scholarly journals Improvements in Access to Care for Vulnerable Children in California between 2001 and 2005

2009 ◽  
Vol 124 (5) ◽  
pp. 682-691 ◽  
Author(s):  
Gregory D. Stevens ◽  
Michael Seid ◽  
Kai-Ya Tsai ◽  
Carmen West-Wright ◽  
Michael R. Cousineau
Keyword(s):  
Risk Factors ◽  
Access To Care ◽  
Insurance Coverage ◽  
California Health Interview Survey ◽  
Individual Risk ◽  
Population Changes ◽  
Vulnerable Children ◽  
Cross Sectional ◽  
Dental Visits ◽  
Percentage Points

Objective. We examined population changes in access to care for children in California during a period of major efforts to improve access to care for children. Methods. We used cross-sectional data on 36,010 children aged 0–19 years from the 2001 and 2005 California Health Interview Survey to assess population changes in access to care. We assessed changes in access by individual risk factors and a composite risk profile. Results. In 2005, a smaller proportion of children were uninsured (8.2% vs. 10.9% in 2001), living in poverty (20.7% vs. 23.2% in 2001), and in families without a high school education (20.8% vs. 23.6% in 2001), all p<0.001. Before and after adjusting for these changes in risk, children were more likely in 2005 to have had a physician visit (odds ratio [OR] = 1.09, 95% confidence interval [CI] 1.07, 1.12) and dental visit (OR=1.11, 95% CI 1.08, 1.14). Children were slightly less likely in 2005 to have a regular source of care (OR=0.94, CI 0.91, 0.96). Children who had the highest risk profiles (≥4 risk factors) experienced the largest gains in access. For example, children with three and ≥4 risk factors had gains in dental visits of 11 and 20 percentage points, respectively ( p<0.001 for each), compared with ≤3 percentage points for children with fewer risk factors. Conclusions. This study found improvements in physician and dental visits between 2001 and 2005 that were not fully explained by changes in insurance coverage or other demographic risk factors. Vulnerable children fared well during this period, suggesting that California may be making important and potentially replicable strides in reducing disparities.

The Effect of Parents' Insurance Coverage on Access to Care for Low-Income Children

2003 ◽  
Vol 40 (3) ◽  
pp. 254-268 ◽  
Author(s):  
Amy Davidoff ◽  
Lisa Dubay ◽  
Genevieve Kenney ◽  
Alshadye Yemane
Keyword(s):  
Access To Care ◽  
Low Income ◽  
Insurance Coverage ◽  
Spillover Effects ◽  
Medical Provider ◽  
Low Income Children ◽  
Point Reduction ◽  
Percentage Points ◽  
Well Child Visit ◽  
Child Visit

This study examines the effects of having an uninsured parent on access to health care for low-income children. Using data from the 1999 National Survey of America's Families, we find that having an uninsured parent decreases the likelihood that a child will have any medical provider visit by 6.5 percentage points, and decreases the likelihood of a well-child visit by 6.7 percentage points. Estimates for low-income children who have insurance but have an uninsured parent indicate a 4.1 percentage-point reduction in the probability of having any medical provider visit, and a similar 4.2 percentage-point reduction in the probability of having a well-child visit relative to those with insured parents. The effects of having an uninsured parent are smaller in magnitude than the effects of a child being uninsured. Efforts to increase insurance coverage of parents, either by extending eligibility for public insurance or through other policy interventions, will have positive spillover effects on access to care for children. Although the magnitude of these effects is small relative to the direct effect of providing insurance to either the child or parent, they should be considered in analyses of costs and benefits of proposed policies.

scholarly journals Malnutrition and related risk factors in older adults from different health-care settings: an enable study

2019 ◽  
Vol 23 (3) ◽  
pp. 446-456 ◽  
Author(s):  
Eva Kiesswetter ◽  
Miriam G Colombo ◽  
Christa Meisinger ◽  
Annette Peters ◽  
Barbara Thorand ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Older Age ◽  
Dietary Behaviour ◽  
Individual Risk ◽  
Mobility Limitations ◽  
Cross Sectional ◽  
Living Situation ◽  
Poor Appetite ◽  
Individual Risk Factors

