Demographic Factors

人口因素
  • 文章类型: Journal Article
    高血压是2型糖尿病患者中非常常见的合并症,这导致了重要的健康和治疗挑战。本研究旨在确定2型糖尿病患者的高血压患病率及其危险因素。这项研究是使用来自Fasa队列研究中基线诊断为2型糖尿病的年龄在35至70岁之间的1245名参与者的横断面数据进行的。确定高血压患病率,并使用多变量逻辑回归来估计各种危险因素与高血压患病率之间的关联的比值比(OR)和95%置信区间(CI)。参与者的平均年龄为53.5±8.7岁,其中71.7%(n=893)为女性,28.3%(n=352)为男性。2型糖尿病患者的高血压患病率为45.5%(n=566)。年龄较高(AOR,95%CI:8.1,4.6-14.3),女性性别(或,95%CI:1.8,1.2-2.5),法尔斯(AOR,95%CI:1.6,1.1-2.4)和土耳其人(AOR,95%CI:1.6,1.1-2.5)与其他种族,和超重(AOR,95%CI:1.8,1.38-2.38)和肥胖(AOR,95%CI:2.7,2.0-3.8)与BMI<25与较高的高血压患病率相关,而较高的身体活动(AOR,95%CI:0.57,0.42-0.78)与多变量模型中高血压患病率较低相关。2型糖尿病患者的高血压患病率较高,并且随着年龄的增长而增加,在一些种族中,BMI较高,体力活动较低。需要进一步的前瞻性研究来调查该人群中的这些关联。
    Hypertension is a very common comorbidity in type 2 diabetes patients, which leads to important health and treatment challenges. The present study was conducted with the aim of determining the prevalence of hypertension and its risk factors in type 2 diabetes patients. This study was conducted using cross-sectional data from 1245 participants aged between 35 and 70 years and diagnosed with type 2 diabetes at baseline in the Fasa cohort study. The prevalence hypertension was determined and multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between various risk factors and hypertension prevalence. The average age of the participants was 53.5 ± 8.7 years and 71.7% (n = 893) were female and 28.3% (n = 352) were male. The prevalence of hypertension in people with type 2 diabetes was 45.5% (n = 566). Higher age (AOR, 95% CI: 8.1, 4.6-14.3), female gender (OR, 95% CI: 1.8, 1.2-2.5), Fars (AOR, 95% CI: 1.6, 1.1-2.4) and Turk (AOR, 95% CI: 1.6, 1.1-2.5) vs. other ethnicity, and overweight (AOR, 95% CI: 1.8, 1.38-2.38) and obesity (AOR, 95% CI: 2.7, 2.0-3.8) vs. BMI < 25 was associated with a higher prevalence of hypertension, while higher physical activity (AOR, 95% CI: 0.57, 0.42-0.78) was associated with lower prevalence of hypertension in the multivariable model. The prevalence of hypertension in persons with type 2 diabetes was high and increased with greater age, in some ethnic groups, and with higher BMI and low physical activity. Further prospective studies are needed to investigate these associations in this population.
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  • 文章类型: Journal Article
    背景在数字化快速推进的时代,数字健康和医疗数据的保密性和隐私已成为首要问题。本研究调查了居住在冰雹市的个人对这些关键问题的看法,特别强调人口因素的影响,如年龄,性别,和计算机熟练程度对个人\'不适的卫生专业人员使用计算机和他们对研究人员的信任。对这些因素有更深入的了解对于制定有针对性的干预措施至关重要,这些干预措施旨在增强患者对数字健康/医疗技术的舒适度和信任。方法论本研究采用描述性横截面设计,涉及对冰雹市18岁及以上775人的调查。问卷旨在收集有关参与者人口统计学特征的信息,计算机熟练,数字健康和医疗信息的经验,以及对健康信息安全和隐私的看法。为了检查变量之间的关联和预测关系,卡方检验,相关分析,并进行逻辑回归。结果发现性别与使用计算机的卫生专业人员的不适之间存在显着关联(卡方=60.29,p<0.0001),以及年龄和对研究人员关于医疗信息隐私的信任之间(卡方=50.14,p<0.0001)。计算机熟练程度与健康信息安全感知呈正相关(r=0.12,p=0.0002),而由于隐私问题,计算机所有权和避免医学检查之间存在负相关(r=-0.08,p=0.03)。Logistic回归分析确定年龄,性别,和计算机熟练程度是使用计算机的卫生专业人员不适的重要预测因素。研究结果强调了人口因素在塑造对数字健康和医疗信息的隐私和安全的态度方面发挥的关键作用。结论这项研究的结果强调了人口因素在塑造对数字健康和医疗信息的隐私和安全性的态度方面发挥的关键作用。性别和年龄被发现显著影响个人的不适和信任水平,而计算机熟练被证明可以增强人们的安全感。基于这些发现,研究人员建议实施有针对性的干预措施,例如对性别问题有敏感认识的培训计划和倡议,提高数字素养,提高患者对数字健康技术的舒适度和信任度。
    Background In the era of rapid digital advancement, the confidentiality and privacy of digital health and medical data have become paramount concerns. This study investigates the perspectives of individuals residing in Hail City regarding these critical issues, with a particular emphasis on the influence of demographic factors such as age, gender, and computer proficiency on individuals\' discomfort with health professionals using computers and their trust in researchers. Gaining a deeper understanding of these factors is vital for the development of targeted interventions aimed at enhancing patient comfort and trust