1
|
Sheikhattari P, Barsha RAA, Apata J, Assari S. Race by Education Intersectional Differences in Exposure to Tobacco Advertisement in Baltimore City. J Lung Health Dis 2023; 7:9-17. [PMID: 38264144 PMCID: PMC10805540 DOI: 10.29245/2689-999x/2023/2.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Objective This study aimed to examine the intersectional effects of race and educational attainment on tobacco advertising exposure among adults in Baltimore, given the growing evidence on differential influence of education for Black and White populations. Methods A survey was conducted in Baltimore, collecting data on educational attainment, demographics, and tobacco advertising exposure among adults (n = 3028, 22.7% 18 - 29, 17.9% 30 - 39, 23.4% 40 - 49, 20.9% 50-59, and 11.1% 60+ years old). The sample included both Black and White adult individuals. Logistic regression analyses were employed to assess the association between educational attainment and tobacco advertising exposure, without and with interaction with race, adjusting for relevant covariates such as age, gender, and employment. Sensitivity analysis also controlled for smoking status. Results The study results indicated that while high educational attainment is associated with less exposure to tobacco ads, highly educated Black adults report significantly higher tobacco advertising exposure compared to highly educated White adults. Same results were observed after controlling for smoking status. Conclusion Educational attainment may not exhibit a large protective effect against environmental risks such as tobacco ad exposure for Black populations, possibly because of segregation and racism that hinder highly educated Black people ability to move to low-risk neighborhoods.
Collapse
Affiliation(s)
- Payam Sheikhattari
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
- The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA
| | - Rifath Ara Alam Barsha
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
| | - Jummai Apata
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA
| | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| |
Collapse
|
2
|
Caldas ADR, Nobre AA, Brickley E, Alexander N, Werneck GL, Farias YN, Garcia Barreto Ferrão CT, Tavares FG, Pantoja LDN, Duarte MCDL, Cardoso AM. How, what, and why: housing, water & sanitation and wealth patterns in a cross-sectional study of the Guarani Birth Cohort, the first Indigenous birth cohort in Brazil. Lancet Reg Health Am 2023; 21:100496. [PMID: 37214221 PMCID: PMC10193232 DOI: 10.1016/j.lana.2023.100496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/23/2023] [Accepted: 04/12/2023] [Indexed: 05/24/2023]
Abstract
Background Despite the importance of social determinants of health, studies on the effects of socioeconomic, sanitary, and housing conditions on Indigenous child health are scarce worldwide. This study aims to identify patterns in housing, water & sanitation, and wealth (HSW) in the first Indigenous birth cohort in Brazil-The Guarani Birth Cohort. Methods Cross-sectional study using baseline data from The Guarani Birth Cohort. We used Multiple Correspondence Analysis and Cluster Analysis. The clusters identified were ordered in increasing degrees of access to public policies and wealth, defining the patterns of HSW. Finally, we explored the association between the patterns and one of the health outcomes, hospitalization, in the birth cohort. Findings Three patterns were identified for housing and water & sanitation, and four for wealth status, resulting in 36 combinations of patterns (3 × 3 × 4). More than 62% of children in the cohort were found with the lowest wealth patterns. The distribution of children across patterns in one dimension was not fully determined by the other two dimensions. Statistically significant associations were found between precarious households and extreme poverty, and hospitalization. Interpretation We observed substantial heterogeneity in the distribution of children across the 36 combinations. These findings highlight that, should the dimensions of HSW be associated with health outcomes, as seen for hospitalization, they should be considered separately in multivariable models, in order to improve the estimation of their independent effects. Funding National Council for Scientific and Technological Development, Brazil (CNPq); Oswaldo Cruz Foundation, Brazil (Fiocruz); Research Foundation of the State of Rio de Janeiro, Brazil (FAPERJ).
Collapse
Affiliation(s)
| | - Aline Araújo Nobre
- Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Elizabeth Brickley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Neal Alexander
- Institute of Studies in Public Health, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Felipe Guimarães Tavares
- Department of Epidemiology and Biostatistics, Institute of Collective Health, Fluminense Federal University, Niterói, RJ, Brazil
| | | | | | | |
Collapse
|
3
|
Heikkilä R, Myklebust TÅ, Møller B. Regional variation in cancer survival in Norway. Cancer Epidemiol 2021; 75:102038. [PMID: 34571393 DOI: 10.1016/j.canep.2021.102038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/10/2021] [Accepted: 09/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cancer services in Norway are intended to provide high quality services and equal access for all citizens. Still, regional variation in cancer survival has been reported. Currently, the public hospitals are organized in Health Trusts (HTs), respectively within one of four regional trusts (RHTs). We aimed to evaluate the extent and rank pattern of regional and intraregional variation in cancer survival systematically over the last three decades. We postulated that organizational reforms during this period might have modulated the variation. METHODS Excess hazard ratios (EHR) of death from cancer were estimated for all individuals identified in The Cancer Registry of Norway as diagnosed with cancer from 1984 to 2018. The model covariates included continuous age at diagnosis, sex, cancer site, stage, 5-year time period of diagnosis and place of residence. In addition to analyses for all cancers combined, selected cohorts with predominantly centralized vs. not centralized primary surgery were evaluated. RESULTS For all cancer sites combined and for the centralized surgery cohort, the range of variation in EHR among the four regions was in the order of 0.10. The ranks among the regions were fairly consistent over time. For the not centralized surgery cohort, the range of inter-regional EHR-variation was in the order of 0.10 - 0.15, with no consistent ranks. Intra-regionally, the ranges of EHR-variation were similar, but with more complex rank patterns. CONCLUSIONS The range of inter- and intra-regional variation in cancer survival was minor, as compared to the general improvement in cancer survival in the period, with no evidence of effect from organizational reforms on regional variation.
Collapse
Affiliation(s)
- Reino Heikkilä
- Department of Oncology, Oslo University Hospital, Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Tor Åge Myklebust
- Department of Registration, Cancer Registry of Noikrway, Box 5313 Majorstuen, 0304 Oslo, Norway; Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway.
| | - Bjørn Møller
- Department of Registration, Cancer Registry of Noikrway, Box 5313 Majorstuen, 0304 Oslo, Norway.
| |
Collapse
|
4
|
Xu J, Wan CS, Ktoris K, Reijnierse EM, Maier AB. Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis. Gerontology 2021; 68:361-376. [PMID: 34315158 DOI: 10.1159/000517099] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sarcopenia can predispose individuals to falls, fractures, hospitalization, and mortality. The prevalence of sarcopenia depends on the population studied and the definition used for the diagnosis. OBJECTIVE This systematic review and meta-analysis aimed to investigate the association between sarcopenia and mortality and if it is dependent on the population and sarcopenia definition. METHODS A systematic search was conducted in MEDLINE, EMBASE, and Cochrane from 1 January 2010 to 6 April 2020 for articles relating to sarcopenia and mortality. Articles were included if they met the following criteria - cohorts with a mean or median age ≥18 years and either of the following sarcopenia definitions: Asian Working Group for Sarcopenia (AWGS and AWGS2019), European Working Group on Sarcopenia in Older People (EWGSOP and EWGSOP2), Foundation for the National Institutes of Health (FNIH), International Working Group for Sarcopenia (IWGS), or Sarcopenia Definition and Outcomes Consortium (SDOC). Hazard ratios (HR) and odds ratios (OR) were pooled separately in meta-analyses using a random-effects model, stratified by population (community-dwelling adults, outpatients, inpatients, and nursing home residents). Subgroup analyses were performed for sarcopenia definition and follow-up period. RESULTS Out of 3,025 articles, 57 articles were included in the systematic review and 56 in the meta-analysis (42,108 participants, mean age of 49.4 ± 11.7 to 86.6 ± 1.0 years, 40.3% females). Overall, sarcopenia was associated with a significantly higher risk of mortality (HR: 2.00 [95% CI: 1.71, 2.34]; OR: 2.35 [95% CI: 1.64, 3.37]), which was independent of population, sarcopenia definition, and follow-up period in subgroup analyses. CONCLUSIONS Sarcopenia is associated with a significantly higher risk of mortality, independent of population and sarcopenia definition, which highlights the need for screening and early diagnosis in all populations.
