scholarly journals Lifestyle, socioeconomic status and healthcare seeking among women with gynaecological cancer alarm symptoms: a combined questionnaire-based and register-based population study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021815 ◽  
Author(s):  
Kirubakaran Balasubramaniam ◽  
Sandra Elnegaard ◽  
Sanne Rasmussen ◽  
Peter Fentz Haastrup ◽  
René dePont Christensen ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Educational Level ◽  
Lifestyle Factors ◽  
Gynaecological Cancer ◽  
High Educational Level ◽  
Postmenopausal Bleeding ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Recent Onset ◽  
High Educational

ObjectivesTo determine the proportion of contacts to general practitioner (GP) with recent onset gynaecological cancer alarm symptoms (pelvic pain, postmenopausal bleeding, bleeding during intercourse or pain during intercourse) and to analyse the associations between lifestyle factors, socioeconomic status and GP contact for these symptoms.DesignCross-sectional survey combined with data from national registers.SettingThe general Danish population.ParticipantsA total of 25 866 non-pregnant women ≥20 years completed the survey. Women reporting at least one of four gynaecological alarm symptoms within the preceding 6 months form the study base (n=2957).ResultsThe proportion of women reporting GP contact ranged from 21.1% (pain during intercourse) to 32.6% (postmenopausal bleeding). Women aged 60+ years had higher odds of reporting GP contact for at least one of the four gynaecological cancer alarm symptoms compared with those aged 20–39 years (OR 2.56, 95% CI 1.69 to 3.89), and immigrants had higher odds of reporting GP contact for at least one of the symptoms (OR 1.56, 95% CI 1.13 to 2.15) compared with ethnic Danish individuals. Among those reporting postmenopausal bleeding and/or bleeding during intercourse, women in the age group 60+ years had higher odds of reporting GP contact compared with those aged 20–39 years (OR 2.79, 95% CI 1.33 to 5.87). A high educational level (>12 years) was positively associated with reporting GP contact for postmenopausal bleeding and/or bleeding during intercourse compared with a low educational level (<10 years) (OR 2.23, 95% CI 1.19 to 4.19). No associations were found with lifestyle factors.ConclusionsFew women contacted their GP with recent onset gynaecological cancer alarm symptoms. Higher age, being immigrant and higher educational level increased the odds of GP contact. Future studies should explore the reasons for these findings as this may aid in prompting early diagnosis and thereby improve the prognosis of gynaecological cancer.

scholarly journals The mediating effect of lifestyles on the association between social factors and DNA methylation

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Maugeri ◽  
M Barchitta ◽  
G Favara ◽  
C La Mastra ◽  
MC La Rosa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Dna Methylation ◽  
Socioeconomic Status ◽  
Mediterranean Diet ◽  
Educational Level ◽  
Methylation Level ◽  
Mediating Effect ◽  
High Educational Level ◽  
Age Related ◽  
High Educational

Abstract Background Social disadvantage and unhealthy lifestyles may induce molecular changes associated with aging and age-related diseases. For instance, previous studies reported socioeconomic difference in DNA methylation, which in turn led to aberrant gene expression and genome instability. Socioeconomic status (SES) alone, however, does not completely explain this difference, and further studies are needed to unveil what factors contribute to it. Methods We conducted a cross-sectional study on 349 Italian women, aged 25-64 years, to assess SES differences in LINE-1 methylation level - a surrogate marker of global DNA methylation - and to examine the mediating effect of lifestyles (i.e. diet, smoking habits, physical activity, and weight status). Educational level was used as SES indicator. The adherence to Mediterranean diet (MD) was assessed by the Mediterranean Diet Score (MDS). Leukocyte LINE-1 methylation was assessed by pyrosequencing. Mediation analysis was conducted using the PROCESS macro for the SPSS software. Results We first observed that women with high educational level were more likely to be normal weight (p &lt; 0.001) and to adhere to MD (p = 0.018), and less likely to perform physical activity (p = 0.012) than their less educated counterpart. Moreover, age-adjusted linear regression demonstrated that LINE-1 methylation level increased with increasing educational level (β = 0.016; SE = 0.003; p &lt; 0.001). In line, mediation analysis demonstrated an indirect effect of high educational level on LINE-1 methylation through the adherence to MD (β = 0.003; 95%CI=0.001-0.006). Specifically, the mediator could account for 9.5% of the total effect. None of the other lifestyles, instead, exhibited a significant mediating effect. Conclusions To our knowledge, this is the first study demonstrating the mediation of diet in the relationship between SES and DNA methylation. Thus, our findings add even more value to the promotion of healthy dietary habits among social disadvantaged people. Key messages Social disadvantage is associated with epigenetic changes related to aging and age-related diseases. Adherence to the Mediterranean diet might mediate the association between socioeconomic status and DNA methylation.

