Home About us Contact
|
Home About us Contact | ||
|
|
||
Lower SES (lower + se)
Selected AbstractsClinical and socio-demographic profile of an Australian multi-institutional prostate cancer cohortASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 4 2009Kerri BECKMANN Abstract Aims: To describe the clinical and socio-demographic data from a South Australian prostate cancer cohort (PCCOD). Methods: Clinical data for 2329 prostate cancer patients treated at three South Australian teaching hospitals between 1998 and 2007 were analyzed by place of residence, time of diagnosis and socioeconomic status (SES). ,2 tests were used to investigate differences in stage, grade and prostate-specific antigen (PSA) at diagnosis, among subgroups and over time. Logistic regression was used to examine predictors of treatment modalities. Five-year survival was assessed using Kaplan,Meier methods. Results: The distributions of age, SES and place of residence of PCCOD patients closely reflected those of the state-based prostate cancer population, with rural patients slightly underrepresented. Lower SES or rural residence was not associated with higher stage, grade, PSA level or disease-specific survival. Treatment modalities varied with SES (for radical prostatectomy), rural residence (radical prostatectomy, radiotherapy and androgen ablation), age and clinical characteristics. There was a trend over time towards a younger age at diagnosis and more favorable clinical profiles, consistent with earlier diagnosis. However, the current risk profile for this cohort is similar to that reported approximately a decade earlier in a US series. Conclusion: PCCOD patients have a broadly similar socio-demographic profile to prostate cancer patients statewide. Socioeconomic status is not associated with clinical characteristics at diagnosis, but does predict treatment type. The clinical characteristics of the cohort are consistent with a much later stage presentation than reported in current US case series. [source] Cross-cultural differences in the macronutrient intakes of women with anorexia nervosa in Australia and SingaporeEUROPEAN EATING DISORDERS REVIEW, Issue 6 2008Nerissa Li-Wey Soh Abstract Aim To compare the macronutrient intakes of women with and without anorexia nervosa (AN) across cultures. Method Participants were women with AN (n,=,39) and without AN (n,=,89) of North European and East Asian backgrounds recruited in Australia and Singapore. Energy and the percentage energy contributed by protein (%protein), fat (%fat) and carbohydrate (%CHO) were assessed from participant's diet histories and analysed in terms of cultural group, acculturation, socio-economic status (SES) and education level. Results AN status was associated with lower energy and higher %CHO. Greater %protein was associated with greater acculturation to Western culture and lower SES, but not AN. Greater %fat was associated with lower SES and lower acculturation in women with AN, but with higher acculturation in controls. Greater %CHO was also associated with higher SES. Conclusion The findings may represent Western diets' higher protein and fat contents, ,Western' knowledge of weight-loss diets, and affordability of low fat foods. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Can a publicly funded home care system successfully allocate service based on perceived need rather than socioeconomic status?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2007A Canadian experience Abstract The present quantitative study evaluates the degree to which socioeconomic status (SES), as opposed to perceived need, determines utilisation of publicly funded home care in Ontario, Canada. The Registered Persons Data Base of the Ontario Health Insurance Plan was used to identify the age, sex and place of residence for all Ontarians who had coverage for the complete calendar year 1998. Utilisation was characterised in two dimensions: (1) propensity , the probability that an individual received service, which was estimated using a multinomial logit equation; and (2) intensity , the amount of service received, conditional on receipt. Short- and long-term service intensity were modelled separately using ordinary least squares regression. Age, sex and co-morbidity were the best predictors (P < 0.0001) of whether or not an individual received publicly funded home care as well as how much care was received, with sicker individuals having increased utilisation. The propensity and intensity of service receipt increased with lower SES (P < 0.0001), and decreased with the proportion of recent immigrants in the region (P < 0.0001), after controlling for age, sex and co-morbidity. Although the allocation of publicly funded home care service was primarily based on perceived need rather than ability to pay, barriers to utilisation for those from areas with a high proportion of recent immigrants were identified. Future research is needed to assess whether the current mix and level of publicly funded resources are indeed sufficient to offset the added