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PubMed2006

Acceptability of caesarean delivery to antenatal patients in a tertiary health facility in south-west Nigeria.

Today, caesarean section is one of the most commonly performed surgical procedures the world over. Despite the well-documented record of safety, the strong aversion of women in sub-Saharan Africa to the procedure, especially in the presence of life-threatening indications, is of great concern to many obstetricians. This cross-sectional study, aimed at assessing the knowledge of the patients about caesarean section and its acceptability as mode of delivery, was conducted among antenatal patients at a University Teaching Hospital in south-west Nigeria. A pre-tested structured questionnaire was used. Among the 201 patients surveyed, a high level of acceptability of caesarean section (85%) was found. However, 96.5% of those who would accept would give consent only after seeking the opinion of other people, especially their husbands. Previous major surgery and caesarean section were found to favour its acceptability, while age, tribe, marital status and the woman or her husband's educational status did not have any influence. With proper health education, especially during antenatal care, many more women would find caesarean section acceptable.

Adult↗

PubMed1984

Undocumented migration to Venezuela.

"In 1980 Venezuela took...steps to regularize the undocumented migrant population. While the number responding to the amnesty was small relative to expectations, the majority of illegals appeared to have regularized their status. For the first time it was possible to assess objectively the characteristics of the undocumented population. Moreover, the problem of illegal migrants seems to have been temporarily solved, a result of both the amnesty and the country's declining economic activity." Topics covered in the present article include the nationality, geographic distribution, sex and age distribution, educational status, and occupations of undocumented migrants.

Age Distribution↗

PubMed1998

Men's knowledge, attitude and practices of family planning in north Gondar.

This community-based cross-sectional study assessed the perceptions and practices of 832 men on family planning in North Gondar, Ethiopia, in June 1995. Sixty one percent of men knew at least one method of family planning (FP) and 64.3% of them approved the use of FP. Forty one percent of these said that only women should use contraception. Involvement of couples on the choice of family planning methods and desired number of children in the family was approved by 58.3% of men. Half of the men did not support nulliparous women of any age using contraception. The mean +/- SD desired life-time children was 6.7 +/- 3.5. Only 47.2% of the study participants had heard about condoms. Misconceptions and negative attitudes towards condoms prevailed among men. Only 23.9% of married men have discussed family planning with their wives. Overall, 10.6% of men have ever used condoms in the past, and 6.1% are currently using condoms. Only 39.3% of current non-users of FP are planning to use FP in the future. Educational status was positively associated with higher awareness, favourable attitude and practice of family planning (p < 0.00001).

Adolescent↗

PubMedDate not supplied

Effect of economic barriers to medical care on patients' noncompliance.

The post-hospital care of 290 patients with selected chronic conditions of a specific severity who were discharged over a 3-month period from a general hospital in Halifax, Canada, was studied. The majority of the patients were married. The average age of the men was 59.2 years and of the women 58.1. More than half of the patients belonged to the low socioeconomic group earning between $1,000 and $6,999 a year. Their average period of education was 8.4 years. Interviews with the patients about their compliance with physicians' orders revealed that 40.4 percent had not complied with one or more of their physician's recommendations. Lack of compliance was related to age, marital status, education, income, and severity of disease. It was also associated with high dosages of medicine and multiple prescriptions. Cost barriers constituted a significant factor in noncompliance.

Adult↗

PubMed1988

The stability of health status in rheumatoid arthritis: a five-year study of patients with established disease.

We employed a health status measure to describe the outcomes of rheumatoid arthritis patients over five years. Of the 410 rheumatoid arthritis patients who were originally administered the Arthritis Impact Measurement Scales (AIMS), 299 completed a follow-up five years later. Data were analyzed using nine health status scales, three components of health status, and an overall arthritis impact item. Results for survivors indicated that there were no clinically important deteriorations in any of these measures. In fact, small improvements on most measures were found. The health status changes were similar for patients originally in a clinical trial and for those receiving routine specialty care. Age was found to positively relate to improvements in psychological status and overall arthritis impact, but we were unable to demonstrate any consistent effects of sex, marital status, education, or disease duration. Our results contrast with other studies that have noted major declines over time in the health status of patients with rheumatoid arthritis. Furthermore, level of education was not a major determinant of morbidity in this group. These results suggest that health status in certain patients with rheumatoid arthritis is more stable than previously thought. This has implications for both clinical practice and clinical research in rheumatology.