scholarly journals Willingness of patients to use unused medication returned to the pharmacy by another patient: a cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024767 ◽  
Author(s):  
Charlotte Bekker ◽  
Bart van den Bemt ◽  
Toine CG Egberts ◽  
Marcel Bouvy ◽  
Helga Gardarsdottir
Keyword(s):  
Outcome Measures ◽  
Patient Characteristics ◽  
Secondary Outcome ◽  
High Educational Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Included Patient ◽  
Willingness To Use ◽  
High Educational ◽  
Patient Willingness

ObjectivesRedispensing by pharmacies of medication unused by another patient could contribute to optimal use of healthcare resources. This study aimed to assess patient willingness to use medication returned by another patient and patient characteristics associated with this willingness.DesignCross-sectional survey.SettingA total of 41 community and 5 outpatient pharmacies in the Netherlands.ParticipantsTotal of 2215 pharmacy visitors.Primary and secondary outcome measuresPatients completed a questionnaire regarding their willingness to use medication returned unused to the pharmacy by another patient, assuming quality was guaranteed. Secondary outcome measures included patient sociodemographic characteristics that were associated with patient willingness, analysed using logistic regression analysis and reported as ORs with 95% CIs.ResultsOf the 2215 patients (mean (SD) age 50.6(18.0) years; 61.4% female), 61.2% were willing to use medication returned unused to the pharmacy by another patient. Patients who were unwilling mostly found it risky. Men were more willing to use returned medication (OR 1.3 95% CI 1.1 to 1.6), as did patients with a high educational level (OR 1.8 95% CI 1.3 to 2.5), those who regularly use 1–3 medications (OR 1.3 95% CI 1.1 to 1.7), those who returned medication to the pharmacy for disposal (OR 1.5 95% CI 1.0 to 2.3) and those who ever had unused medication themselves (OR 1.3 95% CI 1.1 to 1.6)). Patients with non-Dutch cultural background were less willing to use returned medication (OR 0.395% CI 0.3 to 0.4)).ConclusionsWhen quality is guaranteed, a substantial proportion of patients are willing to use medication returned unused to the pharmacy by another patient. This suggests that implementation of redispensing may be supported by patients.

scholarly journals Women’s barriers for contacting general practice when experiencing gynecological cancer symptoms: a population-based study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kirubakaran Balasubramaniam ◽  
Sanne Rasmussen ◽  
Peter Fentz Haastrup ◽  
Kaspar Suadicani ◽  
Jens Søndergaard ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Educational Level ◽  
Gynecological Cancer ◽  
Population Based ◽  
High Educational Level ◽  
Postmenopausal Bleeding ◽  
Population Based Study ◽  
Cancer Symptoms ◽  
Lower Odds ◽  
Healthcare Seeking

Abstract Background A prerequisite for general practitioners (GPs) being able to refer patients with gynecological cancer alarm symptoms for further investigations is that individuals present the symptoms to the GP. Not all symptoms are presented to the GP, and knowledge of barriers for healthcare-seeking is sparse. The aim of this study was to analyze associations between age, socioeconomic status, and common barriers (“being too embarrassed”, “being too busy”, “worried about wasting the doctors time” and “worried what the GP might find”) towards GP contact with gynecological alarm symptoms. Methods Nationwide population-based study in Denmark based on a random sample of 51 090 women aged 20 years or older. A web-based questionnaire regarding experience of four predefined alarm symptoms of gynecological cancer, decisions about contact to GPs, and barriers towards GP contact was distributed. Information about socioeconomic status was collected from Statistics Denmark. Results A total of 26 466 women (54.5%) completed the questionnaire. The proportion of women with no contact to the GP varied between 64.6% and 78.1% for postmenopausal bleeding and pain during intercourse, respectively. Between 32.3% (bleeding during intercourse) and 45.3% (postmenopausal bleeding) of the women reported no barriers for GP contact. The proportions of reported barriers ranged from 7.5% for being too embarrassed (pelvic pain) to 26.8% for being too busy (bleeding during intercourse). Women aged 40–59 years had lower odds of reporting “being too embarrassed” and “worried about wasting the GP´s time”, while women aged 60 + years of age had lower odds of reporting “being too busy” compared to the youngest age group. Women in the highest income groups had lower odds of reporting “being too embarrassed” and “wasting the GP´s time” compared to those with a low income, while those with high educational level had lower odds of reporting “being too embarrassed” and “worried what the GP might find” compared to those with low educational level. Conclusions More than half of the respondents with no contact to the GP, reported one or more barriers towards GP contact. Lower age and socioeconomic status were significantly associated with higher odds of reporting barriers. As this may explain the differences in healthcare seeking behavior, healthcare planners, policy makers and clinicians should be aware of these findings.

