Characterization of Adolescent Pregnancy and Legal Abortion in Situations Involving Incest or Sexual Violence by an Unknown Aggressor

Background and Objectives: In pregnancies resulting from incest, the adolescent maintains close family and emotional relations with the aggressor, different from what occurs when pregnancy results from sexual violence by strangers. Evidence indicates that this type of relationship with the aggressor may interfere in the dynamics of such violence and the adolescent’s access to health services. Materials and Methods: The objective of this research was to describe and correlate aspects associated with pregnancy when resulting from rape of adolescents in situations of incest; rape when perpetrated by an unknown aggressor and an abortion as allowed by law was sought. Method: A cross-sectional, epidemiological study of adolescents treated at the Pérola Byington Hospital, São Paulo, Brazil, bringing an allegation of pregnancy, resulting from sexual violence and a request for abortion as allowed by law. A total of 311 adolescents, being 134 in the “pregnancy from incest group”, and 174 in the group “pregnancies resulting from rape by a stranger” were considered under the study variables; relationships were investigated using the chi-squared test and Poisson regression with robust variance. Results: The study included 137 cases (44.1%) of pregnancy resulting from incest, and 174 cases (55.9%) of pregnancy from rape by a stranger. In cases of incest, a declaration of religion (92.0%) was significantly more frequent, and the adolescents were approached in spaces considered safe or private (92.7%); the aggressor taking advantage of the adolescent’s legal condition of vulnerability as a function of age (83.3%). Cases of incest presented a lower median adolescent age and greater gestational development, with gestations being ≥ 13 weeks prevailing. Conclusion: Cases of pregnancy by incest presented indicators suggesting both proximity and relationship with the aggressor, and pregnancy at a very early age, which postponed the adolescent’s procurement of health service, and interfered negatively with abortion assistance as allowed by law.

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Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v1i1.16 ◽

1970 ◽

Vol 1 (1) ◽

pp. 44-49

Author(s):

Beatriz Bertolaccini Martínez ◽

Fernanda Marcelino Da Silva ◽

Vinícius Tavares Veiga ◽

Rodrigo Pereira Custódio ◽

José Vítor Da Silva

Keyword(s):

Social Inequality ◽

Access To Health Care ◽

Young Patients ◽

Cross Sectional Study ◽

Access To Health Services ◽

Access To Treatment ◽

Cross Sectional ◽

Economic Class ◽

Access To Health ◽

Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05. Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist.

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Undernutrition and associated factors in orphan children aged 6–59 months in Gambella Southwest, Ethiopia: A community-based cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-045892 ◽

2021 ◽

Vol 11 (7) ◽

pp. e045892

Author(s):

Solomon Feleke ◽

Gudina Egata ◽

Firehiwot Mesfin ◽

Gizachew Yilak ◽

Abebaw Molla

Keyword(s):

Associated Factors ◽

Wealth Index ◽

Cross Sectional Study ◽

Sectional Study ◽

Access To Health Services ◽

Cross Sectional ◽

Orphaned Children ◽

Access To Health ◽

Study Participants ◽

Children Under 5

ObjectiveThe study aimed to assess the prevalence of stunting, wasting, underweight and associated factors in orphaned children under 5 years old.DesignA cross-sectional study.SettingGambella City, Ethiopia.ParticipantsA sample of 419 under 5 orphaned children included in the study. Eligible households with orphans had selected using a systematic random sampling method. The lottery method was used when more than one eligible study participants live in the household. An OR with 95% CI was performed to measure the strength of association between each dependent variable and independent variables. Variables with p<0.05 were declared statistically significant.Primary outcomeThe main outcome of this study was the prevalence of undernutrition among orphaned under 5 and its associated factors.ResultsPrevalence of stunting, wasting and underweight in orphan children under 5 were 12.2%, 37.8% and 21.7%, respectively. The prevalnce of wasting peaks among age group of 36–47 months (42.5%), whereas underweight peaks in 48–59 months (27.7%). Food insecurity, wealth index, family size, vitamin A supplementation, diarrhoea, fever 2 weeks before the survey, children under 5 and parents’ death were associated with undernutrition.ConclusionThe prevalence of stunting, wasting and underweight among orphan children under 5 was significantly high. Multisectoral collaborative efforts towards access to health services, improving income-generating activities, micronutrient supplementation and social support and protection targeting orphan and vulnerable populations have to be built up.

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Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study

The Lancet ◽

10.1016/s0140-6736(12)60278-5 ◽

2012 ◽

Vol 379 (9818) ◽

pp. 805-814 ◽

Cited By ~ 332

Author(s):

Qun Meng ◽

Ling Xu ◽

Yaoguang Zhang ◽

Juncheng Qian ◽

Min Cai ◽

...