AbstractObjective:The origin of malnutrition in older age is multifactorial and risk factors may vary according to health and living situation. The present study aimed to identify setting-specific risk profiles of malnutrition in older adults and to investigate the association of the number of individual risk factors with malnutrition.Design:Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m2 and/or weight loss of >3 kg in the previous 3–6 months. Associations between factors of six domains (demographics, health, mental function, physical function, dietary intake-related problems, dietary behaviour), the number of individual risk factors and malnutrition were analysed using logistic regression.Setting:Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH).Participants:CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all ≥65 years.Results:Malnutrition prevalence was lower in CD (11 %) than in the other settings (16–19 %). In the CD sample, poor appetite, difficulties with eating, respiratory and gastrointestinal diseases were associated with malnutrition; in GDH patients, poor appetite and respiratory diseases; in HC receivers, younger age, poor appetite and nausea; and in NH residents, older age and mobility limitations. In all settings the likelihood of malnutrition increased with the number of potential individual risk factors.Conclusions:The study indicates a varying relevance of certain risk factors of malnutrition in different settings. However, the relationship of the number of individual risk factors with malnutrition in all settings implies comprehensive approaches to identify persons at risk of malnutrition early.

scholarly journals Individual and Environmental Factors Associated with Recurrent Falls in Elderly Patients Hospitalized after Falls

2020 ◽  
Vol 17 (7) ◽  
pp. 2441
Author(s):  
Hai Minh Vu ◽  
Long Hoang Nguyen ◽  
Huong Lan Thi Nguyen ◽  
Giang Thu Vu ◽  
Cuong Tat Nguyen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Environmental Factors ◽  
Elderly Patients ◽  
Environmental Conditions ◽  
Social Consequences ◽  
Individual Risk ◽  
Cross Sectional ◽  
Factors Associated ◽  
Recurrent Falls ◽  
The Individual

Falls and recurrent falls cause great health and social consequences in older people. However, these problems are poorly understood in Vietnam. A cross-sectional study was performed at seven hospitals in Thai Binh province, Vietnam, to investigate the individual and environmental factors associated with recurrent falls among elderly patients hospitalized due to fall injuries in Vietnam. A history of recurrent falls within the last 12 months, sociodemographic, health, and clinical characteristics, as well as environmental conditions, were obtained via self-reported interviews. Multivariate logistic and Poisson regression models were used to identify associated factors. Overall, the mean fall episodes in the last 12 months were 1.8 (Standard deviation—SD = 1.2) episodes, and the 12-month prevalence of recurrent falls was 40.5%. The individual risk factors included not receiving fall prevention guidelines, walking with devices, loss of sensation in hand or foot, and using pain relief medications. The environmental risk factors comprised having too-high stairs and not having dry, clean, and nonslippery bathrooms. This study highlights a significantly high 12-month prevalence of recurrent falls in older patients hospitalized after falls in Vietnam. Moreover, regular assessments of functional disabilities and hazardous environmental conditions, as well as the provision of prevention programs, have potential to prevent falls and recurrent falls.

scholarly journals A Bayesian Model to Analyze the Association of Rheumatoid Arthritis With Risk Factors and Their Interactions

2021 ◽  
Vol 9 ◽  
Author(s):  
Leon Lufkin ◽  
Marko Budišić ◽  
Sumona Mondal ◽  
Shantanu Sur
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Characteristic Curve ◽  
Strong Association ◽  
Mixed Data ◽  
Validation Dataset ◽  
Individual Risk ◽  
Third Order ◽  
Cross Sectional ◽  
Organ Systems

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that commonly manifests as destructive joint inflammation but also affects multiple other organ systems. The pathogenesis of RA is complex where a variety of factors including comorbidities, demographic, and socioeconomic variables are known to associate with RA and influence the progress of the disease. In this work, we used a Bayesian logistic regression model to quantitatively assess how these factors influence the risk of RA, individually and through their interactions. Using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), a set of 11 well-known RA risk factors such as age, gender, ethnicity, body mass index (BMI), and depression were selected to predict RA. We considered up to third-order interactions between the risk factors and implemented factor analysis of mixed data (FAMD) to account for both the continuous and categorical natures of these variables. The model was further optimized over the area under the receiver operating characteristic curve (AUC) using a genetic algorithm (GA) with the optimal predictive model having a smoothed AUC of 0.826 (95% CI: 0.801–0.850) on a validation dataset and 0.805 (95% CI: 0.781–0.829) on a holdout test dataset. Apart from corroborating the influence of individual risk factors on RA, our model identified a strong association of RA with multiple second- and third-order interactions, many of which involve age or BMI as one of the factors. This observation suggests a potential role of risk-factor interactions in RA disease mechanism. Furthermore, our findings on the contribution of RA risk factors and their interactions to disease prediction could be useful in developing strategies for early diagnosis of RA.

scholarly journals Assessment of Individual Cardiovascular Risk Among Population in Public Pharmacies Using the Heart-Score Questionnaire

