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PubMed2005

Delay in presentation to hospital for surgery for congenital and developmental cataract in Tanzania.

BACKGROUND: Childhood cataract is a leading cause of blindness in children in eastern Africa. High quality surgical services have been established at a few tertiary facilities in the region; however, there appears to be delay in presentation to hospital. METHODS: Parents or guardians of all children presenting to KCMC Hospital or CCBRT Hospital with congenital (recognised since birth or within the first year) or developmental (cataract leading to reduction in vision after 1 year of age) cataract were interviewed regarding the actions taken (and timing of these) before coming to hospital. Demographic information was also collected. For analysis children were grouped as either late presenters (more than 12 months after recognition) or not late presenters (within 12 months of recognition) and predictors of late presentation were assessed. RESULTS: Among 178 children (74 congenital cataract and 104 developmental cataract) analysed, the mean delay between recognition by the caregiver and presentation to hospital was 34 months, almost 3 years. The median delay was 18 months-9 months for congenital cataract and 24 months for developmental cataract. Long delay in presentation was associated with having developmental cataract, living far from the hospital, and low socio-educational status of the mother. Among children with congenital cataract, having another sibling increased the likelihood of early presentation. CONCLUSION: Delay in presentation remains a significant problem for children needing surgery for congenital or developmental cataract. Parents who have multiple children may be more likely to seek early treatment, possibly because their expectations of achievable sight at a young age are based on previous experience of their older children. Educational efforts should aim to reach the most "unreachable" (those living the furthest from the hospital and having the lowest socio-educational status of the mother).

Cataract↗
PubMedDate not supplied

Better psychological functioning and higher social status may largely explain the apparent health benefits of wine: a study of wine and beer drinking in young Danish adults.

BACKGROUND: Findings from a recent series of Danish studies suggest that moderate wine drinkers are healthier than those who drink other alcoholic beverages or those who abstain. OBJECTIVE: To identify possible explanatory factors associated with the health benefits of wine consumption through the examination of a wide spectrum of social, cognitive, and personality characteristics related to both beverage choice and health in young Danish adults. SUBJECTS AND METHODS: Descriptive cross-sectional study of characteristics associated with beverage choice in a sample of 363 men and 330 women between the ages of 29 and 34 years, selected from the Copenhagen Perinatal Cohort on the basis of perinatal records. MAIN OUTCOME MEASURES: Socioeconomic status, education, IQ, personality, psychiatric symptoms, and health-related behaviors, including alcohol consumption, were analyzed. The outcome variables were subjected to linear and logistic regression analyses with 2 factors (beer and wine), each with 2 levels (drinking or not drinking a certain beverage type). RESULTS: Wine drinking was significantly associated with higher IQ, higher parental educational level, and higher socioeconomic status. Beer drinking was significantly associated with lower scores on the same variables. On scales concerning personality, psychiatric symptoms, and health-related behaviors, wine drinking was associated with optimal functioning and beer drinking with suboptimal functioning. CONCLUSIONS: Our data demonstrate that wine drinking is a general indicator of optimal social, cognitive, and personality development in Denmark. Similar social, cognitive, and personality factors have also been associated with better health in many populations. Consequently, the association between drinking habits and social and psychological characteristics, in large part, may explain the apparent health benefits of wine.

Adult↗
PubMed1991

Evaluation of social marketing of oral rehydration therapy.

Attempts, at social marketing of oral rehydration therapy (ORT) through television, in changing the knowledge and practice of mothers with regard to its use was assessed. One hundred and eighty seven consecutive mothers (38 excluded due to non use of ORT) were administered a preplanned questionnaire to assess their socio-economic profile, educational status, concept of diarrhea and correct use of ORT. Fifty nine mothers who watched these programmes on TV regularly formed the study group. These were compared with 90 mothers who had gained such knowledge from non-television sources. The correct application of knowledge of ORT was significantly better in study group compared with control group. The educational status of mothers had a positive impact on motivation to use ORT at home in the study group. Mass media campaigns through "TV spots" is an effective way of improving knowledge of mothers on ORT in a developing country.