Collapse
Affiliation(s)
- Jane Xu
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Ching S Wan
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Melbourne, Victoria, Australia
| | - Kiriakos Ktoris
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Singapore
| |
Collapse
|
5
|
Bazargan M, Cobb S, Assari S. End-of-Life Wishes Among Non-Hispanic Black and White Middle-Aged and Older Adults. J Racial Ethn Health Disparities 2020; 8:1168-1177. [PMID: 33078334 PMCID: PMC10173885 DOI: 10.1007/s40615-020-00873-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Although some research has been done on end-of-life (EOL) preferences and wishes, our knowledge of racial differences in the EOL wishes of non-Hispanic White and non-Hispanic Black middle-aged and older adults is limited. Previous studies exploring such racial differences have focused mainly on EOL decision-making as reflected in advance healthcare directives concerning life-sustaining medical treatment. In need of examination are aspects of EOL care that are not decision-based and therefore not normally covered by written advance healthcare directives. This study focuses on racial differences in non-decision-based aspects of EOL care, that is, EOL care that incorporates patients' beliefs, culture, or religion. AIM To test the combined effects of race, socioeconomic status, health status, spirituality, perceived discrimination and medical mistrust on the EOL non-decision-based desires and wishes of a representative sample of non-Hispanic White and non-Hispanic Black older California adults. METHODS This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. To perform data analysis, we used multiple logistic regression models. RESULTS Non-Hispanic Blacks reported more EOL non-decision-based desires and wishes than non-Hispanic Whites. In addition to gender, age, and education other determinants of EOL non-decision-based medical desires and wishes included perceived and objective health status, spirituality, and medical trust. Poverty level, perceived discrimination did not correlate with EOL medical wishes. CONCLUSION Non-Hispanic Blacks desired a closer relationship with their providers as well as a higher level of respect for their cultural beliefs and values from their providers compared with their White counterparts. Awareness, understanding, and respecting the cultural beliefs and values of older non-Hispanic Black patients, that usually are seen by non-Hispanic Black providers, is the first step for meaningful relationship between non-Hispanic Black patients and their providers that directly improve the end-of-life quality of life for this segment of our population.
Collapse
Affiliation(s)
- Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, USA.
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.
| | - Sharon Cobb
- School of Nursing, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, USA
| | - Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, USA
| |
Collapse
|
6
|
Assari S. Differential Association between Actual and Perceived Obesity between African Americans and Whites in the United States. Int J Epidemiol Res 2020; 7:107-114. [PMID: 32999940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND AND AIMS Although actual and perceived obesity are associated, some research has shown that this association may differ across racial and ethnic groups. Accordingly, this cross-sectional study tested racial differences regarding the association between actual and perceived obesity among American adults. METHODS The Health Information National Trends Survey (HINTS 5- Cycle 3) is a representative survey of American adults conducted in 2019. A total number of 3731 adults entered our analysis, including 3054 (81.9%) non-Hispanic Whites and 677 (18.1%) African Americans (AAs). The independent variable was actual obesity, which was defined as a body mass index of 30 or greater. The outcome was perceived as obesity. In addition, age, gender, marital status, education, and income were considered as control variables (confounders), and the race was the focal effect modifier. Finally, logistic regressions without and with interaction terms were utilized to analyze the data. RESULTS Overall, actual and perceived obesity were associated, with obese individuals having higher odds of seeing themselves as obese (odds ratio [OR]=25.82, 95% CI=18.58-35.89, P< 0.001), indicating a weaker link between the two for AAs compared to non-Hispanic Whites. Race-stratified models also confirmed the same pattern with the actual and perceived obesity, showing a weaker association for AAs (OR=15.61, 95% CI=9.53-25.59, P<0.001 in comparison with non-Hispanic Whites (OR=46.23, 95% CI=27.01-709.14, P P<0.001). CONCLUSION AAs compared to non-Hispanic Whites differed in the effect of their actual obesity on their perceived obesity. This may explain the looser association of obesity and depression in AAs as compared to Whites.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA
| |
Collapse
|
7
|
Santos LP, de Oliveira Meller F, Amann VR, Schäfer AA. Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina. BMC Public Health 2020; 20:1390. [PMID: 32917178 PMCID: PMC7488766 DOI: 10.1186/s12889-020-09512-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/06/2020] [Indexed: 02/01/2023] Open
Abstract
Background Despite available information on trends in behavioral factors for Brazil and Argentina, little is known about the association of these trends with mortality. Understanding this association is important to avoid early deaths. Therefore, we aimed to evaluate temporal trends in behavioral risk and protective factors in Brazil and Argentina, and to assess their association with overall and cause-specific mortality rates. Methods Ecological study with data from two population surveys from Brazil and Argentina. Weighted prevalence of tobacco smoking, excessive alcohol consumption, fruit and vegetable consumption and physical activity for the 27 Brazilian state capitals and for the 23 Argentinean provinces were used as behavioral factors. Information on overall mortality as well as cardiovascular diseases and cancer mortality for the year 2015 was collected from national mortality banks of both countries. Estimated prevalence rates were used to describe trends in behavioral factors from 2006 to 2014 in Brazil, and from 2005 to 2013 in Argentina, while Pearson’s correlation and linear regression models were used to assess their association with overall and cause-specific mortality rates. Results Brazil presented improvements in behavioral risk and protective factors: sharp decrease in tobacco smoking prevalence (from 15 to 9%), increase in regular fruit and vegetable consumption (from 28 to 36%), and increase in physical activity (45 to 51%). In Argentina, results were more disappointing: small reduction in tobacco smoking (from 55 to 50%) and decrease in physical activity (from 55 to 45%). In both countries, excessive alcohol consumption remained stable, with increase only among women. The association between behavioral factors and mortality showed that in those Brazilian capitals with higher prevalence of regular consumption of fruits and vegetables, there were lower overall mortality rates. Stratification by gender revealed that significant results were only found among women. Conclusion Prevalence of regular consumption of fruits and vegetables increased in Brazilian capitals and was associated with lower overall mortality rate, suggesting a positive impact of Brazilian policies to improve dietary intake patterns on its population’s mortality. Approaches focusing on behavioral factors are especially needed in Argentina to reach similar results of those seen in Brazil.