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Vesna Maksimovic ◽  
Biljana Jakovljevic
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Cardiovascular Event ◽  
Parallel Implementation ◽  
Absolute Risk ◽  
Adult Population ◽  
Individual Risk ◽  
Total Risk ◽  
Cross Sectional ◽  
Heart Score

Abstract The SCORE model was calibrated according to mortality statistics for each European country. If it is used for the population aged 40-65, it will predict the possibility of fatal cardiovascular consequences that will appear after 10 years. The aim of this study was to investigate individual risk factors for cardiovascular complications in the adult population in the city of Belgrade. The study was designed as a cross-sectional study. Using Heart Score tool for determining of the total risk of CVD, could be projected to the age of 60, which may be of particular importance for guiding young adults, aged 20 to 30, with low absolute risk but already with an unhealthy risk profile, which will lead to a much higher risk as they age. In our study, predominately were present female participants without hypertension, then male and were dominate frequent non-smokers compared with smokers in male and female. Furthermore, in study population were more present smokers with longer duration of smoking (>10 years). After calculated Heart Score, we can see that 25.6% of respondents have a high risk of cardiovascular event, of which 19.6% high risk, 4.4% very high risk, and 1.6% extremely high risk of developing some an adverse fatal cardiovascular event. The present risk factors and high mortality and morbidity from cardiovascular disease indicate the need for taking preventive measures already in children, with the parallel implementation of population strategies and high risk.

RISK FACTORS FOR BURNOUT IN PHYSICIANS

2021 ◽  
Vol 9 (1) ◽  
pp. 27-44
Author(s):  
Gabriela Massaro Carneiro Monteiro ◽  
Glen Owens Gabbard ◽  
Simone Hauck
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Alcohol Abuse ◽  
Work Environment ◽  
Online Survey ◽  
Psychological Treatment ◽  
Personal Accomplishment ◽  
Individual Risk ◽  
Cross Sectional ◽  
Work Related

Objective: To evaluate factors potentially associated with burnout in Brazilian physicians and medical students. Methods: In this cross-sectional online survey, participants were evaluated in October 2019 regarding sociodemographic, personal, work-related, and mental health factors. Different phases of medical careers and work settings were represented. Burnout symptoms were assessed by means of the Maslach Burnout Inventory. The most common cut-off points were used for emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). The total scores of these dimensions were used as dependent variables in order to assess the risk factors for each burnout dimension. Results: 2,486 participants were included in the study. The mean age was 38.92 years (SD = 12.64), 62.8% were female, and 39.9% declared themselves as burned out. EE was present in 59.3%, DP in 45.5%, and low PA in 33.1% of the sample. Workload, age, sex, work environment, psychiatric history, quality of the relationships with family and friends, leisure and physical activity were all associated with burnout. Those participants who reported that they were not undergoing any type of psychological treatment, but nevertheless felt like they should be in treatment, actually had more symptoms. Burnout was also related to having suicidal ideation in the last month and to alcohol abuse. Conclusion: In addition to individual risk factors, this study shows the importance of characteristics of the work environment such as fostering cooperation, empathy and shared values between superiors, institutions, and physicians. Also, stigma and the barriers to seeking care appear as an important issue, as well as the association between burnout, alcohol abuse, and suicidal ideation.

scholarly journals Risk factors for stunting among under-fives in Libya

2009 ◽  
Vol 12 (8) ◽  
pp. 1141-1149 ◽  
Author(s):  
Adel El Taguri ◽  
Ibrahim Betilmal ◽  
Salah Murad Mahmud ◽  
Abdel Monem Ahmed ◽  
Olivier Goulet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Risk Groups ◽  
Young Age ◽  
Sample Survey ◽  
Individual Risk ◽  
Cross Sectional ◽  
Psychosocial Stimulation ◽  
Nationally Representative

