Sociodemographic factors influencing Breslow thickness at diagnosis for patients with melanoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6552-6552
Author(s):  
K. B. Stitzenberg ◽  
N. E. Thomas ◽  
M. Berwick ◽  
H. Anton-Culver ◽  
U. J. Mujumdar ◽  
...  
Keyword(s):  
Rural Areas ◽  
Secondary Data ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Geographic Region ◽  
Breslow Thickness ◽  
Outcome Variable ◽  
Effective Measure ◽  
Significant Difference ◽  
Incident Cases

6552 Background: In previous work, we demonstrated that Breslow thickness at diagnosis is significantly related to distance to provider for patients with melanoma in North Carolina (NC). Expanding the study population to include patients in New Jersey (NJ) and southern California (CA), we hypothesize that distance to provider is an effective measure of access to melanoma care regardless of geographic region. Methods: An IRB-approved secondary data analysis was performed of all incident cases of invasive cutaneous melanoma in 2000 from 3 population-based ascertainment areas (CA, NC, NJ). Patients and providers were geocoded to street address; Euclidian distances between patients and providers were calculated. The outcome variable, Breslow thickness at diagnosis, was logged for analysis. Simple and multiple linear regression were used to test associations between Breslow thickness and multiple sociodemographic factors. Results: Of 1,408 eligible cases, 16% were excluded for missing Breslow data. Median Breslow thickness was 0.6 mm (range 0.01–30.0 mm). Median distance to provider was 7 miles (range 0–372 miles). There was no significant difference in Breslow between the 3 geographic regions. Males had on average 15.5% thicker tumors than females, p=0.009. Patients 51–80 years old had 15.3% thicker tumors than patients =50, p=0.015, and those >80 had 64.3% thicker tumors than patients =50, p<0.001. For all patients, Breslow thickness increased only 2% for each 10 mile increase in distance, p=0.047. However, when limited to patients from rural areas, each 10 mile increase in distance corresponded to an 8% increase in Breslow, p<0.001. Meanwhile, Breslow was not associated with any area-based measures of rurality or provider supply. Each 1% increase in poverty rate corresponded to a 1% increase in Breslow, p=0.036. Conclusion: Breslow thickness at diagnosis is strongly correlated with distance to provider, especially for patients from rural areas. Distance to provider is a better measure of access to melanoma care than area-based measures of rurality. No significant financial relationships to disclose.

Cancer Survival from the Incident Cases of the Registry of Vaud, Switzerland

1989 ◽  
Vol 75 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Fabio Levi ◽  
Guerrino Mezzanotte ◽  
Van Cong Te ◽  
Carlo La Vecchia
Keyword(s):  
Lower Limb ◽  
Rural Areas ◽  
Cancer Survival ◽  
Female Gender ◽  
Population Based ◽  
Gastric Fundus ◽  
Favorable Effect ◽  
Significant Difference ◽  
Long Term Prognosis ◽  
Incident Cases

Survival statistics from the incident cases of the Vaud Cancer Registry over the period 1974–1980 were computed on the basis of an active follow-up based on verification of vital status as to December 31, 1984. Product-moment crude and relative 5 to 10 year rates are presented in separate strata of sex, age and area of residence (urban or rural). Most of the rates are comparable with those in other published series from North America or Europe, but survival from gastric cancer (24% 5-year relative rates) tended to be higher, and that from bladder cancer (about 30 %) lower than in most other datasets. No significant difference in survival emerged according to residence in urban Lausanne vs surrounding (rural) areas. Interesting indications according to subsite (higher survival for the pyloric region vs the gastric fundus, but absence of substantial differences for various colon subsites), histology (higher rates for squamous carcinomas of the lung, seminomas of the testis or chronic lymphatic leukemias as compared with other histotypes), or site of origin (higher survival for lower limb melanomas), require further quantitative assessment from other population-based series. A Cox proportional hazard model applied to melanomatous skin cancers showed an Independent favorable effect on long-term prognosis of female gender and adverse implications for advanced age, stage at diagnosis and tumor site other than lower limb.

