scholarly journals Clinical differences between children with asthma and rhinitis in rural and urban areas

2019 ◽  
pp. 46-48
Author(s):  
Andrés Fandiño Losada
Keyword(s):  
Sample Size ◽  
Effect Size ◽  
Rural Areas ◽  
Urban Areas ◽  
Sample Size Calculation ◽  
Detectable Effect ◽  
Asthma Control Test ◽  
Cross Sectional ◽  
Interesting Study ◽  
The Difference

Dear Editors: In their article, Sánchez, et al 1 have reported about an interesting study on asthma and rhinitis symptoms among children in urban and rural Colombian areas, describing that the control of symptoms, over time, is more difficult among children in urban areas. Their article has the methodological advantage of having done a prospective follow-up of pediatric patients with asthma and rhinitis; nevertheless I have some questions: 1) The sample size calculation is not clear. The authors mentioned the prevalence of asthma and rhinitis in the urban areas and their corresponding error, but they did not use these parameters in the sample size calculation. On the other hand, the authors argued that the main outcome was comparing the treatment of asthma and rhinitis between urban and rural areas; thus readers could assume that the measure of effect was the difference of the Asthma Control Test (ACT) score between both areas; but the authors did not clearly explain it. Furthermore, it is not clear why the ratio of urban/rural subjects is 1.57; is the ratio observed in the study health centers? In this line, it seems that the appropriate sample size calculation must have been the difference of means between two independent populations, although the authors did not report any ACT effect size based on previous studies. Thus, I have estimated the means difference (as the effect size) given the power (80%) and the study sample size (urban= 201 and rural= 128) provided by the authors; using Stata® 14.2 (power twomeans command). In this manner, the detectable effect size would be 3.5; which is higher than the ACT effect size estimated in the Sánchez, Sánchez and Cardona’s article (i.e.: 3.0), leading to an underpowered study, at least for the cross-sectional estimates. In this manner, what was the appropriate sample size calculation?

scholarly journals Authors Response: Clinical differences between children with asthma and rhinitis in rural and urban areas

2019 ◽  
Vol 50 (1) ◽  
pp. 47-48
Author(s):  
Jorge Sánchez ◽  
Andrés Sánchez ◽  
Ricardo Cardona
Keyword(s):  
Sample Size ◽  
Urban Area ◽  
Rural Area ◽  
Urban Areas ◽  
Sample Size Calculation ◽  
Study Cohort ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Children With Asthma ◽  
The Difference

We greatly appreciate the interest shown in the article "Clinical differences between children with asthma and rhinitis in rural and urban areas", which we hope will be one of several future articles that we intend to carry out in the study cohort. To the questions generated by the reader, one is focused on the calculation of the sample size, while the other two questions are focus in the method of analysis, and the reader suggests, it could be more robust. Regarding the sample size, we describe that infant asthma in urban areas of Medellin was 11% and rhinitis 23%, according to previous studies. There is no data available for the rural area. We note that with a confidence level of 95%, a power of 80% and a sample size error of 0.5%, the sample size was calculated; estimating 201 children for the urban area and 128 for the rural area. Finally, we recruited and were able to continue for a year, a total of 248 children from the urban area and 134 from the rural area. The complaint of the reader, is focus that the more appropriated technique would be "… the appropriate sample size calculation must have been the difference of means between two independent populations, although the authors did not report any ACT effect size based on previous studies."...

scholarly journals Different Patterns in Ranking of Risk Factors for the Onset Age of Acute Myocardial Infarction between Urban and Rural Areas in Eastern Taiwan

2021 ◽  
Vol 18 (11) ◽  
pp. 5558
Author(s):  
Hsiu-Ju Huang ◽  
Chih-Wei Lee ◽  
Tse-Hsi Li ◽  
Tsung-Cheng Hsieh
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Rural Areas ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Onset Age ◽  
Cross Sectional ◽  
The Difference ◽  
Urban And Rural Areas

