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PubMedDate not supplied

[The impact of social security system reform on health services equity in Colombia].

To evaluate the impact on access to, and use of, health services in Colombia's new national health insurance system, the authors compared two cross sections of the population: before (1993) and after (1997), with the approval of Act 100, creating the General System for Social Security in Health (SGSSS). Two equity indicators were assessed: concentration curves (CC) and concentration indices (CI), summarizing the distribution of access to health care and utilization of health care services provided by the SGSSS according to income deciles. Between 1993 and 1997, the CI for access to insurance halved from 0.34 to 0.17; simultaneously, coverage increased from 23% to 57%, especially among the poorest segments of the population, where it increased from 3.7% to 43.7% as a result of subsidies provided by local governments. The CI for utilization of health care services did not vary significantly. Increased disease prevalence and utilization of services among the insured, due to biased selection of risks and moral hazards, were also documented. These findings suggest a positive impact by the Reform on inequalities in access to health care insurance; however, a similar effect on inequities in utilization of health services is not clear.

Adolescent↗
PubMed2003

[Health status, physical functioning, health services utilization, and expenditures on medicines among Brazilian elderly: a descriptive study using data from the National Household Survey].

The objective of this research was to describe health conditions and health services utilization among Brazilian seniors. The study was based on 28,943 adults > 60 years (99.9%) from an overall National Household Survey (PNAD 1998). The results show that prevalence rates for at least one chronic disease (69.0%), hypertension (43.9%), arthritis (37.5%), and inability to feed oneself/bathe/use the toilet (2.0%) are very similar to those observed in other populations. Physician visits and hospitalization patterns are within the variation reported by different countries. The low prevalence rates of older adults who had interrupted activities because of a health problem (13.9%) or had been bedridden (9.5%) in the previous 2 weeks or hospitalized in the previous year (13.6%) show that the vast majority are not subject to these events. Considering that 50% of this population live on less than or equal to one Brazilian monthly minimum wage, expenditures on medications consume approximately one-fourth (23%) of total income for half of the elderly population.

Aged↗
PubMed1991

An overview of beef cattle improvement programs in the United States.

A periodic review of beef improvement programs is useful as a benchmark and as an opportunity to reevaluate industry direction. The history of improvement programs is reviewed with particular emphasis on recording organizations, program financing, and technological progress. The various breed associations have become the primary suppliers of performance programs, which are largely funded through registration income. Current practices are described from the aspects of traits recorded and delivery systems to collect, analyze, and distribute the data. The unique or innovative features of several breed made of the organization, technical, and educational challenges facing beef improvement. Although increased participation in genetic improvement programs is expected, substantial efforts are needed to serve adequately the needs of a changing beef cattle industry.

Animals↗
PubMed1999

[Syphilis in adolescent mothers in the city of Posadas, Province of Misiones].

During three months (April to June 1997) 1,238 consecutive pregnant women were studied at the time of delivery at the Madariaga public Hospital. Syphilis was confirmed in 26 (2.1%) women, and 15 cases (57.7%) of congenital syphilis were demonstrated in newborns one of whom was a stillborn. Of the syphilitic women 61.5% were 20 years old (average), 65.4% were single, 19.2% had a stable partner and 15.4% were married; 70% of them had finished elementary school (seven years), but despite this discrete level of instruction and that they were benefited with free health attention, 73% of them had not started or completed the pregnancy control. None of these women acted as sexual workers or were drug users; 57.7% were unemployed and the remainder worked as domestic servants or were still going to school. Menarca started at 13 (average) and the age of the first sexual activity was 15 (average). The distribution of the cases of syphilis within the city area shows four clusters that coincide with the lower income population, but not with marginal groups. The failure to submit to medical control during pregnancy among syphilitic women is directly linked with an increased risk for congenital syphilis. The specific prevalence of syphilis in women (20 years old or less) pregnant or not, shows an alarming hidden epidemic situation. An interinstitutional and communitary program, with direct interventions within the detected population clusters, is now underway in order to control syphilis. Undesired pregnancy and syphilis seem to be associated with adolescent unsafe sex conducts. A coordinated program between Public Health Service and National Misiones University is operating, visiting home by home, in order to decrease or eliminate congenital syphilis and is considered a priority health problem. Unfortunately, if sexual conducts do not undergo changes in the near future, at least by the correct use of condoms, HIV will replace syphilis.

Adolescent↗
PubMedDate not supplied

Non-nutritive sucking behaviors in preschool children: a longitudinal study.