scholarly journals Associations of sickness absence and disability pension due to mental and somatic diagnoses when aged 60–64 with paid work after the standard retirement age; a prospective population-based cohort study in Sweden

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aleksiina Martikainen ◽  
Alice Svensson Alavi ◽  
Kristina Alexanderson ◽  
Kristin Farrants
Keyword(s):  
Cohort Study ◽  
Sickness Absence ◽  
Disability Pension ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Outcome Variable ◽  
Retirement Age ◽  
Paid Work ◽  
Diagnosis Group ◽  
Lower Likelihood

Abstract Background The proportion of people working beyond age 65 is increasing. We aimed to explore whether sickness absence (SA) and disability pension (DP) due to mental, somatic, or both diagnoses when aged 60–64 were associated with being in paid work when aged 66–71. Methods This prospective population-based cohort study included all 98,551 individuals who in 2010 turned 65 years, lived in Sweden, and were in paid work at some point when aged 60–64. Data from three nationwide registers were used with 2010 as baseline, with SA or/and DP as the exposure variables (2005–2009) and paid work as the outcome variable (2011–2016). Logistic regression was conducted to calculate odds ratios (OR) with 95% confidence intervals (CI) for the association between exposures and outcome, controlling for sociodemographic factors. The analyses were also stratified by sex. Results Nearly half were in paid work during follow-up. Those with SA due to mental diagnoses had lower likelihood of being in paid work among both sexes (women OR: 0.76; 95% CI: 0.69–0.84; men 0.74; 0.65–0.84), while this association was smaller for SA due to somatic diagnoses (women 0.87; 0.84–0.91; men 0.92; 0.89–0.96). SA due to both mental and somatic diagnoses was associated with a lower likelihood of paid work for men (0.77; 0.65–0.91), but not women (0.98; 0.88–1.09). Regardless of diagnosis group and sex, DP had the strongest association with not being in paid work (women mental DP 0.39; 0.34–0.45; women somatic DP 0.38; 0.35–0.41; women mental and somatic DP 0.28; 0.15–0.56; men mental DP 0.36; 0.29–0.43; men somatic DP 0.35; 0.32–0.38; men mental and somatic DP 0.22; 0.10–0.51). Combined SA and/or DP demonstrated ORs in-between the diagnosis groups of SA and DP alone (e.g., mental SA and/or DP women and men combined 0.61; 0.57–0.65). Conclusions SA and DP were negatively associated with being in paid work after the standard retirement age of 65. The association was especially strong for DP, irrespective of diagnosis group. Moreover, compared to somatic diagnoses, SA due to mental diagnoses had a stronger association with not being in paid work. More knowledge is needed on how mental SA impedes extending working life.

Access to cataract services in selected rural communities in South Africa

2019 ◽  
Author(s):  
Lunic Base Khoza ◽  
Wilfred Njabulo Nunu ◽  
Bumani Solomon Manganye ◽  
Pfungwa Mambanga ◽  
Shonisani Tshivhase ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Rural Communities ◽  
Rural Areas ◽  
Access To Health Care ◽  
Health Care Services ◽  
Secondary Data ◽  
Demographic Characteristics ◽  
Outcome Variable ◽  
Patient Records