Collapse
Affiliation(s)
- Leonardo Pozza Santos
- Nutrition College, Federal University of Pampa, Luiz Joaquim de Sá Britto, s/n,, Itaqui, 97650000, Brazil.
| | | | - Valeria Romina Amann
- Scientific and Training Subcommittee of the Nutritionists College, Province of Misiones, Argentina
| | - Antônio Augusto Schäfer
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Criciúma, Brazil
| |
Collapse
|
8
|
Moreno Mochi P, Vargas JM, Vivaldo S, Bottiglieri M, López C, Mochi S, Cobos M, Castillo M, Del Campo R, Jure MA. Molecular epidemiology of methicillin-resistant Staphylococcus aureus from different population groups in Argentina. J Glob Antimicrob Resist 2020; 23:82-86. [PMID: 32763358 DOI: 10.1016/j.jgar.2020.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 07/07/2020] [Accepted: 07/17/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES In Latin America, methicillin-resistantStaphylococcus aureus (MRSA) is a leading cause of nosocomial infections. Limited studies have addressed the molecular epidemiology of MRSA clones in Argentina, characterised by continuous human migratory movements. The aim of this study was to describe the MRSA epidemiology, including distinct patient populations from different regions of the country. METHODS MRSA strains were collected in epidemiological studies conducted from 2009 to 2015 in three cities (Formosa, Córdoba and Tucumán) and involving four population groups: community adult patients; hospitalised adults; hospitalised children; and healthy children (nasal colonisation). Antimicrobial susceptibility testing, SCCmec and Panton-Valentine leukocidin (PVL) typing, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were performed. RESULTS A total of 120 MRSA isolates were recovered with an important population diversity in the groups studied; in community adult patients, MRSA isolates corresponded to ST5, ST267 and ST1619; from hospitalised adults they were ST97, ST5, ST72, ST125, ST200, ST647, ST747, ST935 and ST2941; from hospitalised children they were ST5, ST30, ST34, ST1163 and ST1619; and from colonised children they were ST5, ST125, ST34, ST100, ST1619, ST207 and ST1163. Results of SCCmec typing showed SCCmec I, SCCmec IIIA, SCCmec IV and SCCmec ND associated or not with PVL genes. CONCLUSIONS MRSA genetic lineages have differing distribution in the three regions. The most prevalent was ST5 in colonisation, community and invasive settings. Here we describe ST34-SCCmec IV clone for the first time in the hospitalised paediatric population. These findings contribute to the understanding of epidemiological changes in recent years.
Collapse
Affiliation(s)
- P Moreno Mochi
- Cátedra de Bacteriologia, Instituto de Microbiología Luis C. Verna, Fac. de Bioqcam, Qca y Fcia, Universidad Nacional de Tucumán, Ayacucho 491, San Miguel de Tucumán CP 4000, Argentina
| | - J M Vargas
- Cátedra de Bacteriologia, Instituto de Microbiología Luis C. Verna, Fac. de Bioqcam, Qca y Fcia, Universidad Nacional de Tucumán, Ayacucho 491, San Miguel de Tucumán CP 4000, Argentina
| | - S Vivaldo
- Hospital de la Madre y el Niño, Córdoba 1450, Formosa, CP 3600, Argentina
| | - M Bottiglieri
- Clínica Universitaria Reina Fabiola-Fundación para el Progreso de la UCC, Oncativo 1248, Córdoba, CP 5000, Argentina
| | - C López
- Centro de Microbiología Médica, Rondeau 877, San Miguel de Tucumán CP4000, Argentina
| | - S Mochi
- Hospital Ángel Cruz Padilla, Alberdi 540, San Miguel de Tucumán CP4000, Argentina
| | - M Cobos
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
| | - M Castillo
- Cátedra de Bacteriologia, Instituto de Microbiología Luis C. Verna, Fac. de Bioqcam, Qca y Fcia, Universidad Nacional de Tucumán, Ayacucho 491, San Miguel de Tucumán CP 4000, Argentina
| | - R Del Campo
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain
| | - M A Jure
- Cátedra de Bacteriologia, Instituto de Microbiología Luis C. Verna, Fac. de Bioqcam, Qca y Fcia, Universidad Nacional de Tucumán, Ayacucho 491, San Miguel de Tucumán CP 4000, Argentina.
| |
Collapse
|
9
|
Bogdanov EI, Faizutdinova AT, Mendelevich EG, Sozinov AS, Heiss JD. Epidemiology of Symptomatic Chiari Malformation in Tatarstan: Regional and Ethnic Differences in Prevalence. Neurosurgery 2020; 84:1090-1097. [PMID: 29788393 DOI: 10.1093/neuros/nyy175] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 04/09/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Epidemiology can assess the effect of Chiari I malformation (CM1) on the neurological health of a population and evaluate factors influencing CM1 development. OBJECTIVE To analyze the regional and ethnic differences in the prevalence of CM1. METHODS The population of the Republic of Tatarstan (RT) in the Russian Federation was evaluated for patients with CM1 symptoms over an 11-yr period. Typical symptoms of CM1 were found in 868 patients. Data from neurological examination and magnetic resonance imaging (MRI) measurement of posterior cranial fossa structures were analyzed. RESULTS MRI evidence of CM1, defined as cerebellar tonsils lying at least 5 mm inferior to the foramen magnum, was found in 67% of symptomatic patients. Another 33% of symptomatic patients had 2 to 4 mm of tonsillar ectopia, which we defined as "borderline Chiari malformation type 1 (bCM1)." The period prevalence in the entire RT for symptomatic CM1 was 20:100 000; for bCM1 was 10:100 000; and for CM1 and bCM1 together was 30:100 000. Prevalence of patients with CM1 symptoms was greater in the northern than southern districts of Tatarstan, due to a high prevalence (413:100 000) of CM1 in the Baltasy region in one of the northern districts. CONCLUSION One-third of patients with typical symptoms of CM1 had less than 5 mm of tonsillar ectopia (bCM1). Assessments of the health impact of CM1-type symptoms on a patient population should include the bCM1 patient group. A regional disease cluster of patients with Chiari malformation was found in Baltasy district of RT and needs further study.
Collapse
Affiliation(s)
- Enver I Bogdanov
- Department of Neurology and Rehabilitation, Kazan State Medical University, Kazan, Republic of Tatarstan, Russian Federation.,Department of Neurology, Republican Clinical Hospital, Kazan, Republic of Tatarstan, Russian Federation
| | - Aisylu T Faizutdinova
- Department of Neurology and Rehabilitation, Kazan State Medical University, Kazan, Republic of Tatarstan, Russian Federation.,Clinical Expert Department, Republican Clinical Hospital, Kazan, Republic of Tatarstan, Russian Federation
| | - Elena G Mendelevich
- Department of Neurology and Rehabilitation, Kazan State Medical University, Kazan, Republic of Tatarstan, Russian Federation
| | - Alexey S Sozinov
- Department of Biological and Medical Ethics, Kazan State Medical University, Kazan, Republic of Tatarstan, Russian Federation
| | - John D Heiss
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
10
|
Marinho CC, Nicolato AJPG, Reis VW, Dos Santos RC, Silva JC, Faria HP, Machado-Coelho GLL. Ultrasound evaluation of schistosomiasis-related morbidity among the Xakriabá people in the state of Minas Gerais, Brazil. Radiol Bras 2020; 53:7-13. [PMID: 32313330 PMCID: PMC7159047 DOI: 10.1590/0100-3984.2019.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective To use ultrasound to investigate the morbidity related to schistosomiasis in the Xakriabá indigenous population. Materials and Methods This was a field-based census study conducted in the territory of the Xakriabá people. A total of 166 individuals were invited, and 148 (≤ 77 years of age) agreed to participate. Most participants underwent abdominal ultrasound, physical examination, and stool examination. Mann-Whitney U and chi-square tests were used for comparisons. We determined risk by calculating odds ratio (OR) and performed logistic regression analysis. Results Schistosoma mansoni eggs were found in 31 (26.7%) of the 116 stool samples examined, 22 (70.9%) of the 31 being from individuals 4-16 years of age. The median count was 144 eggs/g of feces (interquartile range, 264). Of the 105 participants examined with ultrasound, 68 (64.8%) had hepatomegaly (left lobe), 6 (5.7%) had splenomegaly, and 4 (3.8%) had portal hypertension. Egg-positive stool samples were more common in those with an enlarged left lobe (OR = 3.4; 95% confidence interval (CI): 1.1-11.2; p = 0.043). Periportal fibrosis was found in 30 participants (28.6%), of whom 9 (30%) had pattern C, 10 (33.3%) had pattern D, and 11 (36.7%) had pattern Dc. Age was the only independent risk factor for fibrosis (p = 0.007). Fibrosis was up to nine-fold more common in alcohol drinkers than in nondrinkers (OR = 9.28; 95% CI: 2.60-33.06; p < 0.001). Among the 138 participants in whom the clinical form was classified, the chronic hepatic form was identified in 54 (39.1%), of whom 32 (59.2%) were under 30 years of age and one (1.8%) was hepatosplenic. Conclusion Schistosomiasis in the Xakriabá population is characterized by a high frequency of egg-positive stool samples, predominantly in children/adolescents, and by chronic hepatic form in the young, especially among alcohol drinkers.
