Changes in Height and Body Weight Within a Time Period of 35 Years in Males of the Same Age / Cambios en la Altura y el Peso Corporal en un Período de 35 Años en Hombres de la Misma Edad

SUMMARY: Height and body weight measurements are among the most important anthropometric variables when assessing a population's growth, development and body composition. This study aimed to evaluate the height and body weight variability of male entities aged 17-18 years within 35 years. This goal was realized by comparing the height and body weight of the population of the same gender and age in three different time studies. The descriptive statistical parameters and T-test for independent groups show systematic and significant differences in measured variables between three measurements in different timelines. Both in body height and body weight, from measurement to measurement, significant systematic and statistically significant differences (p<0.01) have been identified (1985: BH= 172.8cm, BW= 61.7kg; 2004: BH=176.8 cm, BW=66.9 kg; 2019: BH=178.5 cm, BW=72 kg). The results of this study prove that the change in the socio-economic status of a population over a period time of 35 years can significantly affect the growth and development of children/adolescents.

Las medidas de altura y peso corporal se encuentran entre las variables antropométricas más importantes a la hora de evaluar el crecimiento, el desarrollo y la composición corporal de una población. Este estudio tuvo como objetivo evaluar la variabilidad de la altura y el peso corporal de entidades masculinas de 17 a 18 años dentro de 35 años. Este objetivo se logró comparando la altura y el peso corporal de la población del mismo sexo y edad en tres estudios temporales diferentes. Los parámetros estadísticos descriptivos y la prueba T para grupos independientes muestran diferencias sistemáticas y significativas en las variables medidas entre tres mediciones en diferentes líneas de tiempo. Tanto en la altura como en el peso corporal, de medición en medición, se han identificado diferencias significativas sistemáticas y estadísticamente significativas (p<0,01) (1985: BH= 172,8 cm, BW= 61,7 kg; 2004: BH=176,8 cm, BW=66,9 kg; 2019: BH=178,5 cm, BW=72 kg). Los resultados de este estudio demuestran que el cambio en el estatus socioeconómico de una población durante un período de 35 años puede afectar significativamente el crecimiento y desarrollo de niños/ adolescentes.

Measuring categorisation in pre-school children: new toolkit, new insights

Introduction: whilst recent years have witnessed considerable research into infant categorisation, its development during the pre-school period has garnered far less interest and innovation. Objective: this paper documents the development of a valid and reliable new toolkit for measuring categorisation in children, designed to allow fine-grained differentiation through four short tasks. Methods: the paper outlines how a pilot study with 55 children reduced confounding variables, ruled out several explanations for performance variations and enabled procedural refinements. It then documents a study conducted with 190 children aged 30-60 months. Results: this more sophisticated testing mechanism challenges previously accepted developmental norms and suggests both sex and socio-economic status (and their interaction) influence categorisational abilities in pre-schoolers. Conclusion: the results indicate that preschool children's ability to categorise varies markedly, with implications for their capacity to access formal education.

Introdução: embora nos últimos anos tenha havido pesquisas consideráveis sobre a categorização infantil, seu desenvolvimento durante o período pré-escolar atraiu muito menos interesse e inovação. Objetivo: este artigo documenta o desenvolvimento de um novo kit de ferramentas válido e confiável para medir a categorização em crianças, projetado para permitir diferenciação refinada por meio de quatro tarefas curtas. Método: o artigo descreve como um estudo piloto com 55 crianças reduziu variáveis de confusão, descartou várias explicações para variações de desempenho e permitiu refinamentos de procedimentos. Em seguida, documenta um estudo realizado com 190 crianças de 30 a 60 meses. Resultados: este mecanismo de teste mais sofisticado desafia as normas de desenvolvimento previamente aceitas e sugere que o sexo e o status socioeconômico (e sua interação) influenciam as habilidades de categorização em pré-escolares. Conclusão: os resultados indicam que a capacidade de categorização dos pré-escolares varia acentuadamente, com implicações na sua capacidade de acesso à educação forma

Pharmacoeconomics study of rosuvastatin single daily dose versus alternate day dosing in hyperlipidemia patients

