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PubMed2001

The effect of education on patients' willingness to participate in a telemedicine study.

We assessed the effect of previous education on patients' willingness to participate in a clinical study of telemedicine for hypertensive patients. The design was a cross-sectional study of adult patients arriving for appointments in a hypertension clinic. Of the 259 patients approached, 86% completed a baseline survey and were subsequently asked if they would be willing to participate in a one-year telemedicine study. One hundred and fifty patients (58%) agreed to participate. A stepwise logistic regression analysis was performed to assess the effect of level of education on willingness to participate, while controlling for potentially confounding variables. In the final model, only education remained significant. The odds ratio for non-participation of patients with high-school education or less was 3.6 (95% confidence interval 1.9-7.0). Educational status should be carefully considered when designing, implementing and interpreting telemedicine studies.

Aged↗

PubMed1993

Coronal and root decay experience in older adults in Ontario, Canada.

This paper describes the coronal and root caries experience of subjects aged 50 years and older living in four communities in Ontario, Canada. The data were obtained as part of a comprehensive epidemiologic study of the oral health and treatment needs of this population. Caries experience was defined as the number of decayed and filled coronal and root surfaces per subject. Of 907 subjects interviewed and clinically examined, 78.3 percent were dentate and retained a mean of 18.9 teeth. The mean number of coronal decayed and filled surfaces was 23.9; 95.6 percent of subjects had at least one coronal DFS. The mean number of decayed and filled root surfaces was 3.6; 70.9 percent had at least one root DFS. The percent D/DFS was 3.5 for coronal and 20.0 for root caries. In linear regression analysis the number of teeth, making regular preventive visits, being born in Canada, and educational status emerged as predictors of coronal DFS. Predictors of root DFS were the number of surfaces with recession, the number of coronal DFS, the number of teeth, age, sex, and smoking status. These variables accounted for 42 percent and 35 percent of the variance in the number of coronal and root DFS, respectively.

Aged↗

PubMed1987

Dynamics of fertility and labour force participation of Canadian women in 1971 and 1981: a cohort approach.

The authors analyze the relationship between labor force participation and fertility in Canada using data from the Public Use Sample Tapes from the 1971 and 1981 censuses. Factors considered include age, religion, educational status, and marital status. The authors conclude that "labour force participation of women seems to have less influence on fertility compared to [the] fertility effect on labour force participation."

Age Factors↗

PubMed1997

The influence of black race and socioeconomic status on the use of breast-conserving surgery for Medicare beneficiaries.

BACKGROUND: This study explores the influence of socioeconomic status (SES) and black race on the use of breast-conserving surgery (BCS) as opposed to mastectomy for early stage breast carcinoma. METHODS: A cohort of 41,937 female Medicare inpatients age 65-79 years who had undergone BCS or mastectomy treatment in 1990 for local or regional breast carcinoma was studied. SES was estimated based on the patients' zip code of residence. RESULTS: Greater use of BCS was associated with higher income and increased education as determined by the patients' zip code area (P < 0.001 for each), and with lower vacant housing rates and fewer persons living below the poverty line in the patients' zip code area (P < 0.001 for each). Black women were less likely than women of other races to undergo BCS (odds ratio, 0.80; 95% confidence interval, 0.71-0.91). However, in a multivariate regression model adjusting for stage and urban versus rural residence, income, educational status, and poverty rate remained significant predictors of patient receipt of BCS, whereas black race did not remain an independent predictor of this treatment. CONCLUSIONS: Women residing in higher SES areas are more likely to undergo BCS. The reduced use of BCS in black women appears attributable to SES.

Black or African American↗

PubMed1993

Hospital pharmacists' participation in audit in the United Kingdom.