Keyword(s):

Health Services ◽

Cross Sectional Study ◽

Financial Protection ◽

Sectional Study ◽

Access To Health Services ◽

Cross Sectional ◽

Access To Health

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Challenges to access health faced by rural population and their perception regarding healthcare

Acta Scientiarum Health Sciences ◽

10.4025/actascihealthsci.v43i1.54789 ◽

2021 ◽

Vol 43 ◽

pp. e54789

Author(s):

Maria Maiely Bezerra Gomes ◽

Silvana Cavalcanti dos Santos ◽

Jefferson Nunes dos Santos ◽

Valdirene Pereira da Silva Carvalho ◽

Ana Karine Laranjeira de Sá ◽

...

Keyword(s):

Rural Population ◽

Cultural Practices ◽

Public Policies ◽

National Level ◽

Herbal Medicines ◽

Population Diversity ◽

Health Determinants ◽

Access To Health Services ◽

Cross Sectional ◽

Access To Health

The Brazilian nation has rich population diversity, and this makes it responsible for guaranteeing the social rights of all. In this perspective, this research seeks to categorize which are the main challenges in access to health that the rural populations face and to understand how the execution of this health care is carried out by professionals from the perspective of rural people. This is a cross-sectional study with a qualitative approach, carried out at the Nossa Senhora Aparecida Settlement, located in the municipality of Pesqueira (Pernambuco state) in 2018. The results demonstrate that the challenges faced by settled families are due to the difficulty of access to health services. In view of this, the rural population chooses to keep their cultural practices focused on their health alive. Therefore, it is common to use herbal medicines and mystics related to religious beliefs in self-care practices. It was concluded that the current public policies have gaps in their implementation, especially in terms of accessibility, security, health education, equity and respect for cultural differences. In addition, there is precariousness at the national level of studies focused on the health determinants and determinants of the rural population, which makes it necessary that more research be carried out so that new public policies can emerge.

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HUBUNGAN PENDIDIKAN, AKSES PELAYANAN KESEHATAN DAN DUKUNGAN KELUARGA DENGAN PEMANFAATAN PELAYANAN KESEHATAN PENDERITA TB PARU BTA+ DI PUSKESMAS JANTI KOTA MALANG

Preventia : The Indonesian Journal of Public Health ◽

10.17977/um044v4i1p1-14 ◽

2019 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Alfreda Dinayu Purbantari ◽

Roesdiyanto Roesdiyanto ◽

Nurnaningsih Herya Ulfah

Keyword(s):

Public Health ◽

Health Service ◽

Health Services ◽

Health Center ◽

Family Support ◽

Access To Health Services ◽

Cross Sectional ◽

Education Access ◽

Utilization Of Health Services ◽

Access To Health

Abstract: Tuberculosis (TB) is a contagious disease that is still the world's attention, Until now, there is not a single country that is free of TB (Kemenkes 2011). Public Health Center (puskesmas) Janti is a puskesmas where the number of TB BTA+ sufferers increases every year while the number of treatment success rate at Puskesmas Janti decreases every year. In 2013 is 96%, in 2014 is 87,50% and in 2015 is 85,37%. Increasing the number of patients and decreasing the number of success rates of treatment indicates that the utilization of health services is less. This study aims to find out the relationship of Education, Health Service Access and Family Support with Health Service Utilization of BTA+ Pulmonary TB Patients at Public Health Center (puskesmas) Janti Malang. The design of this study is quantitative correlation with samples of all patients with TB Paru + BTA who are still doing treatment at Puskesmas Janti in September 2016 until April 2017. The analysis used correlation test and logistic regression test with cross sectional approach. The results of the research analysis found that there is a significant relationship between education, access to health services and family support together with the utilization of health services of patients Tb Paru BTA+. Based on the results of determination coefficient R2 (Nagelkerke) of 0.619, this means that education (X1), access to health services (X2), and family support (X3) has contributed 61.9% to the utilization of health services of patients with TB Paru BTA+ at Puskesmas Janti.Keywords: education, access, family support, health service utilizationAbstrak: Tuberkulosis (TB) adalah penyakit menular yang masih menjadi perhatian dunia, hingga saat ini, belum ada satu negara pun yang bebas TB (Kemenkes 2011). Puskesmas Janti adalah satu puskesmas yang berada di Kota Malang dengan jumlah pasien TB Paru BTA+ yang paling tinggi dan meningkat setiap tahun diantara puskesmas yang lain di Kota Malang, sedangkan jumlah angka keberhasilan pengobatan di Puskesmas Janti mengalami penurunan setiap tahun. Tahun 2013 sebesar 96%, pada tahun 2014 sebesar 87,50% dan pada tahun 2015 sebesar 85,37%. Peningkatan jumlah penderita dan penurunan jumlah angka keberhasilan pengobatan menunjukkan bahwa pemanfaatan pelayanan kesehatan kurang. Penelitian ini bertujuan untuk mengetahui Hubungan Pendidikan, Akses Pelayanan Kesehatan dan Dukungan Keluarga dengan Pemanfaatan Pelayanan Kesehatan Penderita TB Paru BTA+ di Puskesmas Janti Kota Malang. Rancangan penelitian ini adalah kuantitatif korelasional dengan sampel seluruh penderita TB Paru BTA+ yang masih melakukan pengobatan di Puskesmas Janti pada bulan September 2016 sampai dengan April 2017. Analisis menggunakan uji korelasi dan uji regresi logistik dengan pendekatan cross sectional. Hasil analisis penelitian di dapatkan ada hubungan yang dignifikan antara pendidikan, akses pelayanan kesehatan dan dukungan keluarga secara bersama-sama dengan pemanfaatan pelayanan kesehatan penderita Tb Paru BTA+. Berdasarkan hasil koefisien determinasi R2 (Nagelkerke) sebesar 0,619, hal ini berarti bahwa pendidikan (X1), akses pelayanan kesehatan (X2), dan dukungan keluarga (X3) memiliki kontribusi sebesar 61,9% terhadap pemanfaatan pelayanan kesehatan penderita TB Paru BTA+ di Puskesmas Janti.Kata Kunci: pendidikan, akses pelayanan kesehatan, dukungan keluarga, pemanfaatan pelayanan kesehatan penderita TB Paru BTA+