in digital health/medical technologies. Methodology This study employed a descriptive cross-sectional design, involving a survey of 775 individuals aged 18 and above in Hail City. The questionnaire was designed to gather information on participants\' demographic characteristics, computer proficiency, experiences with digital health and medical information, and perceptions of health information safety and privacy. To examine the associations and predictive relationships between variables, chi-square tests, correlation analyses, and logistic regression were performed. Results Significant associations were found between gender and discomfort with health professionals using computers (chi-square = 60.29, p < 0.0001), and between age and trust in researchers regarding the privacy of medical information (chi-square = 50.14, p < 0.0001). Positive correlations were observed between computer proficiency and perception of health information safety (r = 0.12, p = 0.0002), while a negative correlation was found between computer ownership and avoidance of medical tests due to privacy concerns (r = -0.08, p = 0.03). Logistic regression analysis identified age, gender, and computer proficiency as significant predictors of discomfort with health professionals using computers. The findings highlight the crucial role that demographic factors play in shaping attitudes toward the privacy and security of digital health and medical information. Conclusions The findings of this study highlight the crucial role that demographic factors play in shaping attitudes toward the privacy and security of digital health and medical information. Gender and age were found to significantly influence individuals\' levels of discomfort and trust, while computer proficiency was shown to enhance perceptions of safety. Based on these findings, the researchers recommend implementing targeted interventions, such as gender-sensitive training programs and initiatives, to enhance digital literacy and improve patient comfort and trust in digital health technologies.
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  • 文章类型: Journal Article
    特应性皮炎(AD)是一种慢性复发性,瘙痒,炎症性皮肤病。评估严重AD的特征和危险因素对于医护人员理解和随后对患者进行教育以获得最佳结果至关重要。已知临床特征根据人群和地区而变化。在全球北部,主要是高加索人群中,AD已得到充分记录,虽然对居住在非洲的非洲患者进行的研究很少。这项研究评估了临床特征,严重程度,埃塞俄比亚南部AD儿童的社会人口因素。
    从2022年10月至2023年9月,在埃塞俄比亚南部的四家随机选择的医院中,对461名儿童及其护理人员进行了基于医院的横断面研究。使用系统抽样技术来招募研究参与者。临床概况和社会人口统计学数据由训练有素的数据收集器收集。使用评分异位性皮炎(SCORAD)指数工具。进行描述性分析以表征研究参与者。使用单因素和普通逻辑回归来识别与SCORAD指数评分相关的因素。95%的OR用于显示关联强度,p值<0.05用于说明显著性水平。
    在461名诊断为AD的儿童中,212(46%)是女孩,249(54%)是男孩。在儿科患者的样本中,149例(32.3%)表现为轻度AD,231(46.2%)出现中度,99例(21.5%)出现严重AD的体征和症状。所有患者都有瘙痒。皮肤干燥,excoriation,和红斑,其次是苔藓化,是观察到的最多的迹象。在普通的逻辑回归模型中,发病年龄[AOR95%CI1.95(1.3-2.94)],照顾者或家庭的性别[AOR95%CI0.61(0.41-0.90)],家族特应性病史[AOR95%CI0.64(0.44-0.93)],母亲教育状况[95%CI2.45(1.1-5.47)],和使用草药[AOR95%CI0.50(0.33-0.79)]与AD的严重程度显着相关。
    在这项研究中,68%的儿童被发现患有中度至重度AD。早期发病,母亲教育,家族性过敏史,看护者的性别,和使用草药是儿童重度AD的独立预测因素。我们建议进一步调查这些变量作为评估AD严重程度的标志物的潜力,并改善埃塞俄比亚AD儿童的护理和管理。
    UNASSIGNED: Atopic dermatitis (AD) is a chronic relapsing, pruritic, inflammatory skin disease. Assessing the characteristics and risk factors of severe AD is central to healthcare workers\' understanding and subsequent education of patients for the most optimal outcomes. The clinical characteristics are known to vary depending on populations and regions. AD has been well-documented in the global North in mainly Caucasian populations, while very few studies have been conducted on African patients residing in Africa. This study assessed the clinical characteristics, severity, and sociodemographic factors of children with AD in Southern Ethiopia.