AbstractObjectiveStunting is a chronic condition reflecting poor nutrition and health. Our aim was to ascertain major predictors of stunting in children <5 years old in Libya.Population and methodsA nationally representative, cross-sectional, two-stage stratified cluster sample survey enrolled 4549 under-fives from 6707 households. Logistic regression was used to determine individual risk factors in bivariate and multivariate analyses.ResultsAnthropometric measurements were available for 4498 children. Among the 929 stunted children (20·7 %), 495 were boys (53·3 %) and 434 were girls (46·5 %). In multivariate analysis, risk factors were young age (1–2 years: OR = 2·32, 95 % CI 1·67, 3·22; 2–3 years: OR = 1·64, 95 % CI 1·22, 2·21), resident of Al-Akhdar (OR = 1·67, 95 % CI 1·08, 2·58), being a boy (OR = 1·28, 95 % CI 1·05, 1·55), having a less educated father (illiterate: OR = 2·10, 95 % CI 1·17, 3·77; preparatory school: OR = 1·71, 95 % CI 1·11, 2·65), poor psychosocial stimulation (no family visits or trips: OR = 1·52, 95 % CI 1·07, 2·16; father rarely/never plays with child: OR = 2·24, 95 % CI 1·20, 4·16), filtered water (OR = 8·45, 95 % CI 2·31, 30·95), throwing garbage in the street (OR = 13·81, 95 % CI 2·33, 81·72), diarrhoea (OR = 1·58, 95 % CI 1·09, 2·29) and low birth weight (OR = 1·8, 95 % CI 1·17, 2·40). Protective factors were older age of father (OR = 0·53, 95 % CI 0·32, 0·90) and water storage (OR = 0·70, 95 % CI 0·54, 0·90). These variables only explained 20 % of cases of stunting.ConclusionVarious multilevel actions are needed to improve nutritional status of under-fives in Libya. At risk-groups include those with young age (1–3 years), resident of Al-Akhdar region, boys, father’s low educational level, poor psychosocial stimulation, poor housing environment, diarrhoea and low birth weight.

scholarly journals Osteoporosis and osteoporotic fractures risk factors in men aged 50 years and older

2017 ◽  
Vol 20 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Oksana A. Nikitinskaya ◽  
Natalya V. Toroptsova
Keyword(s):  
Risk Factors ◽  
Calcium Intake ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Individual Risk ◽  
Cross Sectional ◽  
Random Samples ◽  
Federal Districts ◽  
Proximal Forearm ◽  
Individual Risk Factors

Cross-sectional screening of random samples of men aged 50 years and older living in five cities (Arkhangelsk, Murmansk, Tyumen, Krasnoyarsk, and Chelyabinsk) from three Federal Districts (FD) of the Russian Federation was conducted to evaluate the frequency of individual risk factors (RF) of osteoporotic fractures among them. Total 1330 men were included in the study.  We found that the most common were the following RF: smoking, prior fragility fractures after age 40, secondary causes of OP, insufficient calcium intake. Significantly more smokers were among males in Siberian (S) FD and North –Western (NW)FD compared with those from Ural (U) FD (p=0,0011 and p=0,047, respectively), the frequency of other RF did not differ depending on region. The рprevalence of osteoporosis according to peripheral x-ray densitometry of the proximal forearm was higher among residents of the UFD (26%) than among men in the NWFD (17%) and SFO (19%). More than 50% of men in each region had 2 or more RF, while those with 3 or more RF were significantly more in the UFD at any age, and at the age of 50-59 years - in the NWFD. Calcium intake was inadequate in 85% of the respondents in these regions.

scholarly journals Knowledge and Attitude towards Breast Cancer among Medical Undergraduate Students

2021 ◽  
pp. 77-82
Author(s):  
Nasima Iqbal ◽  
Fareya Usmani ◽  
Ali Nawaz Bijarani ◽  
Muhammad Aitmaud Uddolah Khan ◽  
Muhammad Salman Khan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Undergraduate Students ◽  
Study Data ◽  
Individual Risk ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Medical Undergraduate ◽  
Knowledge And Attitude ◽  
Medical Undergraduate Students

Aim: To find out the knowledge and attitude of medical undergraduate students towards breast cancer. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Study was performed in Ziauddin medical university during the period of October to December 2020. Methodology: All the undergraduate Bachelor of Medicine and Bachelor of Surgery (MBBS) female students were included in the study irrespective of year of study. A self-designed, self-explanatory questionnaire was made and validated by doing a pilot study. Data was analyzed by using the Statistical Package for Social Sciences (SPSS version-20). Results: Mean age of the study participants was 22.2 ± 1.7 years. Data regarding knowledge about the risk factors reported that overall more than 62% of the students were aware of the risk factors leading to breast cancer. Looking over the individual risk factors, about 77.3% recognized increased age as a major contributing factor, followed by lack of breast feeding, nulliparity, obesity, use of contraceptive pills, late menopause, early menarche and smoking with 68.3%,54.9%,51.1%, 64.8%,61.6%,39,2% and 48.6%respectively. Focusing specifically the year of MBBS student, the level of medical education increases the awareness about the risk factor also increase. Looking over the attitude of undergraduate MBBS students, about 76.8% of the students consulted to the doctor for breast lump, out of them 41.6% immediately consulted, 27.3% delayed it for weeks and 7.9% waited for months for self-recovery. Conclusion: It can be concluded that majority of undergraduate medical students were having enough knowledge about the breast cancer, associated risk factors, symptoms and diagnostic modalities along with having positive attitude towards seeking medical help.

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