Collapse
Affiliation(s)
| | | | | | | | - Jaime Costa Silva
- Ministério da Saúde, Fundação Nacional de Saúde (Funasa), Brasília, DF, Brazil
| | | | | |
Collapse
|
11
|
Abstract
Background Educational attainment and income are two socioeconomic status indicators with strong protective effects against cigarette smoking. Marginalization-related Diminished Returns, however, refer to less than expected protective effects of socioeconomic status indicators for the members of the racial and ethnic minority groups, particularly Blacks and Hispanics, compared to non-Hispanic Whites. Aim Borrowing data from a nationally representative study in the US, this study tested whether racial and ethnic differences exist in the effects of educational attainment and poverty status on cigarette smoking of American adults. Methods This cross-sectional study entered 28,329 adult participants of the Population Assessment of Tobacco and Health (PATH; 2013). Both educational attainment and poverty status were the independent variables. The dependent variable was current hookah smoking. Age, gender, and region were the covariates. Race and ethnicity were the effect modifiers (moderators). Results Overall, individuals with higher educational attainment were more likely to smoke a hookah. Individuals who lived out of poverty, however, had lower odds of current hookah smoking. Race and ethnicity both showed statistical interactions with both socioeconomic indicators suggesting that Blacks and Hispanics with high educational attainment and those who live out of poverty have disproportionately high odds of hookah smoking, compared to non-Hispanic Whites with high socioeconomic status. Conclusions In the United States, middle-class racial and ethnic minority people remain at higher risk of smoking hookah. As a result, we should expect a high tobacco burden in middle-class Black and Hispanic adults. We suggest that policymakers should not take an over-simplistic way and reduce the problem of race/ethnic inequalities in tobacco use to gaps in socioeconomic status between groups. Marginalization-related diminished returns generate tobacco disparities in higher socioeconomic status levels. Middle-class racial and ethnic minority people need extra support to stay healthy.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Hamid Chalian
- Department of Radiology, Department of Radiology, Duke University Medical Center, Durham, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA.,Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| |
Collapse
|
12
|
Assari S, Bazargan M. Educational Attainment and Tobacco Harm Knowledge Among American Adults: Diminished Returns of African Americans and Hispanics. Int J Epidemiol Res 2020; 7:http://ijer.skums.ac.ir/article_37230_1b660b357edc924c767ce72f1430ab14.pdf. [PMID: 32219175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Minorities' Diminished Returns (MDRs) refer to the smaller effects of educational attainment for ethnic minorities compared to the majority group. As a result of MDRs, research has documented more than expected tobacco use among Hispanics and African Americans (AAs) with high educational attainment. In theory, some of this increased risk may be due to lower tobacco harm knowledge. Accordingly, the present study compared ethnic groups for the association between educational attainment and tobacco harm knowledge among American adults in order to better understand a potential mechanism behind MDRs of educational attainment on tobacco use of Hispanics and AAs. METHODS The current cross-sectional study used baseline data of 27,405 adults, which were obtained from the Population Assessment of Tobacco and Health (2013) study, a nationally representative survey in the U.S. The independent and dependent variables were educational attainment and tobacco harm knowledge, respectively. In addition, age, gender, employment, and poverty status were the covariates, and ethnicity was the moderator. Finally, linear regression was used to analyze the data. RESULTS Educational attainment was inversely associated with tobacco harm knowledge in the pooled sample (b = 0.11, 95% CI = 0.09 - 0.13). Ethnicity showed a statistically significant interaction with educational attainment (b = -0.05, 95% CI = -0.10 - 0.00 for AAs and b = -0.14, 95% CI = -0.19 - -0.09 for Hispanics versus non-Hispanics), suggesting that the effect of educational attainment on tobacco harm knowledge was smaller for Hispanics and AAs compared to non-Hispanics and Whites. CONCLUSION In general, although high educational attainment increases tobacco harm knowledge, highly educated Hispanics and AAs still report a disproportionately low level of tobacco harm knowledge. Eventually, the MDRs of educational attainment on tobacco harm knowledge may explain why highly educated Hispanics remain at high risk of tobacco use.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| |
Collapse
|
13
|
Brito RS, Carmo Filho JRD, Vila VDSC, Souza ACSE. Epidemiological characteristics and strategies for the prevention of diarrheal disease in indigenous children: A scoping review. Enferm Clin (Engl Ed) 2019; 30:53-62. [PMID: 31791883 DOI: 10.1016/j.enfcli.2019.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/05/2019] [Accepted: 08/13/2019] [Indexed: 11/18/2022]
Abstract
AIM The aim of the present scoping review was to map the scientific evidence about diarrheal disease in indigenous children and the strategies that can be used to prevent it. METHODS The subject headings were indigenous population; child; diarrhea; dysentery; epidemiology; and prevention, primary; also the following keywords characteristic, epidemiologic study; and children. The databases consulted were Latin American and Caribbean Health Sciences Literature, MEDLINE via the US National Library of Medicine/National Institutes of Health, and Web of Science. Initially, 268 studies were identified, and after being screened using the eligibility criteria, six were selected. Finally, via reference tracking, five more were identified. The final sample was made up of eleven articles. RESULTS The results confirmed higher mortality rates due to diarrheal disease among indigenous children who are socially disadvantaged and living in poor hygienic and basic sanitation conditions. Among the primary prevention strategies are basic sanitation, health education better hygiene habits, animal control, breastfeeding, supplementing the diet with zinc, vitamins, and the rotavirus vaccine. The preventive strategies included the use of oral rehydration solutions, adequate nutrition, prescribed antimicrobials, and intravenous fluid replacement with glycaemic and electrolyte correction in severe cases. CONCLUSION In conclusion, public policies regarding the indigenous population and cross-cultural care should be strengthened. The present study confirmed that, at a global level, there is a lack of publications studying this issue.
