Factors Associated With Patient's Refusal of Recommended Cancer Surgery: Based on Surveillance, Epidemiology, and End Results

ObjectivesMost non-metastatic cancer patients can harvest a preferable survival after surgical treatment, however, patients sometimes refuse the recommended cancer-directed surgery. It is necessary to uncover the factors associated with patent's decision in taking cancer surgery and explore racial/ethnic disparities in surgery refusal.MethodsBased on the Surveillance, Epidemiology and End Results (SEER)-18 program, we extracted data of non-metastatic cancer patients who didn't undergo surgery. Ten common solid cancers were selected. Four racial/ethnic categories were included: White, black, Hispanic, and Asian/Pacific Islander (API). Primary outcome was patient's refusal of surgery. Multivariable logistic regression models were used, with reported odds ratio (OR) and 95% confidence interval (CI).ResultsAmong 318,318 patients, the incidence of surgery refusal was 3.5%. Advanced age, female patients, earlier cancer stage, uninsured/Medicaid and unmarried patients were significantly associated with higher odds of surgery refusal. Black and API patients were more likely to refuse recommended surgery than white patients in overall cancer (black-white: adjusted OR, 1.18; 95% CI, 1.11–1.26; API-white: adjusted OR, 1.56; 95% CI, 1.41–1.72); those racial/ethnic disparities narrowed down after additionally adjusting for insurance type and marital status. In subgroup analysis, API-white disparities in surgery refusal widely existed in prostate, lung/bronchus, liver, and stomach cancers.ConclusionsPatient's socioeconomic conditions reflected by insurance type and marital status may play a key role in racial/ethnic disparities in surgery refusal. Oncological surgeons should fully consider the barriers behind patient's refusal of recommended surgery, thus promoting patient-doctor shared decision-making and guiding patients to the most appropriate therapy.

Knowledge, attitude and practices of residences toward antimicrobial usage and resistance in Gondar, Northwest Ethiopia

Background Antimicrobials are essential for human and animal health. Drug resistance to an antimicrobial agent follows the introduction of a new antimicrobial agent. Evidence suggests that the public plays an important role in the risk, increase, and spread of antimicrobial resistance. The purpose of this study was to assess the knowledge, attitudes, and practices of the Gondar city residences regarding antimicrobial use and resistance. Methods A cross-sectional study was conducted from April to July 2021 on 400 randomly selected Gondar city residents using a pretested semi-structured questionnaire. The descriptive and Chi-square tests were used to analyse the data. Results The response rate was one hundred percent. Approximately 75% of respondents were men, with 32% having completed secondary school. Nearly 74% and 35% of participants were married and worked in various government jobs, respectively. Furthermore, 48%, 54%, and 50% of respondents, respectively, had moderate knowledge, a positive attitude, and good practice concerning antimicrobial use and resistance. The chi-square analysis revealed a significant (p < 0.05) disparity between knowledge and educational level, marital status, and position in the house. The respondents' attitude level was also significantly associated (p < 0.05) with their educational level, marital status, occupation, and position in the house. Respondents' practice level was also significantly associated (p 0.05) with their educational level and occupation. The study also found a significant relationship between respondents' knowledge and attitude (χ2 = 215.23, p ≤ 0.001), knowledge and practice (χ2 = 147.2, p ≤ 0.001), and attitude and practice (χ2 = 116.03, p ≤ 0.001). Conclusion This study found that study participants had some misconceptions about antimicrobial use and resistance. As a result, enforcing antimicrobial regulation and educating people about antimicrobial use are both recommended.

Levels and Determinants of Place-Of-Death Congruence in Palliative Patients: A Systematic Review

Introduction: Congruence, understood as the agreement between the patient's preferred place of death and their actual place of death, is emerging as one of the main variables indicating the quality of end-of-life care. The aim of this research was to conduct a systematic literature review on levels and determinants of congruence in palliative patients over the period 2010–2021.Method: A systematic review of the literature in the databases of PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Cuiden, the Cochrane Library, CSIC Indexes, and IBECS. Information was extracted on research characteristics, congruence, and associated factors.Results: A total of 30 studies were identified, mainly of retrospective observational design. The congruence values varied substantially between the various studies, ranging from 21 to 100%. The main predictors of congruence include illness-related factors (functional status, treatments and diagnosis), individual factors (age, gender, marital status, and end of life preferences), and environmental factors (place of residence, availability of health, and palliative care services).Conclusion: This review, in comparison with previous studies, shows that treatment-related factors such as physical pain control, marital status, having a non-working relative, age, discussing preferred place of death with a healthcare professional, and caregiver's preference have been associated with higher levels of congruence. Depending on the study, other factors have been associated with either higher or lower congruence, such as the patient's diagnosis, gender, or place of residence. This information is useful for designing interventions aimed towards greater congruence at the end of life.