costs associated with the provision of high-quality home care. [source] County-Level Income Inequality and Depression among Older AmericansHEALTH SERVICES RESEARCH, Issue 6p2 2003Naoko Muramatsu Objectives. To examine (1) whether county-level income inequality is associated with depression among Americans aged 70 and older, taking into consideration county-level mean household income and individual-level socioeconomic status (SES), demographic characteristics, and physical health, and (2) whether income inequality effects are stronger among people with lower SES and physical health. Data Sources. The individual-level data from the first wave of the Assets and Health Dynamics among the Oldest Old survey (1993,1994) were linked with the county-level income inequality and mean household income data from the 1990 Census. Study Design. Multilevel analysis was conducted to examine the association between income inequality (the Gini coefficient) and depression. Principal Findings. Income inequality was significantly associated with depression among older Americans. Those living in counties with higher income inequality were more depressed, independent of their demographic characteristics, SES, and physical health. The association was stronger among those with more illnesses. Conclusions. While previous empirical research on income inequality and physical health is equivocal, evidence for income inequality effects on mental health seems to be strong. [source] Assessing Future Possible Selves by Gender and Socioeconomic Status Using the Anticipated Life History MeasureJOURNAL OF PERSONALITY, Issue 1 2001Harry G. Segal This is a report from the first phase of a longitudinal study of the ways young adults imagine their future lives. The future possible selves of 223 18- and 19-year-old adults were examined using the Anticipated Life History measure (ALH), a psychological instrument prompting participants to describe their future life course from their 21st birthday until their death. When the ALH narratives were coded for presence/absence of life events, female participants were more likely to predict career choice, marriage, children, divorce, and death of spouse than their male counterparts; when coded for psychological qualities, female participants demonstrated greater psychological complexity and awareness of future life role choices and conflicts. Participants with lower SES wrote ALH narratives with fewer altruistic acts, less awareness of life role complexity, and fewer anticipated conflicts and their resolutions than those with higher SES. [source] Measuring Children's Self-Efficacy and Proxy Efficacy Related to Fruit and Vegetable ConsumptionJOURNAL OF SCHOOL HEALTH, Issue 2 2009Karly S. Geller MEd ABSTRACT BACKGROUND:, Social cognitive theory describes self-efficacy and proxy efficacy as influences on fruit and vegetable consumption (FVC). Proxy efficacy was defined as a child's confidence in his or her skills and abilities to get others to act in one's interests to provide fruit and vegetable (FV) opportunities. The purpose of this study was to develop a scale assessing children's self-efficacy and proxy efficacy for FVC at after-school programs and at home. METHODS:, Elementary-aged children (n = 184) attending 7 after-school programs completed a self-efficacy questionnaire relevant to FVC. Questionnaire validity was investigated with exploratory factor analysis and mixed-model analysis of covariance. Internal consistency reliability and readability were also assessed. RESULTS:, The questionnaire assessed 4 constructs: self-efficacy expectations for fruit consumption, self-efficacy expectations for vegetable consumption, proxy efficacy to influence parents to make FV available, and proxy efficacy to influence after-school staff to make FV available. Children perceiving FV opportunities in after-school had greater self-efficacy expectations for FVC and greater proxy efficacy to influence after-school staff compared to students who did not perceive FV opportunities. Children attending schools of higher socioeconomic status (SES) and less diversity were more confident they could influence their parents to make FV available than students attending lower SES and less diverse schools. Adequate internal consistency and test-retest reliabilities were established. CONCLUSIONS:, Self-efficacy is a multicomponent construct that can be assessed in children using the reliable and valid instrument evaluated by the current study. [source] Health-risk behaviours: examining social disparities in the occurrence of stillbirthPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2008Jennifer Goy Summary While an association between low socio-economic status (SES) and increased risk of stillbirth has been observed consistently over several decades, the pathways through which SES exerts these effects have not been established. Given that some key health-risk behaviours for stillbirth, including smoking and pre-pregnancy obesity, have strong relationships with SES, health-risk behaviours