Background: In country like India, therapy with rosuvastatin recommended dose may cost between Rs. 400.00 and Rs. 800.00/month. The lower and middle income groups of Indian society are rapidly becoming major sufferers of cardiovascular disease, among all non-communicable diseases, the economic burden of rosuvastatin therapy may be substantial for this large section of population. Aims and Objectives: The aim of the study was to study the cost-effectiveness of rosuvastatin on alternate day versus daily dosing regimen in hyperlipidemia patients. Materials and Methods: The research was carried out at MNR Medical College and Hospital’s department of pharmacology in association with general medicine. According to the inclusion criteria, 50 patients aged 30–60 years of both sexes were included in this prospective open label trial. The research lasted 6 weeks. All the participants were included in study after obtaining the informed consent and approval of the Institutional Ethics Committee was obtained before enrolment of participants. All patient data were obtained using a pre-designed proforma and put into an excel spreadsheet. Results: A total of 42 patients are included with 16 females (38%) and 26 men (62%). Cost of daily rosuvastatin for 6 weeks is Rs. 1087.80 (yearly daily dosing expenses 9453.50%) accounting for mean reduction of LDL-cholesterol (LDL-C) of 33.50% and for alternate day rosuvastatin for 6 weeks is 543.90% (yearly alternate day dosing expense 4713.80%) accounting for mean reduction of LDL-C of 31%. Conclusion: Treatment with alternate day dose of rosuvastatin is comparably cost-effective when compared to currently practicing daily dose rosuvastatin therapy.

Reproductive Tract Infection : Challenges to Health Policy and Education, Research and Impact on the Socio-economic Situation of Indians

Background : Reproductive Tract Infection (RTI) due to poor hygiene caused by faecal Bacteria or viruses which goes into the vaginal canal during and after defecation is not only damaging to the reproductive organ, but also causes indirect or direct impact on Socio-economic status of the patient and their family as well. Objective : This study highlights the importance of faecal hygiene in preventing damage to the reproductive tract and curbing the impact on social and economic problems in patients and their families. Materials and Methods : This study was conducted at GICE Nursing Home, Kalyani, Nadia, WB, between April 2016 and March, 2022. During this period, 11,872 cases were reported at GICE Nursing Home of which 10,000 cases were selected. Discussion : It was interesting to observe that those who wipe from back to front or vice versa are more likely suffering from Vaginitis (85%), Cervicitis (92%), Endometritis (55%), PID (60%), UTI (70%) and Tubal Block (17%) as compared to those who used Hand shower (10%) or Tissue Paper (9%). This is an indication that proper faecal hygiene can prevent damage to the reproductive system. Further analysis revealed that the inability to pay for medical expenses created a Socio-economic crisis among family members. Conclusion : It is concluded from this study that maintenance of proper faecal hygiene by women in Rural, Urban and Industrial areas, can not only help with prolonged illnesses but also prevent financial losses. As a result, Guardians, Teachers, Health Care Providers and Local Government should conduct outreach programs to teach the importance of faecal hygiene at home, in Schools, Colleges, Public health institutions and so on, etc

Socio-economic and Psychological Correlates of Postpartum Depression at Six Months

Background : A woman undergoes multiple changes physically and emotionally after childbirth. Mothers also experience emotional changes with a new or additional baby related to breastfeeding demands, problems pertaining to maternal dissonance, childcare stress and difficult infant temperament. Materials and Methods : Overall, 100 women out of 178 women who attended obstetrics and Gynaecology department postpartum in our hospital were selected. Socio-economic factors, psychiatric and maternity characteristics were collected using a standard questionnaire. The main outcome of this study was PPD assessed by Edinburgh postpartum depression scale was used to assess the chief outcome of the study, ie, Postpartum Depression. EPDRS scale consisted of 10 questions that has 4 response scored from 0 to 3, so the highest value shows depressed moods. Results : Final results are of 100 postpartum females with age ranging between 18 and 30 years with a mean value 26.5 years � 4.05, 21.3% dwelling in Urban areas and 15.4% having high education. About 2.1% of study participants had postpartum only Depression, 15.3% had only anxiety alone and 23.2% study participant had both. When we look at severity, 8.8%, 10.6%, 2.9%, and 0.4% suffered from Mild, Moderate, Severe and extremely severe Postpartum Depression, respectively. 14.2%, 9.2%, 6.9% and 3.9% suffered mild, moderate, severe, and extremely severe Postpartum anxiety, respectively. Conclusion : Around 23% female patients in our hospital suffer from Postpartum Depression and/or anxiety. Very low Socio-economic levels, past history of Depression and Anxiety, mothers� education and occupation levels, family support during pregnancy, mothers� stress levels are important predictors.