Adult↗
PubMed2006

Social disadvantage and schizophrenia. A combined neighbourhood and individual-level analysis.

OBJECTIVE: To study, in a geographically defined area, associations between the neighbourhood social environment and individual socioeconomic status on the one hand, and treated incidence of schizophrenia and level of subsequent service use on the other. METHOD: A combined data set of (i) patients with a case register diagnosis of schizophrenia and (ii) population controls was subjected to multilevel analyses, including neighbourhood exposures (neighbourhood socioeconomic disadvantage and social capital) and individual level confounders. Separate analyses were conducted for inpatient and outpatient psychiatric service consumption as indexed by the case register. RESULTS: Neighbourhood socioeconomic disadvantage and neighbourhood social capital did not impact on the treated incidence of schizophrenia, but quantity of inpatient service consumption was higher in neighbourhoods with higher level of social control (i.e. where it is more likely that neighbours intervene in neighbourhood-threatening situations). In addition, most indicators of lower individual socioeconomic status were associated with higher treated incidence, while treated incidence was lower when individual educational status was low. CONCLUSION: Residents of high social control neighbourhoods may seek greater levels of resolution of psychiatric disorder in patient-residents, and by consequence may induce greater levels of inpatient service consumption in patients diagnosed with schizophrenia. Individual-level indicators of social disadvantage are associated with higher risk of treated psychotic disorder, with the exception of lower educational status, which may confer a lower probability of treatment given the presence of psychotic disorder.

Adult↗
PubMed2006

Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren.

BACKGROUND: Intestinal parasitic infections are a public health problem in developing countries such as Mexico. As a result, two governmental programmes have been implemented: a) "National Deworming Campaign" and b) "Opportunities" aimed at maternal care. However, both programmes are developed separately and their impact is still unknown. We independently investigated whether a variety of socio-economic factors, including maternal education and employment levels, were associated with intestinal parasite infection in rural school children. METHODS: This cross-sectional study was conducted in 12 rural communities in two Mexican states. The study sites and populations were selected on the basis of the following traits: a) presence of activities by the national administration of albendazole, b) high rates of intestinal parasitism, c) little access to medical examination, and d) a population having less than 2,500 inhabitants. A total of 507 schoolchildren (mean age 8.2 years) were recruited and 1,521 stool samples collected (3 per child). Socio-economic information was obtained by an oral questionnaire. Regression modelling was used to determine the association of socio-economic indicators and intestinal parasitism. RESULTS: More than half of the schoolchildren showed poliparasitism (52%) and protozoan infections (65%). The prevalence of helminth infections was higher in children from Oaxaca (53%) than in those from Sinaloa (33%) (p < 0.0001). Giardia duodenalis and Hymenolepis nana showed a high prevalence in both states. Ascaris lumbricoides, Trichuris trichiura and Entamoeba hystolitica/dispar showed low prevalence. Children from lower-income families and with unemployed and less educated mothers showed higher risk of intestinal parasitism (odds ratio (OR) 6.0, 95% confidence interval (CI) 1.6-22.6; OR 4.5, 95% CI 2.5-8.2; OR 3.3, 95% CI 1.5-7.4 respectively). Defecation in open areas was also a high risk factor for infection (OR 2.4, 95% CI 2.0-3.0). CONCLUSION: Intestinal parasitism remains an important public health problem in Sinaloa (north-western Mexico) and Oaxaca (south-eastern Mexico). Lower income, defecation in open areas, employment status and a lower education level of mothers were the significant factors related to these infections. We conclude that mothers should be involved in health initiatives to control intestinal parasitism in Mexico.

Analysis of Variance↗
PubMed1995

Coffee intake and risk of hip fracture in women in northern Italy.

