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Factors associated with active aging in Finland, Poland, and Spain
Ayuso-Mateos, Jose Luis; Miret, Marta; Leonardi, Matilde; Martin, Steven; Chatterji, Somnath; Moneta, Victoria; Tobiasz-Adamczyk, Beata; Perales, Jaime; Koskinen, Seppo; Garin, Noe; Olaya, Beatriz; Haro, Josep Maria ( 2014-04-15 )

BACKGROUND: Continuous population aging has raised international policy interest in promoting active aging (AA). AA theoretical models have been defined from a biomedical or a psychosocial perspective. These models may be expanded including components suggested by lay individuals. This paper aims to study the correlates of AA in three European countries, namely, Spain, Poland, and Finland using four different definitions of AA. METHODS: The EU COURAGE in Europe project was a cross-sectional general adult population survey conducted in a representative sample of the noninstitutionalized population of Finland, Poland, and Spain. Participants (10,800) lived in the community. This analysis focuses on individuals aged 50 years old and over (7,987). Four definitions (two biomedical, one psychosocial, and a complete definition including biomedical, psychosocial, and external variables) of AA were analyzed. RESULTS: Differences in AA were found for country, age, education, and occupation. Finland scored consistently the highest in AA followed by Spain and Poland. Younger age was associated with higher AA. Higher education and occupation was associated with AA. Being married or cohabiting was associated with better AA compared to being widowed or separated in most definitions. Gender and urbanicity were not associated with AA, with few exceptions. Men scored higher in AA only in Spain, whereas there was no gender association in the other two countries. Being widowed was only associated with lower AA in Poland and not being married was associated with lower AA in Poland and Finland but not Spain. CONCLUSIONS: Associations with education, marital status, and occupation suggest that these factors are the most important components of AA. These association patterns, however, seem to vary across the three countries. Actions to promote AA in these countries may be addressed at reducing inequalities in occupation and education or directly tackling the components of AA lacking in each country.

Factors associated with acute diarrhoea in children in Dhahira, Oman: a hospital-based study
Patel, P.K.; Mercy, J.; Shenoy, J.; Ashwini, B. ( 2008 )

To elucidate the bacterial etiology of childhood diarrhoea in Dhahira, 856 children < 12 years admitted for diarrhoea to Ibri Regional Referral Hospital from 2000 to 2002 were studied. The mean age was 2.4 [SD 2.3] years; the majority [92.9%] were < 5 years. Bacterial etiology was found in 15.2% of cases; 10.6% due to Shigella and 2.1% to Salmonella. Sh. sonnei was the commonest Shigella serogroup isolated. Salmonella infection was significantly associated with cramps, while Shigella infection was associated with fever, bloody stools and cramps. Antibiotics were prescribed in 36.2% of cases and the resistance to the common antibiotics tested was low

Factors associated with breast self-examination among Malaysian women teachers
Parsa, P.; Kandiah, M.; Parsa, N. ( 2011 )

The purpose of this study was to examine factors related to breast self-examination [BSE] among teachers in Selangor, Malaysia. A cross-sectional study was conducted among 425 female teachers in 20 randomly selected secondary schools. A self-administered questionnaire based on the health belief model was used, including sociodemographic background and knowledge, beliefs and practices about breast cancer and BSE. Only 19% of the women performed BSE on a regular basis. Higher knowledge about breast cancer, greater confidence in performing BSE and regular visits to a physician were significant predictors for practising BSE. To promote BSE practice among Malaysian women, tailored health education and health promotion programmes should be developed based on a specific understanding of women's health beliefs

Factors associated with cognitive function in older adults in Mexico
Salinas-Rodriguez, Aarón; Miu, Jenny; Cumming, Robert; Negin, Joel; Sosa-Ortiz, Ana Luisa; Manrique-Espinoza, Betty; Kowal, Paul ( 2016-03-30 )