Arthritis, Rheumatoid↗

PubMed2001

Use of complementary and alternative therapies in HIV-infected patients.

The use of complementary and alternative medicine (CAM) therapies is widespread in many chronic illnesses, including human immunodeficiency virus (HIV) infection. The objective of this study was to determine the impact of increasingly effective antiretroviral therapy on the use of CAM in an HIV-positive patient population. A written survey was given to 191 HIV-positive outpatients. Participation was voluntary and anonymous. One hundred twenty-eight patients (67%) used CAM at some time to control HIV and 76 (40%) of the patients were currently using CAM. The major forms of CAM used were exercise (43%), lifestyle changes (38%), dietary supplements (37%), counseling (27%), herbal medications (26%), megavitamins (24%), and prayer therapy (24%). One hundred forty-one patients (74%) used a protease inhibitor medication, 28 (15%) used a protease inhibitor sparing regime, and 22 (11%) had no current or prior antiretroviral use. Eighty-two (43%) patients indicated that their doctor knew they used CAM and 56 patients (29%) received their information about CAM from a doctor or other health care professional. Of 128 patients who used CAM, 90 (70%) felt CAM improved their quality of life. Income of $15,000 or more per year and discontinuation of medications by patients for any reason in the past were the best predicators of CAM use for patients in general and also those on protease inhibitor therapy. CD(4) count, educational status, year of HIV diagnosis, and martial status were not effective predictors of CAM use. Use of CAM remains widespread among patients with HIV infection even with the availability of effective, yet noncurative antiretroviral therapy and does not correlate with type of antiretroviral therapy used or clinical status.

Adult↗

PubMed2001

[Educational level of patients with germ cell tumor radiated in childhood].

In order to estimate the influence of radiotherapy on the intellectual development of children with brain tumor, we investigated the educational level of 21 patients with germ cell tumor who had undergone radiotherapy. They were divided into three groups in accordance with their age at the time of radiation; under school age group (under 6 years of age), elementary school age group (from 7 to 12 years of age), and junior high and high school age group (from 13 to 18 years of age). There were 2 cases in the under school age group, one of them graduated from high school and the other is presently a junior high school student. There were 5 cases in the elementary school age group. 3 of these graduated from university, 1 is presently a university student and 1 is a high school student. There were 14 cases in the junior high and high school age group. 2 of these are university students, 7 graduated from high school, 1 is presently a junior high school student, and 4 died because of tumor progression. The mean period of hospitalization of the patients who have been admitted to university was 63.0 days, and that of patients who have not been admitted university was 135 days. There is a statistical difference (p < 0.05). It could be concluded that the period of hospitalization rather than radiotherapy seemed to influence the educational status of children with brain tumor.

Adolescent↗

PubMed2006

Organ donation: knowledge, attitudes, and practice in Lagos, Nigeria.

A cross-sectional study was conducted to determine knowledge and attitudes toward organ donation and transplant in Lagos, Nigeria. The study sample was selected through a multistaged sampling technique. The survey instrument was a standardized self-administered questionnaire. Four hundred and twenty-eight subjects participated in the study. The mean age was 31.1 +/- 2.1 years. Two hundred and fifty-six (60%) were aware of organ donation. Renal failure was the most commonly identified indication for transplant. One hundred and twenty-seven (30%) subjects were willing to donate an organ. Knowledge about organ donation was significantly higher among those with tertiary level of education (P = 0.000). Willingness to donate an organ showed a significant relationship with younger age (P = 0.002), but not with gender (P = 0.47) or educational status (P = 0.09). There is a need to increase awareness about organ donation in Lagos, Nigeria.

Adult↗

PubMed1988

High status immigrants: a statistical profile of Iranians in the United States.