Abstract Background Despite government efforts to improve access to health care services through the re-engineered Primary Health Care and National Health insurance platform, access still remain a challenge particularly in rural areas. The aim of this study was to analyse secondary data on cataract patients who were attended to in selected hospitals in rural Limpopo of South Africa. Methodology A cross section survey was conducted on 411 patient records from five selected hospitals in Vhembe district. A pre tested structured checklist was used to guide retrieval of variables from patient records. The collected data was entered into excel spreadsheet, cleaned and imported into Statistical Package for Social Sciences version 26 for analysis. Proportions of demographic characteristics were presented and these were cross tabulated with the outcome variable “success of operation” using Chi Squared tests. Results Findings point out that majority of patients who attended hospital for eye services were aged 65 years above and females (63%). There was no association between the tested demographic characteristics and the outcome variable. Most patients were diagnosed in the period 2015-2018 (60%). Over 90% of those that were operated had successful operations. Of the remaining 10% that had unsuccessful operations, 30% cited complications as being the reason why these operations were unsuccessful. Conclusions It is evident from the findings that cataract services offered in rural areas have low impact as they are not accessible to the patient. It is critical to have a worker retention strategy to retain experts.

scholarly journals Sickness absence among privately employed white-collar workers: A total population study in Sweden

2020 ◽  
pp. 140349482093427
Author(s):  
Kristin Farrants ◽  
Kristina Alexanderson
Keyword(s):  
Sickness Absence ◽  
Rural Areas ◽  
White Collar ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Small Towns ◽  
Older Individuals ◽  
Individual Level ◽  
White Collar Workers ◽  
The Individual

Background: Knowledge about sickness absence (SA) and disability pension (DP) among privately employed white-collar workers is very limited. Aims: This study aimed to explore SA and DP among privately employed white-collar women and men using different measures of SA to investigate differences by branch of industry, and to analyse the association between sociodemographic factors and SA. Methods: This was a population-based study of all 1,283,516 (47% women) privately employed white-collar workers in Sweden in 2012, using register data linked at the individual level. Several different measures of SA and DP were used. Logistic regression was used to investigate associations of sociodemographic factors with SA. Results: More women than men had SA (10.9% women vs. 4.5% men) and DP (1.8% women vs. 0.6% men). While women had a higher risk of SA than men and had more SA days per employed person, they did not have more SA days per person with SA than men. The risk of SA was higher for women (odds ratio (OR)=2.54 (95% confidence interval (CI) 2.51–2.58)), older individuals (OR age 18–24 years=0.58 (95% CI 0.56–0.60); age 55–64 years OR=1.43 (95% CI 1.40–1.46) compared to age 45–54 years), living in medium-sized towns (OR=1.05 (95% CI 1.03–1.06)) or small towns/rural areas (OR=1.13 (95% CI 1.11–1.15)), with shorter education than college/university (OR compulsory only=1.64 (95% CI 1.59–1.69); OR high school=1.38 (95% CI 1.36–1.40)), born outside the EU25 (OR=1.23 (95% CI 1.20–1.27)) and singles with children at home (OR=1.33 (95% CI 1.30–1.36)). Conclusions: SA and DP among privately employed white-collar workers were lower than in the general population. SA prevalence, length and risk varied by branch of industry, sex and other sociodemographic factors, however, depending on the SA measure used.

scholarly journals School environment and obesity in primary schools. An analysis of the WHO European COSI in Austria

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Aufschnaiter ◽  
K Schindler ◽  
B Fuchs-Neuhold ◽  
K Maruszczak ◽  
E Pail ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Rural Areas ◽  
School Environment ◽  
Urban Areas ◽  
Primary Schools ◽  
Secondary Data ◽  
Overweight And Obesity ◽  
Substantial Contribution ◽  
Significant Difference ◽  
School Playgrounds

