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Ogata Y, Yokoyama Y, Akiyama Y, Yamagata Z. [Relationship between economic disparity and eating habits of 3-year-old children]. Nihon Koshu Eisei Zasshi 2021; 68:493-502. [PMID: 33994489 DOI: 10.11236/jph.20-114] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objectives This study aimed to clarify the relationship between economic disparity and eating habits of young children to explore the support that should be provided to families with young children.Methods We conducted an anonymous self-administered questionnaire survey of parents who brought their children to the 3-year-old health checkup in four wards in City A. Questionnaire items examined the children's eating habits and the childrearing environment, such as the parents' socioeconomic status. Of 1,150 parents asked to participate in the survey, 616 responded (response rate: 53.6%). Invalid questionnaires (e.g., with missing answers) were eliminated. The remaining 498 parents (effective response rate: 80.8%) were classified into two groups to examine the association of household financial status with their 3-year-old eating habits: the relative poverty group and the non-relative poverty group. The groups were divided according to the poverty line of the Comprehensive Survey of Living Conditions. Statistical analysis was performed using Fisher's exact test and the Mann-Whitney U test. Eating habits that were identified to be associated with relative poverty were further tested using logistic regression analysis.Results Analysis of the children's eating habits in the two groups revealed that, compared with the non-relative poverty group, there was a higher proportion of 3-year-olds who ate vegetables less than 6 days a week (P=0.003) and who consumed snacks 6 days or more per week (P=0.034) in the relative poverty group. The associations of relative poverty with vegetable intake less than 6 days a week and snack consumption 6 days or more a week remained significant after adjusting for parents' age, highest educational attainment, and subjective views on the everyday economic situation. Regarding the childrearing environment, the relative poverty group had a higher proportion of parents who were younger than 30 years of age (P<0.001) and in single-parent households (P=0.007). The relative poverty group had a higher proportion of parents whose highest education level was high school (P<0.001). Furthermore, the subjective view of the everyday economic situation was more negative in the relative poverty group (P<0.001).Conclusion Economic disparity was related to the eating habits of 3-year-old children. The study results indicate that identifying families with financial difficulties during pregnancy and childbirth is necessary to support them early on so that young children can acquire healthy eating habits.
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Affiliation(s)
- Yasue Ogata
- School of Health Sciences Department of Nursing, Bukkyo University
| | | | - Yuka Akiyama
- Department of Health Sciences, School of Medicine, University of Yamanashi
| | - Zentaro Yamagata
- Department of Health Sciences, School of Medicine, University of Yamanashi
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Ploos van Amstel S, Noordzij M, Borzych-Duzalka D, Chesnaye NC, Xu H, Rees L, Ha IS, Antonio ZL, Hooman N, Wong W, Vondrak K, Yap YC, Patel H, Szczepanska M, Testa S, Galanti M, Kari JA, Samaille C, Bakkaloglu SA, Lai WM, Rojas LF, Diaz MS, Basu B, Neu A, Warady BA, Jager KJ, Schaefer F. Mortality in Children Treated With Maintenance Peritoneal Dialysis: Findings From the International Pediatric Peritoneal Dialysis Network Registry. Am J Kidney Dis 2021; 78:380-390. [PMID: 33549627 DOI: 10.1053/j.ajkd.2020.11.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 01/10/2020] [Accepted: 11/19/2020] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Research on pediatric kidney replacement therapy (KRT) has primarily focused on Europe and North America. In this study, we describe the mortality risk of children treated with maintenance peritoneal dialysis (MPD) in different parts of the world and characterize the associated demographic and macroeconomic factors. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS Patients younger than 19 years at inclusion into the International Pediatric Peritoneal Dialysis Network registry, who initiated MPD between 1996 and 2017. EXPOSURE Region as primary exposure (Asia, Western Europe, Eastern Europe, Latin America, North America, and Oceania). Other demographic, clinical, and macroeconomic (4 income groups based on gross national income) factors also were studied. OUTCOME All-cause MPD mortality. ANALYTICAL APPROACH Patients were observed for 3 years, and the mortality rates in different regions and income groups were calculated. Cause-specific hazards models with random effects were fit to calculate the proportional change in variance for factors that could explain variation in mortality rates. RESULTS A total of 2,956 patients with a median age of 7.8 years at the start of KRT were included. After 3 years, the overall probability of death was 5%, ranging from 2% in North America to 9% in Eastern Europe. Mortality rates were higher in low-income countries than in high-income countries. Income category explained 50.1% of the variance in mortality risk between regions. Other explanatory factors included peritoneal dialysis modality at start (22.5%) and body mass index (11.1%). LIMITATIONS The interpretation of interregional survival differences as found in this study may be hampered by selection bias. CONCLUSIONS This study shows that the overall 3-year patient survival on pediatric MPD is high, and that country income is associated with patient survival.
