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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Intrauterine growth curves in a high-income population]

OBJECTIVE: Growth curves can be used to assess intrauterine growth, to predict diseases in newborns, and to characterize different populations. The objective of this study was to obtain intrauterine growth curves of newborns from the maternity ward of the Hospital Albert Einstein (MAE) and compare them with intrauterine growth curves of a population from California, USA. METHODS: We plotted the growth curves according to weight at birth and gestational age, which was obtained according to information from the mother, after the 32nd week of gestation, between February 1995 and February 1999. We calculated the birth weights for the 10th, 50th, and 90th percentiles by each gestational age and compared them with those presented by California growth curves. RESULTS: The growth curves for the 10th and the 50th percentiles did not differ from the California growth curves. For the 90th percentile, however, the MAE growth curves were lower than those of California. The MAE population presented fewer small-for-gestational age (SGA) and big-for-gestational age (BGA) newborns when assessed according to the California curves. The categories of SGA, normal, and BGA for both male and female newborns indicated a statistically significant relation with the weight gain of mothers. CONCLUSIONS: The two populations assessed in this study were different according to intrauterine growth curves. Further studies should be carried out in order to identify specific factors that may be acting on the MAE population.

Journal Article↗
PubMed2002

Firearm availability and female homicide victimization rates among 25 populous high-income countries.

OBJECTIVE: to determine the association between firearm availability and female homicide victimization among high-income countries. METHODS: Data were assembled for the most recent available year (1994-1999) from the official reports of the ministries of health for those countries that had more than 2 million inhabitants and were dassified as high income by the World Bank. Twenty-five nations provided sufficient information for the analysis. Rates of female victimization from homicide, firearm homicide, and nonfirearm homicide were compared with a validated proxy for household firearm ownership (the percentage of total national suicides that are committed with firearms). Possible confounding variables included in the analysis were the percentage of the population living in urban areas and income inequality. RESULTS: The United States is an outlier. It had the highest level of household firearm ownership and the highest female homicide rate. The United States accounted for 32% of the female population in these high-income countries, but for 70% of all female homicides and 84% of all female firearm homicides. Female homicide victimization rates were significantly associated with firearm availability largely because of the United States. CONCLUSION: Among high-income countries, where firearms are more available, more women are homicide victims. Women in the United States are at higher risk of homicide victimization than are women in any other high-income country.

Adult↗
PubMed2002

Letting the Gini out of the bottle? Challenges facing the relative income hypothesis.

The relative income hypothesis interprets statistical associations between income inequality and average health status at the population level, as evidence that income inequality has a deleterious psychosocial effect on individual health. An alternative explanation is that these, population-level associations, are statistical artefacts of curvilinear, individual-level relationships between income and health. Indeed, provided the cost-benefit ratio of health-enhancing goods and services vary, the law of diminishing returns should produce curvilinear, asymptotic relationships between income and health at the individual level, which create ('artefactual') associations between income inequality and health at the population level. However, proponents of the relative income hypothesis have argued that these relationships are unlikely to be responsible for the associations observed between income inequality and average health status amongst high-income populations. In these populations, the individual-level relationships between income and health would be nearer their asymptotes, where a shallower slope should ensure that income inequality has little (if any) 'artefactual' effect on average health status. Yet this argument was based on analyses of population-level data which underestimated the slope and curvilinearity of underlying, individual-level relationships between income and health. It is therefore likely that (at least some part of) the population-level associations between income inequality and average health status (amongst low-, middle- and high-income populations) are 'artefacts' of curvilinear, individual-level relationships between income and health. Nevertheless, it is also possible that income inequality is somehow (partly or wholly) responsible for the curvilinear nature of individual-level relationships between income and health. Likewise, it is possible that income inequality alters the height, slope and/or curvilinearity of these relationships in such a way that income inequality has an independent effect on individual health. In either instance, the 'artefactual' effect of curvilinear relationships between income and health at the individual level would simply reflect the mechanism underlying the relative income hypothesis.

Female↗
PubMed1990

An outreach program to low-income, high risk populations through WIC.

Through a special New York State legislative grant, we were able to produce brochures in Spanish and Haitian French, and to train WIC Staff, Public Health Nurses and Healthy Neighborhood staff in poison prevention. This study involved all the WIC sites in our seven county region, who reach a population of over 10,000 families who have been identified as low income, high-risk individuals in a survey conducted by the American Red Cross. Pre-test showed that the staff knew of the Poison Center but had not instructed clients in poison prevention. Post-testing of WIC staff showed a significant increase in knowledge about poison prevention and increase in the frequency of client instruction. The main thrust of this program was to assure that the phone number of the Poison Center was prominently posted in each home and that clients knew that the Poison Center was available 24 h every day in a poison emergency.

