Place, poverty and prescriptions: a cross-sectional study using Area Deprivation Index to assess opioid use and drug-poisoning mortality in the USA from 2012 to 2017

ObjectiveTo identify the relationships between county-level area deprivation and patterns of both opioid prescriptions and drug-poisoning mortality.Design, setting and participantsFor this retrospective cross-sectional study, we used the IQVIA Xponent data to capture opioid prescriptions and Centres for Disease Control and Prevention National Vital Statistics System to assess drug-poisoning mortality. The Area Deprivation Index (ADI) is a composite measure of social determinants of health comprised of 17 US census indicators, spanning four socioeconomic domains. For all US counties with available opioid prescription (2712 counties) and drug-poisoning mortality (3133 counties) data between 2012 and 2017, we used negative binomial regression to examine the association between quintiles of county-level ADI and the rates of opioid prescriptions and drug-poisoning mortality adjusted for year, age, race and sex.Primary outcome measuresCounty-level opioid prescription fills and drug-poisoning mortality.ResultsBetween 2012 and 2017, overall rates of opioid prescriptions decreased from 96.6 to 72.2 per 100 people, while the rates of drug-poisoning mortality increased from 14.3 to 22.8 per 100 000 people. Opioid prescription and drug-poisoning mortality rates were consistently higher with greater levels of deprivation. The risk of filling an opioid prescription was 72% higher, and the risk of drug-poisoning mortality was 36% higher, for most deprived compared with the least deprived counties (both p<0.001).DiscussionCounties with greater area-level deprivation have higher rates of filled opioid prescriptions and drug-poisoning mortality. Although opioid prescription rates declined across all ADI quintiles, the rates of drug-poisoning mortality continued to rise proportionately in each ADI quintile. This underscores the need for individualised and targeted interventions that consider the deprivation of communities where people live.

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Free Sugars Intake among Chinese Adolescents and Its Association with Dental Caries: A Cross-Sectional Study

Nutrients ◽

10.3390/nu13030765 ◽

2021 ◽

Vol 13 (3) ◽

pp. 765

Author(s):

Qiping Yang ◽

Yue Xi ◽

Hanmei Liu ◽

Jing Luo ◽

Yufeng Ouyang ◽

...

Keyword(s):

Oral Health ◽

Dental Caries ◽

Cross Sectional Study ◽

Chinese Adolescents ◽

Food Sources ◽

Caries Experience ◽

Sectional Study ◽

Cross Sectional ◽

Free Sugars ◽

Targeted Interventions

This study aims to estimate the free sugars intake, identify the primary food sources of free sugars, and explore the relationship between free sugars intake and dental caries among Chinese adolescents. This cross-sectional study included 1517 middle-school students aged 12–14 years in Changsha city, China. Adolescents completed a 12-item Food Frequency Questionnaire (FFQ) and oral health assessment. The students’ dental caries experience was available as DMFT score (number of decayed, missing, and filled permanent teeth). Statistical analyses included the Mann–Whitney test, Kruskal–Wallis test, Chi-square test, and binary logistic regression model. The average intake of free sugars was 53.1 g/d in adolescents, and 43.2% of the students consumed more than 50 g of free sugars daily. The primary contributor to free sugars was sugar-sweetened beverages (SSBs). Age, boarders, and high family income were risk factors for excessive free sugars intake (p < 0.05), and increased free sugars intake was a risk factor for dental caries (odds ratio, OR = 1.446, 95% confidence interval: 1.138–1.839). Both the free sugars intake and dental caries prevalence in Chinese adolescents were high. Targeted interventions are urgently needed to address the excessive consumption of free sugars and improve Chinese adolescents’ oral health.