BACKGROUND: Information on a possible relation between coffee, caffeine, and other methylxanthine-containing beverages and hip fracture is relatively scanty and controversial. We present here the results of a case-control study conducted in northern Italy. METHODS: A total of 279 cases of hip fracture and 1,061 controls in hospital for acute, nonneoplastic nontraumatic, non-hormone-related diseases were interviewed during their hospital stay. Odds ratios (OR) and their 95% confidence intervals (CI) according to consumption of coffee and other methylxanthine-containing beverages were derived from multiple logistic regression equations including terms for age, education, body mass index, smoking status, alcohol drinking, calcium intake, menopausal status, and estrogen replacement therapy. RESULTS: Compared with nondrinkers, the OR was 1.2 (95% CI, 0.8 to 1.7) for coffee drinkers. No association emerged with number of cups/day (OR = 1.2 for 1 cup/day, 1.0 for 2, 1.4 for 3 and 4, and 1.2 for 5 or more cups/day) or with duration of coffee intake (OR = 1.0 for less than 30 years and OR = 1.1 for more than 30 years). Similarly, no statistically significant association was observed with decaffeinated coffee (OR = 1.3), tea (OR = 1.3), or cola intake (OR = 0.6). OR for coffee drinking were computed across strata of age, menopausal status, education, smoking status, total alcohol drinking, and calcium intake. CONCLUSIONS: The present study found no association between hip fractures among women and consumption of regular or decaffeinated coffee, tea, and cola.

Adult↗
PubMed1998

Differences in neuropsychological functioning associated with age, education, neurological status, and magnetic resonance imaging findings in neurologically healthy elderly individuals.

In a cross-sectional study, a sample of 113 individuals, 55 to 85 years old, without any neurological diseases was investigated. The study provides information on differences associated with age, education, and gender, and in relation to neurological status, magnetic resonance imaging, and cognitive functioning. Differences between age groups were shown in memory, constructional, and language functions, and especially in tests related to speed and attention. Education was related to most of the cognitive functions, but especially to verbal intellectual functions, visual and logical memory, language functions, and calculation. Gender differences were found in finger tapping, constructional functions, and verbal intellectual functions. Primitive reflexes showed a tendency to correlate with comprehension and memory of sentences. Extrapyramidal signs were related to psychomotor speed, and attention, verbal fluency, and set shifting together with intellectual functions and learning. Central atrophy on magnetic resonance imaging was related to memory functions in those 65 and 70 years of age, whereas in the oldest age groups immediate recall was associated with the severity of lesions.

Journal Article↗
PubMed2005

Relation between early life socioeconomic position and all cause mortality in two generations. A longitudinal study of Danish men born in 1953 and their parents.

OBJECTIVE: To examine (1) the relation between parental socioeconomic position and all cause mortality in two generations, (2) the relative importance of mother's educational status and father's occupational status on offspring mortality, and (3) the effect of factors in the family environment on these relations. DESIGN: A longitudinal study with record linkage to the Civil Registration System. The data were analysed using Cox regression models. SETTING: Copenhagen, Denmark. SUBJECTS: 2890 men born in 1953, whose mothers were interviewed regarding family social background in 1968. The vital status of this population and their parents was ascertained from April 1968 to January 2002. MAIN OUTCOME MEASURES: All cause mortality in study participants, their mothers, and fathers. RESULTS: A similar pattern of relations was found between parental social position and all cause mortality in adult life in the three triads of father, mother, and offspring constituted of the cohort of men born in 1953, their parents, and grandparents. The educational status of mothers showed no independent effect on total mortality when father's occupational social class was included in the model in either of the triads. Low material wealth was the indicator that remained significantly associated with adult all cause mortality in a model also including parental social position and the intellectual climate of the family in 1968. In the men born in 1953 the influence of material wealth was strongest for deaths later in adult life. CONCLUSION: Father's occupational social class is associated with adult mortality in all members of the mother-father-offspring triad. Material wealth seems to be an explanatory factor for this association.

Adult↗
PubMed1996

Correlates of depression in chronic pain patients: a comprehensive examination.

