Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly:a community-based cross-sectional survey

Context: Population-based screening has been advocated for subclinical thyroid dysfunction in the elderly because the disorder is perceived to be common, and health benefits may be accrued by detection and treatment. Objective: The objective of the study was to determine the prevalence of subclinical thyroid dysfunction and unidentified overt thyroid dysfunction in an elderly population. Design, Setting, and Participants: A cross-sectional survey of a community sample of participants aged 65 yr and older registered with 20 family practices in the United Kingdom. Exclusions: Exclusions included current therapy for thyroid disease, thyroid surgery, or treatment within 12 months. Outcome Measure: Tests of thyroid function (TSH concentration and free T 4 concentration in all, with measurement of free T3 in those with low TSH) were conducted. Explanatory Variables: These included all current medical diagnoses and drug therapies, age, gender, and socioeconomic deprivation (Index of Multiple Deprivation, 2004) Analysis: Standardized prevalence rates were analyzed. Logistic regression modeling was used to determine factors associated with the presence of subclinical thyroid dysfunction Results: A total of 5960 attended for screening. Using biochemical definitions, 94.2% [95% confidence interval (CI) 93.8-94.6%] were euthyroid. Unidentified overt hyper- and hypothyroidism were uncommon (0.3, 0.4%, respectively). Subclinical hyperthyroidism and hypothyroidism were identified with similar frequency (2.1%, 95% CI 1.8-2.3%; 2.9%, 95% CI 2.6-3.1%, respectively). Subclinical thyroid dysfunction was more common in females (P < 0.001) and with increasing age (P < 0.001). After allowing for comorbidities, concurrent drug therapies, age, and gender, an association between subclinical hyperthyroidism and a composite measure of socioeconomic deprivation remained. Conclusions: Undiagnosed overt thyroid dysfunction is uncommon. The prevalence of subclinical thyroid dysfunction is 5%. We have, for the first time, identified an independent association between the prevalence of subclinical thyroid dysfunction and deprivation that cannot be explained solely by the greater burden of chronic disease and/or consequent drug therapies in the deprived population. Copyright © 2006 by The Endocrine Society.

The two-dose measles, mumps, and rubella (MMR) immunisation schedule: factors affecting maternal intention to vaccinate

BACKGROUND: In the light of sub-optimal uptake of the measles, mumps, and rubella (MMR) vaccination, we investigated the factors that influence the intentions of mothers to vaccinate. METHOD: A cross-sectional survey of 300 mothers in Birmingham with children approaching a routine MMR vaccination was conducted using a postal questionnaire to measure: intention to vaccinate, psychological variables, knowledge of the vaccine, and socioeconomic status. The vaccination status of the children was obtained from South Birmingham Child Health Surveillance Unit. RESULTS: The response rate was 59%. Fewer mothers approaching the second MMR vaccination (Group 2) intended to take their children for this vaccination than Group 1 (mothers approaching the first MMR vaccination) (Mann-Whitney U = 2180, P < 0.0001). Group 2 expressed more negative beliefs about the outcome of having the MMR vaccine ('vaccine outcome beliefs') (Mann-Whitney U = 2155, P < 0.0001), were more likely to believe it was 'unsafe' (chi 2 = 9.114, P = 0.004) and that it rarely protected (chi 2 = 6.882, P = 0.014) than Group 1. The commonest side-effect cited was general malaise, but 29.8% cited autism. The most trusted source of information was the general practitioner but the most common source of information on side-effects was television (34.6%). Multiple linear regression revealed that, in Group 1, only 'vaccine outcome beliefs' significantly predicted intention (77.1% of the variance). In Group 2 'vaccine outcome beliefs', attitude to the MMR vaccine, and prior MMR status all predicted intention (93% of the variance). CONCLUSION: A major reason for the low uptake of the MMR vaccination is that it is not perceived to be important for children's health, particularly the second dose. Health education from GPs is likely to have a considerable impact.

The Socioeconomic Background of the Divergence of Belarusian and Ukrainian Political Systems

The aim of this paper is to analyze the political, social and economic background of the divergence of Belarusian and Ukrainian transitions. We focus on Belarus in order to find explanation for questions such as why could Lukashenko remain the authoritarian leader of Belarus, while in Ukraine the position of the political elite had proved less stable and collapsed in 2004. On the theoretical framework of elite-sociology, we seek to determine whether the internal factors (as macroeconomic conditions, standard of living, the oppressive nature of the political system and the structure of the political elite) play a significant role in the operation of the domino effect. This article emphasises the determining role of immanent internal factors, thus the political stability in Belarus can be explained by the role of the suppressing political regime, the hindrance of democratic rights and the relatively good living conditions that followed the transformational recession. Whilst in Ukraine, the markedly different circumstances brought forth the success of the Orange Revolution.