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Ultra-processed food consumption in Barbados: evidence from a nationally representative, cross-sectional study

Journal of Nutritional Science ◽

10.1017/jns.2021.21 ◽

2021 ◽

Vol 10 ◽

Author(s):

Rachel M. Harris ◽

Angela M. C. Rose ◽

Suzanne Soares-Wynter ◽

Nigel Unwin

Keyword(s):

Communicable Disease ◽

Population Based ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Targeted Interventions ◽

Sweetened Beverages ◽

Group 4 ◽

The Mean ◽

Nationally Representative

Abstract Our objective was to describe, for the first time in an English-speaking Caribbean country, the contribution of ultra-processed foods (UPFs) to nutrients linked to non-communicable disease. Using a cross-sectional study design, dietary data were collected from two non-consecutive 24-h dietary recalls. Recorded food items were then classified according to their degree of processing by the NOVA system. The present study took place in Barbados (2012–13). A representative population-based sample of 364 adult Barbadians (161 males and 203 females) aged 25–64 years participated in the study. UPFs represented 40⋅5 % (838 kcal/d; 95 % CI 791, 885) of mean energy intake. Sugar-sweetened beverages made the largest contribution to energy within the UPF category. Younger persons (25–44 years) consumed a significantly higher proportion of calories from UPF (NOVA group 4) compared with older persons (45–64 years). The mean energy shares of UPF ranged from 22⋅0 to 58⋅9 % for those in the lowest tertile to highest tertile. Within each tertile, the energy contribution was significantly higher in the younger age group (25–44 years) compared with the older (45–64 years). One-quarter of persons consume ≥50 % of their daily calories from UPF, this being significantly higher in younger persons. The ultra-processed diet fraction contained about six times the mean of free sugars and about 0⋅8 times the dietary fibre of the non-ultra-processed fraction (NOVA groups 1–3). Targeted interventions to decrease the consumption of UPF especially in younger persons is thus of high priority to improve the diet quality of Barbadians.

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Differences in Disaster Preparedness Among Dog and Other Pet Owners in Oporto, Portugal

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.159 ◽

2021 ◽

pp. 1-6

Author(s):

Zélia Pereira ◽

Luís Cardoso ◽

Ana Cláudia Coelho

Keyword(s):

Emergency Preparedness ◽

Disaster Preparedness ◽

Cross Sectional Study ◽

County Level ◽

Sectional Study ◽

Cross Sectional ◽

Convenience Sample ◽

Pet Owners ◽

Inadequate Knowledge ◽

Structured Questionnaire

Abstract Objectives: The aim of this study was to assess the knowledge and practices related to disaster preparedness among pet owners in North Portugal. The present research provides an evaluation of differences among pet owners regarding preparedness in the event of disasters. Methods: A cross-sectional study was conducted among a convenience sample of 155 pet owners between September and November 2018. Subjects were interviewed using a structured questionnaire with items addressing sociodemographic characteristics and questions related to owners’ emergency preparedness and practices. Results: In this study, 53.5% of the respondents thought about the possibility of a disaster. Only 21.3% of respondents reported having knowledge on the existence of a disaster kit for pets in case of an emergency. The majority (94.8%) of respondents said they were not aware of the preparedness county-level organization plans. Knowledge and preparedness were found to be signiﬁcantly higher among dog owners compared with owners of other pet species. Conclusions: The results suggest that Portuguese pet owners have inadequate knowledge on how to prepare for inclusion of their pets in a disaster.

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Attitudes Toward Caring for People Living with HIV/AIDS: A Cross-Sectional Study of Nursing Faculty in Six Countries

The Open AIDS Journal ◽

10.2174/1874613602014010090 ◽

2020 ◽

Vol 14 (1) ◽

pp. 90-99

Author(s):

Juan. M. Leyva-Moral ◽

Karen A. Dominguez-Cancino ◽

Joan E. Edwards ◽

David Moriña-Soler ◽

Sandra K. Cesario ◽

...