This cross-sectional study aimed to investigate the difference in ranking of risk factors of onset age of acute myocardial infarction (AMI) between urban and rural areas in Eastern Taiwan. Data from 2013 initial onset of AMI patients living in the urban areas (n = 1060) and rural areas (n = 953) from January 2000 to December 2015, including onset age, and conventional risk factors including sex, smoking, diabetes, hypertension, dyslipidemia, and body mass index (BMI). The results of multiple linear regressions analysis showed smoking, obesity, and dyslipidemia were early-onset reversible risk factors of AMI in both areas. The ranking of impacts of them on the age from high to low was obesity (β = −6.7), smoking (β = −6.1), and dyslipidemia (β = −4.8) in the urban areas, while it was smoking (β = −8.5), obesity (β= −7.8), and dyslipidemia (β = −5.1) in the rural areas. Furthermore, the average onset ages for the patients who smoke, are obese, and have dyslipidemia simultaneously was significantly earlier than for patients with none of these comorbidities in both urban (13.6 years) and rural (14.9 years) areas. The findings of this study suggest that the different prevention strategies for AMI should be implemented in urban and rural areas.

scholarly journals Knowledge and intake of folic acid to prevent neural tube defects among pregnant women in urban China: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mingming Cui ◽  
Xiao-Lin Lu ◽  
Yan-Yu Lyu ◽  
Fang Wang ◽  
Xiao-Lu Xie ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Unplanned Pregnancy ◽  
Urban China ◽  
Cross Sectional

Abstract Background The prevalence of neural tube defects (NTDs) in China declined during 2000–2017 with periconceptional folic acid (FA) supplementation, which is effective in reducing the risk of birth defects. We aimed to assess the knowledge and actual use of FA among Chinese pregnant women and to explore factors associated with FA use before pregnancy. Methods All data were collected in face-to-face interviews during health visits among pregnant women. We collected information about knowledge and use of FA supplements and demographic, socioeconomic, and health status. One maternity and childcare hospital was chosen in each of four cities: Beijing, Huaibei, Kunming, and Haikou. In total, 435 pregnant women were randomly recruited for interviews conducted from June to December 2016. Results A total of 428 pregnant women were included in this survey. Of these, 82.0% (351/428) knew that FA can prevent NTDs, and 75.9% (325/428) knew the correct time to take FA. Overall, 65.9% (282/428) of women knew both that FA can prevent NTDs and the recommended time to take FA before pregnancy. Approximately 95.1% (407/428) of women reported having ever taken FA, only 46.3% (198/428) had begun to take FA supplementation before conception, and 64.5% (109/169) of women from rural areas failed to take FA before pregnancy. Women living in northern China (odds ratio [OR] = 1.81, 95% confidence interval [CI], 1.18–2.77), those with unplanned pregnancy (OR = 1.99, 95% CI 1.30–3.04), and highly educated women (OR = 2.37, 95% CI 1.45–3.88) were more likely to know about FA. Women who were homemakers (OR = 1.94, 95% CI 1.21–3.11) and had unplanned pregnancy (OR = 6.18, 95% CI 4.01–9.53) were less likely to begin taking FA before pregnancy. Conclusions Our survey showed that most pregnant women knew about FA. Although preconception intake of FA can help to reduce NTDs, improving the rate of FA intake before pregnancy is needed in urban areas of China, especially among homemakers and women from rural areas or with unplanned pregnancy. Campaigns are needed to increase awareness about FA and FA use before pregnancy among rural women, homemakers, and those with unplanned pregnancy and lower education levels.

scholarly journals Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

2021 ◽  
Vol 18 (6) ◽  
pp. 2818
Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Older Adults ◽  
Middle School ◽  
Depressive Symptoms ◽  
Rural Areas ◽  
Urban Areas ◽  
Depression Scale ◽  
Wealth Index ◽  
School Level ◽  
Cross Sectional ◽  
Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

scholarly journals A cross-sectional study to assess knowledge of women about cervical cancer: an urban and rural comparison

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Małgorzata Lesińska-Sawicka
Keyword(s):  
Cervical Cancer ◽  
Life Expectancy ◽  
Correct Answer ◽  
Rural Areas ◽  
Urban Areas ◽  
Statistical Significance ◽  
Average Life Expectancy ◽  
Cross Sectional ◽  
Awareness Campaigns ◽  
The City