As populations age, cognitive decline and dementia pose significant burdens for societies and health care systems, including low- and middle-income countries such as Mexico. Minor age-related declines in cognitive function appear to represent a stable but heterogeneous phase in the continuum between normal cognitive ageing and dementia. Loss of cognitive function has impacts at societal and individual levels and understanding the risk factors can help provide a framework for health policies and interventions to target at-risk groups.A cohort of older Mexican adults (50+) from the World Health Organization's Study on global AGEing and adult health (WHO SAGE) was used to examine cognitive function, including a total of 2315 respondents, with 325 respondents aged 80 years and older. Cognition was objectively evaluated using verbal recall, verbal fluency, forward digit span and backward digit span, with differences in an overall cognitive score assessed against sociodemographic variables, and associated factors using linear regression.The most significant predictors of poorer cognitive function were found to be older age (β=-13.88), rural living (β=-2.25), low income (β=-8.28), self-reported severe or extreme memory difficulties (β=-6.62), and difficulty with two or more activities of daily living (β=-2.02).These findings can inform public health initiatives to address cognitive impairment in ageing populations in Mexico and other middle-income countries.

Factors associated with declining under-five mortality rates from 2000 to 2013: an ecological analysis of 46 African countries
Aliyu, Muktar H; Ketsela, Tigest; Shepherd, Bryan E; Mwinga, Kasonde; Kipp, Aaron M; Vermund, Sten H; Blevins, Meridith; Haley, Connie A; Habimana, Phanuel ( 2016-01-08 )

Inadequate overall progress has been made towards the 4th Millennium Development Goal of reducing under-five mortality rates by two-thirds between 1990 and 2015. Progress has been variable across African countries. We examined health, economic and social factors potentially associated with reductions in under-five mortality (U5M) from 2000 to 2013.Ecological analysis using publicly available data from the 46 nations within the WHO African Region.We assessed the annual rate of change (ARC) of 70 different factors and their association with the annual rate of reduction (ARR) of U5M rates using robust linear regression models.Most factors improved over the study period for most countries, with the largest increases seen for economic or technological development and external financing factors. The median (IQR) U5M ARR was 3.6% (2.8 to 5.1%). Only 4 of 70 factors demonstrated a strong and significant association with U5M ARRs, adjusting for potential confounders. Higher ARRs were associated with more rapidly increasing coverage of seeking treatment for acute respiratory infection (β=0.22 (ie, a 1% increase in the ARC was associated with a 0.22% increase in ARR); 90% CI 0.09 to 0.35; p=0.01), increasing health expenditure relative to gross domestic product (β=0.26; 95% CI 0.11 to 0.41; p=0.02), increasing fertility rate (β=0.54; 95% CI 0.07 to 1.02; p=0.07) and decreasing maternal mortality ratio (β=-0.47; 95% CI -0.69 to -0.24; p<0.01). The majority of factors showed no association or raised validity concerns due to missing data from a large number of countries.Improvements in sociodemographic, maternal health and governance and financing factors were more likely associated with U5M ARR. These underscore the essential role of contextual factors facilitating child health interventions and services. Surveillance of these factors could help monitor which countries need additional support in reducing U5M.

Factors associated with elevated blood lead concentrations in children in Karachi, Pakistan / Mohammad Hossein Rahbar ... [et al.]
Rahbar, Mohammad Hossein; White, Franklin; Agboatwalla, Mubina; Hozhabri, Siroos; Luby, Stephen P ( 2002 )
Factors associated with HIV status awareness and Linkage to Care following home based testing in rural Malawi
Maman, D; Etard, J F; Mendiharat, P; Chilima, B; Salumu, L; Ben-Farhat, J; Szumilin, E; Ford, N; Masiku, C; Masson, S ( 2016-10-07 )

