scholarly journals Sociodemographic Determinants of Adolescent Childbirths in Ghana: Results from a nationwide survey

2020 ◽  
Author(s):  
Emmanuel Dankwah
Keyword(s):  
Adolescent Girls ◽  
Rural Areas ◽  
Nationwide Survey ◽  
Population Based ◽  
Adolescent Childbearing ◽  
Shared Frailty ◽  
Sociodemographic Determinants ◽  
The Rich ◽  
Cox Proportional Hazard Regression ◽  
Adolescent Birth

Abstract Objective: To investigate the sociodemographic determinants of adolescent childbearing in Ghana.Methods: This research studied reproductive-aged women who were systematically sampled in Ghana. Kaplan Meier and Cox proportional hazard regression with shared frailty were fitted on a nationwide population-based data from the 2014 Ghana Demographic and Health Survey (GDHS) to predict adolescent childbirth.Results: The analysis revealed that approximately 49% initiated childbirth during adolescence. This study found higher adolescent childbirth rates among women who were not working (adjusted hazard ratio (AHR) =1.17; 95% confidence interval (CI) = 1.07 to 1.29) and resided in rural areas (AHR =1.22; 95% CI = 1.09 to 1.37). In addition, poor women (AHR= 1.71; 95% CI = 1.49 to 1.95) and middle-class women (AHR=1.67; 95% CI = 1.48 to 1.88) had a higher likelihood of having adolescent birth compared to the rich. Lastly, secondary and higher educated women were 0.74 (95% CI= 0.67 to 0.82) and 0.10 (95% CI= 0.06 to 0.16) times less likely to have adolescent birth, respectively.Conclusions: This research revealed that adolescent childbearing was greatly influenced by socioeconomically disadvantaged background within the contexts of the women and the community in which they reside. This finding suggests the need to initiate and improve interventions that seek to reduce poverty among women and to promote and encourage adolescent girls to pursue secondary and higher education to help reduce unintended adolescent childbirths. Finally, adolescent girls should be empowered through counseling and education on reproductive and sexual health options and rights to ensure more informed decision-making about contraception.

scholarly journals Malaysian Health Literacy: Scorecard Performance from a National Survey

2021 ◽  
Vol 18 (11) ◽  
pp. 5813
Author(s):  
Norrafizah Jaafar ◽  
Komathi Perialathan ◽  
Manimaran Krishnan ◽  
Nurashma Juatan ◽  
Masitah Ahmad ◽  
...  
Keyword(s):  
Health Literacy ◽  
Nationwide Survey ◽  
Population Based ◽  
Average Score ◽  
Future Health ◽  
Limited Health Literacy ◽  
Health Literacy Level ◽  
Prevention And Health Promotion ◽  
Literacy Level ◽  
Limited Health

Health literacy is an indicator of a society’s ability to make better health judgements for themselves and the people around them. This study investigated the prevalence of health literacy among Malaysian adults and provided an overall picture of the society’s current health literacy status, which has not been previously assessed. The study also highlighted socio-demographic markers of communities with limited health literacy that may warrant future intervention. A population-based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized a two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above, drawn from the living quarter list, participated in the study. The health literacy score was divided into three levels; limited, sufficient, and excellent. Findings showed a majority of the Malaysian population had a sufficient health literacy level in all three domains—healthcare, diseases prevention and health promotion (49.1%, 44.2%, and 47.5%, respectively)—albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups were prevalent among respondents with older age (68%), lower education level (64.8%), and lower household income (49.5%). The overall health literacy status for Malaysia was categorized at a lower sufficiency level. Future health literacy improvements should focus on communities with a limited health literacy level to improve the overall score.

scholarly journals How long does it take patients to find a new primary care physician when theirs retires: a population-based, longitudinal study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lindsay Hedden ◽  
Megan A. Ahuja ◽  
M. Ruth Lavergne ◽  
Kimberlyn M. McGrail ◽  
Michael R. Law ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Rural Areas ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Care Physician ◽  
Potential Threat ◽  
Patient Age ◽  
Patient Âgé