OBJECTIVE: To investigate systematically participation in audit of NHS hospital pharmacists in the United Kingdom. DESIGN: Questionnaire census survey. SETTING: All NHS hospital pharmacies in the UK providing clinical pharmacy services. SUBJECTS: 462 hospital pharmacies. MAIN MEASURES: Extent and nature of participation in medical, clinical, and pharmacy audits according to hospital management and teaching status, educational level and specialisation of pharmacists, and perceived availability of resources. RESULTS: 416 questionnaires were returned (response rate 90%). Pharmacists contributed to medical audit in 50% (204/410) of hospitals, pharmacy audit in 27% (108/404), and clinical audit in only 7% (29/404). Many pharmacies (59% (235/399)) were involved in one or more types of audit but few (4%, (15/399)) in all three. Participation increased in medical and pharmacy audits with trust status (medical audit: 57% (65/115) trust hospital v 47% (132/281) non-trust hospital; pharmacy audit: 34% (39/114) v 24% (65/276)) and teaching status (medical audit: 58% (60/104) teaching hospital v 47% (130/279) non-teaching hospital; pharmacy audit 30% (31/104) v 25% (68/273)) and similarly for highly qualified pharmacists (MPhil or PhD, MSc, diplomas) (medical audit: 54% (163/302) with these qualifications v 38% (39/103) without; pharmacy audit: 32% (95/298) v 13% (13/102)) and specialists pharmacists (medical audit: 61% (112/184) specialist v 41% (90/221) non-specialist; pharmacy audit: 37% (67/182) v 19% (41/218)). Pharmacies contributing to medical audit commonly provided financial information on drug use (86% 169/197). Pharmacy audits often concentrated on audit of clinical pharmacy services. CONCLUSION: Pharmacists are beginning to participate in the critical evaluation of health care, mainly in medical audit.

Educational Status↗

PubMed1997

[Relationship between education and risk factors for coronary artery disease].

Recent epidemiological studies in the western countries show an association between the incidence of coronary artery disease and its risk factors and socioeconomic status. Education is the single factor most frequently used as to base classification of social status. The purpose of this study was to estimate the association between education level and coronary artery disease risk factors in Iceland. The study population was 18919 individuals aged 33 to 8l who were living in Reykjavik and its neighbourhood. They were divided into four groups according to their educational level. A model of the relationship was constructed using linear regression analysis and the groups compared. Risk factors such as cholesterol, triglycerides, diastolic and systolic blood pressure, height, fasting blood sugar, 90 minute blood sugar, BMI and smoking were studied. In most cases and for both sexes there was an increased risk for those in the lowest educational group compared with the other groups.

Adult↗

PubMed2006

Syndromic approach for determination of reproductive tract infections among adolescent girls.

The present study shows overall prevalence (64%) of reproductive tract infection among adolescent girls, based on self-perceived symptoms. Mean age of respondents were found to be 17.8 +/- 0.82 years and mean age at marriage and mean age at first pregnancy were 17.2 years and 17.5 years respectively; 35.35% of girls in the present study were married. In addition, no significant difference was observed between unmarried (60.10%) and married (71.17%) reproductive tract infection groups. Moreover, no significant association was present in prevalence of reproductive tract infection between the Muslim (67%) and the Hindu (60%). Highest prevalence (84.06%) of reproductive tract infection was observed among illiterate girls and with improvement of educational status there was decrease in the prevalence and the association was found highly significant. Significantly, higher prevalence (72%) was observed among members of family size 7 and above.

Adolescent↗

PubMed1993

Perinatal mortality in a northern Nigerian rural community.

87 perinatal deaths which occurred out of 1484 births in a rural area of Northern Nigeria over a 9 month period were reviewed. The perinatal mortality rate was 58.6 per 1000 births. Babies born to very young adolescent mothers aged between 10-14 years had the highest perinatal mortality of 375 per 1000 births. Statistically significant relationships were also established between perinatal mortality and parity, educational status of the mother and birth weight. The leading cause of perinatal death was birth trauma which accounted for 48% of all perinatal deaths. Strategies for the reduction of perinatal mortality in the rural community are highlighted.

Adolescent↗

PubMed1984

Recognition of dementia among medical patients.

