A Public Health Home Intervention among Families of Low Socioeconomic Status

1989 ◽  
Vol 18 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Claire Infante-Rivard ◽  
Gisele Filion ◽  
Mona Baumgarten ◽  
Madeleine Bourassa ◽  
Johanne Labelle ◽  
...  
Author(s):  
Rahul Singh ◽  
Alpana Nand

<p><strong>Background: </strong>Rhinosporidiosis is an age-old endemic scourge which has affected various parts of the world, most notably India and Sri Lanka. Rhinosporidiosis is endemic in the state of Chhattisgarh although a large body of literature exists regarding this problem, postoperative recurrence rates continue to vary, and the effect of public health education in the eradication of this disease has not been taken into account. The aim of this study was to find out the site, presentation and postoperative recurrence rate in patients with rhinosporidiosis.</p><p><strong>Methods: </strong>This was a Prospective study involving operated cases of rhinosporidiosis in the department of ear, nose and throat of a tertiary care referral center over a period of 3 years. The behavioral pattern of the disease, its epidemiology, rate of recurrence and outcomes of surgical management were analyzed.</p><p><strong>Results: </strong>A statistically significant correlation could be found between male gender and rural residential status and incidence of rhinosporidiosis. Bathing in rivers and ponds were found to be strongly associated with rhinosporidiosis (p=0.005). Almost all patients were found to be of low socioeconomic status. Nasal obstruction and epistaxis were the most common presenting complaints.</p><p><strong>Conclusions: </strong>Rhinosporidiosis is strongly associated with male gender, young and middle-aged adults, agricultural occupations, rural residential status, a history of bathing in ponds and rivers and a low socioeconomic status. Post-surgical recurrence of rhinosporidial masses can be avoided with careful and complete clearance of the mass and cauterization of the base. Appropriate and consistent public health education helps to reduce the incidence of rhinosporidiosis in endemic communities.</p>


2014 ◽  
Author(s):  
Sarah Dayle Herrmann ◽  
Jessica Bodford ◽  
Robert Adelman ◽  
Oliver Graudejus ◽  
Morris Okun ◽  
...  

2020 ◽  
Vol 91 (6) ◽  
pp. 2042-2062
Author(s):  
Susana Mendive ◽  
Mayra Mascareño Lara ◽  
Daniela Aldoney ◽  
J. Carola Pérez ◽  
José P. Pezoa

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e043547
Author(s):  
Donald A Redelmeier ◽  
Kelvin Ng ◽  
Deva Thiruchelvam ◽  
Eldar Shafir

ObjectivesEconomic constraints are a common explanation of why patients with low socioeconomic status tend to experience less access to medical care. We tested whether the decreased care extends to medical assistance in dying in a healthcare system with no direct economic constraints.DesignPopulation-based case–control study of adults who died.SettingOntario, Canada, between 1 June 2016 and 1 June 2019.PatientsPatients receiving palliative care under universal insurance with no user fees.ExposurePatient’s socioeconomic status identified using standardised quintiles.Main outcome measureWhether the patient received medical assistance in dying.ResultsA total of 50 096 palliative care patients died, of whom 920 received medical assistance in dying (cases) and 49 176 did not receive medical assistance in dying (controls). Medical assistance in dying was less frequent for patients with low socioeconomic status (166 of 11 008=1.5%) than for patients with high socioeconomic status (227 of 9277=2.4%). This equalled a 39% decreased odds of receiving medical assistance in dying associated with low socioeconomic status (OR=0.61, 95% CI 0.50 to 0.75, p<0.001). The relative decrease was evident across diverse patient groups and after adjusting for age, sex, home location, malignancy diagnosis, healthcare utilisation and overall frailty. The findings also replicated in a subgroup analysis that matched patients on responsible physician, a sensitivity analysis based on a different socioeconomic measure of low-income status and a confirmation study using a randomised survey design.ConclusionsPatients with low socioeconomic status are less likely to receive medical assistance in dying under universal health insurance. An awareness of this imbalance may help in understanding patient decisions in less extreme clinical settings.


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