This study examined the relations between depression and demographic, pain-related, and work-related variables in 254 chronic pain patients. Regression analyses were conducted, initially by category (i.e., demographic, pain-related, and work-related), and finally a comprehensive regression analysis was performed, containing the significant independent variables from each category. Among the demographic variables, education level and marital status were related to depression, and an interaction between age and gender was associated with depression, with younger women and older men reporting more depression. Among the pain-related variables, longer duration of pain was associated with increased depression. Among the work-related variables, unemployment was associated with depression, and there was an interaction between work status and litigation status, with working and litigating being associated with depression and not working and not litigating being associated with depression. In the comprehensive analysis, work status, education level, and marital status accounted for a significant amount of the variance in depression scores. These findings, together with future research directions, are discussed.

Adult↗
PubMed2004

Country of birth and body mass index: a national study of 2,000 immigrants in Sweden.

The aim of this study is to analyse the influence of country of birth on body mass index (BMI) after adjustment for age, educational status, physical activity and smoking habits. Two random samples of men and women, aged 27-60, were used: 1,957 immigrants and 2,975 Swedes, both from 1996. Men and women were analysed in separate models by the use of linear regression. The BMI levels were significantly higher among Polish (0.8 BMI units) and Chilean (0.7 BMI units) men, and Chilean (1.9 BMI units) and Turkish (1.5 BMI units) women than among their Swedish controls, after adjustment for all explanatory variables. Other intermediate risk factors for cardiovascular disease, such as physical inactivity and daily smoking, were also more frequent among almost all the immigrant subgroups. This study shows a strong influence of country of birth on BMI even after adjustment for age, educational status, physical activity and smoking habits.

Adult↗
PubMedDate not supplied

Health problems and other characteristics of child workers in a market in Ibadan.

A cross sectional study was conducted on child workers in a large market in Ibadan to determine their social and demographic characteristics and identify their health problems. Two hundred and twenty-five children were interviewed using a questionnaire which sought information on demographic characteristics, occupational and marital status of parents and educational status of children. Information on current illness and injuries occurring within the last three months was obtained. Interview was followed by a physical examination, measurement of packed cell volume and urine examination for schistosoma ova. Of the total of 225 children interviewed 132 (59%) were females and 93 (41%) were males. One hundred and twenty four (55%) of them were from monogamous homes and 95 (42%) were from polygamous homes. Six children did not give a response to this question. Thirty two (14%) had lost one parent. One hundred and sixty three (72%) lived with their parents, 55 (24%) lived with relations, 7(3%) lived with non relatives and 1 lived on the street. One hundred and three (46%) were currently in school, 117 (52%) were out of school and 5 (2%) had never been to school. The most common reason for taking up child work was to earn money needed by parents. Sixty-four children (28%) reported that they had injuries at the time of the survey. Current health problems reported were skin infection (12%), diarrhoea (3%), fever (21%), upper respiratory tract infection (15%), visual problems 4% and musculoskeletal disorders (19%). Thirty six percent ofthese children were underweight. Thirty one children (14%) had schistosoma ova in their urine. One hundred and nineteen children (53%) had at least one health problem. The prevalence of at least one health problem was higher among children who were out of school compared to those in school, 61% and 48% respectively (P < 0.05). The factors responsible for the health and social problems of child workers are complex and the solutions are not simple. Provision of free education by the government will greatly reduce the financial burden on parents and may reduce the number of children on the streets. School attendance and concomitant improvement in parental care may improve the health status of these children.

Adolescent↗
PubMedDate not supplied

Oral health education needs of diabetic patients in Ibadan.