Collapse
Affiliation(s)
- Raquel Santos Brito
- Master in Health Care, Feral University of Mato Grosso, Av: Valdon Varjão, N° 6.390, CEP: 78.600-000 Barra do Garças, Mato Grosso, Brazil
| | - José Rodrigues do Carmo Filho
- Master's Program in Health Care, School of Social and Health Sciences Pontifical Catholic University of Goiás, Mestrado em Atenção à Saúde, Área IV, Av, Universitária 1.440, Setor Leste Universitário, CEP: 74605-010 Goiânia, Goiás, Brazil.
| | - Vanessa da Silva Carvalho Vila
- Master's Program in Health Care, School of Social and Health Sciences Pontifical Catholic University of Goiás, Mestrado em Atenção à Saúde, Área IV, Av, Universitária 1.440, Setor Leste Universitário, CEP: 74605-010 Goiânia, Goiás, Brazil
| | - Adenícia Custódia Silva E Souza
- Master's Program in Health Care, School of Social and Health Sciences Pontifical Catholic University of Goiás, Mestrado em Atenção à Saúde, Área IV, Av, Universitária 1.440, Setor Leste Universitário, CEP: 74605-010 Goiânia, Goiás, Brazil
| |
Collapse
|
14
|
Glatman-Freedman A, Amir K, Dichtiar R, Zadka H, Vainer I, Karolinsky D, Enav T, Shohat T. Factors associated with childhood influenza vaccination in Israel: a cross-sectional evaluation. Isr J Health Policy Res 2019; 8:82. [PMID: 31771629 PMCID: PMC6878635 DOI: 10.1186/s13584-019-0349-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 10/25/2019] [Indexed: 11/15/2022] Open
Abstract
Background Vaccinating children against influenza has shown both direct and indirect beneficial effects. However, despite being offered free of charge, childhood influenza vaccine coverage in Israel has been low. Our objective was to evaluate the factors associated with childhood influenza vaccination in Israel. Methods A cross-sectional language-specific telephone survey was conducted among adults 18 years or older, to examine childhood influenza vaccination practices and their associations with socio-demographic and relevant health variables. We further explored the reasons for these practices among parents. Multivariate logistic regression was used to identify factors associated with childhood influenza vaccine acceptance. Results Of a total of 6518 individuals contacted by mobile phone, 1165 eligible parents, ≥18 years old with children 1–18 years of age, were interviewed, and 1040 of them completed the survey successfully. Overall, factors associated with childhood influenza vaccination were younger child’s age, influenza vaccination of other family members and belonging to the Arab population group. No association was found between childhood influenza vaccination and routine childhood vaccine uptake. Several of the parents’ reasons for vaccine acceptance - preventing influenza or its transmission, awareness regarding the need for influenza vaccination and receipt of invitation to get vaccinated - differed significantly between Jewish and Arab parents. Several reasons reported by parents for not vaccinating children against influenza, indicated a likelihood to accept influenza vaccine outreach efforts. Such reasons were reported by 27.5% of Jewish parents and 37.5% of Arab parents. Conclusions We found that certain demographic factors were associated with childhood influenza vaccination in Israel. Several reasons described by the parent for not vaccinating their children indicate that outreach efforts are likely to increase childhood influenza vaccination. Addressing population group-specific needs is recommended to optimize the success of influenza vaccine outreach efforts.
Collapse
Affiliation(s)
- Aharona Glatman-Freedman
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel. .,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Kanar Amir
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Hila Zadka
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Ifat Vainer
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Dolev Karolinsky
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Teena Enav
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel
| | - Tamy Shohat
- Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Ramat-Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
15
|
Bokor-Billmann T, Langan EA, Billmann F. The reporting of race and/or ethnicity in the medical literature: a retrospective bibliometric analysis confirmed room for improvement. J Clin Epidemiol 2019; 119:1-6. [PMID: 31715264 DOI: 10.1016/j.jclinepi.2019.11.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/19/2019] [Accepted: 11/06/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Although the collection of race and/or ethnicity data is an important way to identify and address inequalities in health care provision and disparities in access to treatment, studies examining the extent to which race and/or ethnicity data are reported in the medical literature, and the quality of these data, are lacking. Therefore, we sought to objectively determine the quality of reporting of race and/or ethnicity in original medical research papers. STUDY DESIGN AND SETTING A retrospective bibliometric analysis was used. Two independent investigators analyzed original articles investigating race/ethnicity, published between 2007 and 2018, in the 10 top-ranking academic journals in each of the following categories: general medicine, surgery, and oncology. RESULTS A total of 995 original articles were included in our analysis. Only 45 studies (4.52%) provided a formal definition of race/ethnicity, and 8.94% identified the investigator responsible for the classification. While race/ethnicity was a key part of study design in 31.86% of the included investigations, the method used to classify individuals into racial/ethnic groups was described in only 10.25% of articles. In terms of terminology, we identified 81 different race/ethnicity classifications, but these were often imprecise and open to interpretation. CONCLUSION There is significant room for improvement in the collection, reporting, and publishing of data describing ethnicity and/or race in the medical literature.
Collapse
Affiliation(s)
| | - Ewan A Langan
- Department of Dermatology, University Hospital Schleswig Holstein, Campus Lübeck, Lübeck, Germany; Dermatological Sciences, University of Manchester, Manchester, UK
| | - Franck Billmann
- Department of Surgery, University Hospital of Heidelberg, Heidelberg, Germany.
| |
Collapse
|
16
|
Gallaway MS, Berens AS, Puckett MC, Foster S. Understanding geographic variations of indoor radon potential for comprehensive cancer control planning. Cancer Causes Control 2019; 30:707-712. [PMID: 31073874 DOI: 10.1007/s10552-019-01162-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/20/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Lung cancer is the leading cause of U.S. cancer deaths and radon is the second leading risk factor for lung cancer. By better understanding geologic variations of radon production in states, comprehensive cancer control efforts could be improved. The study purpose was to assess states with the greatest potential for elevated radon and the likelihood of radon-related actions in National Comprehensive Cancer Control Program (NCCCP) awardee cancer plans. METHODS Two state-level variables were derived to approximate potential for elevated radon using the Environmental Protection Agency county map and the 2015 U.S. Census. The association between radon potential and inclusion of radon activity within cancer plans was evaluated using logistic regression. RESULTS Fifty-one percent of cancer plans recognized an association between radon and cancer risk, and included measurable radon activities. Most states with high radon potential included radon activity in cancer plans. Both measures of radon potential were significantly associated with NCCCP cancer plans including radon activity. CONCLUSIONS Geospatial analyses help to prioritize radon-related lung cancer activities. In areas with high potential for radon exposure, increasing knowledge about potential for radon exposure may result in increased radon testing, mitigation, or other radon reducing strategies, and ultimately reduction of lung cancer deaths.
Collapse
Affiliation(s)
- Michael Shayne Gallaway
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F76, Atlanta, GA, 30341, USA.
| | - Andrew S Berens
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program (GRASP), Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary C Puckett
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F76, Atlanta, GA, 30341, USA
| | - Stephanie Foster
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program (GRASP), Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
17
|
Strömberg U, Peterson S, Holmén A, Holmberg E, Hultcrantz R, Martling A, Nilbert M. Rational targeting of population groups and residential areas for colorectal cancer screening. Cancer Epidemiol 2019; 60:23-30. [PMID: 30897387 DOI: 10.1016/j.canep.2019.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/08/2018] [Accepted: 01/17/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Sociodemographic and spatial disparities in incidence and mortality burden of colorectal cancer (CRC) are important to consider in the implementation of population screening, in order to achieve expected benefit and not increase health inequities. Analytic methods should be adapted to provide rational support for targeted interventions. METHODS CRC incidence rates by tumor stage (I-IV) and location (colon vs. rectum) were analyzed for the time period 2008-2016 within a screening-relevant age interval of 55-74 years for the population of South and West Sweden, where screening is planned for. The study population was stratified by sex, country of birth, educational level (for Swedish-born citizens) and residential area. We also estimated disparities in excess mortality from CRC across groups of patients accordant to relevant population groups. RESULTS The analyses were based on 8961 patients with a first CRC diagnosis. There were marked socioeconomic gradients in the stage II-IV CRC incidence rates among Swedish-born men and women. Compared to men with high educational level, the incidence rate ratios (IRRs) of stage II, III, and IV CRC in men with low educational level were 1.38 (95% confidence interval 1.18, 1.62), 1.09 (0.95, 1.26), and 1.18 (1.02, 1.37), respectively. In women, the corresponding figures were 1.26 (1.06, 1.51), 1.19 (1.01, 1.39), and 1.45 (1.20, 1.80). The groups of patients with low educational level showed relatively high excess mortality burdens from CRC. CONCLUSIONS Our analytic approach provided rational support for targeted intervention when implementing CRC screening, aiming at optimizing participation in groups with low educational level.