A Community Based Cross-Sectional Study to Assess the Socio-Economic and Health Status of Rag Pickers in Varanasi slums, North India

Background- Rag picking is one of the inferior economic activities in the urban informal sector, largely undertaken by children belonging to weaker sections of society for their survival and for supplementing their family income. Rag picking is one of the most dangerous activities in India. Rag pickers are working in a filthy environment surrounded by dust, dogs, and pigs. They suffer from many diseases, such as respiratory problems, anemia, fever, and other problems which include cuts, rashes, and injuries. Waste pickers are the general term adopted by the 1 st World Conference of Waste Pickers in 2008. Objective- [a] To assess the socio-economic condition of ragpickers in Varanasi, [b] To know the health condition and treatment behavior of ragpickers in Varanasi. Materials and Methods- A community-based descriptive cross-sectional study in which ragpickers reside in the slum area of Varanasi. All men and women present at the time of the interview who were involved in rag picking from the last 6 months were included. Seriously ill men and women were excluded. Since we had no prior knowledge about the proportion of cases (P) so a pilot study was conducted in which prevalence of health problem found in rag pickers in the last 6 months (P) = 0.90. Total estimated sample size is 100. In this study, Simple Random sampling was used. By using this sampling 100 individuals were selected randomly, fulfilling the inclusion criteria. Results-82 (82.0%) rag pickers were not educated in which 75 (91.5%) rag pickers suffered from health problems. Maximum 74 (74.0 %) rag pickers were migrants. Maximum 74 (74.0%) rag pickers were married in which 36 (48.0 %) rag pickers were married between 14- 18 ages. 80 (80.0%) rag pickers had not used any precautionary measure during rag picking in which 73 (91.2%) rag pickers faced health problems. Maximum 39(39.0%) were affected by dust during rag picking. Only 17(17%) ragpickers preferred government hospitals for treatment. 75 (75.0 %) rag pickers were addicted to intoxication in which 66 (88.0%) rag pickers faced health problems. 91 (91%) ragpickers affected by any health problems in the last 6 months in which a maximum of 63.7% of rag pickers suffered from fever, 60.4% of rag pickers complained about injuries, 56.2 % of rag pickers suffered from weakness problems, 52.7% of rag pickers affected by cough problems. There is a highly significance between educational status and any kind of intoxication. Discussion- The literacy level among the rag pickers was 18% which is much lower than the average literacy rate of Varanasi 75.60% (2011census). A study on slum dwellers in Dhaka showed the literacy rate higher than the finding of this study (18 vs 25 %). 28.0% of rag pickers adopted this work because they had no education. There is a high significance between educational status and any kind of intoxication. Chances of intoxication are high when no education among rag pickers. It is highly significant between educational status and health problems of rag pickers in the last 6 months. Uneducated rag pickers were not aware of the health effects.

Social determinants of diabetic retinopathy and impact of sight-threatening diabetic retinopathy: A study from Pune, India

Purpose: Diabetes?related retinopathy is the leading cause of blindness in India. The study was carried out with the purpose of studying the association of sight?threatening diabetic retinopathy (STDR) with socioeconomic factors and demonstrating the impact of STDR on the affected individual. Methods: A mixed methods (quantitative and qualitative) research design was used. The study participants were divided into two groups for quantitative analysis. The control group consisted of non–sight?threatening diabetic retinopathy, whereas the study group consisted of sight?threatening diabetic retinopathy. Apart from demographics, data on comorbidities, type and duration of diabetes mellitus (DM), health insurance status, and socioeconomic data were collected from each individual. A statistical test (Chi?square) was performed to study the association between socioeconomic (SE) classes and STDR. For the qualitative part, a few people were chosen. Face?to?face interviews were conducted in depth. Results: A total of 207 individuals, were recruited, of which 69 had STDR and the remaining 138 had non?STDR. The incidence of STDR was high among patients with lower socioeconomic class (SEC) (upper lower and lower), and univariate analysis revealed a strong association between STDR and SEC, the presence of comorbidities, presence of health insurance, type and duration of DM, and P value <0.05. SEC, in contrast, emerged as an independent risk factor for STDR in multivariate analysis. STDR had a devastating effect on all patients interviewed. The financial impact was most likely the most severe. Conclusion: People with lower SEC are more likely to suffer from STDR?related vision loss. The impact of such vision loss on individuals is multifaceted, including a negative impact on social and work life, psychological well?being, and, most importantly, a significant financial impact.

Socio-Economic Status As An Associate Of Emotional Competence Of Secondary School Students

The study aims to find out the association between socio-economic status (SES) of the family and emotional competence (EC) of secondary school students by taking the construct as a whole and in terms of of its component factors. The cross- sectional study collected data from a stratified random sample of 866 students from the secondary schools of Ernakulam and Thrissur districts (Kerala, India), representing the population of adolescents in the age range 13-15, studying in the secondary classes (Std. VIII to X) of schools affiliated to the Board of Public Examinations, Govt. of Kerala. Data were collected by administering the Emotional Competence Scale for Secondary School Pupils (Rekha & Salim Kumar, 2015) and the Socio-Economic Status Scale (Usha & Vijayan, 2014). Chi-square test of association was employed to analyse the data inferentially. The result revealed the presence of significant association between SES of the family and emotional competence in total and two of the constituent factors of EC, viz., self-awareness and relationship management