To determine how accurately dementia was diagnosed among medical inpatients, we compared the judgments of medical interns with diagnoses based on standard criteria. Fifty-seven interns rendered opinions regarding the presence of dementia in 380 medical inpatients who were simultaneously examined by physician-investigators applying criteria derived from DSM III. The sensitivity and specificity of diagnosis by interns were 79% and 80%, respectively. Patients who were misdiagnosed as demented were less likely to be high school graduates than their correctly classified nondemented counterparts, and those with unrecognized dementia were more likely to be younger than 65 years than patients whose dementia was recognized by house staff. It is concluded that misdiagnosis is related to age and educational status and that attention to these factors may improve diagnostic accuracy.

Adult↗

PubMed1996

The adolescent parturient: a study of an Israeli population.

The aim of this study was to describe the frequency and characteristics of adolescent deliveries and to identify issues that might require intervention, in Haifa District, which is the third largest in Israel. The specific objectives were to assess the prevalence of 15-19-year-old parturients in the district, to characterize the younger (15-17-year) age group for demographics and educational status as well as for pregnancy and delivery progress, to describe the newborn babies of these mothers, and to compare the Jewish and Arabic subpopulations within the younger group for these parameters.

Adolescent↗

PubMed2003

Irritable bowel syndrome prevalence in city center of Sivas.

BACKGROUND/AIMS: We planned to determine irritable bowel syndrome prevalence in our region with its distribution according to clinical characteristics of patients and the factors which are considered to be related with irritable bowel syndrome. METHODS: 998 of 1250 individuals (mean age 38.99+0.44) replied to our questionnaire including Rome II criteria. RESULTS: We found the irritable bowel syndrome prevalence in the city center of Sivas to be 19.1%. Distribution of irritable bowel syndrome (+) patients age groups showed no significant difference but irritable bowel syndrome was significantly more common in females. The most common occupation showing irritable bowel syndrome positivity was workers. Irritable bowel syndrome prevalence was also significantly higher in persons not eating three regular meals per day. There was a significantly positive correlation between irritable bowel syndrome prevalence and psychological events, previous abdominal operations and infections. A change in bowel habitus was observed in 41.8% of irritable bowel syndrome patients, and the most common change was constipation. 39.8% of the irritable bowel syndrome patients had applied to the doctor, most often to doctors of internal medicine. We found the irritable bowel syndrome prevalence not to be related with educational status, smoking, daily tea and coffee consumption, alcohol intake, menstrual periods or weight loss. CONCLUSION: Irritable bowel syndrome prevalence in our region with its demographic characteristics was similar to the results seen in western countries.

Adult↗

PubMed2004

Body mass index and factors related to overweight among women workers in electronic factories in Peninsular Malaysia.

Factors related to overweight were examined in a cross-sectional survey that included 1612 women workers from 10 large electronics assembly factories in Peninsular Malaysia. Respondents were Malaysian citizens, direct production workers below the supervisory level, and had worked at least a year in the factory where they were presently employed. Heights and weights were taken to calculate the body mass index (BMI). Weights and BMI increased with increasing age. After adjusting for age, odds ratios for overweight were significantly raised for married women in relation to not married women (OR 1.5, 95% CI=1.15-2.02), lower secondary education in relation to higher than upper secondary education (OR 1.8, 95% CI=1.06-3.14), monthly income RM800-999 (OR 1.7, 95% CI=1.21-2.45) and >/=RM1,000 (OR 1.8, 95% CI=1.23-2.72) in relation to <RM600, working in rotating shifts that included nightshifts (OR 1.6, 95% CI=1.28-2.06), and not staying in hostel (OR 1.4, 95% CI=1.02-1.88). In a logistic regression model with all variables included as covariates, the factors significantly associated with overweight were age, marital status, education, income, and working in rotating shifts. The overall prevalence of overweight was 37.4%; the overall mean BMI was 24.2+/-5.4 kg/m(2). Prevalence of overweight and mean BMI for younger age groups were similar to Malay women in the country-wide representative National Health and Morbidity Survey II, but the older age groups in this study had higher overweight prevalence and mean BMI than the national sample. Electronics women workers face a higher risk of overweight, and is an important group for nutrition intervention.