scholarly journals Prevalence of High HDL Cholesterol and Its Associated Factors Among Tunisian Women of Childbearing Age: A Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5461
Author(s):  
Fatma Ben Cherifa ◽  
Jalila El Ati ◽  
Radhouene Doggui ◽  
Myriam El Ati-Hellal ◽  
Pierre Traissac
Keyword(s):  
Associated Factors ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Protective Role ◽  
Lifestyle Factors ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Biological Variables

The protective role of high high-density lipoprotein cholesterol (HDL-C) against cardiovascular risk has been questioned recently. Due to the increasing trend of cardiovascular diseases (CVD) in Tunisia, this study aimed to determine the prevalence of high HDL-C and its associated factors in Tunisian women of childbearing age. A cross-sectional survey was conducted among a subsample of 1689 women, aged 20 to 49 years, in the Great Tunis region. Data on socio-demographic and lifestyle factors were collected by a questionnaire. Overall adiposity was assessed by body mass index (BMI). All biological variables were assayed in blood samples coated with anticoagulant ethylene diamine tetra acetic acid (EDTA) by enzymatic methods. Stata software (2015) was used for data management and statistical analysis. High HDL-C values were recorded in 26.6% of selected women. After adjustment for all socio-demographic and lifestyle factors, age, hypertension, and smoking were negatively associated with high HDL-C levels, while family history of cancer was positively associated with high HDL-C in women. An additional investigation on the relationship between high HDL-C and cancer risk should be performed due to controversial results.

scholarly journals Pregnant women and risk factors: a cross-sectional study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V L a Fauci ◽  
R Squeri ◽  
C Genovese ◽  
V Alessi ◽  
A Facciolà
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Health Education ◽  
Pregnant Women ◽  
Educational Level ◽  
Demographic Characteristics ◽  
Alcoholic Beverages ◽  
High Educational Level ◽  
Significant Difference ◽  
High Educational

Abstract Background Many investigations have shown the important role played by risk factors such as tobacco and alcohol in the development of congenital anomalies. Methods Through the administration of an hoc questionnaire, we evaluated the attitude towards smoking and alcohol of a sample of 200 pregnant women at the University Hospital of Messina. The questionnaire was structured to collect information about socio-demographic characteristics, type of gynaecological assistance and their lifestyles (smoking and alcohol). Statistical analysis was performed using version 10 of StatSoftVR software. Results 14% of the women continued to smoke despite pregnancy; the majority of these were young adults, divorced, employed and with a high educational level. Correlating the smoking habit with the socio-demographic characteristics of the studied women, we found a statistically significant difference for the marital status, with a higher number of smokers among the single women (p &lt; 0.05).Moreover, we found a statistically significant difference also for the profession with a higher number of smokers in the worker women (p &lt; 0.05). About the drinking habit, the 4.3% declared to be moderate drinkers (occasional use of alcohol equal to 2-3 glasses a week) despite pregnancy, the 34.4% stated they do not drink alcohol during pregnancy and the 56% stated do not usually drink alcohol. Particularly, about the drinkers' socio-demographic characteristics, the 50% of them were 24-25 years old and the 75% were married. About the type of alcoholic beverages consumed, 86% stated they usually drink bier during the weekend. Conclusions Our study shows that the awareness of the women about the importance of these risk factors is still rather poor. In order to improve the awareness of pregnant women on the importance of avoiding these risk factors and prevent CAs, health education campaigns at various levels surely represent the public health cornerstone. Key messages In our sample 14% of the pregnant women continued to smoke and 4.3% to drink despite pregnancy and they generally were young or young adults and with a high educational level. Our results highlight the importance of continuous health education about the risk to smoke and drink during pregnancy.

scholarly journals Prevalence of low back pain in different educational levels: a systematic review

2017 ◽  
Vol 30 (suppl 1) ◽  
pp. 351-361 ◽  
Author(s):  
Alexandre Apolinário de Souza Batista ◽  
Nicholas Henschke ◽  
Vinícius Cunha Oliveira
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Educational Level ◽  
Critical Appraisal ◽  
Meta Analysis ◽  
High Educational Level ◽  
Low Back ◽  
Educational Levels ◽  
Educational Differences ◽  
High Educational