HIV diagnosis and linkage to care are the main barriers in Africa to achieving the UNAIDS 90-90-90 targets. We assessed HIV-positive status awareness and linkage to care among survey participants in Chiradzulu District, Malawi.Nested cohort study within a population-based survey of persons aged 15-59 years between February and May 2013. Participants were interviewed and tested for HIV (and CD4 if found HIV-positive) in their homes. Multivariable regression was used to determine factors associated with HIV-positive status awareness prior to the survey and subsequent linkage to care.Of 8277 individuals eligible for the survey, 7270 (87.8%) participated and were tested for HIV. The overall HIV prevalence was 17.0%. Among HIV-positive participants, 77.0% knew their status and 72.8% were in care. Women (adjusted odds ratio [aOR] 6.5, 95% CI 3.2-13.1) and older participants (40-59 vs. 15-29 years, aOR 10.1, 95% CI 4.0-25.9) were more likely to be aware of their positive status. Of those newly diagnosed, 47.5% were linked to care within 3 months. Linkage to care was higher among older participants (40-59 vs. 15-29, adjusted hazard ratio [aHR] 3.39, 95% CI 1.83-6.26), women (aHR 1.73, 95% CI 1.12-2.67) and those eligible for ART (aHR 1.61, 95% CI 1.03-2.52).In settings with high levels of HIV awareness, home-based testing remains an efficient strategy to diagnose and link to care. Men were less likely to be diagnosed, and when diagnosed to link to care, underscoring the need for a gender focus in order to achieve the 90-90-90 targets.

Factors associated with immediate relapse among Bahraini heroin abusers
Derbas, A.N.; Al Haddad, M.K. ( 2001 )

Demographic characteristics and factors associated with immediate relapse to heroin use among 40 male Bahraini heroin abusers were studied 1 week after discharge from the Drug and Alcohol Rehabilitation Unit in Bahrain. The mean age of the patients was 32.7 years, the age at which drug abuse began ranged from 12 years to 31 years, and the age range of regular use was 15-37 years. More than half the patients were single, unemployed, unskilled labourers with secondary-school education. The vast majority used heroin intravenously. Negative emotional states and drug-related cues were seen by the majority of the subjects as influential in their immediate relapse after discharge. Findings suggest that the treatment and rehabilitation unit in Bahrain should look into the issues of after-care

Factors associated with interruption of treatment among Pulmonary Tuberculosis patients in Plateau State, Nigeria. 2011
Dalhatu, Ibrahim; Dankoli, Raymond; Nwanyanwu, Okey; Nguku, Patrick; Ibrahim, Luka Mangveep; Oyemakinde, Akin; Waziri, Ndadilnasiya Endie; Hadejia, Idris Suleiman; Ogiri, Samuel; Akhimien, Moses Obiemen; Nsubuga, Peter ( 2014-01-31 )

INTRODUCTION: Nigeria has one of the highest tuberculosis (TB) burdens in the world with estimated incidence of 133 per 100,000 populations. Multi-drug resistant TB (MDR-TB) is an emerging threat of the TB control in Nigeria caused mainly by incomplete treatment. This study explored factors that affect adherence to treatment among patients undergoing direct observation of TB treatment in Plateau state, Nigeria. METHODS: Between June and July 2011, we reviewed medical records and interviewed randomly selected pulmonary TB patients in their eighth month of treatment. Information on patients? clinical, socio-demographic and behavioral characteristics was collected using checklist and structured questionnaire for knowledge of treatment duration and reasons for interruption of treatment. We conducted focus group discussions with patients about barriers to treatment adherence. Data were analyzed with Epi Info software. RESULTS: Of 378 records reviewed, 229 (61%) patients were male; mean age 37.6±13.5 years and 71 (19%) interrupted their treatment. Interruption of treatment was associated with living >5 km from TB treatment site (AOR: 11.3; CI 95%: 5.7-22.2), lack of knowledge of duration of treatment (AOR: 6.1; CI 95%: 2.8-13.2) and cigarette smoking (AOR: 3.4; CI 95%: 1.5- 8.0). Major reasons for the interruption were lack of transport fare (40%) and feeling well (25%). Focused group discussions revealed unfriendly attitudes of health care workers as barriers to adherence to treatment. CONCLUSION: This study revealed knowledge of the patients on the duration of treatment, distance and health workers attitude as the major determinants of adherent to TB treatment. Training for health care workers on patient education was conducted during routine supportive supervision.