Collapse
Affiliation(s)
- Ulf Strömberg
- Health Metrics Unit, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
| | | | - Anders Holmén
- Department of Research and Development, Region Halland, Halmstad, Sweden
| | - Erik Holmberg
- Regional Cancer Center West, Gothenburg, Sweden; Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Rolf Hultcrantz
- Department of Gastroenterology and Hepatology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Martling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Mef Nilbert
- Institute of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden; Clinical Research Centre, Hvidovre Hospital, Copenhagen University, Hvidovre, Denmark; The Danish Cancer Society Research Center, Copenhagen University, Copenhagen, Denmark
| |
Collapse
|
18
|
Gimeno-Feliu LA, Calderón-Larrañaga A, Díaz E, Laguna-Berna C, Poblador-Plou B, Coscollar-Santaliestra C, Prados-Torres A. The definition of immigrant status matters: impact of nationality, country of origin, and length of stay in host country on mortality estimates. BMC Public Health 2019; 19:247. [PMID: 30819146 PMCID: PMC6394150 DOI: 10.1186/s12889-019-6555-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 02/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mortality is a robust indicator of health and offers valuable insight into the health of immigrants. However, mortality estimates can vary significantly depending on the manner in which immigrant status is defined. Here, we assess the impact of nationality, country of origin, and length of stay in the host country on mortality estimates in an immigrant population in Aragón, Spain. METHODS Cross-sectional retrospective study of all adult subjects from the EpiChron Cohort in 2011 (n = 1,102,544), of whom 146,100 were foreign-born (i.e., according to place of birth) and 127,213 were non-nationals (i.e., according to nationality). Directly standardized death proportions between years 2012-2015 were calculated, taking into account the age distribution of the European population in 2013. Binary logistic regression was used to compare the four-year probability of death. RESULTS The age- and sex-standardized number of deaths per 1000 subjects were 45.1 (95%CI 44.7-45.2) for the Spanish-born population, 29.3 (95%CI 26.7-32.1) for the foreign-born population, and 18.4 (95%CI 15.6-21.6) for non-Spanish nationals. Compared with the Spanish-born population, the age- and sex-adjusted likelihood of dying was equally reduced in the foreign-born and non-national populations (OR 0.6; 95%CI 0.5-0.7) when the length of stay was less than 10 years. No significant differences in mortality estimates were detected when the length of stay was over 10 years. CONCLUSIONS Mortality estimates in immigrant populations were lower than those of the native Spanish population, regardless of the criteria applied. However, the proportion of deaths was lower when immigrant status was defined using nationality instead of country of birth. Age- and sex-standardized death proportions tended to increase with increased length of stay in the host country.
Collapse
Affiliation(s)
- Luis Andrés Gimeno-Feliu
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Aragón Healthcare Service, San Pablo Health Centre, Zaragoza, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Amaia Calderón-Larrañaga
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Esperanza Díaz
- Department of Global Public Health and Primary Care, Research Group for General Practice, University of Bergen, Bergen, Norway
- Norwegian Centre for Minority Health Research, Oslo, Norway
| | - Clara Laguna-Berna
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain
| | - Beatriz Poblador-Plou
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain
| | - Carlos Coscollar-Santaliestra
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Aragón Healthcare Service, San Pablo Health Centre, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Alexandra Prados-Torres
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Carlos III Health Institute, Madrid, Spain
| |
Collapse
|
19
|
Abstract
There are a number of hard to reach and underserved communities who experience inadequate health care. In Australia, the Aboriginal and Torres Strait Islanders peoples experience low life expectancy, higher levels for chronic disease and elevated smoking and drinking. These problems are further exacerbated when living in regional and rural Australia and poverty. There are growing concerns over helping such groups in order to close the health disparity gap. A student-led clinic (SLC) was developed to address clinical placement shortages while providing free health and social services in an underserved community in regional Australia. Health data was collected from 2086 attendees enrolled in the SLC to determine health changes and outcomes of student-delivered services. A series of health data was routinely collected at all contact points. This included physical health care, behavioural health risk, and chronic disease measures. All data was recorded in an electronic monitoring system. Population data identified some significant and positive changes to health patterns-smoking, waist size, and body mass index. Unfortunately, gaps in data entry precluded more robust findings. It was clear that this community suffered from experiences commonly associated with health disparity and poverty. There were higher risks of drinking alcohol and smoking with raised levels of lifestyle disease including diabetes. Some of these issues were mitigated by the community being able to attend a locally situated community driven clinic.
Collapse
Affiliation(s)
- Cynthia M Stuhlmiller
- School of Nursing, University at Buffalo, Buffalo, NY, USA.,School of Health, University of New England, Armidale, NSW, 2351, Australia
| | - Barry Tolchard
- School of Health, University of New England, Armidale, NSW, 2351, Australia. .,School of Health & Social Care, Mental Health & Intellectual Disabilities Research Policy Unit, London South Bank University, London, UK.
| |
Collapse
|
20
|
DeSisto CL, Hirai AH, Collins JW Jr, Rankin KM. Deconstructing a disparity: explaining excess preterm birth among U.S.-born black women. Ann Epidemiol 2018; 28:225-30. [PMID: 29433978 DOI: 10.1016/j.annepidem.2018.01.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 01/24/2018] [Accepted: 01/24/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine components of excess preterm birth (PTB) rates for U.S.-born black women relative to both foreign-born black women and U.S.-born white women attributable to differences in observed sociodemographic, behavioral, and medical risk factors. METHODS Using the 2013 U.S. natality files, we used Oaxaca-Blinder decomposition on the absolute scale to estimate the contribution of the group differences in the prevalence of PTB predictors between U.S.- and foreign-born black women and U.S.-born black and U.S.-born white women. RESULTS U.S.-born blacks had a 3.2 (95% confidence interval: 3.0-3.5) and 4.4 (95% confidence interval: 4.3-4.5) percentage point higher risk of PTB than foreign-born blacks and U.S.-born whites, respectively. The variables in the models explained between 18% and 27% of the PTB disparities. Differences in paternal acknowledgment (about 12%), maternal hypertension (about 7%-11%), and maternal education (about 6%-10%) explained the largest proportion of these disparities. CONCLUSIONS Programs and policies that address both distal and proximate factors, including the social determinants of health and the prevention and management of hypertension, may reduce the higher rates of PTB among U.S.-born black women compared to foreign-born black women and U.S.-born white women.