Abstract Background The retirement of a family physician can represent a challenge in accessibility and continuity of care for patients. In this population-based, longitudinal cohort study, we assess whether and how long it takes for patients to find a new majority source of primary care (MSOC) when theirs retires, and we investigate the effect of demographic and clinical characteristics on this process. Methods We used provincial health insurance records to identify the complete cohort of patients whose majority source of care left clinical practice in either 2007/2008 or 2008/2009 and then calculated the number of days between their last visit with their original MSOC and their first visit with their new one. We compared the clinical and sociodemographic characteristics of patients who did and did not find a new MSOC in the three years following their original physician’s retirement using Chi-square and Fisher’s exact test. We also used Cox proportional hazards models to determine the adjusted association between patient age, sex, socioeconomic status, location and morbidity level (measured using Johns Hopkins’ Aggregated Diagnostic Groupings), and time to finding a new primary care physician. We produce survival curves stratified by patient age, sex, income and morbidity. Results Fifty-four percent of patients found a new MSOC within the first 12 months following their physician’s retirement. Six percent of patients still had not found a new physician after 36 months. Patients who were older and had higher levels of morbidity were more likely to find a new MSOC and found one faster than younger, healthier patients. Patients located in more urban regional health authorities also took longer to find a new MSOC compared to those in rural areas. Conclusions Primary care physician retirements represent a potential threat to accessibility; patients followed in this study took more than a year on average to find a new MSOC after their physician retired. Providing programmatic support to retiring physicians and their patients, as well as addressing shortages of longitudinal primary care more broadly could help to ensure smoother retirement transitions.

scholarly journals The Association of Sensory Impairment With Incident Disability-Related Cessation of Employment in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 216-216
Author(s):  
Ahmed Shakarchi ◽  
Emmanuel Garcia Morales ◽  
Nicholas Reed ◽  
Bonnielin Swenor
Keyword(s):  
Older Adults ◽  
Hearing Aids ◽  
Population Based ◽  
Sensory Impairment ◽  
Loss To Follow Up ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression ◽  
Study Participants ◽  
Adjusted Model

Abstract Sensory impairment (SI) is common among older adults, and it is an increasingly important public health challenge as the population ages. We evaluated the association between SI and incident disability-related cessation of employment in older adults using the population-based Health and Retirement Study. Participants employed in 2006 completed biennial interviews until self-reported incident disability-related cessation of employment. Participants were censored at loss to follow-up, retirement, or 2018. Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, excellent). SI was defined as poor or fair ability, and SI was categorized as neither SI (NSI), vision impairment alone (VI), hearing impairment alone (HI), and dual SI (DSI). Cox proportional hazard regression assessed the association between SI and incident disability-related cessation of employment, adjusting for demographic and health covariates. Overall, 4726 participants were included: 421 (8.9%) were with VI, 487 (10.3) with HI, and 203 (4.3%) with DSI. Mean age was 61.0 ± 6.8 years, 2488 (52.6%) were women, and 918 (19.4) were non-White. In the fully adjusted model, incident disability-related cessation of employment over the 12-year follow-up period was higher in VI (Hazard Ratio (HR)=1.30, 95% confidence interval (CI)=0.92, 1.85), HI (HR=1.60, CI=1.16, 2.22), and DSI (HR=2.02, CI=1.38, 2.96). These findings indicate that employed older adults with SI are at increased risk of incident disability-related cessation of employment, and that older adults with DSI are particularly vulnerable. Addressing SI in older adults may lengthen their contribution to the workforce.

scholarly journals The design of Lil’Flo, a socially assistive robot for upper extremity motor assessment and rehabilitation in the community via telepresence

2021 ◽  
Vol 8 ◽  
pp. 205566832110018
Author(s):  
Michael J Sobrepera ◽  
Vera G Lee ◽  
Michelle J Johnson
Keyword(s):  
Rural Areas ◽  
Motor Rehabilitation ◽  
Rehabilitation Care ◽  
Rehabilitation Professionals ◽  
Novel Approach ◽  
Assistive Robot ◽  
Care Facilities ◽  
The Rich ◽  
Socially Assistive Robot ◽  
Assistive Robotic

Introduction We present Lil’Flo, a socially assistive robotic telerehabilitation system for deployment in the community. As shortages in rehabilitation professionals increase, especially in rural areas, there is a growing need to deliver care in the communities where patients live, work, learn, and play. Traditional telepresence, while useful, fails to deliver the rich interactions and data needed for motor rehabilitation and assessment. Methods We designed Lil’Flo, targeted towards pediatric patients with cerebral palsy and brachial plexus injuries using results from prior usability studies. The system combines traditional telepresence and computer vision with a humanoid, who can play games with patients and guide them in a present and engaging way under the supervision of a remote clinician. We surveyed 13 rehabilitation clinicians in a virtual usability test to evaluate the system. Results The system is more portable, extensible, and cheaper than our prior iteration, with an expressive humanoid. The virtual usability testing shows that clinicians believe Lil’Flo could be deployed in rural and elder care facilities and is more capable of remote stretching, strength building, and motor assessments than traditional video only telepresence. Conclusions Lil’Flo represents a novel approach to delivering rehabilitation care in the community while maintaining the clinician-patient connection.

scholarly journals Salt intake and blood pressure in Iranian children and adolescents: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hassan Emamian ◽  
Hossein Ebrahimi ◽  
Hassan Hashemi ◽  
Akbar Fotouhi
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Urban Areas ◽  
Salt Intake ◽  
Daily Intake ◽  
Population Based ◽  
World Health ◽  
Second Phase ◽  
Salt Consumption ◽  
The Mean