The drivers of perception: Identifying the driving factors of resident perceptions of municipal service quality in cities of South Florida

The idea of comparative performance assessment is crucial. Recent study findings show that in South Florida the use by most municipalities of external benchmarks for performance comparison is virtually non-existent. On one level this study sought to identify the factors impacting resident perceptions of municipal service quality. On a different and more practical level, this study sought to identify a core set of measures that could serve for multi jurisdictional comparisons of performance. ^ This study empirically tested three groups of hypotheses. Data were collected via custom designed survey instruments from multiple jurisdictions, representing diverse socioeconomic backgrounds, and across two counties. A second layer of analysis was conducted on municipal budget documents for the presence of performance measures. A third layer of analysis was conducted via face-to-face interviews with residents at the point of service delivery. Research questions were analyzed using descriptive and inferential statistic methodologies. ^ Results of survey data yielded inconsistent findings. In absolute aggregated terms, the use of sociological determinants to guide inquiry failed to yield conclusive answers regarding the factors impacting resident perceptions of municipal service quality. At disaggregated community levels, however, definite differences emerged but these had weak predictive ability. More useful were the findings of performance measures reporting via municipal budget documents and analyses of interviews with residents at the point of service delivery. Regardless of socio-economic profile, neighborhood characteristics, level of civic engagement or type of community, the same aspects were important to citizens when making assessments of service quality. For parks and recreation, respondents most frequently cited maintenance, facility amenities, and program offerings as important while for garbage collection services timely and consistent service delivery mattered most. Surprisingly municipalities participating in the study track performance data on items indicated as important by citizen assessments but regular feed back from residents or reporting to the same is rarely done. ^ The implications of these findings suggest that endeavors, such as the one undertaken in this study, can assist in determining a core set of measures for cross jurisdictional comparisons of municipal service quality, improving municipal delivery of services, and to communicate with the public. ^

Obesity, cardiovascular disease risk factors and weight loss in a population of adult Mexican Americans

The study of obesity has evolved into one of the most important public health issues in the United States (U.S.), particularly in Hispanic populations. Mexican Americans, the largest Hispanic ethnic subgroup in the U.S., have been significantly impacted by obesity and related cardiovascular diseases. Mexican Americans living in the Lower Rio Grande Valley (the Valley) in the Texas-Mexico border are one of the most disadvantaged and hard-to-reach minority groups. Demographic factors, socioeconomic status, acculturation, and physical activity behavior have been found to be important predictors of health, although research findings are mixed when establishing predictors of obesity in this population. Furthermore, while obesity has long been linked to cardiovascular disease (CVD) risk factors such as hypertension, type 2 diabetes, and dyslipidemia; information on the relationships between obesity and these CVD risk factors have been mostly from non-minority population groups. Overall, research has been mixed in establishing the association between obesity and related CVD risk factors in this population calling attention to the need for further research. Nevertheless, identifying predictors of success for weight loss in this population will be important if health disparities are to be addressed. The overall objective of the findings presented in this dissertation was to attain a more informed profile of obesity and CVD risk factors in this population. In particular, we examined predictors of obesity, measures of obesity and association with cardiovascular disease risk factors in a sample of 975 Mexican Americans participating in a health promotion program in the Valley region. Findings suggest acculturation factors to be one of the most important predictors of obesity in this population. Results also point to the need of identifying other possible risk factors for predicting CVD risk. Finally, initial body mass index is an important predictor of weight loss in this population group. Thus, indicating that this population is not only amenable to change, but that improvements in weight loss are feasible. This finding strengthens the relevance of prevention programs such as Beyond Sabor for Mexican populations at risk, in particular, food bank recipients.

Discovering complex interrelationships between socioeconomic status and health in Europe: A case study applying Bayesian Networks

Studies assume that socioeconomic status determines individuals’ states of health, but how does health determine socioeconomic status? And how does this association vary depending on contextual differences? To answer this question, our study uses an additive Bayesian Networks model to explain the interrelationships between health and socioeconomic determinants using complex and messy data. This model has been used to find the most probable structure in a network to describe the interdependence of these factors in five European welfare state regimes. The advantage of this study is that it offers a specific picture to describe the complex interrelationship between socioeconomic determinants and health, producing a network that is controlled by socio demographic factors such as gender and age. The present work provides a general framework to describe and understand the complex association between socioeconomic determinants and health.