Adolescent fertility and its determinants in Kenya: Evidence from Kenya demographic and health survey 2014

Background Adolescent fertility in Kenya is vital in the development and execution of reproductive health policies and programs. One of the specific objectives of the Kenyan Adolescent Sexual Reproductive Health (ASRH) policy developed in 2015 is to decrease early and unintended pregnancies in an attempt to reduce adolescent fertility. We aimed to establish determinants of adolescent fertility in Kenya. Methods The Kenya Demographic and Health Survey (KDHS) 2014 data set was utilized. Adolescent’s number of children ever born was the dependent variable. The Chi-square test was utilized to determine the relationship between dependent and independent variables. A Proportional-odds model was performed to establish determinants of adolescent fertility at a 5% significance level. Results Over 40% of the adolescent girls who had sex below 17 years had given birth i.e, current age 15–17 years (40.9%) and <15 years (44.9%) had given birth. In addition, 70.7% of the married adolescents had given birth compared to 8.1% of the unmarried adolescents. Moreover, 65.1% of the adolescents who were using contraceptives had given birth compared to only 9% of the adolescents who were not using a contraceptive. Approximately 29.4% of the adolescents who had no education had given birth compared to 9.1% who had attained secondary education. Age at first sex (18–19 years: OR: 0.221, 95% CI: 0.124–0.392; 15–17 years: OR: 0.530, 95% CI: 0.379–0.742), current age (18–19 years: OR: 4.727, 95% CI: 3.318–6.733), current marital status (Not married: OR:0.212, 95% CI: 0.150–4.780), and current contraceptive use (Using: OR 3.138, 95% CI: 2.257–4.362) were associated with adolescent fertility. Conclusion The study established that age at first sex, current age, marital status, and contraceptive use are the main determinants of adolescent childbearing. The stated determinants should be targeted by the government to control the adolescent birth rate in Kenya. Consequently, delaying the age at first sex, discouraging adolescent marriage, and increasing secondary school enrollment among adolescent girls are recommended strategies to control adolescent fertility in Kenya.

The Legitimacy of The Marriage of Husband and Wife Who Are Converts to Islam and the Implications for Their Descendants

Marriage in Indonesia has been regulated in laws and regulations that apply to all Indonesian people, namely the Marriage Law Number 1 of 1974.[1] In this Law as stated in Article 2 which reads that marriage is only valid, if it is carried out according to each religion and belief, then each marriage is recorded based on the applicable laws and regulations. The Jambi Religious Court as the executor of judicial power in the Jambi Religious High Court area has received 2 (two)cases isbat/ marriage ratifications for non-Muslim husbands and wives to become converts to get legal certainty from marriage before embracing Islam, namely the case with Number 14/Pdt.P /2017/PA Jmb on 01 February 2017 and the case with Number 64/Pdt.P/2019/PA Jmb on 09 August 2019. The reason for converting husbands and wives to submit isbat/ marriage ratification is because marriage before embracing Islam does not have a certificate marriage from the Civil Registry Office. So that the husband and wife of the converts filed a case isbat/ marriage ratification to the Jambi Religious Court to ask for the validity of their marriage. The Jambi Religious Court judge who tried the case, in his decision, granted the request and declared the marriage of a husband and wife to be converts to Islam without advocating remarriage. Even though the marital status of a non-Muslim husband and wife when they converted to Islam, the scholars were still debating until they were divided into two groups.

The Health Status of Labor Force in East Kalimantan Province: Effect of Individual Characteristics and Household Conditions

The aims of this research are first, to explore the factors that are associated with health status. Second, to address the individual characteristics and household conditions that affect the health status of labor force, taking into account the urban-rural differences. This research utilized data from SUSENAS Cor 2018, and employed a cross sectional - multinomial logistic regression analysis method. The dependent variable is the health conditions of the labor force. The findings show that, age and number of household members were significant for both sick and very sick health status in all two type of areas analyzed. In urban and rural areas simultaneously gender, expenditure per capita, and drinking water were only significant for sick health group while marital status, education, employment status, sanitation, house area was only significant for very sick health status group. In urban areas, the results indicated that gender, employment status, and drinking water were only significant for sick health status, while marital status, education, sanitation, and house area significant for very sick health status. Moreover, in rural areas, marital status was only significant for sick health status whereas, sanitation and house area were significant for the very sick health status.

The association between financial strain and volatility in daily relationship uncertainty: A dyadic investigation

Prior research suggests that financial strain negatively impacts relational outcomes and that fluctuations (i.e., volatility) in daily reports of relationship aspects may be detrimental for relational outcomes. Daily relational uncertainty may also be associated with financial stressors; however, little is known about the association between financial strain and levels of daily relational uncertainty, as well as the volatility in day-to-day relational uncertainty. The current study includes both members of 100 adult different-sex couples (relationship length M = 7.0 years, SD = 7.1) who completed 14 days of daily diaries. We examined whether greater baseline financial strain is associated with higher levels of daily relational uncertainty and greater day-to-day volatility in relational uncertainty among actors and partners. Individuals who reported greater financial strain also reported higher overall levels of daily relationship uncertainty, as well as greater volatility in daily relationship uncertainty. The association between actor financial strain and volatility in daily relationship uncertainty was moderated by gender and marital status, such that financial strain was only associated with greater volatility in daily relationship uncertainty for men (but not for women) and for unmarried (but not married) individuals. Evidence for partner effects were also found, where partners’ higher levels of financial strain was associated with less volatility in actors’ daily relational uncertainty; however, this relationship was moderated by income, gender, and marital status. Individuals with lower income levels (versus high income levels) reported less volatility in their daily relationship uncertainty when their partners reported higher financial strain. Males rather than women reported lower volatility in daily relational uncertainty when their partners reported greater financial strain. In addition, unmarried rather than married individuals reported greater volatility in daily relationship uncertainty when their partners reported higher financial strain. Implications for future research and practice are discussed.

Age and Sex-Related Associations between Marital Status, Physical Activity and TV Time

Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health effect of marriage or divorce is age-dependent and differs between women and men. The study aimed to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals from 18 to 99 years, with a TV time > 3 h/day (prevalence = 25.2%) and PA > 150 min/week (prevalence = 35%). Later, we divided our sample in seven age groups by marital status and sex. Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants >30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, our study suggests that the investments in public policies to encourage the practice of PA and reduction of TV time could be based on the marital status, sex, and age, prioritizing less active groups.