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.

scholarly journals "I was tricked": understanding reasons for unintended pregnancy among sexually active adolescent girls

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Sally Atieno Odunga ◽  
Clement Oduor ◽  
Ramatou Ouedraogo ◽  
Boniface Ayanbekongshie Ushie ◽  
...  
Keyword(s):  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Rural Areas ◽  
Teenage Pregnancy ◽  
Formal Education ◽  
School Attendance ◽  
Clear Understanding ◽  
Sexually Active ◽  
Unintended Pregnancies ◽  
Study Setting

Abstract Background While the Kenya government is mobilizing high-level strategies to end adolescent pregnancy by 2030, a clear understanding of drivers of early unintended pregnancy in the country is a necessary precursor. In this study, we determine the prevalence, associated factors, and reasons for unintended pregnancy among sexually active adolescent girls (aged 15–19 in two Kenya counties with the highest rate of teenage pregnancy. Methods We used the “In Their Hands” (ITH) program's baseline evaluation data. The study adopted a mixed-methods design with 1110 sexually active adolescent girls in the quantitative component and 19 girls who were either pregnant or nursing a child in the qualitative. We used adjusted and unadjusted logistic regression to model factors associated with unintended pregnancy among respondents. We used a thematic analysis of qualitative data to examine girls’ reasons for having unintended pregnancy. Results Overall, 42% of respondents have had an unintended pregnancy; however, higher proportions were observed among girls who were 19 years (49.4%), double orphans (53.6%), never used contraceptive (49.9%), out-of-school (53.8%), and married (55.6%). After adjusting for relevant covariates, the odds of unintended pregnancy were higher among girls who resided in rural areas (AOR 1.64, 95% CI 1.22–2.20), had primary or no formal education (AOR 1.50 95% CI 1.11–2.02), and had never used contraceptive (AOR 1.69 95% CI 1.25–2.29) compared with their counterparts. Current school attendance was associated with a 66% reduction in the probability of having an unintended pregnancy. Participants of the qualitative study stated that the desire to maintain a relationship, poor contraceptive knowledge, misinformation about contraceptive side effects, and lack of trusted mentors were the main reasons for their unintended pregnancies. Conclusion A massive burden of unintended pregnancy exists among sexually active adolescent girls in the study setting. Adolescent boys and girls need better access to sexuality education and contraceptives in the study setting to reduce early unintended pregnancy.

scholarly journals Risk of cancer development in patients with keloids

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ying-Yi Lu ◽  
Hung-Pin Tu ◽  
Chieh-Hsin Wu ◽  
Chien-Hui Hong ◽  
Kuo-Chia Yang ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Relative Risk ◽  
Skin Cancer ◽  
Cancer Risk ◽  
Population Based ◽  
Abdominal Ultrasonography ◽  
Cancer Risk Factors ◽  
Oral Cancers ◽  
Cox Proportional Hazard Regression ◽  
Risk Of Cancer

AbstractKeloid is a skin disease characterized by exaggerated scar formation, excessive fibroblast proliferation, and excessive collagen deposition. Cancers commonly arise from a fibrotic microenvironment; e.g., hepatoma arises from liver cirrhosis, and oral cancers arise from submucosal fibrosis. As keloids are a prototypic fibroproliferative disease, this study investigated whether patients with keloids have an increased cancer risk. In a matched, population-based study, first 17,401 patients treated for keloids during 1998–2010 with 69,604 controls without keloids at a ratio of 1:4 were evaluated. The association between keloids and risk of cancer was estimated by logistic regression or Cox proportional hazard regression models after adjustment of covariates. In total, 893 first-time cases of cancer were identified in the 17,401 patients with keloids. The overall cancer risk was 1.49-fold higher in the keloids group compared to controls. Regarding specific cancers, the keloids group, had a significantly higher risk of skin cancer compared to controls (Relative risk = 1.73). The relative risk for skin cancer was even higher for males with keloids (Relative risk = 2.16). Further stratified analyses also revealed a significantly higher risk of developing pancreatic cancer in female patients with keloids compared to controls (Relative risk = 2.19) after adjustment for known pancreatic cancer risk factors. This study indicates that patients with keloids have a higher than normal risk for several cancer types, especially skin cancers (both genders) and pancreatic cancer (females). Therefore, patients with keloids should undergo regular skin examinations, and females with keloids should regularly undergo abdominal ultrasonography.