Obesity, Cardiovascular Risk Factors, and Weight Loss in a Population of Adult Mexican Americans

The study of obesity has evolved into one of the most important public health issues in the United States (U.S.), particularly in Hispanic populations. Mexican Americans, the largest Hispanic ethnic subgroup in the U.S., have been significantly impacted by obesity and related cardiovascular diseases. Mexican Americans living in the Lower Rio Grande Valley (the Valley) in the Texas-Mexico border are one of the most disadvantaged and hard-to-reach minority groups. Demographic factors, socioeconomic status, acculturation, and physical activity behavior have been found to be important predictors of health, although research findings are mixed when establishing predictors of obesity in this population. Furthermore, while obesity has long been linked to cardiovascular disease (CVD) risk factors such as hypertension, type 2 diabetes, and dyslipidemia; information on the relationships between obesity and these CVD risk factors have been mostly from non-minority population groups. Overall, research has been mixed in establishing the association between obesity and related CVD risk factors in this population calling attention to the need for further research. Nevertheless, identifying predictors of success for weight loss in this population will be important if health disparities are to be addressed. The overall objective of the findings presented in this dissertation was to attain a more informed profile of obesity and CVD risk factors in this population. In particular, we examined predictors of obesity, measures of obesity and association with cardiovascular disease risk factors in a sample of 975 Mexican Americans participating in a health promotion program in the Valley region. Findings suggest acculturation factors to be one of the most important predictors of obesity in this population. Results also point to the need of identifying other possible risk factors for predicting CVD risk. Finally, initial body mass index is an important predictor of weight loss in this population group. Thus, indicating that this population is not only amenable to change, but that improvements in weight loss are feasible. This finding strengthens the relevance of prevention programs such as Beyond Sabor for Mexican populations at risk, in particular, food bank recipients.

The Worsening of the employment and work conditions and its relationship to the self-perceived health in European working population. Relevance and effects of the latest socioeconomic crisis

The recent crisis of the capitalistic economic system has altered the working conditions and occupations in the European Union. The recession situation has accelerated trends and has brought transformations that have been observed before. Changes have not looked the same way in all the countries of the Union. The social occupation norms, labour relations models and the type of global welfare provision can help underline some of these inequalities. Poor working conditions can expose workers to situations of great risk. This is one of the basic assumptions of the theoretical models and analytical studies of the approach to the psychosocial work environment. Changes in working conditions of the population seems to be important to explain in the worst health states. To observe these features in the current period of economic recession it has made a comparative study of trend through the possibilities of the European Working Conditions Survey in the 2005 and 2010 editions. It has also set different multivariate logistic regression models to explore potential partnerships with the worst conditions of employment and work. It seems that the economic crisis has intensified changes in working conditions and highlighted the effects of those conditions on the poor health of the working population. This conclusion can’t be extended for all EU countries; some differences were observed in terms of global welfare models.

Socioeconomic Status and Health Behavior in Nepal

Thesis (Master's)--University of Washington, 2016-07

Impact of dead and sunken water hyacinth on biotic communities, the aquatic environment and socioeconomic activities

The mobile water hyacinth, which was produced in growth zones, especially Murchison bay, was mainly exported to three sheltered storage bays (Thruston, Hannington and Waiya). Between 1996 and May 1998, the mobile form of water hyacinth occupied about 800 ha in Thruston bay, 750 ha in Hannington bay and 140 ha in Waiya bay). Biological control weevils and other factors, including localised nutrient depletion, weakened the weed that was confined to the bays and it sunk around October 1998. The settling to the bottom of such huge quantities of organic matter its subsequent decomposition and the debris from this mass was likely to have environmental impacts on biotic communities (e.g. fish and invertebrate), physico-chemical conditions (water quality), and on socio-economic activities (e.g. at fish landings, water abstraction, and hydro-power generation points). Sunken water hyacinth debris could also affect nutrient levels in the water column and lead to reduction in the content of dissolved oxygen. The changes in nutrient dynamics and oxygen levels could affect algal productivity, invertebrate composition and fish communities. Socio-economic impacts of dead sunken weed were expected from debris deposited along the shoreline especially at fish landings, water abstraction and hydropower generation points. Therefore, environmental impact assessment studies were carried out between 1998 and 2002 in selected representative zones of Lake Victoria to identify the effects of the sunken water hyacinth biomass.

Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees

Background In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model – effort, rewards and ERI – are associated with the co-occurrence of lifestyle risk factors. Methods Based on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational -level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index ≥25 kg/m2, and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models. Results After adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously ≥3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors. Conclusion This study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evidence.