Collapse
|
21
|
Ostovar R, Kiani F, Sayehmiri F, Yasemi M, Mohsenzadeh Y, Mohsenzadeh Y. Prevalence of metabolic syndrome in Iran: A meta-analysis. Electron Physician 2017; 9:5402-5418. [PMID: 29238477 PMCID: PMC5718841 DOI: 10.19082/5402] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/02/2017] [Indexed: 12/13/2022] Open
Abstract
Background Metabolic syndrome) MetS( is a complex risk factor which increases the risk of cardiovascular diseases and type 2 diabetes. There are many studies with various populations and results about the prevalence of MetS in Iran; in order to authenticate these studies and have an overall estimation of its prevalence in Iran, performing a meta-analysis seems to be necessary. Objective This study aimed to investigate the prevalence of MetS and its components in Iran via meta-analysis method. Methods All associated published papers in national and international journals of PubMed, Scopus, Web of Science, Magiran, Iranmedex, Science Direct, Medlib, and SID databases were searched from January, 2000 to October, 2016. All types of studies, including local and national surveys that reported the prevalence of MetS among healthy populations in Iran were reviewed. The effects of age, sample size and publication date as possible sources of heterogeneity among the study findings was examined by meta-regression. P-values less than 0.05 were considered as significant in heterogeneity tests. All analysis was done by R Ver. 3.2.1 and STATA (version 10). Results Seventy eligible studies were selected for meta-analysis. The overall estimation of MetS prevalence was 25% (95% CI: 22-29%) based on the Adult Treatment Panel III (ATP III) criteria, 30% (95% CI: 25-36%) according to the International Diabetes Federation (IDF), and 39% (95% CI: 26-52%) based on the Joint Interim Societies (JIS) criteria. The prevalence of MetS was lower in men than in women (26.9% versus 35.7%). The prevalence of various MetS components including High TG (triglyceride), Low HDL-C, High BP and High FBS (fasting blood sugar) was 43%, 54%, 38% and 22% among the adult population. Conclusion Findings from the present meta-analyses study displayed a high prevalence of metabolic syndrome in Iran, especially in women, which increases with age in both sexes. It alerts health care providers and policy makers to find solutions in order to take action to reduce MetS risk in society.
Collapse
Affiliation(s)
- Rahim Ostovar
- PhD, Associate Professor, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Faezeh Kiani
- Msc, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Fatemeh Sayehmiri
- PhD, Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masood Yasemi
- MD, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yazdan Mohsenzadeh
- MSc, Department of Paramedical Sciences, Faculty of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Yousof Mohsenzadeh
- MD, Assistant Professor, Department of Cardiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| |
Collapse
|
22
|
Loyola-Sanchez A, Hurd K, Barnabe C. Healthcare utilization for arthritis by indigenous populations of Australia, Canada, New Zealand, and the United States: A systematic review ☆. Semin Arthritis Rheum 2017; 46:665-74. [PMID: 28012565 DOI: 10.1016/j.semarthrit.2016.10.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 10/24/2016] [Accepted: 10/28/2016] [Indexed: 01/09/2023]
Abstract
PURPOSE Indigenous populations of Australia, Canada, New Zealand, and the United States of America (USA) experience a higher prevalence of arthritis conditions. Differences in clinical outcomes and mortality may reflect healthcare service use inequities. The objective of this study was to summarize healthcare service use patterns described in the existing literature in order to identify gaps and inform strategies to limit the pronounced negative impact of arthritis on Indigenous populations. METHODS Medline, EMBASE, CINAHL, and Indigenous-specific electronic databases (to June 2015) were used to identify cohort, case-control and cross-sectional studies describing healthcare service use by Indigenous populations with specified inflammatory arthritis, osteoarthritis, or rheumatic disease conditions. We extracted information on the study setting and methodology, primary outcome and assessed study quality, and risk of bias. RESULTS In total, 19 studies were identified describing three types of healthcare service use: physician visits, hospitalizations, and surgeries. In Canada and New Zealand, Indigenous populations had 36-51% fewer visits to specialists than the non-Indigenous population. Indigenous populations in Canada, New Zealand, and the USA had 37-300% more hospitalizations due to arthritis complications than the non-Indigenous population. Indigenous populations in Australia, Canada, and New Zealand had 27-85% fewer arthroplasties for osteoarthritis than the non-Indigenous population. CONCLUSIONS Indigenous populations had higher hospitalization rates but lower use of specialized services for arthritis conditions. Strategies to improve access to specialized arthritis services might reduce health outcome inequities.
Collapse
|
23
|
Pressick EL, Gray MA, Cole RL, Burkett BJ. A systematic review on research into the effectiveness of group-based sport and exercise programs designed for Indigenous adults. J Sci Med Sport 2016; 19:726-32. [PMID: 26703238 DOI: 10.1016/j.jsams.2015.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/26/2015] [Accepted: 11/14/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate research into the effectiveness of group-based sport and exercise programs targeting Indigenous adults on anthropometric, physiological and quality of life outcomes. DESIGN A systematic review with quality assessment of study design. METHODS A computer-based literature search of EBSCO, SPORTDiscus, CINAHL, Informit, Scopus, Web of Science, Medline, PubMed, Global Health, ProQuest and Discover databases was conducted. Methodological quality of individual articles was assessed using McMasters University Guidelines and Appraisal Forms for Critical Review for Quantitative Research. Results of the effectiveness of programs are then summarised. RESULTS Six articles were identified with critical appraisal scores ranging from 6 to 12 (from a possible 15 points), with a mean score of 9.6. Five articles were of moderate to good quality. Significant improvements were observed in anthropometric, physiological and quality of life outcomes across all studies. Elements of successful group-based exercise and sport programs corresponded to global recommendations on physical activity for health for 18 to 64 year olds, and were implemented over a period of time ranging from 12 to 24 weeks to exhibit results, plus community consultation in developing programs and nutrition education. CONCLUSIONS Group-based programs that include nutrition, exercise and/or sport components are effective in producing short to intermediate term health outcomes among Indigenous adults. Further high quality research, specifically on group-based modified sport programs for Indigenous adults that are culturally appropriate and aim to improve quality of life are needed.
Collapse
Affiliation(s)
- Elizabeth L Pressick
- Cluster for Health Improvement, School of Sport and Health Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Australia.