Keyword(s):

Nursing Faculty ◽

Cross Sectional Study ◽

Faculty Attitudes ◽

Composite Score ◽

People Living With Hiv ◽

Sectional Study ◽

Cross Sectional ◽

Targeted Interventions ◽

Living With Hiv ◽

Hiv Aids

Background: Since the earliest study about nursing faculty and student attitudes about caring for people living with HIV/AIDS (PLHIV) in 1992, there have been less than 20 additional studies reported in the literature. Yet, PLHIV continues to report stigma and experience discrimination. Nursing faculty attitudes are part of the informal curriculum. Negativity about caring for PLHIV can adversely impact student perceptions as well as their care. Current research in this area is essentially non-existent. Objective: To describe the attitudes of the university nursing faculty toward caring for PLHIV; and to identify the relationship between faculty attitudes and explanatory factors such as age, education, religion, nationality, teaching in a clinical setting, years of experience, and university attributes. Methods: This was a multicenter cross-sectional study with nonrandomized electronic purposeful sampling. The Healthcare Provider HIV/AIDS Stigma Scale (HPASS) is a 30-item scale with three subscales: Prejudice, stereotype, and discrimination. The English and Spanish versions of the HPASS exhibit stable psychometric properties for cross-cultural research. The HPASS was delivered to university nursing faculty in six countries across three continents. Results: A sample of 368 nursing faculty completed the HPASS. The mean composite score was 2.41 (SD = 0.69), six-point scale with lower scores indicating more positive attitudes, with subscale scores: Stereotypes 2.55 (SD = 0.84), discrimination 2.28 (SD = 0.74), and prejudices 2.41 (SD = 0.63). Peruvian faculty had the highest scores while Canadian had the lowest. Significant correlations were observed between attitudes and the three subscales, and between the three subscales and the composite score. Conclusion: Attitudes of the nursing faculty toward caring for PLHIV were slightly positive to slightly negative depending on the region and country. Knowledge deficiencies about HIV persist, incorrect beliefs are common, and attitudes appear to be influenced by culture. The correlation between subscales justifies continued research to implement targeted interventions. Education about HIV/AIDS can address knowledge deficits while structured interactions with PLHIV can facilitate experiential learning.

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Factors affecting male partners’ involvement in maternity waiting home utilization in North Achefer district, Northwest Ethiopia: a cross-sectional study

10.21203/rs.2.21046/v1 ◽

2020 ◽

Author(s):

Getachew Asmare ◽

Dabere Nigatu ◽

Yamrot Debela

Keyword(s):

Decision Making ◽

Maternal Health ◽

Male Partner ◽

Cross Sectional Study ◽

Male Partners ◽

Sectional Study ◽

Cross Sectional ◽

Factors Affecting ◽

Targeted Interventions ◽

Maternity Waiting Home

Abstract Background: Maternity waiting home is a direct strategy to improving newborn and maternal survival. The utilization of maternity waiting home, however, remains very low in Ethiopia. The involvement of men in maternal health programs is a key strategy to increase utilization of various maternal health services including maternity waiting home. Thus, this study is aimed to determine the proportion of and factors affecting male partners’ involvement in maternity home utilization.Methods: A community-based cross-sectional study was conducted from November 01 – December 30, 2018. A total of 403 male partners were involved in the study. Data were analyzed by statistical package for social science (SPSS) version 23. Independent predictors were identified by multivariable logistic regression model. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) was reported.Results: The proportion of male partner’s involvement in maternity waiting home utilization was 55.6% (50.71, 60.45). Age (AOR=0.88, 95% CI=0.82-0.94), knowledge (AOR=4.75, 95% CI=2.65-8.49), decision making power (AOR=4.00, 95% CI=1.38-11.57), and male partners’ who got counseling about maternity waiting home during spousal antenatal care visit (AOR=9.15, 95% CI=3.34-25.03) had statistically significant association with male partner’s involvement in maternity waiting home utilization.Conclusions: Nearly, a half of male partners were involved in maternity waiting home utilization. Men’s age, knowledge, decision making power, and receiving counseling were factors for male partner involvement in maternity waiting home utilization. Targeted interventions on increasing men’s knowledge about maternity waiting home and changing patriarchal thinking in the society can improve men’s involvement in maternity waiting home utilization.