Factors associated with maternal mortality : exemplary research protocol, research results and their implementation
Joint WHO/DGIS/RTI Project on Health Systems Research for the Southern African Region; World Health Organization ( 1994 )
Factors associated with osteoporosis among a sample of Jordanian women referred for investigation for osteoporosis
El Heis, M.A.; Al Kamil, E.A.; Kheirallah, K.A.; Al Shatnawi, T.N.; Gharaibia, M.; Al Mnayyis, A. ( 2013 )

This cross-sectional study was carried out to examine the association between osteoporosis and specific risk factors among 384 women referred to the Radiology Department at King Abdullah University Hospital, Irbid, Jordan during the period September 2009-August 2010 for diagnosis of osteopenia or osteoporosis. Bone mineral density measurements were carried out using dual energy X-ray absorptiometry at both the lumbar spine [AP: L1-L4] and femoral hip [neck, trochanter]. Studied risk factors included age, age at menarche, menopause, body mass index, diabetes mellitus, hypertension, renal problems and smoking. The prevalence of osteoporosis among the studied sample was 13.5%. Osteoporosis was significantly associated with current age, age at menarche, diabetes mellitus, hypertension, and renal problems

Factors associated with patient delay in accessing pulmonary tuberculosis care, Gezira State, Sudan, 2009
Mohamed, E.Y.; Abdalla, S.M.; Khamis, A.A.; Abdelbadea, A.; Abdelgadir, M.A. ( 2013 )

Analyses of patient delays in seeking treatment for tuberculosis [TB] provide useful evidence for national TB control programmes. The objectives of this study in Gezira State/ Sudan were to estimate the extent of, and factors associated with, pulmonary TB patient delay in accessing care. A cross-sectional phase was conducted to determine the length of delay, followed by a nested case-control phase comparing patients delaying above or below the median time. The mean patient delay was 27.2 days, median 4 days [range 0-365 days]. There were no significant differences between case and control groups in terms of age/ sex, marital status, educational level or smoking status. However, patients living in urban areas, with low income status and who were housewives or unemployed were more likely to delay. Also patients with a history of contact with a TB patient, those who suspected TB and those with a history of chronic obstructive pulmonary disease were more likely to delay

Factors associated with skeletal muscle mass, sarcopenia, and sarcopenic obesity in older adults: a multi-continent study
Ayuso-Mateos, Jose Luis; Leonardi, Matilde; Miret, Marta; Chatterji, Somnath; Tobiasz-Adamczyk, Beata; Koyanagi, Ai; Koskinen, Seppo; Tyrovolas, Stefanos; Olaya, Beatriz; Haro, Josep Maria ( 2015-10-07 )

The aim of this study was to evaluate the factors associated with low skeletal muscle mass (SMM), sarcopenia, and sarcopenic obesity using nationally representative samples of people aged ≥65 years from diverse geographical regions of the world.Data were available for 18 363 people aged ≥65 years who participated in the Collaborative Research on Ageing in Europe survey conducted in Finland, Poland, and Spain, and the World Health Organization Study on global AGEing and adult health survey conducted in China, Ghana, India, Mexico, Russia, and South Africa, between 2007 and 2012. A skeletal muscle mass index (SMI) was created to reflect SMM. SMM, SMI, and percent body fat (%BF) were calculated with specific indirect population formulas. These estimates were based on age, sex, weight, height, and race. Sarcopenia and sarcopenic obesity were defined with specific cut-offs.The prevalence of sarcopenia ranged from 12.6% (Poland) to 17.5% (India), and that of sarcopenic obesity ranged from 1.3% (India) to 11.0% (Spain). Higher %BF was associated with lower SMM in all countries, and with sarcopenia in five countries (p < 0.001). Compared to high levels of physical activity, low levels were related with higher odds for sarcopenia [OR 1.36 (95%CI 1.11-1.67)] and sarcopenic obesity [OR 1.80 (95%CI 1.23-2.64)] in the overall sample. Also, a dose-dependent association between higher numbers of chronic diseases and sarcopenic obesity was observed.Physical activity and body composition changes such as high %BF are key factors for the prevention of sarcopenia syndrome.