Adolescent↗

PubMed1999

The stratifying force of family size, urbanization and parental education in socialist-era Poland.

The strength of influence upon statural variation of: (1) the degree of urbanization of the locality of habitat, (2) family size, (3) paternal and (4) maternal educational status was analysed in three generations of 19-year-old Polish conscripts, examined in 1965, 1986 and 1995. Each of the above factors of an individual's social situation was described by a 4-level scale. Each factor was found to exert a highly significant residual effect on stature throughout the three decades considered, even after the effects of other correlated factors were partialed out by three-factor ANOVA. However, the stratifying force of each factor, as expressed by the dispersal of the level-specific main effects around the national mean, has been changing over time. For example, the growth-stunting effect of the condition of coming from a large sibship was dramatic in the 1965 cohort and considerably attenuated in 1986 but ceased to diminish thereafter. The growth-enhancing effect of the condition of being a large-city dweller, initially marked, has almost disappeared; but the growth-stunting effect of the condition of being a rural dweller has remained equally strong across all cohorts. These and other shifts in the relative importance of the social factors, as presumed determinants of family living standards, are described and some explanations attempted.

Adolescent↗

PubMed2002

Psycho-social well-being and general health status after surgical treatment for localized renal cell carcinoma.

OBJECTIVE: To comparatively assess the psychological, social well-being and general state of health in patients with stage 1 renal cell carcinoma (RCC) (according to 1997 TNM), who underwent either elective nephron sparing surgery (NSS) or radical nephrectomy. PATIENTS AND METHODS: We evaluated the health-related quality of life (HR-QoL) in 88 patients who underwent radical nephrectomy and in 56 treated with elective NSS. The measurement of the main QoL components has been made using domain-specific questionnaires tested and validated in Italian language. Each questionnaire has been self-administrated during follow-up (cross-sectional study). RESULTS: The two analysed group resulted perfectly comparable regarding age, gender, civil status, educational level, profession and mean follow-up. A low level anxiety has been documented in 11.4% of patients after radical nephrectomy and in 1.8% of those treated with an elective conservative surgery. The mean score difference between the two groups resulted statistically significant (p = 0.003). A mild depression has been recorded in 7% of patients who underwent radical nephrectomy and in 2.3% of NSS group. The mean score difference between the two groups was statistically significant (p = 0.01). The general health status was impaired in 12.5% of cases after radical nephrectomy and in 7% after elective NSS. Social problems were present in 18% of patients who underwent radical nephrectomy and in 18% of NSS group. There was no significant difference between radical and conservative group in terms of both General health Questionnaire and Social Problem Questionnaire mean scores. CONCLUSION: HR-QoL in patients who underwent surgery for RCC is not particularly negatively affected. Nevertheless, the comparative analysis of the results showed that, at a long term follow-up, radical surgery seems to eventually cause a more relevant negative impact on the psychological well-being than conservative surgery.

Anxiety↗

PubMed2006

Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians.

OBJECTIVE: To assess the maternal sociodemographic, anthropometric, dietary and micronutrient status in apparently healthy pregnant women in order to determine their associations with intrauterine growth retardation (IUGR). DESIGN: Prospective observational study. SETTING: Bangalore City, India. SUBJECTS: A total of 478 women were recruited at 12.9+/-3.3 weeks of gestation and followed up at the first, second and third trimesters of pregnancy and at delivery. The dropout rate was 8.5%. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Birth weight was measured at hospital delivery. RESULTS: The mean birth weight was 2.85+/-0.45 kg. In all, 28.6% of newborns were IUGR. There was a strong inverse relationship between maternal educational level and risk of IUGR. A low body weight at baseline was also associated with a high risk of IUGR. Compared with women in the highest quartile for second trimester weight gain, those in the lowest quartile had a significantly higher adjusted odds ratio (AOR: 3.98; 95% CI: 1.83, 8.65) for IUGR. Women in the lowest tertile for serum vitamin B(12) concentration during each of the three trimesters of pregnancy had significantly higher risk of IUGR (AOR: 5.98, 9.28 and 2.81 for trimesters 1-3, respectively). CONCLUSIONS: The present study demonstrates associations between educational status, maternal weight and gestational weight gain with IUGR. Importantly, in a subsample, there were strong associations of vitamin B(12) status with IUGR, suggesting that better socioeconomic conditions, improved nutritional status and early detection of vitamin B(12) deficiency in pregnancy combined with appropriate interventions are likely to play an important role in reducing IUGR.