PURPOSE: Prolonged duration of non-nutritive sucking behaviors may have consequences in regard to the developing orofacial structures and occlusion. Little is known as to why some children have prolonged sucking habits beyond the first 2 to 3 years of life. This paper reports on non-nutritive sucking patterns among a large cohort of healthy children from birth to 36 months of age and older, and identifies factors predictive of prolonged non-nutritive sucking habits. METHODS: Over 600 children were followed from birth to at least 36 months of age using mailed questionnaires sent when children reached the ages of 6 weeks, and 3, 6, 9, 12, 16, and 24 months, and then yearly thereafter. Parents answered questions concerning non-nutritive sucking behaviors including use of pacifier and digit sucking. The study categorized children who maintained habits to 36 months of age or older as having prolonged habits, and using multivariate analyses, compared them to children without prolonged habits on various sociodemographic variables. RESULTS: The study found that for over 20% of the children, a non-nutritive sucking habit was prolonged to 36 months of age or older. Factors associated with prolonged sucking habits included older maternal age, higher maternal education level, and having no older siblings. CONCLUSIONS: Identifying factors related to prolonged non-nutritive sucking habits may be important in developing and targeting recommendations regarding such behaviors in an effort to prevent malocclusions that result from prolonged sucking habits.

Chi-Square Distribution↗
PubMed2000

Impact of environmental inequity on health outcome: where is the epidemiological evidence?

A significant amount of evidence reveals a presence of environmental inequity. Although there is a disproportionate distribution of waste treatment, storage and disposal facilities, and chemical and manufacturing plants in minority and low-income communities in the United States, little research has been devoted to show any associations based on analytic epidemiological methods. To date, attempts to quantify health disparities have included demographic data, race, sex, income, other socioeconomic factors, and broad symptomatic survey instruments. To study this, we examined the latest epidemiological evidence documenting the existence of adverse health impacts resulting from environmental inequity. We observed that the overwhelming majority of studies were descriptive in nature and lacked comparison populations. As a result, we believe that further research based on analytic epidemiological methods would further contribute to the determination of the cause-effect relationship between environmental exposure and health outcome.

Causality↗
PubMed2001

Prevalence of self-reported allergic conditions in an adult population in Israel.

BACKGROUND: Asthma, allergic rhinitis, and atopic dermatitis are leading causes of chronic diseases in developed countries, with at least one allergic condition troubling 10 to 20% of the general population. The few studies performed in Israel determined the prevalence of allergic conditions in selected populations (schoolchildren and soldiers); no study representative of the general population has previously been done. OBJECTIVES: To determine the prevalence of allergic conditions in the general population in Israel and the differences between ethnic and socioeconomic groups. METHOD: Using a computer-assisted telephone interview, a telephone questionnaire was conducted in a representative sample of the general Israeli population. RESULTS: Of the population studied, 14% claimed to have bronchial asthma, 14% allergic rhinitis, and 6% other allergic conditions. Prevalence rates were higher in the Israeli Arab population and in those with low income and low education levels. Of those with allergic conditions, 58% were treated by a primary physician, 32% were not treated at all, and only 10% were treated by a different specialist physician. CONCLUSIONS: The prevalence of allergic conditions in this study concurs with that found by other studies in developed countries. Allergic conditions are higher in the Israeli Arab population and in those with low income and low education level.

Adolescent↗
PubMed2001

Levels of career satisfaction amongst dental healthcare professionals: comparison of dental therapists, dental hygienists and dental practitioners.

OBJECTIVE: To compare the levels of career satisfaction expressed by three professional groups working in dental health: dental therapists, dental hygienists and dental practitioners. BASIC RESEARCH DESIGN: Level of career satisfaction was assessed using a ten point scale in three surveys. Postal surveys were conducted of all dental therapists and dental hygienists registered with the General Dental Council. Data for dental practitioners were collected as part of the British Dental Association Omnibus Survey 2000. PARTICIPANTS: Data are reported for 227 dental therapists, 2,251 dental hygienists and 970 dental practitioners. RESULTS: Significant differences were found between groups in the level of career satisfaction expressed. Dental practitioners were less likely to express high levels of satisfaction in comparison with the other two professional groups. Within each group characteristics of the respondents were associated with satisfaction levels. Younger dental therapists and dental hygienists expressed lower levels of career satisfaction. The level of career satisfaction expressed by dental practitioners was associated with gender, place of work (North vs South UK), year of qualification, size of practice and system of remuneration. CONCLUSIONS: Dental practitioners express lower levels of job satisfaction in comparison to other groups of dental health care professionals. Job dissatisfaction among dental practitioners is related to a number of socio-demographic factors.

Adult↗
PubMed2001

Demographic structure of patients taking dental X-rays in the Lublin region.