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Affiliation(s)
- Sophie Ploos van Amstel
- IPNA Global RRT Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Marlies Noordzij
- IPNA Global RRT Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Dagmara Borzych-Duzalka
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany; Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Gdansk, Poland
| | - Nicholas C Chesnaye
- IPNA Global RRT Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Hong Xu
- Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Lesley Rees
- Great Ormond Street Hospital, London, United Kingdom
| | - Il-Soo Ha
- Pediatrics Seoul, National University Children's Hospital, Seoul, South Korea
| | - Zenaida L Antonio
- Department of Pediatric Nephrology, National Kidney and Transplant Institute, Quezon City, Philippines
| | - Nakysa Hooman
- Aliasghar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran
| | - William Wong
- Starship Children's Hospital, Auckland, New Zealand
| | | | - Yok Chin Yap
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Hiren Patel
- Nationwide Children's Hospital, Columbus, OH
| | - Maria Szczepanska
- Department of Pediatrics, Faculty of Medical Sciences, Zabrze, Medical University of Silesia, Katowice, Poland
| | - Sara Testa
- Fondazione Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Jameela A Kari
- Pediatric Nephrology Center of Excellence, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Charlotte Samaille
- Service de Néphrologie Pédiatrique, Hôpital Jeanne De Flandre, Lille, France
| | - Sevcan A Bakkaloglu
- Department of Pediatric Nephrology, School of Medicine, Gazi University, Ankara, Turkey
| | - Wai-Ming Lai
- Department of Paediatric & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, People's Republic of China
| | | | | | | | - Alicia Neu
- School of Medicine, Johns Hopkins University, Baltimore, MD
| | | | - Kitty J Jager
- IPNA Global RRT Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
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Moreno TA, Kim SJ. Ranibizumab (Lucentis) versus Bevacizumab (Avastin) for the Treatment of Age-Related Macular Degeneration: An Economic Disparity of Eye Health. Semin Ophthalmol 2016; 31:378-84. [PMID: 27116030 DOI: 10.3109/08820538.2016.1154174] [Citation(s) in RCA: 13] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, and the advent of anti-vascular endothelial growth factor agents (VEGF) has revolutionized treatment for neovascular AMD. Two of the most popular anti-VEGF agents, ranibizumab (Lucentis; Genentech/Roche) and bevacizumab (Avastin; Genentech/Roche), effectively treat neovascular AMD but have a substantial difference in price. Multiple level 1 trials have demonstrated that bevacizumab is noninferior to ranibizumab in the treatment of neovascular AMD and that both have similar safety profiles. The decision to use one drug over the other is multifactorial with influences from industry as well as individual physician biases. However, the additional billions spent on ranibizumab result in a large economic disparity that is not rationalized by cost effectiveness models.
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Affiliation(s)
- Tomas A Moreno
- a Department of Ophthalmology , Vanderbilt Eye Institute , Nashville , TN , USA
| | - Stephen J Kim
- a Department of Ophthalmology , Vanderbilt Eye Institute , Nashville , TN , USA
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