The Effect of Catastrophic Health Expenditure on Work After Retirement

Several factors can force retirees to go to paid work. Catastrophic health-care expenditure (CHCE) is one of the driving forces for retirees to go to paid work. This cross-sectional study was based on 6,307 Iran retirees’ data. Xu method was used to calculate CHCE, and a logit model was estimated to show the association between CHCE and bridge employment. Other control variables were added to the model. The findings showed that there was positive relationship between CHCE and bridge employment. Retirement pension had negative relationship with work after retirement. Prevalence of work after retirement was higher in people who lived in rural region and increased due to increase in household size. The financial constraint was the main pushing factor for the retiree to go to paid work. Thus, covering retirees with health insurances and identifying and listing diseases that may face the retirees with CHCE are some possible efforts to decrease CHCE.

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Sonographic Assessment of Renal Volume in Normotensive Pregnant Women and Women With Pregnancy-Induced Hypertension in Enugu Metropolis

Journal of Diagnostic Medical Sonography ◽

10.1177/87564793211021094 ◽

2021 ◽

pp. 875647932110210

Author(s):

Idigo Felicitas Ugochinyere ◽

Nwankwo Sylvia Chiamaka ◽

Abonyi Everistus Obinna ◽

Anakwue Angel-Mary Chukwunyelu ◽

Agbo Julius Amechi

Keyword(s):

Reference Range ◽

Interobserver Variability ◽

Correct Diagnosis ◽

Negative Relationship ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Renal Volume ◽

Cross Sectional ◽

Significant Difference ◽

Induced Hypertension

Objective: Renal volume (RV) assessment during obstetric sonography is rarely considered in our locality. Understanding the changes in RV in both normotensive pregnant (NP) and pregnancy-induced hypertensive (PIH) women is important in making correct diagnosis regarding pregnancy outcome. This study is aimed at determining the RV in NP and PIH women and correlating RV with fetal gestational age (FGA), body mass index (BMI), and parity in NP women. Materials and Methods: This cross-sectional study involved 450 patients recruited at a Tertiary Hospital. A pilot study was done to determine the interobserver variability in RV measurement. RV was calculated using the following formula: L × W × AP × 0.523. Parity, BMI, and blood pressure were documented, while FGA was calculated as an average of FGAs obtained from the measurements of fetal biometric parameters. Results: Mean RV of PIH women was significantly higher than that of NP women ( P < .05). RV shows a positive significant relationship with BMI and FGA, while it shows a negative relationship with parity in NP ( P < .05). Conclusion: Reference range values of RV were generated for clinical use in our locality, while there is statistically significant difference between RV in NP and PIH women.

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Prevalence of Microalbuminuria and Overt Proteinuria in Hypertension and Their Relations with Renal Function in a Rural Population of Bangladesh

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v24i2.18700 ◽

2014 ◽

Vol 24 (2) ◽

pp. 59-64 ◽

Cited By ~ 1

Author(s):

ANME Karim ◽

D Das ◽

M Salahuddin ◽

GA Marjan ◽

MN Islam ◽

...

Keyword(s):