The authors present a profile of Iranians in the United States. "First, the paper will review trends in Iranian immigration to the United States from 1950 to 1986....Second, all available data will be used to derive an estimate of the 1986 population size of Iranians in the U.S., and major centers of Iranian concentration such as California and Los Angeles. The rest of the paper will present a detailed analysis of the 1980 U.S. Census.... Since students made up a large proportion of Iranians in 1980, separate statistical profiles will be given for the total Iranian population, non-students, and students." Consideration is given to geographic distribution and to demographic characteristics, including economic and educational status.

Americas↗

PubMed2001

Risk factors for human immunodeficiency virus infection in Ethiopian children with tuberculosis.

BACKGROUND: Separate risk factors for HIV infection and for tuberculosis (TB) are well-studied, but it is unclear whether these risk factors still apply in the new epidemiologic situation of dual infection. This study examines risk factors associated with seropositivity for HIV in Ethiopian children with clinical TB. METHODS: A prospective, controlled study of children with TB diagnosed in Addis Ababa from December 11, 1995, to January 28, 1997, in which HIV-positive children were compared with HIV-negative children with regard to sociodemographic background, previous medical history and vaccination. RESULTS: HIV prevalence among children with clinical TB was 11.2%. High educational status of mothers, low age, loss of one or two parents and earlier Calmette-Guérin bacillus (BCG) vaccination of the child were factors independently related to HIV infection. CONCLUSION: Factors associated with HIV infection among children with clinical TB include higher education of parents, higher income and better living conditions. The HIV epidemic might thus modify traditional risk factors for tuberculosis. It might also decrease the overall effect of BCG vaccination given that BCG did not provide protection in children infected with HIV. An expected increase of dually infected children who are younger, more in need of hospitalization and often lacking one or both parents will put an additional burden on the Ethiopian health care system.

Adolescent↗

PubMed2006

Prevalence and determinants of asthma in adult male leather tannery workers in Karachi, Pakistan: a cross sectional study.

BACKGROUND: This study aimed to estimate the prevalence and to identify some risk factors of adult asthma in male leather tannery workers in Karachi, Pakistan. METHODS: A cross sectional study was conducted from August 2003 to March 2004 on leather tannery workers of Karachi, Pakistan. Data were collected from 641 workers engaged in 95 different tanneries in Korangi industrial area selected as sample of convenience. Face to face interviews were performed using a structured pre-tested questionnaire by trained data collectors. RESULTS: Prevalence of adult asthma was 10.8% (69/641) in this study population. The prevalence of perceived work-related asthma was 5.3% (34/641). Multivariable logistic regression model showed that after taking into account the age effect, the leather tannery worker were more likely to be asthmatic, if they were illiterate (adjusted OR = 2.13, 95% CI: 1.17-3.88), of Pathan ethnicity (adjusted OR = 2.69; 95% CI: 1.35-5.36), ever-smoked (adjusted OR = 2.22, 95% CI: 1.16-4.26), reportedly never used gloves during different tanning tasks (OR = 3.28; 95% CI : 1.72-6.26). Also, the final model showed a significant interaction between perceived allergy and duration of work. Those who perceived to have allergy were more likely to have asthma if their duration of work was 8 years (adjusted OR = 2.26; 95% CI: 1.19 - 4.29) and this relationship was even stronger if duration was 13 years (adjusted OR = 3.67; 95% CI: 1.98-6.79). CONCLUSION: Prevalence of asthma in leather tannery workers appears to be high and is associated with educational status, ethnicity, smoking, glove use, perceived to have allergy and duration of work.

Adolescent↗

PubMed1991

Risk factors for age-related cortical, nuclear, and posterior subcapsular cataracts. The Italian-American Cataract Study Group.