Health Education↗
PubMed2001

Nutritional status of middle-aged Vietnamese in Ho Chi Minh City.

OBJECTIVE: To investigate the nutritional status of middle-aged Vietnamese in Ho Chi Minh City. METHODS: A cross-sectional survey in 300 Vietnamese aged 40 to 59 years (113 men, 187 women) was conducted in an urban, suburban and rural area of Ho Chi Minh City based on interviews that included a 24-hour dietary recall, food frequency questionnaire, and a short socioeconomic questionnaire. Anthropometry and blood pressure were measured, and blood was collected for serum protein and lipid analysis. RESULTS: A high prevalence of underweight (BMI < 18.5) was observed in the rural and suburban populations (35% and 23%, respectively), and overweight (BMI > or = 25) was observed in the urban population (18%). A high percentage of serum total cholesterol (TC) below 150 mg/dL was observed in the rural and suburban areas (43% and 37%, respectively). By contrast, the prevalence of TC above 220 mg/dL was twofold higher in the urban and suburban residents (13% and 12%, respectively) than in rural residents (6%). More than 80% of urban residents were of medium or high-income status, whereas 61% of suburban residents were of medium-income status and 66% of rural residents were of low-income status. CONCLUSIONS: The nutritional status of middle-aged Vietnamese in Ho Chi Minh City was characterized by undernutrition in 35% of the low-income population and by overnutrition in 18% the high-income population. Undenutrition was still a public health problem in the rural area whereas overnutrition started to become a noteworthy problem in the urban area. The suburban area suffered from both under- and overnutrition problems. Low lipid intake was the most important problem related to undernutrition in middle-aged residents of Ho Chi Minh City.

Adult↗
PubMed1998

Epidemiology, etiology, diagnostic evaluation, and treatment of low back pain.

Low-income populations have a lower prevalence of low back pain than high-income populations. Pathologic processes affecting the intervertebral disc are affected by genetic factors and degeneration of annular fibers. Historical and physical findings are not helpful in identifying damaged tissues in patients with nonspecific low back pain. Agency for Health Care Policy and Research guidelines for plain radiographs in the evaluation of low back pain are too sensitive and expose patients unnecessarily to ionizing radiation. Clinical entities reviewed in the literature include septic sacroiliitis, prognosis of metastatic spinal tumors, and low back pain in health care professionals. Epidural corticosteroid injections are useful for leg pain and sensory deficits early in the course of sciatica secondary to a herniated nucleus pulposus. Poor nutritional state increases the risk for postoperative infections for spinal fusion patients.

Adrenal Cortex Hormones↗
PubMed1991

[Disability pensions and long-term sick-listing in Oslo--a study of different city districts].

In Oslo there are significant differences in the incidence and prevalence of medically determined disability pensions. In regions with a population characterized by low level of education and low annual income the prevalence of disability pensions is high in relation to regions with a highly educated and high income population. The main reasons for a disability pension are mental complaints, mainly anxiety and depressive states, and musculo-skeletal disorders (chronic states of muscular pain). In recent years subjective symptoms have become an increasingly more important reason for disability pensions. Social and economic factors, possibility of employment, and other non-medical factors seem to play a more determining role than ill health in the process leading to disability.

Adult↗
PubMedDate not supplied

The need for prenatal care in the United States: evidence from the 1980 National Natality Survey.

Seventy-eight percent of U.S. mothers begin prenatal care during the first three months of pregnancy; 18 percent wait until the second three months; and five percent wait until the third trimester or receive no care at all. Patterns of prenatal care vary widely among population subgroups: Mothers younger than 18 and unmarried mothers are the least likely to obtain first-trimester care (49 percent and 56 percent, respectively), and the most likely to obtain care only in the third trimester or none at all (about 12 percent of each group). Women aged 18-19, blacks, Hispanics, poor women and women with little education also have disproportionately high levels of very late or no care (7-9 percent). Married, white, nonpoor women, in contrast, obtain the most timely prenatal care: In 1980, only two percent initiated care in the third trimester or received no care. Compared with this subgroup of women, the population as a whole has two times the risk of obtaining inadequate care. Unmarried women run the highest relative risk (five times the risk for married, white, nonpoor women), followed by teenagers, Hispanic women, women with little education, poor women and blacks (who have from three to more than four times the risk of the comparison group).