Factors associated with obesity in Brazilian children enrolled in the School Health Program: a case-control study

Case-control studies evaluating the factors associated with childhood obesity are scarce in Brazil. We aimed to analyze the factors associated with obesity in Brazilian schoolchildren enrolled in the School Health Program.A case-control study was conducted on 80 schoolchildren aged 7 to 9 years, 40 of them obese and 40 of normal weight according to the cut-off points established by the World Health Organization (2007). Weight, height and waist circumference were obtained. Socioeconomic, demographic, health, eating behavior and lifestyle data were collected by applying a questionnaire to the person responsible and by determining his/her nutritional status. A binary unconditional logistic regression model (univariate and multivariate) was used for data analysis. The prevalence of obesity was 7.21%. The final model showed that duration of breast-feeding ≥6 months of age (OR 5.3; 95% CI: 1.3-22.1), excess weight of the person responsible (OR 7.1; 95% CI: 1.2-40.2), a sedentary level of physical activity (OR 4.1; 95% CI: 1.115.5), and fast chewing (OR 7.4; 95% CI: 2.1-26.9) were significantly associated with childhood obesity. The factors associated with obesity in schoolchildren were duration of breast-feeding ≥6 months, persons responsible with excess weight, and sedentary children who chew fast. The present study contributes information to be used for the health actions planned by the School Health Program.

Contextual factors related to chronic condition in portuguese adolescents: Highlights from the HBSC/WHO study

Adolescence’s changes may become more pronounced when living with a chronic condition (CC). This study aims to examined the differences in satisfaction with family life, perception of school competence and “pressure with homework” of Portuguese adolescents’ 1) living with CC; 2) how living with CC affects school participation; taking into account age, gender and family socioeconomic status (SES). Five thousand fifty Portuguese adolescents (mean age 14 ± 1.85) of the Health Behaviour in School-aged Children (HBSC/WHO) were included. Results showed increased vulnerability in adolescents living with CC, presenting a lower satisfaction with family life and poor school outcomes. Younger boys, having a higher SES and not having CC are significantly associated with satisfaction with family life. Older girls, having a lower SES and living with CC were associated with more stress related to school work. Future interventions should include these features combined with ‘listening’ to adolescents and their needs, allowing their participation in the promotion of personal health.

Distinguishing predisposing factors for enamel hypoplasia and molar-incisor hypomineralization in children in Ile-Ife, Nigeria

Aim: To determine if the prevalence of enamel hypoplasia, molar-incisor hypomineralisation (MIH) and deciduous molar hypomineralisation (DMH) is associated with the socioeconomic status of the child and to determine the prevalence of enamel hypoplasia and MIH/DMH comorbidity in the study population. Methods: Information was collected on the sex and socioeconomic status of the 1,169 study participants’ resident in Ile-Ife, Nigeria, recruited through a household survey. The children were clinically examined to assess for the presence of enamel hypoplasia, MIH and DMH. Associations between sex, socioeconomic status and the prevalence of enamel hypoplasia, MIH and DMH were determined. The proportion of children with enamel hypoplasia and MIH/DMH co-morbidity was also determined. Results: Among the 1,169 study participants, 47(4.0%) had MIH, 15 (1.3%) had DMH and 161 (13.8%) had enamel hypoplasia. One (0.09%) study participant had MIH/DMH co-morbidity, 12 (1.0%) had DMH/enamel hypoplasia co-morbidity, and 9 (0.8%) had MIH/hypoplasia co-morbidity. There was no significant association between the socioeconomic status and presence of enamel hypoplasia (p=0.22), MIH (p=0.78) or DMH (p=1.00). Conclusions: The socioeconomic status cannot be used as a distinguishing factor for enamel hypoplasia, MIH and DMH. The possibility of co-existence of enamel hypoplasia and MIH/DMH makes it imperative to find ways to distinguish between the lesions.

Caregiver factors and pool fencing: An exploratory analysis

To explore the relationship between caregiver characteristics and the adequacy of domestic swimming pool fencing.A typical metropolitan area of a large Australian capital city, Brisbane.From a reanalysis of the dataset of the 1989 Brisbane Home Safety Survey of 1050 householders, associations between 10 caregiver factors, pool ownership, and quality of pool fencing, were analysed. Household characteristics relating to toddlers (children < or = 4 years), and socioeconomic measures were also included in the analyses. Pool fencing quality was measured on an ordinal scale derived from Australian Standards Association guidelines, confirmed through home visits by trained inspectors.Caregiver factors did not distinguish households with a swimming pool from those without, nor were they associated with adequacy of pool fencing among pool owners. Pool owners, with or without children, were less likely to perceive having a childproof fence as being important. Strongest correlates of adequacy of pool fencing were socioeconomic indicators of surrounding districts.These results do not support the arguments of opponents of compulsory pool fencing that caregiver factors are adequate to prevent toddler drownings and obviate the need for a pool fence. Pool owners do not appear to perceive their pool as a hazard for young children, and complacency about the adequacy of pool fencing needs to be replaced by increased caregiver health beliefs, skills, and perceptions. Article in Injury Prevention 3(4):257-61 · December 1997