62% reduced risk for CVD (OR, 0.43; 95% CI, 0.21-0.92 and OR, 0.38; 95% CI, 0.15-0.95, respectively). CONCLUSION Future intervention should include strategies to addressing social isolation and also focus on older Korean Chinese with low education. Knowledge enhancement program is warranted for the prevention of CVD in this population.
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Affiliation(s)
- Chun Yu Li
- School of Nursing, Yanbian University, Yanbian, China
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, USA
| | - Jiyun Kim
- Department of Nursing, Kyungwon University, Seongnam, Korea
| | - Miyong T Kim
- School of Nursing, Johns Hopkins University, Baltimore, USA
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Muhamadi L, Tumwesigye NM, Kadobera D, Marrone G, Wabwire-Mangen F, Pariyo G, Peterson S, Ekström AM. Lack of pre-antiretroviral care and competition from traditional healers, crucial risk factors for very late initiation of antiretroviral therapy for HIV--a case-control study from eastern Uganda. Pan Afr Med J 2011; 8:40. [PMID: 22121448 PMCID: PMC3201604 DOI: 10.4314/pamj.v8i1.71155] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 04/03/2011] [Indexed: 12/02/2022] Open
Abstract
Background Although WHO recommends starting antiretroviral treatment at a CD4 count of 350 cells/[µ]L, many Ugandan districts still struggle with large proportions of clients initiating ART very late at CD4 < 50 cells/[µ]L. This study seeks to establish crucial risk factors for very late ART initiation in eastern Uganda. Methods All adult HIV-infected clients on ART in Iganga who enrolled between 2005 and 2009 were eligible for this case-control study. Clients who started ART at CD4 cell count of < 50 cells/[µ]L (very late initiators) were classified as cases and 50-200 cells/[µ]L (late initiators) as control subjects. A total of 152 cases and 202 controls were interviewed. Multivariate analyses were performed to calculate adjusted odds ratios and 95% confidence intervals. Results Reported health system-related factors associated with very late ART initiation were stock-outs of antiretroviral drugs stock-outs (affecting 70% of the cases and none of the controls), competition from traditional/spiritual healers (AOR 7.8, 95 CI% 3.7-16.4), and lack of pre-ARV care (AOR 4.6, 95% CI: 2.3-9.3). Men were 60% more likely and subsistence farmers six times more likely (AOR 6.3, 95% CI: 3.1-13.0) to initiate ART very late. Lack of family support tripled the risk of initiating ART very late (AOR 3.3, 95% CI: 1.6-6.6). Conclusion Policy makers should prevent ARV stock-outs though effective ARV procurement and supply chain management. New HIV clients should seek pre-ARV care for routine monitoring and determination of ART eligibility. ART services should be more affordable, accessible and user-friendly to make them more attractive than traditional healers
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Affiliation(s)
- Lubega Muhamadi
- District Health Office, Iganga District Administration, PO Box 358, Iganga, Uganda
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Living alone is associated with an increased risk of type 2 diabetes mellitus in men but not women from the general population: the MONICA/KORA Augsburg Cohort Study. Psychosom Med 2009; 71:784-8. [PMID: 19592514 DOI: 10.1097/psy.0b013e3181ae5770] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine sex-specific associations between living alone and incident Type 2 diabetes mellitus in a representative population sample in Germany. METHODS The study was based on 4424 men and 4380 women (aged 35-74 years) who participated in one of the three Monitoring trends and determinants on cardiovascular diseases Augsburg surveys between 1984 and 1995 and who were free of diabetes at baseline. Sex-specific hazard ratios (HRs) were estimated from Cox proportional hazard models. RESULTS A total of 402 cases of incident Type 2 diabetes among men and 271 among women were registered during the mean follow-up period of 10.9 years. Living alone was significantly associated with incident Type 2 diabetes in men but not in women. After adjustment for age, survey, parental history of diabetes, hypertension, dyslipidemia, smoking, physical activity, alcohol intake, and body mass index, the risk of developing diabetes for those who lived alone at baseline compared with those who did not live alone was 1.69 (95% confidence interval (CI), 1.19-2.37) in men and 0.85 (95% CI, 0.57-1.24) in women; the p value for the sex interaction was .006 in this model. Inclusion of education and depressed mood in the models in addition to other risk factors had no impact on the observed HRs in women and even increased the risk in men (women: HR, 0.83; 95% CI, 0.52-1.32; men: HR, 1.89; 95% CI, 1.33-2.70). CONCLUSIONS Living alone is an independent predictor of Type 2 diabetes in men but not in women from the general population.
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