    UNASSIGNED: A hospital-based cross-sectional study was conducted among 461 children and their caregivers in four randomly selected hospitals in Southern Ethiopia from October 2022 to September 2023. A systematic sampling technique was used to enroll study participants. Clinical profile and sociodemographic data were collected by trained data collectors. The Scoring Atopic Dermatitis (SCORAD) index tool was used. The descriptive analysis was performed to characterize study participants. Univariate and ordinary logistic regression were used to identify factors associated with the SCORAD index score. The OR with 95% was used to show the strength of association, and a p-value of <0.05 was used to declare the level of significance.
    UNASSIGNED: Out of 461 AD-diagnosed children, 212 (46%) were girls and 249 (54%) were boys. In the sample of pediatric patients, 149 (32.3%) exhibited mild AD, 231 (46.2%) presented with moderate, and 99 (21.5%) showed signs and symptoms of severe AD. All patients had itching. Dryness of skin, excoriation, and erythema, followed by lichenification, were the most observed signs. In the ordinary logistic regression model, age onset of the disease [AOR 95% CI 1.95 (1.3-2.94)], sex of caregiver or family [AOR 95% CI 0.61 (0.41-0.90)], family atopy history [AOR 95% CI 0.64 (0.44-0.93)], mother education status [95% CI 2.45 (1.1-5.47)], and use of herbal medication [AOR 95% CI 0.50 (0.33-0.79)] were significantly associated with the severity of AD.
    UNASSIGNED: In this study, 68% of children were found to have moderate-to-severe AD. Early onset, maternal education, familial atopy history, sex of caregiver, and use of herbal medication were independent predictors of severe AD in children. We recommend further investigation into these variables for their potential to serve as markers to assess the severity of AD and improve the care and management of children with AD in Ethiopia.
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  • 文章类型: Journal Article
    背景:充血性心力衰竭(CHF)是导致住院和再入院的主要原因,给医疗保健系统带来沉重负担。确定与再入院风险相关的因素对于制定有针对性的干预措施和改善患者预后至关重要。本研究旨在调查社会经济和人口因素对主要因CHF入院的患者30天和90天再入院率的影响。方法本研究采用横断面研究设计,数据来自2016年至2020年的全国再入院数据库(NRD)。包括初步诊断为CHF的成年患者。主要结果是30天和90天全因再入院率。多变量逻辑回归用于确定与再入院独立相关的因素,包括种族,种族,保险状况,收入水平,和生活安排。结果本研究共纳入219,904例初步诊断为CHF的患者。总体30天和90天再入院率分别为17.3%和23.1%,分别。在多变量分析中,30天再入院风险较高的独立相关因素包括西班牙裔种族(OR1.18,95%CI1.03-1.35),非裔美国人种族(OR1.15,95%CI1.04-1.28),医疗保险(OR1.24,95%CI1.12-1.38),和城市住宅(OR1.11,95%CI1.02-1.21)。较高的收入与较低的再入院风险相关(OR0.87,95%CI0.79-0.96最低四分位数)。在90天的再入院中观察到类似的模式。结论社会经济和人口因素,包括种族,种族,保险状况,收入水平,和生活安排,显著影响CHF患者30天和90天的再入院率。这些发现强调了有针对性的干预措施和政策的必要性,以解决健康的社会决定因素并促进CHF管理中的健康公平。未来的研究应侧重于发展和评估文化敏感性,以社区为基础的策略,以减少再入院和改善高危CHF患者的预后。
    Background Congestive heart failure (CHF) is a leading cause of hospitalizations and readmissions, placing a significant burden on the healthcare system. Identifying factors associated with readmission risk is crucial for developing targeted interventions and improving patient outcomes. This study aimed to investigate the impact of socioeconomic and demographic factors on 30-day and 90-day readmission rates in patients primarily admitted for CHF. Methods The study was carried out using a cross-sectional study design, and the data were obtained from the Nationwide Readmissions Database (NRD) from 2016 to 2020. Adult patients with a primary diagnosis of CHF were included. The primary outcomes were 30-day and 90-day all-cause readmission rates. Multivariable logistic regression was used to identify factors independently associated with readmissions, including race, ethnicity, insurance status, income level, and living arrangements. Results A total of 219,904 patients with a primary diagnosis of CHF were used in the study. The overall 30-day and 90-day readmission rates were 17.3% and 23.1%, respectively. In multivariable analysis, factors independently associated with higher 30-day readmission risk included Hispanic ethnicity (OR 1.18, 95% CI 1.03-1.35), African American race (OR 1.15, 95% CI 1.04-1.28), Medicare insurance (OR 1.24, 95% CI 1.12-1.38), and urban residence (OR 1.11, 95% CI 1.02-1.21). Higher income was associated with lower readmission risk (OR 0.87, 95% CI 0.79-0.96 for highest vs. lowest quartile). Similar patterns were observed for 90-day readmissions. Conclusion Socioeconomic and demographic factors, including race, ethnicity, insurance status, income level, and living arrangements, significantly impact 30-day and 90-day readmission rates in patients with CHF. These findings highlight the need for targeted interventions and policies that address social determinants of health and promote health equity in the management of CHF. Future research should focus on developing and evaluating culturally sensitive, community-based strategies to reduce readmissions and improve outcomes for high-risk CHF patients.