Abstract Introduction Cervical cancer and its etiopathogenesis, the age of women in whom it is diagnosed, average life expectancy, and prognosis are information widely covered in scientific reports. However, there is no coherent information regarding which regions—urban or rural—it may occur more often. This is important because the literature on the subject reports that people living in rural areas have a worse prognosis when it comes to detection, treatment, and life expectancy than city dwellers. Material and methods The subjects of the study were women and their knowledge about cervical cancer. The research was carried out using a survey directly distributed among respondents and via the Internet, portals, and discussion groups for women from Poland. Three hundred twenty-nine women took part in the study, including 164 from rural and 165 from urban areas. The collected data enabled the following: (1) an analysis of the studied groups, (2) assessment of the respondents’ knowledge about cervical cancer, and (3) comparison of women’s knowledge depending on where they live. Results The average assessment of all respondents’ knowledge was 3.59, with women living in rural areas scoring 3.18 and respondents from the city—4.01. Statistical significance (p < 0.001) between the level of knowledge and place of residence was determined. The results indicate that an increase in the level of education in the subjects significantly increases the chance of getting the correct answer. In the case of age analysis, the coefficients indicate a decrease in the chance of obtaining the correct answer in older subjects despite the fact that a statistically significant level was reached in individual questions. Conclusions Women living in rural areas have less knowledge of cervical cancer than female respondents from the city. There is a need for more awareness campaigns to provide comprehensive information about cervical cancer to women in rural areas. A holistic approach to the presented issue can solve existing difficulties and barriers to maintaining health regardless of the place of life and residence. Implication for cancer survivors They need intensive care for women’s groups most burdened with risk factors.

scholarly journals Urinary Concentrations of Metals and Metalloids in Malaysian Adults

2021 ◽  
Author(s):  
Zurahanim Fasha Anual ◽  
Noraishah Mohammad Sham ◽  
Rashidah Ambak ◽  
Fatimah Othman ◽  
Rafiza Shaharudin
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Inductively Coupled Plasma ◽  
Geometric Mean ◽  
Urine Samples ◽  
Cross Sectional ◽  
Metals And Metalloids ◽  
High Exposure ◽  
Academic Qualification ◽  
Metal Levels

AbstractExposure to environmental pollutants in humans can be conducted through direct measurement of biological media such as blood, urine or hair. Assessment studies of metals and metalloids in Malaysia is very scarce although cross-sectional nationwide human biomonitoring surveys have been established by the USA, Canada, Germany, Spain, France, and Korea. This study aims to assess urinary metal levels namely cadmium (Cd), nickel (Ni), lead (Pb) and arsenic (As) among Malaysian adults. This was a cross-sectional study involving 1440 adults between the age of 18 and 88 years old. After excluding those with 24 h urine samples of less than 500 ml, urine creatinine levels < 0.3 or > 3.0 g/L and those who refuse to participate in the study, a total of 817 respondents were included for analysis. A questionnaire with socio-demographic information such as age, gender, occupation, ethnic, academic qualification and medical history was administered to the respondents. Twenty-four-hour urine samples were collected in a container before being transported at 4 °C to the laboratory. Samples were then aliquoted into 15 ml tubes and kept at − 80 °C until further analysis. Urine was diluted ten-fold with ultrapure water, filtered and analysed for metals and metalloids using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). The geometric mean of urinary As, Ni, Cd and Pb concentrations among adults in Malaysia was 48.21, 4.37, 0.32, and 0.80 µg/L, respectively. Males showed significantly higher urinary metal concentrations compared to females for As, Cd and Pb except for Ni. Those who resided in rural areas exhibited significantly higher As, Cd and Pb urinary concentrations than those who resided in urban areas. As there are no nationwide data on urinary metals, findings from this study could be used to identify high exposure groups, thus enabling policy makers to improve public health strategically.

scholarly journals Urban–rural disparity in cancer incidence in China, 2008–2012: a cross-sectional analysis of data from 36 cancer registers

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042762
Author(s):  
Shuai Yuan ◽  
Shao-Hua Xie
Keyword(s):  
Cancer Incidence ◽  
Rural Areas ◽  
Urban Areas ◽  
Incidence Rates ◽  
Cancer Type ◽  
Anatomic Site ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural disparity in cancer incidence in China.MethodsUsing data from 36 regional cancer registries in China in 2008–2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.ResultsThe incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.ConclusionsOur findings suggest substantial urban–rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.

scholarly journals Acute food insecurity and short-term coping strategies of urban and rural households of Bangladesh during the lockdown period of COVID-19 pandemic of 2020: report of a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043365
Author(s):  
Subhasish Das ◽  
Md. Golam Rasul ◽  
Md Shabab Hossain ◽  
Ar-Rafi Khan ◽  
Md Ashraful Alam ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Coping Strategies ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Rural Households ◽  
P Value ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Food Insecure Households