Abstract Background Overweight and obesity in childhood and the associated secondary diseases are constantly on the increase. Studies show that the school environment can have an influence on the weight of children. The Childhood Obesity Surveillance Initiative (COSI) of the WHO is a Europe-wide epidemiological monitoring of anthropometric sizes of school children aged six to nine, with Austria participating in COSI for the first time in 2016. Methods A retrospective secondary data analysis based on two standardized questionnaires was performed. On the one hand, data on determinants specific to the school field were collected, on the other hand anthropometric data of children in third grade were measured. Across Austria, data from 97 schools and 2530 children were collected and evaluated using descriptive and inductive statistical methods. Results In 43,3 % of the schools, an existing playground can be used outside school opening hours. 73,2 % of the schools integrate nutrition education into their school curriculum either as a separate subject or in combination with another subject. Milk and dairy products are available in 60,8 % of schools, fresh fruit in 63,9 % and vegetables in 51,5 %. 28,3 % of the examined, 8 to 9-year-old children are overweight or obese (n = 658), while boys have a significant higher BMI than girls (p &lt; 0,001). Also, in urban areas children have a significant higher BMI on average than in rural areas (p = 0,025). No significant relationship could be identified between the duration of physical education lessons per week and the BMI. However, a significant difference in childreńs BMI became visible when school playgrounds were also accessible outside opening hours (p = 0,018). Conclusions The alarming number of overweight children in Austria should be diminished through policies and further interventions. Schools can make a substantial contribution to this. The course of the development could be closely observed through possible further surveys by COSI. Key messages 73,2% of the schools include nutrition education in their curricula. Yet, about every third Austrian child aged between 8 and 9 is overweight, with boys being significantly more overweight than girls. If school playgrounds are accessible outside opening hours, the childreńs BMI is significantly lower. In urban areas, children have a significantly higher BMI than in rural areas.

Survival after Pleural Malignant Mesothelioma a Population-based Study in Italy

2002 ◽  
Vol 88 (4) ◽  
pp. 266-269 ◽  
Author(s):  
Corrado Magnani ◽  
Silvia Viscomi ◽  
Paola Dalmasso ◽  
Cristiana Ivaldi ◽  
Dario Mirabelli ◽  
...  
Keyword(s):  
Malignant Mesothelioma ◽  
Hospital Admissions ◽  
Population Based ◽  
Histologic Diagnosis ◽  
Significant Difference ◽  
Clinical Series ◽  
Therapeutic Procedures ◽  
Nw Italy ◽  
Improvement In Survival ◽  
Incident Cases

Aims and Background The study analyzed survival after malignant mesothelioma in the population-based Registry of Malignant Mesothelioma of Piedmont (NW Italy, 4.5 million total population). It focused on possible differences related to period of diagnosis a proxy of changes in diagnostic or therapeutic procedures. Methods Cases were actively searched in pathology units and files of hospital admissions and discharges. In 1990-1998, 693 incident cases were diagnosed in residents in the region: 590 of them had a histologic diagnosis of pleural mesothelioma in life and were included in the study. Vital status was ascertained at the municipality of residence as of January 1, 2000. Results Fifty-eight cases were alive (9.8%) and 20 were lost (3.6%) at the end of the follow-up. Median survival was 0.71 years (95% Cl, 0.64-0.78). Cumulative survival was 35.9% at 1 year (95% Cl, 32.0-39.8) and 14.2% at 2 years (95% Cl, 11.2-17.1). Survival was associated to age (longer survival for younger subjects at diagnosis; P <0.0001) and to histology (longer survival for epithelial mesothelioma, shorter for fibrous and intermediate for mixed or unspecified types; P <0.0001). There was no difference in survival for period of diagnosis. The results were confirmed in multivariate analyses. Analyses according to type of hospital (with vs without thoracic surgery) did not show any statistically significant difference. Discussion The study on survival after malignant mesothelioma is the second largest of the three population-based studies in the world, which showed results similar to ours. Survival measured in published clinical series ranged between 18.4% and 57.6% at 1 year for pleural and 24.1% and 33.8% for peritoneal mesothelioma. The most striking effect of the present study was the absence of improvement in survival with period of diagnosis. Either there was no change in treatment efficacy or the effect was limited to small subgroups and could not be noticed when the analysis included larger categories.

scholarly journals Stunting prevalence and its associated factors among children in primary school in Sidoarjo District: A secondary data analysis