| | - Marion A Gray
- Cluster for Health Improvement, School of Sport and Health Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Australia
| | - Rachel L Cole
- Cluster for Health Improvement, School of Sport and Health Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Australia
| | - Brendan J Burkett
- Cluster for Health Improvement, School of Sport and Health Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Australia
| |
Collapse
|
24
|
Assari S, Burgard S. Black-White differences in the effect of baseline depressive symptoms on deaths due to renal diseases: 25 year follow up of a nationally representative community sample. J Renal Inj Prev 2015; 4:127-34. [PMID: 26693500 PMCID: PMC4685983 DOI: 10.12861/jrip.2015.27] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/01/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION More studies are needed to examine whether race moderates the effect of baseline depressive symptoms on cause-specific mortality including deaths due to renal diseases in the United States. OBJECTIVES The present longitudinal study compared Blacks and Whites for the effect of baseline depressive symptoms on deaths due to renal diseases over a 25-year period in a nationally representative community sample. PATIENTS AND METHODS Data came from the Americans' Changing Lives (ACL) study, a nationally representative cohort that followed 3361 Black (n = 1156) or White (n = 2205) adults 25 and older for up to 25 years from 1986 to 2011. Month, year and cause of death were extracted from death certificates or national death index reports and coded based on ICD-9 or ICD-10 codes, depending on the year of death. We used Cox proportional hazards models for data analysis. Time to death due to renal diseases over a 25-year period was the outcome, baseline depressive symptoms (11-item Center for Epidemiological Studies-Depression [CES-D]) was the predictor, demographic characteristics, socio-economic status and chronic medical conditions (CMC) (hypertension, diabetes, chronic lung disease, heart disease, stroke, cancer, and arthritis) at baseline were controls, and race was the focal moderator. RESULTS In the pooled sample, race and baseline depressive symptoms showed a significant interaction, suggesting a stronger effect of baseline depressive symptoms on deaths due to renal diseases for Whites compared to Blacks. In race-specific models, high depressive symptoms at baseline increased risk of death due to renal diseases among Whites but not Blacks. CONCLUSION The Black-White difference in the predictive role of baseline depressive symptoms on deaths due to renal diseases over a 25-year period found here provides support for the Black-White health paradox.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Center for Research on Ethnicity, Culture and Health, School of Public Health, Ann Arbor, University of Michigan, USA
| | - Sarah Burgard
- Department of Sociology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
25
|
Sandoval NR, Ríos N, Mena A, Fernández R, Perea M, Manzano-Román R, Santa-Quiteria JAR, Hernández-Gonzalez A, Siles-Lucas M. A survey of intestinal parasites including associated risk factors in humans in Panama. Acta Trop 2015; 147:54-63. [PMID: 25823566 DOI: 10.1016/j.actatropica.2015.03.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/19/2015] [Accepted: 03/20/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Intestinal parasitic infections are among the most common infections worldwide, leading to illness with serious and long lasting implications in children and immunocompromised people. Transmission of intestinal parasites is more frequent in tropical and sub-tropical areas where sanitation is poor and socioeconomic conditions are deficient. Panama is a country where climate and social conditions could be reflected in a high number of people infected with intestinal parasites. The presence, prevalence, and distribution of intestinal parasites in this country have been approached to date only in very restricted areas and population groups, but the impact of intestinal parasite infections at the national level is unknown. METHODOLOGY/PRINCIPAL FINDINGS We conducted a cross-sectional survey between 2008 and 2010 to determine the prevalence of intestinal parasites across Panama. Overall, 14 municipalities in seven provinces of Panama were surveyed. The presence of eggs, cysts, and larvae was assessed by microscopy in 1123 human fecal samples using a concentration technique. A questionnaire to identify risk factors associated with the frequency of intestinal parasites in the study population was also prepared and performed. Overall, 47.4% of human samples presented parasites. Variables including community type, age group, occupation, co-presence of commensals and socioeconomic factors (use of shoes and type of sanitation) were significantly associated with intestinal parasites (p<0.05). CONCLUSIONS/SIGNIFICANCE The preliminary data obtained in the current study, showing a high prevalence of fecal-oral transmitted parasites in Panama, place intestinal parasitism as a major health problem in this country. Specific interventions should be planned for the indigenous population, the group most afflicted by intestinal parasites.
Collapse
|
26
|
Sanders AE, Campbell SM, Mauriello SM, Beck JD, Jimenez MC, Kaste LM, Singer RH, Beaver SM, Finlayson TL, Badner VM. Heterogeneity in periodontitis prevalence in the Hispanic Community Health Study/Study of Latinos. Ann Epidemiol 2014; 24:455-62. [PMID: 24731697 DOI: 10.1016/j.annepidem.2014.02.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 02/21/2014] [Accepted: 02/28/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of the study was to examine acculturation and established risk factors in explaining variation in periodontitis prevalence among Hispanic/Latino subgroups. METHODS Participants were 12,730 dentate adults aged 18-74 years recruited into the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from four U.S. field centers between 2008 and 2011. A standardized periodontal assessment measured probing pocket depth and gingival recession at six sites per tooth for up to 28 teeth. Periodontitis was defined according to the Centers for Disease Control and Prevention and American Academy of Periodontology case classifications developed for population surveillance. Covariates included acculturation indicators and established periodontitis risk factors. Survey estimation procedures took account of the complex sampling design. Adjusted multivariate binomial regression estimated prevalence ratios and 95% confidence limits (CLs). RESULTS Unadjusted prevalence of moderate and severe periodontitis was 38.5% and ranged from 24.7% among Dominicans to 52.1% among Cubans. Adjusted prevalence ratios for subgroups relative to Dominicans were as follows: (1) 1.34 (95% CL, 1.13-1.58) among South Americans; (2) 1.37 (95% CL, 1.17-1.61) among Puerto Ricans; (3) 1.43 (95% CL, 1.25-1.64) among Mexicans; (4) 1.53 (95% CL, 1.32-1.76) among Cubans; and (5) 1.55 (95% CL, 1.35-1.78) among Central Americans. CONCLUSIONS Heterogeneity in prevalence of moderate/severe periodontitis among Hispanic/Latino subpopulations was not explained by acculturation or periodontitis risk factors.
Collapse
|
27
|
Hernández-Díaz J, Paredes-Carbonell JJ, Marín Torrens R. [How to design workshops to promote health in community groups]. Aten Primaria 2013; 46:40-7. [PMID: 24280035 PMCID: PMC6985510 DOI: 10.1016/j.aprim.2013.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 07/06/2013] [Accepted: 07/08/2013] [Indexed: 12/01/2022] Open
Abstract
One of the strategies of health promotion is to develop life skills people considering themselves as the main health resource. A workshop has to get its participants become «asset» to make decisions and create health, focusing on the development and acquisition of skills in a motivating group and in order to achieve health objectives. The concepts behind the design of a workshop are: participatory planning, training, meaningful learning, group learning and participatory techniques. The steps to follow to design a workshop and facilitate their application are: Stage 0, founding; initial stage, host and initial evaluation; central or construction stage based learning in the acquisition of knowledge, attitudes and skills, and final stage or evaluation.
Collapse
Affiliation(s)
- Josefina Hernández-Díaz
- Unidad de Formación Continua, Escuela Valenciana de Estudios para la Salud (EVES), Valencia, España
| | - Joan J Paredes-Carbonell
- Secció de Promoció de la Salut, Centre de Salut Pública de València, Valencia, España; Àrea de Desigualtats en Salut, Centre Superior d'Investigació en Salut Pública (CSISP-FISABIO), Valencia, España; Departament d'Infermeria, Facultat d'Infermeria i Podologia, Universitat de València, Valencia, España.
| | - Rosa Marín Torrens
- Unidad de Formación Continua, Escuela Valenciana de Estudios para la Salud (EVES), Valencia, España
| |
Collapse
|
28
|
Rodríguez-Carrasco Y, Ruiz MJ, Font G, Berrada H. Exposure estimates to Fusarium mycotoxins through cereals intake. Chemosphere 2013; 93:2297-2303. [PMID: 24012140 DOI: 10.1016/j.chemosphere.2013.07.086] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 07/21/2013] [Accepted: 07/29/2013] [Indexed: 06/02/2023]
Abstract
Mycotoxins are harmful substances produced by fungi in several commodities with a widespread presence in foodstuffs. Human exposure to mycotoxins occurs mainly by contaminated food. The quantitation of mycotoxins in cereal-based food, highly consumed by different age population, is of concern. In this survey, 159 cereal-based samples classified as wheat, maize and rice-based, have been evaluated for the occurrence of patulin, deoxynivalenol, 3-acetyl-deoxynivalenol, fusarenon-X, diacetoxyscirpenol, nivalenol, neosolaniol, HT-2, T-2 and zearalenone by gas chromatography-tandem mass spectrometry. Intakes were calculated for average consumers among adults, children and infants and compared with the tolerable daily intakes (TDI). Data obtained were used to estimate the potential exposure levels. 65.4% of the samples were contaminated with at least one mycotoxin and 15.7% of the analyzed samples showed co-occurrence of mycotoxin. The dietary exposure to HT-2 and T-2 toxins was estimated as 0.010 and 0.086 μg kg(-1) bw d(-1), amounting to 10% and 86% of the TDI, for adults and infants respectively. These results back up the necessity to take a vigilant attitude in order to minimize human intake of mycotoxins.
Collapse
Affiliation(s)
- Yelko Rodríguez-Carrasco
- University of Valencia, Department of Food Science, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
| | | | | | | |
Collapse
|