Adolescent↗

PubMed1991

Epidemiological data on burn injuries in Greece: a statistical evaluation.

This is a statistical evaluation of 4114 burns treated in Greek Hospitals during 1986. The results are based on a questionnaire that was sent to all Greek hospitals. The distribution of burns in every health district, the causes of burns, the educational status and the occupation of burn victims are examined. The adequacy of the present burn care facilities in Greece and the future prospects for better burn care are also discussed.

Accidents, Occupational↗

PubMed1993

A population-based study of syphilis and sexually transmitted disease syndromes in north-western Tanzania. 2. Risk factors and health seeking behaviour.

OBJECTIVE: To determine risk factors for syphilis and sexually transmitted disease (STD) syndromes, and to study health seeking behaviour among those with STD syndromes, in the population of Mwanza Region, North-Western Tanzania. METHODS: A population-based random cluster sample survey, stratified by rural, roadside or urban residence, of 4173 individuals aged 15-54 years was performed in 1990-91. The seroprevalence of syphilis and the prevalence and incidence of self-reported genital ulcer syndrome (GUS) and genital discharge syndrome (GDS) are reported in the accompanying paper. This paper reports on risk factors for these conditions and on health seeking behaviour among those reporting them. RESULTS: In both sexes, the risk of STDs increased with the reported number of sexual partners in the previous five years. Men who were separated, divorced or widowed were at increased risk of STDs, but this was not the case among women. Higher educational status was associated with an increased risk of urethral discharge in males but with a decreased prevalence of syphilis in females. Male circumcision was associated with an increased risk of urethral discharge but a reduced prevalence of syphilis. Nearly all men, and 90% of women, reporting symptoms of genital discharge or ulceration had sought treatment. Of these, approximately 70% of males and 60% of females had sought treatment in the official health sector. CONCLUSIONS: Targetted health education concerning risk reduction for HIV infection and other STDs should be a high priority in this population. Improved case management of STDs in health centres and dispensaries may have a substantial impact on the incidence of these infections.

Adolescent↗

PubMed1994

Determining functional/health status and its relation to disability in stroke survivors.

BACKGROUND AND PURPOSE: Determining the functional/health status of stroke survivors poses special difficulties because of cognitive impairments that frequently result from stroke. A possible means of assessing the status of stroke survivors who are cognitively impaired is getting proxy responses from a family member or other caregiver. Proxy agreement was evaluated for two measures of functional/health status, the Frenchay Activities Index (FAI) and the Health Status Questionnaire (HSQ), and a measure of disability, the Functional Independence Measure (FIM). METHODS: Thirty-eight stroke survivors were administered the measures at follow-up (median time since the stroke, 6 months). Caregivers were instructed to answer as proxies for the stroke survivors in their care. Demographics on age, sex, race, marital status, educational level, side of lesion, and relation of stroke survivor to caregiver were collected. RESULTS: Proxy agreement was excellent for the FAI (intraclass correlation, .85) and the FIM (.87), but poor for the HSQ scales (average proxy agreement, .32). Patients' scores were low and positively skewed for the FAI but high and negatively skewed for the FIM. Although Spearman rho coefficients between the measures were fairly high for both stroke survivors and proxy respondents, the correlation of scores was substantially weaker when the group of less severely impaired survivors (as established by FIM ratings) was considered separately. CONCLUSIONS: The FAI and the FIM are useful for assessing the functional/health status of stroke survivors because answers can be obtained by proxy. Future studies should examine the relations between disability and functional/health status, with explicit attention paid to variations in the level of disability in the stroke survivors.

Activities of Daily Living↗