2021 ◽  
Vol 6 (2) ◽  
pp. 156
Author(s):  
Lini Anisfatus Sholihah
Keyword(s):  
Primary School ◽  
Rural Areas ◽  
Associated Factors ◽  
Secondary Data ◽  
School Age Children ◽  
School Students ◽  
Chi Square ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Third World

Stunting is one under-nutrition condition that might be caused by inadequate nutrition consumption or frequent infection. Stunting prevalence in primary school-age children (PSAC) is still high in the third world and Indonesia. This present paper aimed to study the prevalence and the associated factors such as sex, school-area, and food intakes of stunting in PSAC in Sidoarjo, 2018. This study is cross-sectional research using secondary data from baseline data of emotional demonstration projects in primary school students. Two hundred students were recruited from four schools representing urban and rural areas in Sidoarjo. Food intake was interviewed using SQ-FFQ. Children height was measured using microtoice. HAZ-score was calculated using WHO Anthro Plus software. Student t-test was done to test any differences in stunting prevalence between sex and school areas. The Chi-square test was used to check the difference in proportion for categories. Our results suggested the stunting prevalence among PSAC in Sidoarjo was 18% and was significantly greater in the rural area (p= 0,010). School location has association with stunting (OR= 2,7; 95%CI 1,25-5,8). In conclusion, we did not find any significant difference in food intakes, although stunted children were more likely to consume energy and carbohydrate. This condition must be considered to prevent obesity in stunted children

scholarly journals The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study)

2016 ◽  
Vol 19 (2) ◽  
pp. 104-112 ◽  
Author(s):  
Ivan I. Dedov ◽  
Marina V. Shestakova ◽  
Gagik R. Galstyan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Rural Areas ◽  
Urban Areas ◽  
Adult Population ◽  
Geographic Region ◽  
Haemoglobin A1c ◽  
Significant Difference

Aim. To estimate the prevalence of type 2 diabetes mellitus (T2DM) in Russian adults.Materials and methods. NATION was a national, epidemiological, observational, cross-sectional study. The sample of adults (20–79 years old) was stratified by age, sex, geographic region and settlement type to obtain a representative sample. Recruitment was performed in public areas with large number of people. T2DM was diagnosed by glycated haemoglobin A1c (HbA1c) levels (diabetes: HbA1c≥6.5%; pre-diabetes: HbA1c≥5.7% to 6.5%). Socio-demographic and anthropometric data were collected.Results. Blood samples from 26,620 subjects were available. Overall, 5.4% were diagnosed with T2DM (2.5% were previously diagnosed and 2.9% were previously undiagnosed); 19.3% were pre-diabetic. T2DM prevalence increased with age (up to 70 years), and no significant difference was revealed between females and males (5.6% vs. 5.1%). The estimated prevalence of pre-diabetes and T2DM tended to increase with increasing BMI. T2DM prevalence varied by geographic region and was higher in rural areas than in urban areas (6.7% vs. 5.0%, p 0.001).Conclusion. Approximately one in five adult Russians had pre-diabetes, 5.4% had T2DM and about half of the diabetic subjects were previously undiagnosed. These results demonstrate the need for new programs in the Russian Federation to predict, prevent and manage T2DM.

No Evidence for an Association Between Renal Function and Serious Bleeding Events in Patients Treated With Coumarins: A Population-Based Study

2017 ◽  
Vol 52 (3) ◽  
pp. 221-234
Author(s):  
Eline Houben ◽  
Elisabeth Smits ◽  
Jetty A. Overbeek ◽  
Fernie J. A. Penning-van Beest ◽  
Ron M. C. Herings ◽  
...  
Keyword(s):  
Renal Function ◽  
Index Date ◽  
Anticoagulation Therapy ◽  
Bleeding Event ◽  
Population Based ◽  
Geographic Region ◽  
Bleeding Events ◽  
Significant Difference ◽  
Using Data ◽  
Estimated Glomerular Filtration Rates