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  • 文章类型: Journal Article
    内分泌干扰化学物质(EDCs)在环境中普遍存在,引起公众对人类暴露于这些污染物的关注。在这项研究中,我们分析了各种内分泌干扰化合物的水平,包括对羟基苯甲酸酯(PBs),二苯甲酮(BzPs),三氯卡班(TCC)和三氯生(TCS),从华南地区居民收集的565个尿样。所有11种目标化学物质均以相对较高的频率(41-100%)检测到,最普遍的是3,4-二羟基苯甲酸(5.39ng/mL),对羟基苯甲酸甲酯(5.12ng/mL),对羟基苯甲酸乙酯(3.11ng/mL)和三氯生(0.978ng/mL)。PBs是最主要的组,中位浓度为32.2ng/mL,其次是TC(TCC和TCS的总和,0.998ng/mL)和BzPs(0.211ng/mL)。值得注意的是,成人尿PBs浓度明显升高(p<0.01),而儿童BzPs和TC升高(p<0.001)。儿童中BzPs和TC的增加令人担忧,鉴于它们对化学品的敏感性和脆弱性。发现尿目标化合物与人口统计学因素之间存在显着相关性,包括性别,年龄,和体重指数。具体来说,女性,发现较年轻的成年人(18≤年龄≤35)和体重低于/正常体重(16≤BMI≤23.9)的个体对EDC的暴露水平较高,如他们估计的每日摄入量的中值所示。尽管这些较高的水平仍然低于可接受的每日摄入量阈值,同时暴露于这些EDC的健康风险不容忽视.
    Endocrine-disrupting chemicals (EDCs) are pervasive in the environment, prompting significant public concern regarding human exposure to these pollutants. In this study, we analyzed the levels of various endocrine-disrupting compounds, including parabens (PBs), benzophenones (BzPs), triclocarban (TCC) and triclosan (TCS), across 565 urine samples collected from residents of South China. All 11 target chemicals were detected at relatively high frequencies (41-100%), with the most prevalent ones being 3,4-dihydroxybenzoic acid (5.39 ng/mL), methyl-paraben (5.12 ng/mL), ethyl-paraben (3.11 ng/mL) and triclosan (0.978 ng/mL). PBs emerged as the most predominant group with a median concentration of 32.2 ng/mL, followed by TCs (sum of TCC and TCS, 0.998 ng/mL) and BzPs (0.211 ng/mL). Notably, urinary concentrations of PBs in adults were significantly higher (p < 0.01) compared to children, while BzPs and TCs were elevated in children (p < 0.001). The increased presence of BzPs and TCs in children is a cause for concern, given their heightened sensitivity and vulnerability to chemicals. Significant correlations were found between urinary target compounds and demographic factors, including gender, age and body mass index. Specifically, females, younger adults (18 ≤ age ≤ 35) and individuals with under/normal weight (16 ≤ BMI ≤ 23.9) were found to have higher exposure levels to EDCs, as indicated by the median values of their estimated daily intakes. Despite these higher levels still being lower than the acceptable daily intake thresholds, the health risks stemming from simultaneous exposure to these EDCs must not be overlooked.