Adult Population ◽

Negative Relationship ◽

Cross Sectional Study ◽

Dipstick Test ◽

Significant Deterioration ◽

Cross Sectional ◽

Spot Urine ◽

Urine Dipstick Test ◽

Overt Proteinuria ◽

Stage Renal Disease

Hypertension is the third leading cause of chronic kidney disease (CKD) in Bangladesh. Microalbuminuria and overt proteinuria are the markers of the CKD. So detection of microalbuminuria and overt proteinuria in hypertensive subjects will help to identify the patient at risk of developing progressive renal impairment. This cross sectional study was carried out in a rural area of Bangladesh.1134 adult population (age between 18 and 65 years) were screened. A total of 217 (19.1%) were detected hypertensive; spot urine dipstick test was done among them. Those who where dipstick negative further studied for presence of microalbumin [ mg/L ]. Blood glucose level, serum creatinine, and estimated glomerular filtration rate (eGFR) were evaluated. A group of normotensive people (n=245) taken as comparison group. Microalbuminuria and overt proteinuria were present in 26.4% and 9.7% of the hypertensive subjects, respectively. Correlation between microalbuminuria and eGFR showed that two variables exhibited a tendency for negative relationship, although correlation was not statistically significant (P=0.186, r=-0.064). Overt proteinuric subjects showed no statistically significant deterioration of eGFR (81.6±21.1). Microalbuminuria and overt proteinuria are prevalent among the hypertensive rural Bangladeshi people. So early detection of microalbuminuria and overt proteinuria will help to prevent or delay the development of end stage renal disease. DOI: http://dx.doi.org/10.3329/bjmed.v24i2.18700 Bangladesh J Medicine 2013; 24 : 59-64

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Prevalence and correlates of Multimorbidity among older adults in rural Nepal: a cross sectional study

10.21203/rs.3.rs-19792/v1 ◽

2020 ◽

Author(s):

Uday Narayan Yadav ◽

Saruna Ghimire ◽

Sabuj Kanti Mistry ◽

Selvanaayagam Shanmuganathan ◽

Lal Bahadur Rawal ◽

...

Keyword(s):

Older Adults ◽

Health Care Expenditure ◽

Cross Sectional Study ◽

Rural Setting ◽

Chronic Obstructive ◽

Cluster Sampling ◽

Sectional Study ◽

Cross Sectional ◽

Validated Questionnaire ◽

Rural Nepal

Abstract Background Multimorbidity among older adults is an increasing challenge for health systems. Compared to a single disease condition, multimorbidity lowers the quality of life and experience higher hospital admission and health care expenditure. Although multimorbidity has gained global attention, it remains a less studied area in Nepal. Our study aimed to estimate the prevalence of major chronic diseases and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioral risk factors.Methods We analyzed data of 794 Nepalese older adults recruited using a multi-stage cluster sampling approach in two rural setting of Sunsari and Morang District of Nepal. This was a cross-sectional study, conducted between January to April 2018. Socio-demographics and health conditions data [ Osteoarthritis, Cardiovascular diseases (CVD), Diabetes, Chronic Obstructive Pulmonary Diseases (COPD) ] were collected through the help of trained research assistants using a validated questionnaire. The correlates of multimorbidity were examined using mixed-effects logistic regression.Results 48.9% of the participants had at least one chronic condition, and 14% were multimorbid. The prevalence of individual conditions were osteoarthritis- 41.7%, CVD- 2.39%, diabetes- 5.29%, and COPD- 15.7%. In the adjusted model, older adults aged 70-79 years, those from underprivileged Madhesi and other ethnic groups, without a history of alcohol drinking, and those physically inactive, were significantly associated with multimorbidity.Conclusion Our study found a sizeable proportion of the older adults had multimorbidity in our studied population. This prevalence of multimorbidity and its socioeconomic and behavioural correlates, need to be addressed through multi-level preventive strategies, including clinical guidelines and the development of a multidisciplinary workforce to address the needs of the multimorbid older adults.

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Physical Activity Behavior and Competing Activities: Interrelations in 55- to 70-Year-Old Germans

Journal of Aging and Physical Activity ◽

10.1123/japa.2016-0211 ◽

2017 ◽

Vol 25 (4) ◽

pp. 576-586 ◽

Cited By ~ 5

Author(s):

Volker Cihlar ◽

Sonia Lippke

Keyword(s):

Physical Activity ◽

Nursing Care ◽

Negative Relationship ◽

Physical Activity Behavior ◽

Active Citizenship ◽

Activity Levels ◽

Paid Work ◽

Enabling Factors ◽

Cross Sectional ◽

Activity Behavior

In this study, we draw attention to time-competing activities and psychological variables as impeding or enabling factors of physical activity behavior in 55- to 70-year-old Germans. Cross-sectional data was used (n = 4,891). Results indicate that paid work has a negative relationship with sufficient physical activity. Persons who provide nursing care seem to be motivated to achieve sufficient physical activity behavior, but do not meet established recommendations. Active citizenship positively relates to higher physical activity levels. The investment of energy in life domains and a distinct internal locus of control characterize motivated underachievers. Those sufficiently physically active show higher values in conscientiousness. This suggests that time-consuming and strongly externally determined activities like nursing care and paid work hinder a sufficient level of physical activity, even if the motivation is existent. Active citizenship and physical activity seem to be linked processes.