may serve as a channel through which low SES contributes to stillbirth outcomes. The objective of this study was to estimate the proportion of the relationship between low SES and the occurrence of stillbirth that is explained by health-risk behaviours in populations of Eastern Ontario and Nova Scotia (112 stillbirth cases and 398 controls). Both area and individual level influences of SES were assessed. The study population consisted of 112 cases (women delivering stillborn infants) and 398 controls. Odds ratios and 95% confidence intervals estimated by multivariable logistic regression were used to approximate relative risks. The contribution of health-risk behaviours to relationships between SES and stillbirth was assessed by a change in the relative risk estimate following omission of each health-risk behaviour from the model. Of the three measures of individual level SES examined (household income, education, Blishen occupational index), only household income was a statistically significant predictor of stillbirth. After controlling for individual level SES, no community level SES effects were observed for stillbirth. Adjustments for key health-risk behaviours (smoking) resulted in an 18.5% reduction in the odds ratio estimate for low SES, from 3.31 to 2.79. This large unexplained SES effect that remained highlights the need for research into other potential pathways that may account for increased risk of stillbirth among those of lower SES. [source] Socioeconomic Status in the Treatment of DepressionAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2009Lydia Falconnier PhD This study examined outcomes and attrition across three treatments for depression in relation to socioeconomic status (SES). The study was based on data available from the Treatment of Depression Collaborative Research Program (TDCRP) of the National Institute of Mental Health (NIMH; Elkin, 1994), a multisite collaborative study that examined the effectiveness of two forms of psychotherapy, cognitive behavior therapy and interpersonal psychotherapy, and pharmacotherapy. Results indicated that lower SES, measured by the Hollingshead Index of Social Position, was associated with less improvement across all three treatments for depression. The effect of SES on outcome did not differ by treatment modality. Contrary to expectations, SES was not associated with attrition. These findings suggest that there may be limitations in the use of these empirically validated treatments with lower SES depressed patients, as their improvement rates may be less than those of middle SES depressed patients treated by the same modalities. The results of this study also suggest that a standardized measure of SES may be more sensitive to SES differences in outcome than the more easily obtained measures of education or income. Suggestions are provided for additional research in this area to address the potential mediators and moderators of the association between SES and outcome. [source] Relatedness of identities and emotional closeness with parents across and within culturesASIAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 3 2007E. Olcay Imamo Differences in emotional- and identity-relatedness with parents were explored across two cultural groups (863 university students from the USA and Turkey, representing individualist and collectivist societies, respectively) in Study 1, and across two socioeconomic status (SES) groups (353 high school students from the upper and lower SES in Turkey) in Study 2. In both studies, within-cultural differences in emotional- and identity-relatedness with parents were also explored in terms of: (i) self-directed and other-directed value orientations; and (ii) self-types, as suggested by the Balanced Integration-Differentiation Model. Results indicated cultural groups to be quite similar in emotional-relatedness, but to differ in relatedness of identities, with Turks reporting more related identities. Similarly, in Turkey, SES seemed to have more impact on identities than on emotional closeness, the lower SES adolescents reporting more relatedness with parents than upper SES adolescents. Thus, relatedness of identities appeared to be more important than emotional relatedness in differentiating between cultural and SES contexts. Results involving different self-types and value orientations pointed to both cross-cultural similarities and within-cultural diversity in the two domains of relatedness. Theoretical implications of cross- and within-culture differences in emotional- and identity-relatedness with parents are discussed. [source] Socio-economic gradients in self-reported diabetes for Indigenous and non-Indigenous Australians aged 18,64AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Joan Cunningham Abstract Objective: To examine and compare socio-economic gradients in diabetes among Indigenous and non-Indigenous Australians. Methods: I analysed weighted data on self-reported diabetes and a range of socio-economic status (SES) measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18,64 