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  • 文章类型: Journal Article
    阻生第三磨牙是最常见的牙齿位置异常之一,影响患者及其生活质量。根据影响和侵入性移除程序,本研究的目的是根据第3磨牙的影像学特征及其与人口学特征的关系来评估其特征.HasanSadikin医院口腔颌面外科门诊牙科记录,万隆,印度尼西亚,从2018年1月1日至2019年12月31日,进行了排序,从这些记录中提取了相关的临床和人口统计学数据以及全景X线检查结果。然后使用SPSS版本29对所有数据进行制表和分析。确定了多达3019颗受影响的第三磨牙。我们的发现表明,年龄与患侧第三磨牙的发生之间存在关联,年龄在17至29岁之间的患者患侧第三磨牙的发生率很高。患有阻生第三磨牙的男性患者更有可能患有多个阻生第三磨牙,而这种风险在女性中降低。X线检查显示,近角位置是下颌第三磨牙最常见的位置。受影响的第三磨牙的高发生率变化与几个人口统计学因素有关。
    An impacted third molar is one of the most common abnormalities of the tooth position, impacting patients and their quality of life. Based on the impact and the invasive removal procedure, this study aimed to evaluate the characteristics of impacted third molars based on their radiographic features as well as their association with demographic characteristics. Outpatient dental records of the oral and maxillofacial surgery department of Hasan Sadikin Hospital, Bandung, Indonesia, from 1 January 2018 to 31 December 2019, were sorted, and relevant clinical and demographic data and panoramic radiographic examination results were extracted from these records. All data were then tabulated and analyzed by using SPSS version 29. As many as 3019 impacted third molars were identified. Our findings suggested the association between age to the occurrence of impacted third molars where patients aged between 17 and 29 years old showed high occurrences of impacted third molars. Male patients with impacted third molars are more likely to have multiple impacted third molars, while this risk decreases in females. Radiographic examination showed that the mesioangular position is the most common position for mandibular third molars. The variation in high occurrences of the impacted third molar is associated with several demographic factors.
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  • 文章类型: Journal Article
    这项研究旨在揭示导致暴力犯罪的性别特定关系和途径,使用复杂的分析工具来分析各种因素之间复杂的相互作用。采用混合图形模型和贝叶斯网络,该研究分析了1,254名囚犯(男性占61.64%,女性占38.36%)的样本,以调查人口因素之间的关系,心理健康问题,暴力犯罪。这项研究利用综合措施,包括贝克抑郁量表,贝克焦虑量表,和童年创伤问卷,评估参与者的心理健康状况。主要发现揭示了暴力犯罪途径中的显着性别差异。对于男性来说,不完整的父母婚姻与犯罪行为的严重程度密切相关,虽然婚姻状况成为一个重要因素,已婚男性犯暴力犯罪的可能性较小。相比之下,这些关系对女性来说并不重要。贝叶斯网络分析表明,生活在城市地区不同性别对教育和情感表达的影响不同,强调语境因素的重要性。该研究强调在刑事司法政策和干预措施中需要有针对性别的考虑。它强调了人口和心理健康因素在影响暴力犯罪途径方面的复杂相互作用,为制定更有效的预防策略提供见解。尽管它的横断面设计和对自我报告数据的依赖,这项研究大大有助于理解犯罪行为的性别维度。
    This research aims to uncover gender-specific relationships and pathways that contribute to the perpetration of violent crimes, using sophisticated analytical tools to analyze the complex interactions between various factors. Employing Mixed Graphical Models and Bayesian networks, the study analyzes a sample of 1,254 prisoners (61.64% males and 38.36% females) to investigate the relationships among demographic factors, mental health issues, and violent crime. The study utilizes comprehensive measures, including the Beck Depression Inventory, Beck Anxiety Inventory, and Childhood Trauma Questionnaire, to assess participants\' mental health status.Key findings reveal significant gender differences in the pathways to violent crime. For males, incomplete parental marriages strongly correlate with criminal behavior severity, while marriage status emerges as a significant factor, with married males less likely to commit violent crimes. In contrast, these relationships are not significant for females. Bayesian network analysis indicates that living in urban areas differently influences education and emotional expression across genders, emphasizing the importance of contextual factors. The study highlights the need for gender-specific considerations in criminal justice policies and interventions. It underscores the complex interplay of demographic and mental health factors in influencing violent crime pathways, providing insights for developing more effective prevention strategies. Despite its cross-sectional design and reliance on self-reported data, the research significantly contributes to understanding the gendered dimensions of criminal behavior.