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Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-019-4441-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Siriwan Choojaturo ◽

Siriorn Sindhu ◽

Ketsarin Utriyaprasit ◽

Chukiat Viwatwongkasem

Keyword(s):

Quality Of Life ◽

Health Service ◽

Health Services ◽

Self Management ◽

Access To Health Services ◽

Patient Factors ◽

Cross Sectional ◽

Knee Oa ◽

Access To Health

Abstract Background The main purpose of health service systems is to improve patients’ quality of life (QoL) and to ensure equitable access to health services. However, in reality, nearly half of knee osteoarthritis (OA) patients present to the health system do not have access to health services, and their QoL remains poor. These circumstances raise important questions about what (if any) factors can improve health care accessibility and QoL for knee OA patients. Methods A multicenter, cross-sectional survey was performed with 618 knee OA patients who received care at 16 hospitals in Thailand. Structural equation modeling (SEM) was conducted to investigate the association of health service factors and patient factors with access to health services and QoL. Results The QoL of knee OA patients was very poor (mean score = 33.8). Only 2.1% of the knee OA patients found it easy to obtain medical care when needed. Approximately 39.4% of them were able to access appropriate interventions before being referred for knee replacement. More than 85% of orthopedic health services had implemented chronic disease management (CDM) policy into practice. However, the implementation was basic, with an average score of 5.9. SEM showed that QoL was determined by both health system factors (β = .10, p = .01) and patient factors (β = .29, p = .00 for self-management and β = −.49, p = .00 for disease factors). Access to health services was determined by self-management (β = .10, p = .01), but it was not significantly associated with QoL (β = .00, p = 1.0). Conclusions This study provides compelling information about self-management, access to health services and QoL from the individual and health service system perspectives. Furthermore, it identifies a need to develop health services that are better attuned to the patient’s background, such as socioeconomic status, disease severity, and self-management skills.

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Pattern of blindness in a community based hospital of Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v5i1.7822 ◽

2013 ◽

Vol 5 (1) ◽

pp. 50-56

Author(s):

R Sharma ◽

S Marasini ◽

BP Nepal

Keyword(s):