A total of 1,008 cases and 469 controls, aged 45-79 years, were included in a clinic-based case-control study of age-related cataract in Parma, Italy, from 1987 to 1989. Associations were examined between specific types of cataract and physiologic, behavioral, environmental, and biochemical factors. Cases included subjects with pure cortical (n = 489), pure nuclear (n = 110), pure posterior subcapsular (n = 28), and mixed (n = 381) cataracts. With polychotomous logistic regression, an increased risk of cataract was found for females (cortical; odds ratio (OR) = 2.20) and persons with less than a high school education (all types; OR = 1.53), brown irises (nuclear, mixed; OR = 1.43), job locations in the sunlight (cortical, mixed; OR = 1.75), leisure time activities in the sunlight (cortical, mixed; OR = 1.45), a history of wearing a hat in summertime (posterior subcapsular, cortical, mixed; OR = 1.80), a positive family history of cataract (posterior subcapsular, cortical, mixed; OR = 1.88), a history of cortisone use (posterior subcapsular; OR = 8.39), increased red blood cell glucose-6-phosphate dehydrogenase activity (cortical, nuclear, mixed; OR = 1.36), and increased serum levels of uric acid (posterior subcapsular; OR = 1.62), lactic dehydrogenase (posterior subcapsular; OR = 1.76) and gamma-glutamyl transpeptidase (mixed; OR = 1.22). A decreased risk of cataract was found for persons with a positive history of arthritis (posterior subcapsular, nuclear, mixed; OR = 0.56) and increased handgrip strength (mixed; OR = 0.68). Findings from our study, combined with previously reported evidence, suggest that associations with educational status, cortisone use, sunlight exposure, and handgrip strength are real. Other findings require further evaluation.

Adult↗

PubMed1999

Prevalence of osteoporosis by educational level in a cohort of postmenopausal women.

To evaluate whether the prevalence of osteoporosis and related risk factors might be influenced by the level of education, as has been demonstrated for many other chronic diseases, 6160 postmenopausal women at their first densitometric referral were interviewed about reproductive variables, past and current use of estrogens, prevalence of chronic diseases, and lifestyle factors such as calcium intake, physical activity, smoking and overweight. This sample was stratified by years of formal education. Densitometric evaluation was performed by dual-energy X-ray absorptiometry. Age at menarche, past exposure to oral contraceptives, use of hormone replacement therapy, prevalence of chronic diseases, physical activity, overweight and smoking showed significant trends according to the years of education. The prevalence of osteoporosis showed an inverse relationship with level of education, ranging from 18.3% for the most educated to 27.8% for the least educated women. Multiple logistic regression analysis demonstrated a predictive role toward osteoporosis by age, age at menarche and menopause, hormone replacement therapy, calcium intake, physical activity and body mass index. Using the lowest educational level as reference category, increases in educational status were associated with a significantly reduced risk for osteoporosis (OR = 0.76, 95% CI 0.65-0.90 for 6-8 years of schooling; OR = 0.68, 95% CI 0.57-0.82 for 9 years or more). This study shows differences in the prevalence of osteoporosis among educational classes and the protective role played by increases in formal education. If these results are confirmed in other population studies, public health intervention programs will have to consider the socioeconomic and cultural background of the population strata that run a greater risk of osteoporosis.

Adult↗

PubMed1984

Alcohol abuse in a rural community in India. Part I: Epidemiological study.

By systematic sampling of households after two stage proportionate random sampling of villages, a total of 4670 persons above 15 years of age were selected from the rural areas of Ajmer district in Rajasthan, India, to estimate the prevalence rate of alcohol abuse and to study its socio-demographic correlates (Part I) and the pattern and characteristics of use (Part II, submitted). The data on these aspects were collected through pre-tested questionnaires. The results showed that prevalence of alcohol abuse in the sample was 24.7% (36.1% for males and 13.4% for females) and the percentage of dependents was 3%. Relative risk of alcohol abuse in males was 3.64 with respect to females. Alcohol abuse was found to be significantly associated with religion (higher in Hindus with a relative risk of 8.65 in males and 5.21 in females), marital status (higher in married with a relative risk of 2.51 in males), age (higher in age group more than 20 years with a relative risk of 2.50 in males and 1.63 in females), family structure (higher in nuclear or joint families with a relative risk of 2.88 in males), educational status (higher in illiterates with a relative risk of 1.53 in males) and occupational status (higher in those engaged in agriculture with a relative risk of 1.43 in males and 1.80 in females). It was not significantly associated with per-capita income. These results have been compared with those in similar studies in the country and the possible reasons for differences, if any, have been discussed.