Previous studies on this group showed very high perceived oral health needs of diabetics. The author therefore considered it necessary to investigate their oral health education needs. This study seeks to highlight the oral health knowledge, attitude and practices of the group with the view of designing a dental health education programme which can be incorporated into the already existing health education programme for diabetics. The study was conducted on a sample of 120 adult registered diabetic patients from the two diabetes clinics in Ibadan, University College Hospital (U.C.H.) and Ring Road Government Hospital. The study also included fifty healthy adult non-diabetic volunteers for comparism. Glycaemic control was determined by estimating their fasting blood glucose F.B.G. Four trained interviewers interviewed the participants on their oral health knowledge, attitude and practices as well as on vulnerability factors such as educational status, gender, occupation, location and age. Nineteen (19) diabetic patients and fourteen (14) non-diabetic participants were excluded from the study. This study highlights the comparable oral health knowledge, attitude and practices of diabetic patients with the non-diabetic participants. The study shows the good knowledge of all groups on the frequency of tooth cleaning (86.1%, 84.6% and 95.2%), their poor knowledge on the necessity of regular dental clinic attendance (25%, 23.1% and 45.2%) and the effect of diet on their oral health (2.8%, 31% and 29%). Less than 50% of the subjects knew the cause of periodontal disease. Majority of diabetic patients do not know factors in diabetics that can contribute to oral ill health and most importantly quite a number of diabetics (53.9% and 46.8%) were not aware of the need for glyceamic control to prevent and control oral infections in diabetics. The positively established attitudes of many subjects towards oral health is unequivocal. The habit of tooth cleaning either with toothbrush and paste or with chewing stick is entrenched in the participants. The influence of educational status was highly significant on the frequency of tooth-brushing. Removal of calculus being the highest perceived need in a previous study, in this group, is not consistent with the regular tooth cleaning habits expressed in this study. However, previous researchers have emphasised the efficiency rather than frequency of cleaning as the more important aspect of tooth cleaning. Thus, this study seems to have confirmed previous studies. This study brings into focus the establishment of a positive attitude prior to knowledge without it being followed up with a health directed behaviour.

Attitude to Health↗
PubMed1993

Hypertension education: patient knowledge and satisfaction.

Education of patients with various diseases, including hypertension, usually occurs at an individual level through a patient's doctor as well as via various media campaigns which also includes general community education. To evaluate their effects, the knowledge of 84 patients with hypertension was evaluated by a simple 13 question true/false questionnaire and the results compared with 58 normotensive subjects matched for sex, age and educational status. A significant difference in knowledge about hypertension could not be elicited between the two groups even when compared for sex or educational status. However, subjects > 70 years of age (hypertensives and controls) demonstrated a lower level of knowledge (P < 0.05). Further questioning of the hypertensive group elicited a high level of satisfaction with their doctor's educational skills (68%) and 57% were satisfied with their own knowledge. Nevertheless, 70% requested more information about their disease. These results suggest a reasonable level of knowledge within the general community presumably reflecting community education programmes. While hypertensive patients were not more knowledgeable under the test conditions, they were reasonably satisfied with their knowledge which they stated came primarily from their doctor. Nevertheless, these findings question the effectiveness of some current patient education initiatives.

Female↗
PubMed2002

[Structured patient education in oncology. A prospective study for implementing and effectiveness of interdisciplinary psycho-educational group intervention at a German university clinic].

AIM: To identify the target group for a structured educational group intervention in an acute cancer care setting, and to prove its effectiveness. PATIENTS AND METHODS: Cancer patients were given an opportunity to join an educational group intervention lasting 3 weeks (consisting of six times 1 hour). The intervention consisted of two major components: health education and coping skills. Participating patients (intervention group; n = 51) and nonparticipants (control group; n = 57) were evaluated at the beginning, then 2 months and 4 months later by means of standardized questionnaires (EORTC QLQ-C30, TSK, HADS, Henrich's FTP). RESULTS: Lower social and educational status, nonurban residency, males, and unfavorable prognoses together with palliative treatment intention were found less frequently (p < 0.05) in the intervention group. In comparison to the control group, the intervention group patients were characterized by a significantly greater desire for information and by more treatment-related fear. Improvements in disease-specific knowledge, certain quality of life elements, and in coping occurred only in the intervention group. Increases in the incidence of depression were found only in the control group. CONCLUSION: Patients with a more favorable prognosis, and a higher social and educational status, are more likely to get structured educational group intervention in an acute cancer care setting. For this subset of patients this intervention proves effective. Its importance for the standard care of cancer should be further investigated.

Adaptation, Psychological↗