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  • 文章类型: Journal Article
    本研究旨在确定人口统计学因素之间的关联,身体尺寸,一般人群的水果和蔬菜摄入量,专注于低和高皮肤类胡萝卜素水平的个体。这项横断面研究是在山梨县第14届全国促进食品和营养教育公约(2019年)期间进行的,日本(农村地区)和国家生物医学创新研究所的2019年开放日,健康,东京的营养,日本(市区)。进行皮肤类胡萝卜素测量,参与者被要求填写一份自我管理的问卷。研究人群由492名年龄≥16岁的日本人组成。低皮肤类胡萝卜素水平的优势比(ORs)在男性中升高,那些超重的人,以及那些几乎从不食用或每天只食用一盘蔬菜的人。相反,生活在山梨的人的OR较低,30-39岁,≥70岁,以及那些食用水果≥1次/周的人。对于高皮肤类胡萝卜素水平,年龄≥70岁的人群中的ORs较高,住在山梨县,以及每天食用水果≥1次或蔬菜≥5次的人。人口因素,身体尺寸,习惯性水果和蔬菜的摄入量可以作为皮肤类胡萝卜素水平的指标。
    This study aimed to determine the association between demographic factors, body size, and fruit and vegetable intake in the general population, focusing on individuals with both low and high skin carotenoid levels. This cross-sectional study was conducted during the 14th National Convention on the Promotion of Food and Nutrition Education (2019) in Yamanashi, Japan (a rural area) and the Open House 2019 at the National Institute of Biomedical Innovation, Health, and Nutrition in Tokyo, Japan (an urban area). Skin carotenoid measurements were conducted, and the participants were asked to fill out a self-administered questionnaire. The study population consisted of 492 Japanese individuals aged ≥16 years. The odds ratios (ORs) for low skin carotenoid levels were elevated in males, those who were overweight, and those who almost never consumed or consumed only one vegetable dish/day. Conversely, the ORs were lower in those living in Yamanashi, aged 30-39 and ≥70 years, and those who consumed fruit ≥1 time/week. For high skin carotenoid levels, the ORs were higher among those aged ≥70 years, living in Yamanashi, and those who consumed fruit ≥1 time/day or ≥5 vegetable dishes/day. Demographic factors, body size, and habitual fruit and vegetable intake may serve as indicators of skin carotenoid levels.
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  • 文章类型: Journal Article
    背景:社会经济和文化障碍对晚期慢性肾脏病(ACKD)肾脏替代疗法(RRT)技术选择的影响几乎没有探讨,这会产生不公平的问题,在医疗保健中经常被忽视。这项研究的目的是确定影响西班牙晚期慢性肾脏病(ACKD)咨询中RRT选择的“非医学”障碍。
    方法:回顾性分析,包括2009年至2020年在三级医院接受ACKD会诊的患者总数。纳入ACKD咨询始于资格测试和决策过程,由受过专门训练的护士进行。研究考虑的变量是:年龄,性别,CKD的病因,对日常生活基本活动(Barthel量表)和日常生活工具活动(Lawton和Brody量表)的依赖程度,西班牙与外国国籍,社会经济水平和语言障碍。社会经济水平是根据患者所属的初级保健中心的家庭和卫生区进行推断的。
    结果:在研究期间,共有673人参加了ACKD会诊,其中400人(59.4%)选择血液透析(HD),156(23.1%)用于腹膜透析(PD),4例(0.5%)为早期活体供肾移植(LDRT)和113例(16.7%)选择守旧照护(CC)。选择PD作为选择的RRT技术(与HD)与社会经济水平高的人(38.7%与22.5%)(p=0.002),西班牙国籍(91%vs.77.7%)(p<0.001),较低的语言障碍(0.6%对10.5%)(p<0.001),在Barthel量表(97.4vs92.9)以及Lawton和Brody量表(7vs6.1)上得分较高(p<0.001)。在两种技术的选择上,年龄和性别都没有显着差异。选择CC的患者年龄明显较大(81.1vs67.7岁;p<0.001),依赖性更强(p<0.001),女性比例较高(49.6%vs35.2%;p=0.006),西班牙人比例较高(94.7%vs81%,p=0.001)与其他技术(PD和HD)的选择有关。社会经济水平并不影响CC的选择。
    结论:尽管有规范的决策过程,有社会经济地位等因素,迁移,影响所选择RRT类型的人口的语言障碍和依赖性。为了解决这些可能导致不公平的方面,需要跨学科团队的跨部门和多层次干预,包括,其中,社会工作者,提供更全面和以人为中心的评估。
    BACKGROUND: The influence of socioeconomic and cultural barriers in the choice of renal replacement therapy (RRT) techniques in advanced chronic kidney disease (ACKD) has been scarcely explored, which can generate problems of inequity, frequently unnoticed in health care. The aim of this study is to identify the \"non-medical\" barriers that influence the choice of RRT in an advanced chronic kidney disease (ACKD) consultation in Spain.
    METHODS: Retrospective analysis including the total number of patients seen in the ACKD consultation in a tertiary hospital from 2009 to 2020. Inclusion in the ACKD consultation began with an eligibility test and a decision-making process, conducted by a specifically trained nurse. The variables considered for the study were: age, sex, etiology of CKD, level of dependence for basic activities of daily living (Barthel Scale) and instrumental activities of daily living (Lawton and Brody Scale), Spanish versus foreign nationality, socioeconomic level and language barrier. The socioeconomic level was extrapolated according to home and health district by primary care center to which the patients belonged.