Adolescent↗
PubMedDate not supplied

[Relationship between maternal weight gain and birthweight]

OBJECTIVE: To investigate the influence of gestational weight gain on birthweight of the newborn, in order to clarify if this weight increment results in heavier newborn. METHODS: Retrospective cohort in a tertiary level private institution that attends a high income population of São Paulo - Brazil; inclusion of all the mother-newborn pairs with complete data (2275) in the Cadastro de Informações Perinatais (CIP) in the software EPI 6; from February/95 till June/96.RESULTS: Gestational weight gain between 12 and 20 kg resulted in a greater number of newborn with birthweights between 3000 and 3499g. Pregnancies with a weight gain below or equal 10 kg correlated with newborn of low birthweight (Odds ratio= 1.81; CI= 1.20-2.73; 95% of significance). Gestational gain beneath or equal to 12 kg had a greater risk of a newborn with insufficient weight - 2499< birthweight < 3000g - (Odds ratio= 1.47; CI= 1.19-1.81; 95% of significance). Gestational gain above 16 kg did not correlate with increase in birthweight.CONCLUSIONS: The gestational weight gain of 12 kg is the minimum increase of weight in order that the newborn is over 3000g. The gestational weight gain above 16 kg did not increase birthweight. The high social economic level was not sufficient to avoid low birthweight or insufficient weight at birth.

Journal Article↗
PubMed2004

Effects of weaning cereals with different phytate content on growth, development and morbidity: a randomized intervention trial in infants from 6 to 12 months of age.

BACKGROUND: Phytate decreases iron and zinc bioavailability and contributes to deficiencies of iron and zinc, potentially causing anaemia, poor psychomotor development, impaired growth and increased risk of diarrhoea and respiratory infections. AIM: To investigate whether a reduced dietary intake of phytate, either via extensively phytate-reduced infant cereals [milk cereal drinks (MCDs) and porridge] or a milk-based infant formula, would improve growth and development and reduce morbidity in infants. DESIGN: Infants (n = 300) were, in a double-blind design, randomized to three diet intervention groups from 6 to 12 mo of age-commercial MCD and porridge (CC group), phytate-reduced MCD and phytate-reduced porridge (PR group), or milkbased infant formula and porridge with regular phytate content (IF group)-then followed until 18 mo. Dietary intake, anthropometry, development (Bayley Scales of Infant Development) and episodes of infectious diseases were registered. RESULTS: There were no significant differences between study groups in growth, development or morbidity until 12 mo of age. The IF group had a 77% higher risk (95% CI: 1.05-2.97) of diarrhoea compared to the PR group during the 12-17-mo period. Infants with haemoglobin concentration (Hb) < 110 g/l at 12 mo had lower attained weight at 18 mo (11.14 kg vs 11.73 kg, p = 0.012). Infants with serum zinc (S-Zn) <10.7 pmol/l at 12 mo had higher risk of respiratory infections (RR = 1.74, 95% CI: 1.19-2.56) compared to controls. CONCLUSION: Phytate reduction had no effect on growth, development or incidence of diarrhoeal or respiratory infections. Infants with low Hb or low S-Zn may be at higher risk of poor growth and respiratory infections, even in this high-income population.

Anthropometry↗
PubMedDate not supplied

Use of conventional and complementary health care during the transition to menopause: longitudinal results from the Study of Women's Health Across the Nation (SWAN).

OBJECTIVE: Women beginning the transition to menopause now have access to complementary and alternative therapies (CAM) that were not universally available in the past. Little is known about the association between CAM use and the use of conventional health care during menopause. We investigated the longitudinal association between use of CAM therapies and utilization of conventional health care in a large, multiethnic sample of midlife women who were enrolled in the cohort phase of the Study of Women's Health Across the Nation (SWAN). DESIGN: We used generalized estimating equations, repeated measures modeling to examine the association between CAM use and the yearly number of conventional health-care contacts, adjusting for relevant covariates, during a two-year period. CAM use was evaluated longitudinally as continuous, incident (no CAM use at baseline), sporadic, or no use during the study period. RESULTS: Relative to nonusers, continuous CAM users had more conventional health-care contacts (beta 0.14, 95% CI 0.06, 0.21). Incident users and sporadic users also showed an excess in conventional health-care contacts (beta 0.14, CI 0.06, 0.22) and (beta 0.09, CI 0.01, 0.16), respectively. Ethnicity was independently associated with health-care contacts. Relative to white women, Japanese women had fewer contacts (beta -0.18, CI -0.31, -0.05). CONCLUSIONS: Despite being a generally healthy, well-educated and high-income population with good access to health care, CAM users were using more of both conventional and alternative health-care resources than women who did not use CAM. These findings have practical implications for conventional health-care practitioners, allied health professionals and CAM practitioners.