Age Related Macular Degeneration ◽

Easy Access ◽

Retinal Diseases ◽

Access To Health Services ◽

Community Based ◽

Cross Sectional ◽

Age Related ◽

Access To Health ◽

Disease Pattern ◽

The Mean

Introduction: Because of the availability of modern health facilities and moderately easy access to health services in the last 25 years, the blindness due to cataract and trachoma is expected to decline in Nepal. So it is felt that the causes of blindness need to be revised. Objective: To regroup the disease pattern leading to permanent blindness in patients attending a suburban multidisciplinary community-based hospital of Nepal. Materials and methods: A cross-sectional, descriptive study was conducted in patients attending Dhulikhel hospital over a period of 12 months, from March 2010. Only the patients with best corrected visual acuity of < 3/60 were enrolled in the study. A detailed ocular examination was carried out. Results: A total of 76 eyes of 58 patients were analyzed. Of all, 32 were male (55.2 %). The mean age of the patients was 43.03 ± 22.98, with a range of 7 years to 84 years. Retinal diseases had the higher prevalence (23, 39.7 %) followed by amblyopia (10, 17.2 %) and corneal diseases (9, 15.51 %). Anisometropic amblyopia (3.94 %) was the commonest type of amblyopia. Retinitis pigmentosa (9.21 %) and age-related macular degeneration (7.89 %) were common retinal diseases whereas anterior staphyloma (5.26 %) and leucoma (3.94 %) were common corneal diseases. Other important and rare causes of blindness included ethambutol-induced optic neuropathy and vitelliform dystrophy. Conclusion: Periodic collection of statistics on the relative frequency of the causes of blindness is important in socioeconomically developing nations like Nepal. This helps to revise the pattern of blinding diseases so that priorities can be redefined. Nepal J Ophthalmol 2013; 5(9):50-56 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7822

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Epidemiological Profile of the Victims of Sexual Violence Treated at a Referral Center in Southern Brazil

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1715577 ◽

2020 ◽

Vol 42 (09) ◽

pp. 547-554

Author(s):

Michelle Dornelles Santarem ◽

Mariane Marmontel ◽

Nathália Lima Pereira ◽

Letícia Becker Vieira ◽

Ricardo Francalacci Savaris

Keyword(s):

Sexual Violence ◽

Women Victims ◽

Electronic Record ◽

Cross Sectional Study ◽

University Hospital ◽

Southern Brazil ◽

Cross Sectional ◽

Present Cross Sectional Study ◽

Chi Squared ◽

Epidemiological Profile

Abstract Objective To characterize the sociodemographic profile of women victims of sexual violence treated at a university hospital in southern Brazil. Method The present cross-sectional study included all female victims of sexual violence who attended the sexual violence unit at the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) from April 18, 2000 to December 31, 2017. Data were extracted from the electronic record of the patients and stored in a standardized questionnaire database with epidemiological aspects of the victim, the perpetrators and the type of aggression. Statistical analysis was performed using the chi-squared test for trend and descriptive statistics with 95% confidence interval (CI). Results During the length of the study, 711 women victims of sexual violence were treated. The mean age of the patients was 24.4 (±10) years old (range from 11 to 69 years old) and most of the victims were white (77.4%), single (75.9%) and sought care at the unit within 72 hours after the occurrence (80.7%). In most cases, violence was exerted by a single perpetrator (87.1%), who was unknown in 67.2% of cases. Victims < 19 years old showed a higher risk of not using contraception (relative risk [RR] = 2.7; 95% CI = 1.9–3.6). Conclusion Most victims of sexual violence were treated within 72 hours of the occurrence. The majority of these victims were white and young, and those < 19 years old had a higher risk of not using contraception and to know the sexual perpetrator.

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Analysis of Hospital Lethality of COVID-19 in Mexico

Biomedical & Pharmacology Journal ◽

10.13005/bpj/2313 ◽

2021 ◽

Vol 14 (4) ◽

pp. 2157-2164

Author(s):

Carolina Muñoz- Corona ◽

Elia Lara-Lona ◽

Christian Andrés Díaz- Chávez ◽

Gilberto Flores- Vargas ◽

Daniel Alberto Díaz- Martínez ◽

...

Keyword(s):

Social Dynamics ◽

Age Groups ◽

Hospitalized Patients ◽

Social Changes ◽

Access To Health Services ◽

Ministry Of Health ◽

Cross Sectional ◽

Access To Health ◽

Quantitative Descriptive ◽

General Mortality

Background. COVID-19 has caused 244,830 deaths in Mexico. Evaluating the severity of this contingency is possible if the hospital fatality rate of COVID-19 is described because hospitalized patients present more severe conditions. Objective. To analyze the fatality of COVID-19 in hospitalized patients. Methods. A quantitative, descriptive, analytical, cross-sectional, and retrospective study was conducted using open database from Ministry of Health in Mexico. Results. The analysis included 71,189 discharges from patients diagnosed with COVID-19 in the Mexican Ministry of Health Hospitals during 2020. Of them, 27,403 were due to death, predominantly in men and age groups from 50 to 69 years. The general hospital fatality due to COVID-19 was 38.49%, a hospital fatality of 40.75% in men and 35.03% in women. The 55-to-99-year-old age groups, Baja California, Puebla, and Coahuila had a higher hospital fatality than the general fatality. Conclusion. Besides the deaths caused directly by COVID-19 (those that occurred due to respiratory failures), many deaths were indirect in persons with comorbidities exacerbated by this disease. Access to health services, social changes derived from job loss, home protection, and changes in social dynamics, facts expressed in the general mortality excess, cannot be quantified in our study. There are similar patterns with other persons infected worldwide: this disease is more severe for males and older age subjects.

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