Menstrual Hygiene Practices of Adolescent Girls in Rural Maharashtra

2021 ◽  
Vol 28 (1) ◽  
pp. 127-137
Author(s):  
Sumit Aggarwal ◽  
Deepti Ambalkar ◽  
Jayaprakasam Madhumathi ◽  
Vijay Badge ◽  
Arun Humne
Keyword(s):  
Adolescent Girls ◽  
Rural Areas ◽  
Cultural Beliefs ◽  
Knowledge Dissemination ◽  
Personal Interview ◽  
Menstrual Hygiene ◽  
Hygiene Practices ◽  
Sanitary Products ◽  
Sanitary Pads ◽  
The Right

Menstrual practices of adolescent girls in rural parts of India are greatly influenced by taboos and socio-cultural beliefs. In this study, the menstrual hygiene practices and beliefs of 122 adolescent girls between the ages of 13 and 19 years from rural Maharashtra were evaluated by personal interview and questionnaires. None of the girls had the right scientific knowledge about menstruation and were isolated during menstruation. They used cloth or home-made sanitary pads and were at risk of infections. There is a dire need for knowledge dissemination among school children and their families, increased awareness of menstrual hygiene and access to the requisite sanitary products in rural areas.

Growth status of children and adolescents born small for gestational age at full term in Korea: data from the KNHANES-V

2020 ◽  
Vol 33 (6) ◽  
pp. 743-750
Author(s):  
Ji Hyun Kim ◽  
Dong Ho Kim ◽  
Jung Sub Lim
Keyword(s):  
Short Stature ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Nationwide Survey ◽  
Population Based ◽  
Full Term ◽  
Stunted Growth ◽  
Growth Status ◽  
Health And Nutrition ◽  
Parental Height

AbstractObjectivesSmall for gestational age (SGA) status is known to show stunted growth and results in short stature in adults. The aim of this study was to describe the current short stature in subjects born SGA in Korea and to assess catch-up growth (CUG) or non-CUG.MethodsWe analyzed data from 3,524 subjects (1,831 male) aged 1–18 years who were born as full-term singletons and who participated in the Fifth Korean National Health and Nutrition Examination Survey (2010–2011).ResultsThe prevalence of SGA was 13.4% (n=471). Subjects born SGA had fathers with shorter height, shorter mother’s height, and mid-parental height than non-SGA subjects (p<0.05 for all). The odds ratios (ORs) for SGA birth of a short statured father and a short statured mother were 2.00 (95% CI; 1.15–3.47) and 2.11 (95% CI; 1.30–3.40), respectively. Among 471 SGA subjects, 28 subjects (5.9%) were non-CUG, which made up 36.4% of all subjects with short stature. The CUG subjects had a higher father's height, mother’s height, mid-parental height, and current BMI (p<0.05 for all). The non-CUG subjects had a higher percentage of fathers being near-short stature (height<10th percentile; 33.3 vs. 12.7%; p=0.008) and mothers being near-short stature (39.3 vs. 13.9%; p<0.001).ConclusionKorean subjects born SGA had a higher risk of current short stature. This population-based nationwide survey also showed that both father’s and mother’s short stature are risk factors of not only SGA birth but also non-CUG in their children.

scholarly journals Prevalence and factors associated with intimate partner violence among the adolescent girls and young women in South Africa: findings the 2017 population based cross-sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacqueline Mthembu ◽  
Musawenkosi Mabaso ◽  
Sarah Reis ◽  
Khangelani Zuma ◽  
Nompumelelo Zungu
Keyword(s):  
South African ◽  
Adolescent Girls ◽  
Young Women ◽  
Partner Violence ◽  
Urban Areas ◽  
Population Based ◽  
Intimate Partner ◽  
Low Ses ◽  
Cross Sectional ◽  
Factors Associated

Abstract Background Evidence indicate that intimate partner violence (IPV) is disturbingly high among South African adolescent girls and young women (AGYW). Understanding prevalence and risk factors for IPV among these emerging adults is critical for developing appropriate interventions to prevent adverse health outcomes later in life. This study investigates the prevalence and factors associated with lifetime physical IPV experience among AGYW, aged 15–24 years, using the South African national HIV prevalence, incidence, behaviour and communication survey conducted in 2017. Methods The data used in this secondary analysis was obtained from a cross-sectional, population-based household survey data, conducted using a multi-stage stratified random cluster sampling approach. Multivariate stepwise backward logistic regression modelling was used to determine factors associated with IPV. Results Of 716 AGYW that responded to the two commonly answered questions on IPV, 13.1% (95% CI: 9.6–17.6) indicated that they experienced IPV. The odds of reporting experiences of IPV were significantly lower among AGYW residing in high SES households [AOR = 0.09 (95% CI: 0.02–0.47), p = 0.004] than low SES households, and those residing in rural informal/tribal areas [AOR = 0.01 (95% CI: 0.00–0.22), p = 0.004] than urban areas. AGYW experiencing IPV had higher odds of reporting psychological distress compared to their counterparts [AOR = 4.37 (95% CI, 0.97–19.72), p = 0.054]. Conclusion The findings highlight the need for targeted structural and psychosocial interventions in low SES households and especially in urban areas.

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