Abstract Introduction: Non-specific low back pain (LBP) can be understood through the interaction of biopsychosocial factors such as education. Unfortunately, it remains unclear whether education can be considered an important risk and prognostic factor for the occurrence of LBP. Objective: To investigate the association between education and LBP. Methods: The following databases were searched: MEDLINE, EMBASE, Cochrane, AMED and PsyINFO. Results: Thirteen studies were included in the review. The Prevalence Critical Appraisal Instrument (PCAI) was used to assess risk of bias. Methodological quality scores ranged from 7 to 10 on a scale of 0-10. There was a 23% (95% CI, 13-37) prevalence of LBP (10,582 out of a total of 99,457 cases) in the general sample at the time of assessment. The meta-analysis of studies on the prevalence of LBP in people with low, medium or high educational level found the following results, respectively: 24% (95% CI, 12-43), 27% (95% CI, 9-56), and 18% (95% CI, 5-50). The meta-regression identified heterogeneity among the studies included in the review. This can be explained by educational differences (p < 0.05). Conclusion: Occurrence of LBP varies according to educational level. Individuals with higher educational levels are less often affected by LBP than individuals with medium or low educational levels.

NUTRITIONAL STATUS OF ADOLESCENTS IN THE CONTEXT OF THE MOROCCAN NUTRITIONAL TRANSITION: THE ROLE OF PARENTAL EDUCATION

2011 ◽  
Vol 44 (4) ◽  
pp. 481-494 ◽  
Author(s):  
PILAR MONTERO LÓPEZ ◽  
KARIM ANZID ◽  
MOHAMED CHERKAOUI ◽  
ABDELLATIF BAALI ◽  
SANTIAGO RODRIGUEZ LOPEZ
Keyword(s):  
High School Students ◽  
Nutritional Status ◽  
Educational Level ◽  
Parental Education ◽  
Educational Background ◽  
Overweight And Obesity ◽  
High Educational Level ◽  
Nutritional Transition ◽  
Lower Height ◽  
High Educational

SummaryIn Morocco, the beginning of the nutritional transition is closely linked to social and economic transformations and changes in behaviour and traditional lifestyles. The objective of this study is to describe the current pattern of food consumption and the nutritional status of adolescents in the province of Ouarzazate and its association with parents' educational level. The sample comprises 327 high school students from Ouarzazate: 135 (41.3%) boys and 192 (58.7%) girls (age range 15–20 years). For both boys and girls, the results show lower height and BMI z-scores than the WHO reference values. Adolescents whose parents have a low educational level have lower height/age and BMI/age z-scores than those whose fathers have a high educational level. No differences are observed in total daily energy intake depending on fathers' educational level, but the energy provided by lipids is higher in adolescents whose fathers have a high educational background. The quality of fats consumed (MUFA+PUFA/SFA) is better among those boys whose fathers have low education, but no differences are observed for girls. The process of nutritional transition is not uniform in the sample, but depends on the socioeconomic characteristics of population groups, which include, among others, accessibility of certain food, differences in habits and lifestyles related to energy expenditure, and higher prevalence of overweight and obesity in more favoured groups.

Association of socioeconomic and lifestyle factors with chronic non-communicable diseases and multimorbidity among the elderly in rural southwest China

2019 ◽  
Vol 42 (2) ◽  
pp. 239-246 ◽  
Author(s):  
Xiao Li ◽  
Le Cai ◽  
Wen-long Cui ◽  
Xu-ming Wang ◽  
Hui-fang Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Southwest China ◽  
Communicable Disease ◽  
Fasting Blood Glucose ◽  
The Elderly ◽  
Lifestyle Factors ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background This study estimates the prevalence of five chronic non-communicable disease (NCDs) (hypertension, diabetes, CHD, COPD and stroke) and its multimorbidity, and examines the relationship between SES and lifestyle factors and multimorbidity among older adults in rural southwest China. Methods A cross-sectional survey of 4833 consenting adults aged ≥60 years was conducted in 2017. Data on the demographics, smoking, drinking, height, weight, blood pressure and fasting blood glucose were collected. Results Among the participants, the overall prevalence of hypertension, diabetes, stroke, COPD and CHD was 50.6, 10.2, 6.4, 5.4 and 5.5%, respectively, and of multimorbidity was 16.1%. Females had a higher prevalence of hypertension, diabetes and multimorbidity of chronic NCDs, but a lower prevalence of COPD than males (P &lt; 0.05). Older adults with good household assets and access to medical services were less likely to experience multimorbidity, whereas obese and centrally obese participants, current smokers, current drinkers and those with a family history of chronic NCDs had a greater probability of multimorbidity. Conclusions The findings suggest that effective strategies for prevention and control of chronic NCDs and its multimorbidity are urgently needed, especially for low-income, elderly, ethnic minority adults with poor access to medical services.

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