94 research outputs found
Neighborhood Deprivation and Adverse Birth Outcomes among Diverse Ethnic Groups
Living in a socioeconomically deprived neighborhood has been associated with an increased risk of adverse birth outcomes. However, variation in the effect of neighborhood deprivation among diverse ethnic groups has not been studied
Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries
OBJECTIVE: To assess disparities in pre-eclampsia and eclampsia among immigrant women from various world regions giving birth in six industrialised countries. DESIGN: Cross-country comparative study of linked population-based databases. SETTING: Provincial or regional obstetric delivery data from Australia, Canada, Spain and the USA and national data from Denmark and Sweden. POPULATION: All immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995â2010). METHODS: Data was collected using standardised definitions of the outcomes and maternal regions of birth. Pooled data were analysed with multilevel models. Within-country analyses used stratified logistic regression to obtain odds ratios (OR) with 95% confidence intervals (95% CI). MAIN OUTCOME MEASURES: Pre-eclampsia, eclampsia and pre-eclampsia with prolonged hospitalisation (cases per 1000 deliveries). RESULTS: There were 9Â 028Â 802 deliveries (3Â 031Â 399 to immigrant women). Compared with immigrants from Western Europe, immigrants from Sub-Saharan Africa and Latin America & the Caribbean were at higher risk of pre-eclampsia (OR: 1.72; 95% CI: 1.63, 1.80 and 1.63; 95% CI: 1.57, 1.69) and eclampsia (OR: 2.12; 95% CI: 1.61, 2.79 and 1.55; 95% CI: 1.26, 1. 91), respectively, after adjustment for parity, maternal age and destination country. Compared with native-born women, European and East Asian immigrants were at lower risk in most industrialised countries. Spain exhibited the largest disparities and Australia the smallest. CONCLUSION: Immigrant women from Sub-Saharan Africa and Latin America & the Caribbean require increased surveillance due to a consistently high risk of pre-eclampsia and eclampsia
Selfâmanagement for adults with epilepsy: Aggregate Managing Epilepsy Well Network findings on depressive symptoms
ObjectiveTo assess depressive symptom outcomes in a pooled sample of epilepsy selfâmanagement randomized controlled trials (RCTs) from the Managing Epilepsy Well (MEW) Network integrated research database (MEW DB).MethodsFive prospective RCTs involving 453 adults with epilepsy compared selfâmanagement intervention (n = 232) versus treatment as usual or waitâlist control outcomes (n = 221). Depression was assessed with the nineâitem Patient Health Questionnaire. Other variables included age, gender, race, ethnicity, education, income, marital status, seizure frequency, and quality of life. Followâup assessments were collapsed into a visit 2 and a visit 3; these were conducted postbaseline.ResultsMean age was 43.5 years (SD = 12.6), nearly twoâthirds were women, and nearly oneâthird were African American. Baseline sample characteristics were mostly similar in the selfâmanagement intervention group versus controls. At followâup, the selfâmanagement group had a significantly greater reduction in depression compared to controls at visit 2 (P < .0001) and visit 3 (P = .0002). Quality of life also significantly improved in the selfâmanagement group at visit 2 (P = .001) and visit 3 (P = .005).SignificanceAggregate MEW DB analysis of five RCTs found depressive symptom severity and quality of life significantly improved in individuals randomized to selfâmanagement intervention versus controls. Evidenceâbased epilepsy selfâmanagement programs should be made more broadly available in neurology practices.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151320/1/epi16322_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151320/2/epi16322.pd
Prediction of preterm birth with and without preeclampsia using mid-pregnancy immune and growth-related molecular factors and maternal characteristics.
OBJECTIVE:To evaluate if mid-pregnancy immune and growth-related molecular factors predict preterm birth (PTB) with and without (±) preeclampsia. STUDY DESIGN:Included were 400 women with singleton deliveries in California in 2009-2010 (200 PTB and 200 term) divided into training and testing samples at a 2:1 ratio. Sixty-three markers were tested in 15-20 serum samples using multiplex technology. Linear discriminate analysis was used to create a discriminate function. Model performance was assessed using area under the receiver operating characteristic curve (AUC). RESULTS:Twenty-five serum biomarkers along with maternal age <34 years and poverty status identified >80% of women with PTBâ±âpreeclampsia with best performance in women with preterm preeclampsia (AUCâ=â0.889, 95% confidence interval (0.822-0.959) training; 0.883 (0.804-0.963) testing). CONCLUSION:Together with maternal age and poverty status, mid-pregnancy immune and growth factors reliably identified most women who went on to have a PTBâ±âpreeclampsia
Negative attitudes related to violence against women: gender and ethnic differences among youth living in Serbia
OBJECTIVES: This study aimed to identify to what extent negative attitudes towards intimate partner violence against women are present among young women and men living in Serbia, in Roma and non-Roma settlements. METHODS: We used the data from the 2010 Multiple Indicator Cluster Survey conducted in Serbia, for the respondents who were 15-24Â years old. Regression analyses were used to examine the association between judgmental attitudes, socio-demographic factors and life satisfaction. RESULTS: In Roma settlements, 34.8% of men and 23.6% of women believed that under certain circumstances men are justified to be violent towards wives, while among non-Roma it was 5.6 and 4.0%, respectively. These negative attitudes were significantly associated with lower educational level, lower socio-economic status and being married. In multivariate model, in both Roma and non-Roma population women who were not married were less judgmental, while the richest Roma men were least judgmental (OR 0.40, 95% CI 0.18-0.87). CONCLUSIONS: Violence prevention activities have to be focused on promoting gender equality among youth in vulnerable population groups such as Roma, especially through social support, strengthening their education and employment
Prevalence and socio-demographic correlates of stunting and thinness among Pakistani primary school children
Magnitude and factors associated with malnutrition in children 6â59 months of age in Shinille Woreda, Ethiopian Somali regional state: a cross-sectional study
Socioeconomic and demographic factors modify the association between informal caregiving and health in the Sandwich Generation
Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views
Self-management is an established, effective approach to controlling asthma, recommended in guidelines. However, promotion, uptake and use among patients and health-care professionals remain low. Many barriers and facilitators to effective self-management have 25 been reported, and views and beliefs of patients and health care professionals have been explored in qualitative studies. We conducted a systematic review and thematic synthesis of qualitative research into self-management in patients, carers and health care professionals regarding self-management of asthma, to identify perceived barriers and facilitators associated with reduced effectiveness of asthma self-management interventions. Electronic databases and guidelines were searched systematically for qualitative literature that explored factors relevant to facilitators and barriers to uptake, adherence, or outcomes of self-management in patients with asthma. Thematic synthesis of the 56 included studies identified 11 themes: 1) partnership between patient and health care professional; 2) issues around medication; 3) education about asthma and its management; 4) health beliefs; 5) self-management interventions; 6) co-morbidities 7) mood disorders and anxiety; 8) social support; 9) non-pharmacological methods; 10) access to healthcare; 11) professional factors. From this, perceived barriers and facilitators were identified at the level of individuals with asthma (and carers), and health-care professionals. Future work addressing the concerns and beliefs of adults, adolescents and children (and carers) with asthma, effective communication and partnership, tailored support and education (including for ethnic minorities and at risk groups), and telehealthcare may improve how self-management is recommended by professionals and used by patients. Ultimately, this may achieve better outcomes for people with asthma
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