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Comparison of Health Care Expenditures Among U.S. Older Adults With Pain Who Reported Frequent Exercise Versus Nonfrequent Exercise

Journal of Aging and Physical Activity ◽

10.1123/japa.2021-0301 ◽

2021 ◽

pp. 1-9

Author(s):

David R. Axon ◽

Jonathan Chien ◽

Hanh Dinh

Keyword(s):

Health Care ◽

Medical Expenditure Panel Survey ◽

Survey Design ◽

Health Care Expenditure ◽

Prescription Medication ◽

Health Care Expenditures ◽

Cross Sectional Study ◽

Medical Expenditure ◽

Cross Sectional ◽

Nationally Representative

This cross-sectional study included a nationally representative sample of U.S. adults aged ≥50 years with self-reported pain in the past 4 weeks from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression analyses accounted for the complex survey design and assessed differences in several types of annual health care expenditures between individuals who reported frequent exercise (≥30 min of moderate–vigorous intensity physical activity ≥5 times per week) and those who did not. Approximately 23,940,144 of 56,979,267 older U.S. adults with pain reported frequent exercise. In adjusted analyses, individuals who reported frequent exercise had 15% lower annual prescription medication expenditures compared with those who did not report frequent exercise (p = .007). There were no statistical differences between frequent exercise status for other health care expenditure types (p > .05). In conclusion, adjusted annual prescription medication expenditures were 15% lower among older U.S. adults with pain who reported frequent exercise versus those who did not.

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Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves’ cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-023033 ◽

2019 ◽

Vol 9 (5) ◽

pp. e023033 ◽

Cited By ~ 4

Author(s):

Yafei Si ◽

Zhongliang Zhou ◽

Min Su ◽

Xiao Wang ◽

Xin Lan ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Economic Status ◽

Cross Sectional Study ◽

Catastrophic Health Expenditure ◽

Urban China ◽

Shaanxi Province ◽

Vulnerable Groups ◽

Cross Sectional

ObjectiveDespite the latest wave of China’s healthcare reform initiated in 2009 has achieved unprecedented progress in rural areas, little is known for specific vulnerable groups’ catastrophic health expenditure (CHE) in urban China. This study aims to estimate the trend of incidence, intensity and inequality of CHE in hypertension households (households with one or more than one hypertension patient) in urban Shaanxi, China from 2008 to 2013.MethodsBased on the fourth and the fifth National Health Service Surveys of Shaanxi, we identified 460 and 1289 households with hypertension in 2008 and 2013, respectively for our analysis. We classified hypertension households into two groups: simplex households (with hypertension only) and mixed households (with hypertension plus other non-communicable diseases). CHE would be identified if out-of-pocket healthcare expenditure was equal to or higher than 40% of a household’s capacity to pay. Concentration index and its decomposition based on Probit regressions were employed to measure the income-related inequality of CHE.ResultsWe find that CHE occurred in 11.2% of the simplex households and 22.1% of the mixed households in 2008, and the 21.5% of the simplex households and the 46.9% of mixed households incurred CHE in 2013. Furthermore, there were strong pro-poor inequalities in CHE in the simplex households (−0.279 and −0.283) and mixed households (−0.362 and −0.262) both in 2008 and 2013. The majority of observed inequalities in CHE could be associated with household economic status, household head’s health status and having elderly members.ConclusionWe find a sharp increase of CHE occurrence and the sustained strong pro-poor inequalities for simplex and mixed households in urban Shaanxi Province of China from 2008 to 2013. Our study suggests that more concerns are needed for the vulnerable groups such as hypertension households in urban areas of China.