Factors associated with suboptimal adherence to antiretroviral therapy in Viet Nam: a cross-sectional study using audio computer-assisted self-interview (ACASI)
Kato, Masaya; Nguyen, Kinh V; Dunne, Michael P; Pham, Cuong V; Do, Hoa M ( 2013-03-27 )

BACKGROUND: Optimal adherence to antiretroviral therapy (ART) is necessary for people living with HIV/AIDS (PLHIV). There have been relatively few systematic analyses of factors that promote or inhibit adherence to antiretroviral therapy among PLHIV in Asia. This study assessed ART adherence and examined factors associated with suboptimal adherence in northern Viet Nam. METHODS: Data from 615 PLHIV on ART in two urban and three rural outpatient clinics were collected by medical record extraction and from patient interviews using audio computer-assisted self-interview (ACASI). RESULTS: The prevalence of suboptimal adherence was estimated to be 24.9% via a visual analogue scale (VAS) of past-month dose-missing and 29.1% using a modified Adult AIDS Clinical Trial Group scale for on-time dose-taking in the past 4 days. Factors significantly associated with the more conservative VAS score were: depression (p < 0.001), side-effect experiences (p < 0.001), heavy alcohol use (p = 0.001), chance health locus of control (p = 0.003), low perceived quality of information from care providers (p = 0.04) and low social connectedness (p = 0.03). Illicit drug use alone was not significantly associated with suboptimal adherence, but interacted with heavy alcohol use to reduce adherence (p < 0.001). CONCLUSIONS: This is the largest survey of ART adherence yet reported from Asia and the first in a developing country to use the ACASI method in this context. The evidence strongly indicates that ART services in Viet Nam should include screening and treatment for depression, linkage with alcohol and/or drug dependence treatment, and counselling to address the belief that chance or luck determines health outcomes.

Factors associated with suicidal ideation and attempts in Spain for different age groups. Prevalence before and after the onset of the economic crisis
Caballero, Francisco Félix; Miret, Marta; Moneta, María Victoria; Chatterji, Somnath; Ayuso-Mateos, José Luis; Huerta-Ramírez, Raúl; Olaya, Beatriz; Haro, Josep Maria ( 2014-04-01 )

BACKGROUND: Little is known about whether the prevalence of suicidal ideation and attempts has changed in the wake of the economic crisis. The aim of this study was to estimate current prevalence of suicidal ideation and attempts in the general population in Spain, to compare it with the prevalence found before the economic crisis, and to analyse the factors associated with suicidality in different age groups. METHODS: A total of 4583 non-institutionalised adults were interviewed in a cross-sectional household survey of a nationally representative sample in Spain. Several modules of an adapted version of the Composite International Diagnostic Interview were administered to the participants, and logistic regression models were employed in each age group. RESULTS: Lifetime prevalence of suicidal ideation and attempts in Spain were respectively, 3.67% and 1.46%. Mental disorders presented the highest significant effects on lifetime suicidal ideation. Marital status, heavy alcohol consumption, and occupational status were associated with lifetime suicidal ideation in people aged 18-49, whereas loneliness was associated with the 50-64 group, and financial problems with the 65+ group. A younger age, poor health status and the presence of depression were all associated with lifetime suicide attempts. LIMITATIONS: The cross-sectional design of the study represents a methodological limitation. CONCLUSIONS: The current prevalence of suicidal ideation and attempts in Spain is similar to the one found ten years ago, before the recent economic crisis. The factors associated with suicidality vary among age groups. Suicide prevention programmes should focus on early detection and prevention for depression and anxiety disorders.

Factors associated with the decline of the Cooperative Medical System and barefoot doctors in rural China / Naisu Zhu ... [et al.]
Zhu, Naisu; Ling, Zhihua; Shen, Jie; Lane, J. M; Hu, Shanlian ( 1989 )
Factors associated with the spread of dengue fever in Jeddah Governorate, Saudi Arabia
Kholedi, A.A.N.; Balubaid, O.; Milaat, W.; Kabbash, I.A.; Ibrahim, A. ( 2012 )

Dengue fever resurged sharply in Jeddah in 2004 and rose to 1308 cases in 2006. This case-control study determined factors potentiating the spread of the disease to provide an epidemiological baseline to help dengue control. All [650] suspected cases of dengue in Jeddah in 2007 were eligible for inclusion. Cases were those confirmed with dengue by laboratory investigations [n = 244] and controls those confirmed negative [n = 406]. Of these, 129 cases and 240 controls could be contacted and were included in the study. Variables found significant in the bivariate analysis were included in a logistic regression analysis. The presence of stagnant water in indoor drainage holes [OR = 4.9], indoor larvae [OR = 2.2], nearby construction sites [OR = 2.2], and older age [OR = 1.2] were independent determinants of dengue infection [P< 0.01 for all]. Face-to-face health education significantly decreased the risk of dengue infection. Efforts are needed to control the modifiable factors identified in this study with emphasis on health education