Adolescent↗

PubMed2006

Pathways of behavioural and emotional symptoms in kindergarten children: what is the role of pro-social behaviour?

The study investigated the predictive value of pro-social behaviour for developmental pathways of behavioural and emotional problems at kindergarten age. One hundred and sixty children participated in the study at the ages of 5 and 6. Teachers and parents completed the Strengths and Difficulties Questionnaire; children completed the Berkeley Puppet Interview at both assessment points. Single-informant data were aggregated to enhance the reliability and validity of data. Gender and parental educational status were controlled. Symptoms (conduct problems, hyperactivity and emotional symptoms) and pro-social behaviour were moderately stable over time. Compared to girls, boys showed higher levels and increases of conduct problems and hyperactivity and lower levels of pro-social behaviour. Lower parental educational level was associated with higher levels and increases in hyperactivity. Although pro-social behaviour was cross-sectionally associated with behavioural and emotional symptoms, pro-social behaviour did not predict changes in conduct problems or hyperactivity over time. However, children with above average emotional symptoms and above average pro-social behaviour at Age_5 showed the highest level of emotional symptoms at Age_6. The results indicate that low levels of pro-social behaviour are associated with children's externalising behaviour problems, but that for children with high levels of emotional symptoms, higher levels of pro-social behaviour should also be considered as a risk factor. In sum, our results suggest mainly homotypic pathways of internalising and externalising symptoms across kindergarten age, but indicate that the assessment of pro-social behaviour yields additional information regarding the developmental pathways of emotional symptoms.

Adult↗

PubMedDate not supplied

Acute non-B hepatitis in the Israel Defence Forces: comparison of some epidemiologic features before and after the usage of preexposure immune serum globulin prophylaxis.

Large-scale epidemics of non-B (HBsAg-negative) hepatitis have occurred in the Israel Defense Forces prior to post- and preexposure immune serum globulin administration. Presently, hepatitis morbidity rates have stabilized around 1 to 2 per 1,000. Several years after vaccine initiation, a comparison of epidemiological features was made in order to redefine risk groups. Seasonal morbidity, sex, ethnic origin and educational status (as a representative of socioeconomic level) were not different after the preexposure immunization compared to the preimmunization era. Therefore, a more selective immunization is proposed.

Acute Disease↗

PubMed1985

Cumulative causation and selectivity in labour market oriented migration caused by imperfect information.

This paper is concerned with the implications of job search models for migration. In contrast to earlier models, the model described here does not assume perfect information about the wage offer distribution. "In this model information about the wage offer distribution is imperfect and accumulated through the search process. When based on this search model, the migration model is largely enriched and also more realistic. Strategies, which are suboptimal or even absurd with perfect information about the wage offer distribution, such as purchase of information, can be preferable in a migration model, when imperfect information is assumed." The author suggests that the model can explain many phenomena utilized in the argumentation of polarization theory. Consideration is also given to selectivity with respect to age, educational status, and risk preference, as well as the cumulative effects caused by past migration flows and the size of regions. (summary in FRE, GER)

Age Factors↗

PubMed1990

Smoking in a public health agency: its relationship to sick leave and other life-style behavior.

A survey questionnaire was administered to employees of a public health agency regarding their involvement with smoking and other life-style behavior. Responses were analyzed and combined with sick leave data to determine the use of sick leave among employees who currently smoke, those who never smoked, and those who formerly smoked. Current smokers took significantly more sick leave than those who have never smoked ("nonsmokers") or former smokers. Using an analysis of variance model, only smoking status, education level, and sex, among selected demographic variables, were significantly related to the amount of sick leave taken. Current smokers took excess sick leave (amounting to nearly $40,000) as compared with nonsmokers and ex-smokers combined over a 21-month period. This study also characterizes the relationship between smoking status and selected life-style behavior. Smokers were less active, less likely to use seat belts, less likely to believe that smoking is related to health, and more likely to be heavier and to eat a poor diet than their nonsmoking or former smoking counterparts. We make suggestions regarding the reduction of smoking and other deleterious behavior as a means of controlling costs and reducing employee morbidity.

Absenteeism↗