Intraoral radiograms are the most often taken X-ray pictures in humans and the dose of radiation necessary for such radiogram is very low. However, there exists a considerable anxiousness in Polish society towards Roentgen radiation making patients avoid dental X-rays even when these are indispensable in dental treatment. The aim of the study was the evaluation of demographic structure of patients taking intraoral radiograms. The material consisted of 1,014 adults undergoing dental treatment, who had intraoral radiograms taken in the Department of Dental and Maxillofacial Radiology in 2000. After the informed consent the patients filled an anonymous questionnaire of standardised interview. The collected records were analyzed statistically and data such as age, sex, education, place of residence, employment and income were considered. The demographic structure of population of patients who had intraoral radiograms taken in the course of dental treatment differs considerably from the structure of the general population. These differences were marked especially when taking into account the level of education, employment and place of residence of the studied patients. Inhabitants of rural communities, people with lower level of education as well as older patients avoid taking dental radiograms irrationally fearing ionizing radiation. The economic factor is also important and influences the structure of patients in the domain of employment and income.

Adult↗
PubMedDate not supplied

Prevalence of activity limitation among persons living with HIV/AIDS in British Columbia.

BACKGROUND: As antiretrovirals increase the life expectancy of persons living with HIV, quality of life issues become more important. Little research has examined the types and levels of activity limitations among HIV-positive populations. The objective of this report is to compare the levels of limitations among HIV-positive persons to the general population. METHODS: The BC Persons With AIDS (BCPWA) Society consists of approximately 3,500 HIV-positive members. A recent survey conducted among BCPWA members included a section assessing activity limitations. Prevalence of limitations in this group was compared to the general population of BC using the National Population Health Survey (NPHS) to calculate standardized prevalence ratios (SPR). RESULTS: Compared to the general BC population, BCPWA members were more likely to be male, aged over 30 years, not to have graduated from high school, unemployed, living alone and having a household income less than $10,000 per year. The SPR for activity limitations among male participants applying the rates of limitation among the general population of BC was 9.4 (8.4-10.6). The SPR for women was 9.9 (7.2-11.1). Using an NPHS rate restricted to individuals who reported a chronic condition, the SPR for males was 6.0 (5.9-6.5) and for females was 7.0 (5.8-8.2). INTERPRETATION: Limitations on activity are prevalent, even when comparing those with high CD4 counts and restricting the standard to those with chronic conditions. These findings suggest that implementation of programs offering support with everyday tasks would be of value in this population.

Acquired Immunodeficiency Syndrome↗
PubMed2005

[Female drug abuse in a university setting].

Morocco is a country with Muslim-Arab tradition. In this sociocultural context, drug abuse in women is very taboo. We tried to approach the subject of drug use in women in a cross-sectional study of a sample of 1208 students (744 women and 464 men) who completed an anonymous self-administered questionnaire. We found 6.59% of women and 36.2% of men used drugs. Using DSM IV criteria, drug dependence was found in 2% of the subsample of female drug users and drug abuse in 1.5%. Place of residence and level of income were statistically significant risk factors for drug use.

Arabs↗
PubMed2006

Prevalence and associated factors of head lice infestation among primary schoolchildren in Kelantan, Malaysia.

Head lice infestation contributes a significant morbidity among schoolchildren in Malaysia. A cross-sectional study was designed to determine the prevalence and associated factors of head lice infestation among primary schoolchildren in Kelantan, Malaysia. Six schools were randomly selected from three sub-districts of Kuala Krai, Kelantan. A total of 463 eleven-year-old pupils were screened by visual scalp examination and fine-toothed combing. Self-administered questionnaire was used to collect data on socio-demography and associated factors of head lice infestation. The prevalence of head lice infestation was 35.0% (95% Cl: 30.6, 39.3) with 11.9% inactive, 23.1% active, 18.2% light and 16.8% heavy infestations. The associated factors were girls; family income of RM247 or less; head lice infestation of family member and having four or more siblings. The high prevalence of head lice infestation in this study indicates the need for regular school health program that emphasis on the eradication of head lice. The significant associated factors identified in this study reconfirm the importance of controlling the transmissibility of head lice. Pupils and parents should be informed regarding factors that may facilitate the transmission of head lice.

Child↗
PubMed1988

Dental caries and periodontal disease among Mexican-American children from five southwestern states, 1982-1983.

Analysis of Southwestern HHANES data showed that the prevalence of dental caries among Mexican-American children is similar to that of children of the same age examined during the NIDR survey (1979-1980), despite a lower level of restorative treatment. Approximately 50% of Mexican-American children 17 years of age, however, had five or more teeth that were either decayed or filled. Occlusal surfaces of molars were the most susceptible teeth to decay; few anterior teeth were affected. This distribution of dental caries strongly supports the use of fissure sealants on molar teeth. Children from low-income families had two times more decayed teeth than children from high-income families. Mild gingivitis and poor oral hygiene were more prevalent in the Mexican-American children than in the child population for the region examined during NHANES I in 1971-1974. Children from high-income families had better periodontal health than those from low-income families.

Adolescent↗