    RESULTS: A total of 673 persons were seen in the ACKD consultation during the study period, of whom 400 (59.4%) opted for hemodialysis (HD), 156 (23.1%) for peritoneal dialysis (PD), 4 (0.5%) for early living donor renal transplantation (LDRT) and 113 (16.7%) chose conservative care (CC). The choice of PD as the chosen RRT technique (vs. HD) was associated with people with a high socioeconomic level (38.7% vs. 22.5%) (p = 0.002), Spanish nationality (91% vs. 77.7%) (p < 0.001), to a lower language barrier (0.6% vs 10.5%) (p < 0.001), and to a higher score on the Barthel scale (97.4 vs 92.9) and on the Lawton and Brody scale (7 vs 6.1) (p < 0.001). Neither age nor sex showed significant differences in the choice of both techniques. Patients who opted for CC were significantly older (81.1 vs 67.7 years; p < 0.001), more dependent (p < 0.001), with a higher proportion of women (49.6% vs 35.2%; p = 0.006) and a higher proportion of Spaniards (94.7% vs 81%, p = 0.001) in relation to the choice of other techniques (PD and HD). Socioeconomic level did not influence the choice of CC.
    CONCLUSIONS: Despite a regulated decision-making process, there are factors such as socioeconomic status, migration, language barrier and dependency of the population that influence the type of RRT chosen. To address these aspects that may cause inequity, an intersectoral and multilevel intervention is required with interdisciplinary teams that include, among others, social workers, to provide a more holistic and person-centered assessment.
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  • 文章类型: Journal Article
    UNASSIGNED: Data from recent years show that the COVID-19 pandemic has significantly reduced the scope of child immunisation worldwide. If the numbers continue to fall, we may have a vaccination crisis. In order to understand the local factors of this phenomenon, we studied parents\' viewpoint towards childhood vaccination in Lithuania. Therefore, the aim of our study was to determine the impact of parental attitudes on children\'s vaccination.
    UNASSIGNED: A web-based cross-sectional study was made in Lithuania from October 20th to November 3rd, 2020, using Google Forms. An anonymous questionnaire included both quantitative and qualitative questions. The questionnaire was distributed to the general population in Lithuania via social media and a snowball sampling. Only parents who have at least one child under 18 years old were involved in the study. We analysed the parents\' attitudes towards vaccination by their socioeconomic and demographic determinants using MS Excel and OpenEpi tools. The respondents were considered vaccine supporters if they vaccinated all their children with state-reimbursed vaccines or only vaccinated some of their children, and vaccine sceptics if they did not vaccinate their children with state-reimbursed vaccines.
    UNASSIGNED: The population of our research consisted of 775 parents. There were more males against vaccination than females, respectively, 59.6% and 33.2%. 65.0% of all respondents stated that they vaccinated their children with the full course of vaccines, while the remaining 35.0% did not vaccinate. University-level education dominated in both pro-vaccine and anti-vaccine groups. We found that 16.9% of parents who were unvaccinated as children themselves tend not to vaccinate their children. However, in the pro-vaxx group, only 0.7% of parents were unvaccinated during childhood. 50.8% of vaccine sceptics were not fully informed by healthcare professionals about the benefits and risks of vaccination, while only 31.6% of vaccine supporters were not informed. Social environment did not have an impact on the decision whether to vaccinate or not to vaccinate a child among both vaccine advocates and vaccine deniers (accordingly, 51.2% and 42.9%). 29.3% of respondents stated that the cost of paid vaccinations was too high. Open-text survey responses gave us more in-depth insight about the parental decision-making process. Protection of children and society from infectious diseases (31.7%) was mentioned as the main reason for vaccination. Whereas vaccine-hesitant parents were mostly concerned about already-occurring side effects or their risk (43.4%).
    UNASSIGNED: Our findings confirmed that vaccine hesitancy was associated with not being vaccinated in childhood themselves, lack of information from medical practitioners and male gender. The price of vaccines also had an impact on immunisation rates - more than one-third of the vaccine supporting parents indicated that the cost of paid vaccinations was too high. The main incentive for vaccine compliance was parents\' desire to protect their children and society from infectious diseases. Whereas vaccine-hesitant parents were mostly concerned about already occurring side effects or their risk. There was no consensus, whether vaccination of children should be mandatory in Lithuania, as the answers to the question were almost evenly distributed. The formation of parents\' attitudes towards children\'s vaccination is a complex process that is determined by parents\' attitudes towards the health care system, lack of trust in doctors, and gaps in communication about the benefits and risks of vaccination. All of this information should be taken into account in health policy-making.