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The Effects of Uric Acid, Serum Vitamin D3, and Their Interaction on Parkinson’s Disease Severity

Parkinson s Disease ◽

10.1155/2015/463483 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Rokhsareh Meamar ◽

Pooria Shaabani ◽

Seyed Reza Tabibian ◽

Mohammad Reza Aghaye Ghazvini ◽

Awat Feizi

Keyword(s):

Vitamin D3 ◽

Negative Relationship ◽

Serum Vitamin ◽

Rank Correlation ◽

Positive Association ◽

Total Sample ◽

Cross Sectional Study ◽

Cross Sectional ◽

Referral Hospitals ◽

The One

Objectives. In current study, the relationships between serum vitamin D3 levels and serum UA concentrations as well as their interaction with severity of PD were evaluated in a sample of Iranian PD patients.Method. In a cross sectional study at the one of the main referral hospitals in central region of Iran, during September to November 2011, 112 patients were recruited. Severity of PD was evaluated sing H&R stages and UPDRS.Results. The Spearman rank correlation coefficient suggests the negative significant association between serum vitamin D3 and UPDRS in patients aged >62 (r=-0.34,P<0.05). No statistically significant association was observed between the UA levels and severity of PD (represented by H&Y categories) in different levels of serum vitamin D3 not only in total sample but also in separate age and sex groups. The linear regression coefficients suggested positive association between UA and serum vitamin D3 with UPDRSIII scores while negative relationship between UA and serum vitamin D3 interaction with UPDRSIII; however it was only statistically significant in age group ≤62 (P<0.05).Conclusion. Our study revealed a negative correlation between interaction of serum vitamin D3 and UA with severity of PD; other studies are required to confirm our findings.

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Foods, Dietary Patterns and Occupational Class and Leukocyte Telomere Length in the Male Population

American Journal of Men s Health ◽

10.1177/1557988317743385 ◽

2017 ◽

Vol 12 (2) ◽

pp. 479-492 ◽

Cited By ~ 12

Author(s):

Behrooz Karimi ◽

Ramin Nabizadeh ◽

Masud Yunesian ◽

Parvin Mehdipour ◽

Noushin Rastkari ◽

...

Keyword(s):

Dietary Patterns ◽

Dairy Products ◽

Negative Relationship ◽

Cross Sectional Study ◽

Whole Grains ◽

Leukocyte Telomere Length ◽

Sectional Study ◽

Occupational Class ◽

Male Population ◽

Cross Sectional

Telomeres contain TTAGGG repetitive sequences and are located at the end of human chromosomes. Telomere dysfunction is associated with some age-related and chronic diseases, but its relationship with foods, dietary patterns, and occupational class in the young male population is not yet known. In this cross-sectional study, 300 healthy men, residents of Tehran, aged 25–40 years were enrolled from January to December 2016. We employed a cross-sectional study of 300 healthy people, residents of Tehran, aged 25-40 years. A food frequency questionnaire was used to obtain food intakes of all participants and converted into actual food intake (g/day). The principal components analysis was used to determine dietary patterns and other demographic characteristics. Leukocyte telomere length (TL) was measured by quantitative real-time polymerase chain reaction (PCR) to measure number of telomere repeat copy number (T) to the relative number of 36B4 copies (S) (T/S ratio). T/S in office-workers, waste recyclers, and other workers were 1.22 ± 0.4, 1.08 ± 0.3, and 1.094 ± 0.34, respectively. The results of multivariate linear regression adjusted for age, body mass index (BMI), and smoking were showed that whole grains (β = 0.02; p = .05), refined grains, fruits and vegetables, fish and dairy products were associated with an increase in log-T/S, but consumption of nuts and seeds (β = −0.00072; p = .06), meats (β = −0.00043; p = .9), produced meats (β = −0.00238; p = .03), oils and solid fats (β = −0.00146; p = .03) had a negative relationship with log-T/S in all studied occupational classes. A positive relationship was reported between the healthy (β = 0.017; p = .2) and traditional dietary pattern (β = 0.012; p = .4) with log-T/S, but western pattern identified negative relationship (β = −0.004; p = .7). Adherence to a healthy (with consumption whole grains, refined grains, dairy, and cereals) and then traditional pattern with increased consumption of fruits, vegetables and whole grains, fish and dairy products are necessary to prevent TL destruction in all studied occupational classes.