IntroductionWe conducted a cross-sectional survey to assess the extent and to identify the determinants of food insecurity and coping strategies in urban and rural households of Bangladesh during the month-long, COVID-19 lockdown period.SettingSelected urban and rural areas of Bangladesh.Participants106 urban and 106 rural households.Outcome variables and methodHousehold food insecurity status and the types of coping strategies were the outcome variables for the analyses. Multinomial logistic regression analyses were done to identify the determinants.ResultsWe found that around 90% of the households were suffering from different grades of food insecurity. Severe food insecurity was higher in urban (42%) than rural (15%) households. The rural households with mild/moderate food insecurity adopted either financial (27%) or both financial and food compromised (32%) coping strategies, but 61% of urban mild/moderate food insecure households applied both forms of coping strategies. Similarly, nearly 90% of severely food insecure households implemented both types of coping strategies. Living in poorest households was significantly associated (p value <0.05) with mild/moderate (regression coefficient, β: 15.13, 95% CI 14.43 to 15.82), and severe food insecurity (β: 16.28, 95% CI 15.58 to 16.97). The statistically significant (p <0.05) determinants of both food compromised and financial coping strategies were living in urban areas (β: 1.8, 95% CI 0.44 to 3.09), living in poorest (β: 2.7, 95% CI 1 to 4.45), poorer (β: 2.6, 95% CI 0.75 to 4.4) and even in the richer (β: 1.6, 95% CI 0.2 to 2.9) households and age of the respondent (β: 0.1, 95% CI 0.02 to 0.21).ConclusionBoth urban and rural households suffered from moderate to severe food insecurity during the month-long lockdown period in Bangladesh. But, poorest, poorer and even the richer households adopted different coping strategies that might result in long-term economic and nutritional consequences.

scholarly journals Career Intentions and Dropout Causes Among Medical Students in Kazakhstan

Medicina ◽  
2013 ◽  
Vol 49 (6) ◽  
pp. 45
Author(s):  
Kamila Faizullina ◽  
Galina Kausova ◽  
Zhanna Kalmataeva ◽  
Ardak Nurbakyt ◽  
Saule Buzdaeva
Keyword(s):  
Medical Students ◽  
Human Resources ◽  
Rural Areas ◽  
Urban Areas ◽  
Human Resources For Health ◽  
Medical Schools ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Unequal Distribution ◽  
Survey Tool

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.

Socioeconomic Variation of Multimorbidity in Colombian Older Adults

2021 ◽  
Author(s):  
Silvia Marcela Ballesteros ◽  
José Moreno-Montoya ◽  
Wilhelmus Johannes Andreas Grooten ◽  
Pedro Barrera-López ◽  
José A. De la Hoz-Valle
Keyword(s):  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Structural Equation ◽  
Strong Association ◽  
High Body Mass Index ◽  
Multidimensional Poverty ◽  
The Elderly ◽  
Cross Sectional ◽  
Multidimensional Poverty Index

Abstract BackgroundMultimorbidity prevalence in the elderly is increasing worldwide. Variations regarding the socioeconomic characteristics of the individuals and their context have been described, mostly in high-income scenarios. This study aims to assess the magnitude and the socioeconomic factors associated with variations on multimorbidity in Colombia.MethodsA cross-sectional multilevel study with a nationally representative sample of 23 694 Colombian adults aged 60 years and older was conducted. Individual socioeconomic, demographic, childhood and health related characteristics, as well as group level variables (multidimensional poverty index and infectious diseases mortality rate) were analyzed. A two-level stepwise structural equation model was used to simultaneously adjust the individual and contextual effects. ResultsMultimorbidity prevalence was 62.3% (95% CI 61.7–62.9). In the multilevel adjusted models, age, female sex, having functional limitations, non-white ethnicity, high body mass index, higher income, physical inactivity, poverty during childhood and living in urban areas were associated with multimorbidity. The mediation analysis showed that living in rural areas was significantly associated with infectious disease mortality rate and other individual associations with multimorbidity were mediated by the multidimensional poverty variable. ConclusionsThis paper demonstrates a strong association between multimorbidity and poverty in a low-middle income country. Differences in the factors involved in the etiology of multimorbidity are expected among wealthy and poor countries regarding availability and prioritization of health services.

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