    UNASSIGNED: Pastarųjų metų duomenys rodo, kad COVID-19 pandemija labai sumažino vaikų imunizacijos mastą visame pasaulyje. Jei skaičiai ir toliau mažės, gali kilti vakcinacijos krizė. Siekdami suprasti lokalias šio reiškinio priežastis, tyrėme tėvų požiūrį į skiepijimą Lietuvoje. Todėl šiuo tyrimu buvo siekiama nustatyti tėvų požiūrio įtaką vaikų skiepijimui.
    UNASSIGNED: Lietuvos populiacijoje buvo atliktas skerspjūvio tyrimas nuo 2020 m. spalio 20 d. iki lapkričio 3 d., internete, naudojant ,,Google“ formas. Anoniminėje anketoje buvo pateikti tiek kiekybiniai, tiek kokybiniai klausimai. Anketa buvo išplatinta per socialinius tinklus bei naudojant „sniego gniūžtės“ atranką. Tyrime galėjo dalyvauti tik tėvai, turintys bent vieną vaiką iki 18 metų amžiaus. Gautus duomenis apie tėvų požiūrį į vaikų skiepijimą pagal socialinius, ekonominius ir demografinius veiksnius išanalizavome naudodami MS Excel ir OpenEpi įrankius. Respondentai buvo laikomi skiepų šalininkais, jei jie skiepijo savo vaikus valstybės kompensuojamomis vakcinomis arba skiepijo tik kai kuriuos vaikus. Tuo tarpu, vakcinacijos oponentais – jei neskiepijo savo vaikų valstybės kompensuojamomis vakcinomis.
    UNASSIGNED: Mūsų tyrime dalyvavo 775 tėvai. Vakcinacijos oponentų vyrų buvo daugiau nei moterų, atitinkamai 59.6% ir 33.2%. 65.0% visų apklaustųjų nurodė, kad savo vaikus skiepija visu skiepų kursu, o likę 35.0% – neskiepijo. Universitetinis išsilavinimas dominavo tiek vakcinuojančių, tiek nevakcinuojančiųjų grupėse. Nustatėme, kad 16.9% tėvų, kurie patys vaikystėje buvo neskiepyti, yra linkę neskiepyti savo vaikų. Tačiau vakcinuojančiųjų grupėje tik 0.7% tėvų buvo neskiepyti vaikystėje. 50.8% vakcinacijos skeptikų teigė, jog sveikatos priežiūros specialistai neinformavo jų apie skiepijimo naudą ir riziką, tuo tarpu tik 31.6% vakcinacijai pritariančiųjų nebuvo informuoti. Socialinė aplinka neturėjo įtakos apsisprendimui, ar skiepyti vaiką tiek tarp skiepų šalininkų, tiek skiepų oponentų (atitinkamai: 51.2% ir 42.9%). 29.3% respondentų teigė, kad mokamų skiepų kaina yra per didelė. Atviro klausimo atsakymai suteikė mums išsamesnės informacijos apie tėvų sprendimų priėmimo procesą. Pagrindinis skiepijimo motyvas buvo vaikų ir visuomenės apsauga nuo infekcinių ligų (31.7%). Tuo tarpu skiepyti nesiryžę tėvai nerimavo dėl jau pasireiškusių šalutinių poveikių ar jų rizikos (43.4%).
    UNASSIGNED: Mūsų išvados patvirtino, kad nenoras skiepyti savo vaikų buvo susijęs su pačių tėvų vakcinacijos statusu vaikystėje, informacijos iš gydytojų stoka ir vyriška lytimi. Skiepijimo apimtims įtakos turėjo ir skiepų kaina – daugiau nei trečdalis skiepijimui pritariančių tėvų nurodė, kad mokamų skiepų kaina yra per didelė. Pagrindinė paskata skiepyti buvo tėvų noras apsaugoti savo vaikus ir visuomenę nuo infekcinių ligų. Tuo tarpu vakcinacijos oponentai dažniausiai nerimavo dėl jau pasireiškusių šalutinių poveikių ar jų rizikos. Vieningos nuomonės, ar Lietuvoje privaloma skiepyti vaikus, nebuvo, nes atsakymai į klausimą pasiskirstė beveik po lygiai. Tėvų požiūrio į vaikų skiepijimą formavimasis yra sudėtingas procesas, kurį lemia tėvų požiūris į sveikatos priežiūros sistemą, nepasitikėjimas gydytojais bei komunikacijos apie skiepijimo naudą ir riziką spragos. Į visus šiuos aspektus reikėtų atsižvelgti formuojant sveikatos politiką.
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