Background: Although anticoagulation therapy is closely monitored in the Netherlands, coumarin-induced serious bleeding events are still observed. Current literature suggests that renal impairment may contribute to this. Objective: To explore the association between renal function and bleeding events during coumarin treatment. Methods: A nested case-control study was conducted using data from the PHARMO Database Network. Patients hospitalized for a bleeding event during coumarin treatment were selected as cases and matched on sex, birth year, and geographic region to up to 2 controls using coumarins without hospitalization for bleeding. All values of estimated glomerular filtration rates (eGFRs) were selected in the year before index date (case hospitalization date) and compared between cases and controls using logistic regression analyses. Results: In total, 2224 cases were matched to 4398 controls (61% male; mean ± SD age 75 ± 11 and 78 ± 11 years among cases and controls, respectively). Availability of eGFR values was higher among cases compared with controls (mean ± SD eGFR values 4.5 ± 7.1 vs 3.2 ± 5.5), reflected in the significantly shorter time since last eGFR value (at index date, mean ± SD = 2.7 ± 3.0 vs 3.8 ± 3.1 months; odds ratio [OR] = 0.91, 95%CI = 0.89-0.92). No statistically significant difference was found for the mean eGFR value in the year before index date (mean ± SD 65.7 ± 22.8 vs 64.6 ± 20.9 mL/min/1.73 m2; OR per 10 units [95%CI] = 0.99 [0.96-1.02]). Conclusions: No association between renal function and serious bleeding events during coumarin treatment was observed.

scholarly journals Determinants of HIV Testing Uptake among Women (aged 15-49 years) in the Philippines, Myanmar, and Cambodia

2021 ◽  
Vol 10 (2) ◽  
pp. 221-230
Author(s):  
Wah Myint ◽  
David Washburn ◽  
Brian Colwell ◽  
Jay Maddock
Keyword(s):  
Global Health ◽  
Hiv Testing ◽  
Rural Areas ◽  
Urban Areas ◽  
The Philippines ◽  
Outcome Variable ◽  
People Living With Hiv ◽  
Stigma Reduction ◽  
Hiv Test ◽  
Significant Difference

Background: Many countries have been trying to eliminate Mother-to-Child transmission of the Human Immunodeficiency Virus (HIV) and achieve the 90-90-90 target goals. The targets mean that 90% of People Living with HIV (PLWHIV) know their HIV status, 90% of those who are infected receive Antiretroviral treatment (ART), and 90% of those achieve viral suppression. Despite some progress, the goals have not been met in the Philippines, Myanmar, and Cambodia, countries with relatively high or growing HIV prevalence. This study identifies the sociodemographic determinants of testing among women in these countries so that better health education and stigma reduction strategies can be developed. Methods: Descriptive and multivariable analyses were conducted using Demographic and Health Survey data conducted in the Philippines (2017), Myanmar (2015/2016), and Cambodia (2014). The outcome variable was having ever been tested for HIV. Independent variables included knowledge and attitudes about HIV and social determinants of health. Results: A significant difference in testing rates among women was observed (the Philippines: 5%, Myanmar: 19%, Cambodia: 42%). In Myanmar and Cambodia, women who had more HIV knowledge and less stigma towards PLWHIV were more likely to get tested for HIV than those who did not. Marital status, education, wealth were strong predictors for HIV testing among women. Younger women aged 15-19 and those who live in the rural areas were less likely to get HIV tested than older and those living in urban areas. Employed women were less likely to seek an HIV test than the unemployed in Myanmar and Cambodia, whereas, in the Philippines, the opposite relationship was found. Conclusion and Global Health Implications: Women with less education and those less familiar with HIV should be targeted for HIV testing interventions. Stigma reduction and different testing strategies could facilitate early screening leading to improved HIV testing among women.   Copyright © 2021 Myint et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

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