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Associations between Park and Playground Availability and Proximity and Children’s Physical Activity and Body Mass Index: The BEACH Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010250 ◽

2021 ◽

Vol 19 (1) ◽

pp. 250

Author(s):

Javier Molina-García ◽

Cristina Menescardi ◽

Isaac Estevan ◽

Ana Queralt

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Body Mass ◽

Weight Status ◽

Negative Relationship ◽

Cross Sectional Study ◽

Geographical Information ◽

Active Commuting ◽

Cross Sectional ◽

Parent Questionnaire

A cross-sectional study was designed to evaluate the relationship between the availability and proximity to parks and playgrounds and physical activity (PA). Moreover, the accessibility to parks and playgrounds and its association with active commuting to/from school (ACS) and body mass index (BMI) were analyzed. The sample was composed of children aged 6–12 years old from the BEACH (Built Environment and Active CHildren) study in Valencia, Spain. The availability and proximity to parks and playgrounds were calculated at different buffer sizes (250, 500, 1000 and 1250 m) using geographical information system data. PA out of school was assessed using accelerometers. Sociodemographics and ACS were measured with a parent questionnaire. Objectively measured weight and height were used to calculate BMI. Mixed linear regression analyses were conducted for each exposure variable, adjusting for sociodemographics, neighborhood walkability level, and participant clustering. The number of parks and playgrounds were positively associated with moderate to vigorous PA (MVPA) and total PA (TPA); including light PA and MVPA, during weekdays, in different buffer sizes. A negative relationship between distance to the nearest playground and TPA during weekdays was found. In addition, the number of playgrounds was positively related to ACS in different buffer sizes, whereas park land area was negatively related to the BMI percentile. This study highlights the importance of assessing the availability and proximity to parks and playgrounds in children’s neighborhoods when PA behavior and weight status are analyzed. Study findings may help policymakers when targeting interventions to promote health-enhancing behaviors in children.

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Feasibility of the Schizophrenia Hope Scale-9: A psychometric study

10.20944/preprints202010.0375.v1 ◽

2020 ◽

Author(s):

Kwisoon Choe ◽

Eunjung Ryu ◽

Sunghee Kim

Keyword(s):

Construct Validity ◽

Negative Relationship ◽

Principal Component ◽

Extraction Methods ◽

Cross Sectional Study ◽

Validity And Reliability ◽

Cross Sectional ◽

Mental Health Centers ◽

Using Data ◽

Persons With Schizophrenia

Hope is important in the rehabilitation of persons with schizophrenia, through scales to measure hope are not appropriate for this population. The purpose of this cross-sectional study was to identify the psychometric properties of the Schizophrenia Hope Scale-9 (SHS-9) using data from 83 people with schizophrenia in four mental health centers and 762 healthy persons from two universities in South Korea. The mean (standard deviation) SHS-9 score of the participants with schizophrenia and healthy participants was 11.24 (4.90) and 14.83 (3.10), respectively. Lower scores indicate a lower level of hope. The internal consistency alpha coefficient was 0.92 with a 4-week test-retest reliability of 0.89. Criterion-related construct validity was established by examining the correlation between the SHS-9 and the State-Trait Hope Inventory scores. Divergent validity was identified through a negative relationship of SHS-9 with the Beck Hopelessness Scale. The construct validity of the SHS-9 was confirmed through principal component analysis with extraction methods, which resulted in a one-factor solution, accounting for 49–60% of the total item variance.. This study provided evidence for the validity and reliability of the SHS-9; therefore, it could be used to measure hope in people with schizophrenia.

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