Factors associated with the use of prenatal corticosteroids in the management of preterm delivery in Chinese hospitals
Pang, Ru-yan; Ao, Deng; Vogel, Joshua P; Wang, Yan; Gao, Yan-qiu; Kang, Chu-yun; Wang, Xi ( 2014-07-24 )

OBJECTIVE: To assess the prevalence of the use of prenatal corticosteroids (PCS) in the management of preterm delivery and the factors associated with PCS administration. METHODS: A secondary analysis was performed of a cross-sectional study conducted in 21 Chinese healthcare facilities between November 2010 and January 2011. The medical records of women who delivered preterm were reviewed. Associations between PCS administration and individual and organizational-level factors were determined. RESULTS: The study population comprised 659 women who delivered at 20 facilities. PCS were given to 158 (68.1%) of 232 women delivering after 27-34 weeks of pregnancy and 119 (27.9%) of 427 delivering after 35-36 weeks. Teenaged girls were less likely to receive PCS after 27-34 weeks than were women aged 20-35 years (odds ratio [OR] 0.22; 95% confidence interval [CI] 0.07-0.70). Among women who delivered after 35-36 weeks, the odds of receiving PCS were lower in urban hospitals than in periurban or rural hospitals (OR 0.04; 95% CI 0.00-0.44), and there was significant hospital-level variance with regard to the administration of PCS (P<0.05). CONCLUSION: Generally, PCS were underprescribed to women at risk of preterm delivery and many women received the treatment after 35-36 weeks of pregnancy, when it might not have been effective.

Factors associated with timely initiation of breastfeeding in AI-Hassa province, Saudi Arabia
El Gilany, A.H.; Sarraf, B,; Al Wehady, A. ( 2012 )

The World Health Organization recommends early initiation of breastfeeding [within 1 hour of giving birth]. This study assessed the prevalence of timely initiation of breastfeeding by mothers of neonates in AI-Hassa province, Saudi Arabia. Mothers attendingfor birth registration at primary health care centres were interviewed and various sociodemographic, obstetric and health service related variables as well as breast problems were assessed for any influence on timely breastfeeding rates. While 91.9% of the 906 neonates studied were breastfed [8.1% were never breastfed], only 11.4% were given timely breastfeeding [within 1 hour after birth]. Logistic regression revealed that the independent predictors of timely breastfeeding were: not giving prelacteal feed [OR 13.7], rura\\\\/hegar residence [OR 4.2], absence of breast problems [OR3.4], parity 2 or 3 [OR2.9] and parity 4+ [OR 2.4]. Mothers at risk of delayed breastfeeding initiation should be the target of breastfeeding promotion during prenatal care

Factors associated with treatment default by tuberculosis patients in Fez, Morocco
Slama, K.; Tachfouti, N.; Obtel, M.; Nejjari, C. ( 2013 )

Interruption in tuberculosis [TB] treatment still remains the most important challenge for control of the disease. This study aimed to identify the determinants of TB treatment default in Fez, Morocco. A 1:2 pair-matched case-control study was carried out in the TB control units in Fez. Cases were defaulters to TB treatment and were matched by age and sex to non-defaulters [controls]. Of the 320 patients [108 defaulters, 212 controls], 80.6% were male. The main reason for defaulting reported by patients was the sensation of being cured. Predictive factors for treatment default in the multivariate conditional logistic regression analysis, were: relapsed case [adjusted OR = 4.49; 95% CI: 1.87-10.8], current smoking [aOR = 2.10; 95% CI: 1.07-4.14], alcohol use [aOR = 2.92; 95% CI: 1.04-8.19], being more than 30 minutes away from the health centre [aOR = 3.34; 95% CI: 1.06-10.5] and perception of having received insufficient explanation about the disease [aOR = 2.87; 95% CI: 1.53-5.36]. The rate of defaulting in Fez can be lowered through targeted and realistic measures

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