Adult↗
PubMedDate not supplied

The influence of telephonic nursing care coordination on patient satisfaction in a predominantly low-income, high-risk pregnancy population.

The effect of telephonic nursing case management on patient satisfaction in a predominantly non-Caucasian low-income, high-risk pregnancy population was studied. Patient satisfaction of care was significantly higher for treatment group participants than for controls on 9 of 10 items measuring satisfaction. The satisfaction score of the treatment patients, constructed by summing scores for each item, averaged 8 points higher than the control group's score. Demographics made little difference. Telephonic case management was the strongest predictor of satisfaction in a multiple regression analysis. Satisfaction was unrelated to mode of delivery, infant birth weight, or gestational age. The satisfaction levels of treatment patients were high, whether or not they had outpatient charges. Participants rated the program highly for the nurses' ability to answer questions, overall program experience, the opportunity to ask the nurses questions, health teachings and instructions received, and confidence in the nurse coordinating their care or their child's care.

Adult↗
PubMed2001

Abnormal Pap smear follow-up in a high-risk population.

Low-income women are at high risk of developing cervical cancer attributable not only to the higher prevalence of risk factors in this population but also to the lack of timely follow-up of abnormal Pap smears. This study evaluates the efficacy of an aggressive follow-up strategy. Women with abnormal Pap smear results after screening in a public hospital emergency department were randomly assigned to follow-up either by a case-managed approach using computerized tracking and universal colposcopy or by traditional care. The main outcome was the proportion of women receiving follow-up in 6 months. A secondary outcome was the proportion of women receiving follow-up by 6 months and diagnostic resolution in 18 months. Of 54 women in the intervention group, 65% kept at least one follow-up appointment in 6 months compared with 41% of the 54 women in the control group (P = 0.012). Half the women in the intervention group versus 19% of women in the control group had follow-up in 6 months and diagnostic resolution in 18 months (P = 0.001). After adjusting for age, initial Pap smear result, and race/ethnicity, the odds of having follow-up in 6 months were four times greater for women in the intervention group (odds ratio = 4.0; 95% confidence interval, 1.6-9.7), and the odds of having both follow-up in 6 months and diagnostic resolution in 18 months were more than six times greater (odds ratio = 6.5; 95% confidence interval, 2.4-17.8). This study demonstrates that an aggressive follow-up strategy significantly improves the rate of both initial follow-up and diagnostic resolution of abnormal Pap smears among low-income women with atypical squamous cells of undetermined significance and atypical glandular cells of undetermined significance when compared with traditional care.

Adolescent↗
PubMedDate not supplied

The health status of community based elderly in the United Arab Emirates.

Little is known about the elderly in the United Arab Emirates (UAE), a country with both developing country features (high fertility rate, few elderly, strong traditional culture) and developed country characteristics (high-income economy, urbanized population, high growth rate of people aged 65+ years). In this cross sectional survey of 184 randomly chosen community based people aged 65+ years, the mean age was 71.8 +/- 6.3, 52% were female, 76% were married, 11% were literate, 89% lived in multi-generational households, 85% lived in households with servants and 15% had a personal servant. Health status was largely independent of age. Compared with the ambulatory aged USA population, the rate of functional independence in activities of daily living (ADL) (83%) was similar and chronic medical problems were less frequent, with the notable exception of diabetes (37% UAE, 10-12% USA). Almost all (95%) participants in this study rated their health as satisfactory or higher, compared with 82% of US ambulatory elderly. There appeared to be a significant under-diagnosis of psychological problems. In the presence of a high regard for traditional values, close family ties, universal practice of religion and high economic resources, the elderly in the UAE have a high level of health, which they maintain into their later years. There may be a need to substantially increase health care resources for aged care in the near future due to the high prevalence of diabetes, amount of hidden psychological morbidity and known demographic trends. Encouraging families to continue to provide home based long-term care may minimize the need for government intervention in this area.

Activities of Daily Living↗