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Primary care in Germany: access and utilisation—a cross-sectional study with data from the German Socio-Economic Panel (SOEP)

BMJ Open ◽

10.1136/bmjopen-2017-021036 ◽

2018 ◽

Vol 8 (10) ◽

pp. e021036 ◽

Cited By ~ 2

Author(s):

Gregory Gordon Greiner ◽

Lars Schwettmann ◽

Jan Goebel ◽

Werner Maier

Keyword(s):

Survey Data ◽

Outcome Measure ◽

Cross Sectional Study ◽

Walking Distance ◽

Secondary Outcome ◽

Individual Factors ◽

Area Deprivation ◽

Sectional Study ◽

Cross Sectional ◽

Settlement Structure

Objectives(1) To describe the accessibility of general practitioners (GPs) by the German population; (2) to determine factors on individual and area level, such as settlement structure and area deprivation, which are associated with the walking distance to a GP; and (3) to identify factors that may cause differences in the utilisation of any doctors.DesignCross-sectional study using individual survey data from the representative German Socio-Economic Panel (SOEP) linked with area deprivation data from the German Index of Multiple Deprivation for 2010 (GIMD 2010) and official data for settlement structure (urban/rural areas) at district level. Logistic regression models were estimated to determine the relationship of individual and area factors with the distance to a GP. Negative binomial regressions were used to analyse the association with utilisation.SettingGermany.Populationn=20 601 respondents from the SOEP survey data 2009.Primary outcome measureWalking distance to a GP.Secondary outcome measureDoctor visits.ResultsNearly 70% of the sample lives within a 20 min walk to a GP. People living in the most deprived areas have a 1.4-fold (95% CI 1.3 to 1.6) increased probability of a greater walking distance compared with the least deprived quintile, even after controlling for settlement structure and individual factors. In rural districts, people have a 3.1-fold (95% CI 2.8 to 3.4) higher probability of a greater walking distance compared with those in cities. Both area deprivation and rurality have a negative relationship with the utilisation of physicians, whereas the distance to a GP is not associated with the utilisation of physicians.ConclusionWalking distance to a GP depends on individual and area factors. In Germany, area deprivation is negatively correlated with the accessibility of GPs while controlling for settlement structure and individual factors. Both area factors are negatively associated with the utilisation of doctors. This knowledge could be used for future GP requirement plans.

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County-Level Effects of Green Space Access on Physical Activity

Journal of Physical Activity and Health ◽

10.1123/jpah.10.2.232 ◽

2013 ◽

Vol 10 (2) ◽

pp. 232-240 ◽

Cited By ~ 34

Author(s):

Christopher Coutts ◽

Timothy Chapin ◽

Mark Horner ◽

Crystal Taylor

Keyword(s):

Physical Activity ◽

Green Space ◽

Vigorous Physical Activity ◽

Cross Sectional Study ◽

Geographical Information ◽

County Level ◽

Sectional Study ◽

Recreational Physical Activity ◽

Cross Sectional ◽

Activity Measurements

Background:Parks and other forms of green space are among the key environmental supports for recreational physical activity. Measurements of green space access have provided mixed results as to the influence of green space access on physical activity.Methods:This cross-sectional study uses a geographical information system (GIS) to examine the relationships between the amount of and distance to green space and county-level (n = 67) moderate and vigorous physical activity (MVPA) in the state of Florida.Results:The gross amount of green space in a county (P < .05) and the amount of green space within defined distances of where people live (1/4 mile, P < .01; 1/2 mile, P < .05; 1 mile, P < .01) were positively associated with self-reported levels of MVPA. Distance to the nearest green space and the amount of green space furthest from where people live (10 miles) were not significantly associated with MVPA. All measures were weighted by the population living in census tracts.Conclusions:The results suggest that there is an association between the accessibility created by having more green space closer to home and MVPA, but this holds only for areas up to and including 1 mile from home.

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