years from two nationally representative surveys conducted in parallel by the Australian Bureau of Statistics in 2004,05. Results: After adjusting for age, diabetes prevalence was significantly higher among those of lower SES in both Indigenous and non-Indigenous populations. The age- and sex-adjusted odds ratios (OR) for diabetes for the lowest versus the highest SES group were similar for the two populations on many variables. For example, the OR for the lowest quintile of equivalised household income (compared with quintiles 3,5 combined) was 2.3 (95% CI 1.6,3.4) for the Indigenous population and 2.0 (95% CI 1.5,2.8) for the non-Indigenous population. However, Indigenous people of high SES had greater diabetes prevalence than low SES non-Indigenous people on every SES measure examined. Conclusion: Socio-economic status explains some but not all of the difference in diabetes prevalence between Indigenous and non-Indigenous Australians. Other factors that may operate across the socio-economic spectrum, such as racism, stress, loss and grief, may also be relevant and warrant further examination. Implications: Indigenous Australians do not constitute a homogeneous group with respect to socio-economic status or diabetes prevalence, and this diversity must be recognised in developing measures to redress Indigenous health disadvantage. [source] Health-related quality of life and psychosocial factors in patients with prostate cancer scheduled for radical prostatectomy or external radiation therapyBJU INTERNATIONAL, Issue 3 2003G. Van Andel OBJECTIVE To assess whether baseline health-related quality of life (HRQOL) and psychosocial profiles differ in patients with prostate cancer scheduled for radical prostatectomy (RP) or external radiation therapy (ERT), as there is evidence that HRQOL is influenced by psychosocial factors (PFs), so that any variation at baseline should be considered when comparing the effect of therapy on HRQOL. PATIENTS AND METHODS Before receiving therapy, HRQOL and PFs were assessed in 65 patients scheduled for RP and in 73 scheduled for ERT. To measure HRQOL (generic and disease-specific) and PFs, an extended questionnaire was constructed, using validated and standardized instruments. Clinical data were collected from patients' medical records. Comparisons adjusted for age and socio-economic status (SES) were analysed using Student's t -test and univariate analyses of variance and covariance. RESULTS Patients scheduled for ERT were 7.9 years older and had a lower SES (both P < 0.001), more often had stage T3 and T4 disease, had poorer histopathological differentiation and higher levels of prostate-specific antigen (all P < 0.01). They also reported a worse physical, role, cognitive and social function, more fatigue, more pain, a lower overall HRQOL and worse sexual function than patients scheduled for RP. There were no differences in urinary and bowel function, nor in the PFs assessed. CONCLUSION The baseline HRQOL profile of patients scheduled for RP is better than in those scheduled for ERT. These results are in line with those from the few other studies on this subject. Knowing the impact of RP and ERT on HRQOL should therefore be based mainly on longitudinal studies including baseline measures, the analyses of which should be adjusted for age and SES. In the present small study, baseline PFs did not differ between the treatments. [source] Helicobacter pylori infection in children: population-based age-specific prevalence and risk factors in a developing countryACTA PAEDIATRICA, Issue 2 2010W Jafri Abstract Aim:, We estimated the prevalence, age of acquisition and risk factors for Helicobacter pylori (H. pylori) seroprevalence in children aged 1,15 years. Methods:, Exposure was assessed using ELISA. Parents responded to a questionnaire regarding number of individuals sharing house, rooms, water source, latrines, housing and assessment of socioeconomic status (SES) by Hollingshead Index. Results:, Serum of 1976 children was tested. Helicobacter pylori seropositivity in children aged 11,15 years was 53.5% (OR: 2.0, 95% CI: 1.58,2.5). It increased with moderate crowding index (CRI) of 2,4 to 45.9% (OR: 1.23, 95% CI: 0.92,1.63) and to 51.2% with CRI >4 (OR: 1.52, 95% CI: 1.12,2.06). In middle SES, seropositivity was 50.5% (331/655) (OR: 1.7, 95% CI: 1.29,2.35), whereas in lower SES, it was 47.1% (500/1062) (OR: 1.5, 95% CI: 1.1,2.0). Multivariate analysis showed that Helicobacter pylori seroprevalence was high in children aged 6,10 and 11,15 years (OR: 1.5, 95% CI: 1.2,1.9 and OR: 1.9, 95% CI: 1.56,2.47 respectively), in lower-middle SES (OR: 1.6, 95% CI: 1.2,2.1 and OR: 1.5, 95% CI: 1.10,2.0 respectively) and in uneducated fathers (OR: 1.58, 95% CI: 1.27,1.95). Conclusion:,Helicobacter pylori seropositivity increases with age, in low-middle SES and is related to father's educational status. Reducing H. pylori seroprevalence will require improvement in sanitary conditions and educational status of the population. [source] | |||||||||||||