How did South Africans with disabilities experience COVID-19? Results of an online survey

Background: People with disabilities are a large, disadvantaged minority, comprising approximately 12% of the population. The South African government has ratified international and regional disability treaties but deals with disability rights within general anti-discrimination legislation. There are no specific frameworks to monitor justice for people with disabilities. The study aims to inform further development of disability inclusive mechanisms relating to crises including pandemics. Objectives: This study explored the perceptions of South Africans with disabilities, to understand their experiences during coronavirus disease 2019 (COVID-19), focussing on socioeconomic, well-being and human rights aspects. Method: An online survey tool generated quantitative and qualitative data. Widespread publicity and broad recruitment were achieved through project partners networks. Participants responded via mobile phone and/or online platforms. Results: Nearly 2000 people responded, representing different genders, impairments, races, socio-economic status, education and ages. Findings include: (1) negative economic and emotional impacts, (2) a lack of inclusive and accessible information, (3) reduced access to services, (4) uncertainty about government and non-government agencies' support and (5) exacerbation of pre-existing disadvantages. These findings echo international predictions of COVID-19 disproportionally impacting people with disabilities. Conclusion: The evidence reveals that people with disabilities in South Africa experienced many negative impacts of the pandemic. Strategies to control the virus largely ignored attending to human rights and socioeconomic well-being of this marginalised group. Contribution: The evidence will inform the development of the national monitoring framework, recognised by the South African Government and emphasised by the United Nations as necessary to ensure the realisation of the rights of people with disabilities during future crises including pandemics.

Prevalence of Periodontitis and its Association with Smokeless Tobacco (SLT) Use amongst the Adult Population of Greater Noida, India - A Cross-Sectional Study

Context: Smokeless tobacco (SLT) has been consumed in India since times immemorial. It is the need of an hour to emphasise about awareness and harmful effects of SLT in relation to periodontium. Aim: The aim of the study was to access the prevalence of periodontitis and its association with SLT amongst the adult population of Greater Noida, India. Settings and Design: Hospital?based study and cross?sectional design. Methods and Material: This cross?sectional study included 512 SLT subjects between the ages of 18 and 79 years. The study was carried out from December 2019 to January 2022. A self?designed questionnaire was used for recording demographic details, forms of SLT, frequency, duration of use, and sites of retention of SLT products. The clinical periodontal parameters such as periodontal pocket depth (PPD) and clinical attachment level (CAL) were recorded in a given point of time. Statistical Analysis Used: Chi?square test and logistic regression analysis. Results: The prevalence of periodontitis among SLT was 81.6% with the highest occurrence of Stage III Periodontitis (35.4%). The use of SLT for ?10 years [odds ratio (OR) = 3.05, 95% confidence interval (CI) 1.86–6.27] showed threefold the risk for periodontitis compared to others who consumed SLT for 4–5 years. Gutkha consumers [OR = 2.56 (95% CI = 0.75–3.48)] were 2.56 times more prone to have periodontitis as compared to other forms of SLT. Conclusions: Periodontitis is positively associated with SLT use. Awareness, timely intervention, and periodic screening in the SLT users will help to prevent the progression of periodontitis.

A STUDY ON PROBLEMS OF STREET WOMEN FISH VENDORS IN KANYAKUMARI DISTRICT

This article is an attempt to describe problem of women street Fish vendors in kanyakumari district. This study explore the various problems related women street fish vendors such as socio economic condition like low income level, This analysis based on collect information through primary and secondary data. Women fish vendors play a major role in between the fisherman and consumers. Selling fish is a form of occupation and it is livelihood of large number of population in many places. Women street fish vendors were found to many problems and there is no significant differences between the marital position and problems between the women street fish vendors.

Niveles de actividad física en población adulta del municipio Pereira, Colombia / Levels of physical activity in the adult population of the municipality of Pereira, Colombia

Introducción: En la calidad de vida tiene una fuerte influencia los estilos de vida. A su vez, la inactividad física es uno de los estilos de vida más perjudiciales que genera discapacidad y años de vida perdidos, debido a su papel en la génesis y exacerbación de las enfermedades crónicas no transmisibles. Objetivo: Determinar los niveles de actividad física y factores asociados en la población adulta del municipio Pereira. Métodos: Estudio transversal analítico. Se estimó una muestra de 1000 participantes entre las edades de 18 a 64 años. Los niveles de actividad física se midieron con el cuestionario internacional de actividad física versión larga. Se realizaron análisis bivariados. Resultados: El total de participantes fue de 996. La prevalencia global del cumplimiento de recomendaciones en actividad física del estudio fue de un 52,9 por ciento, en la que prevaleció el dominio de actividad física moderada. Los sujetos de mayor nivel socioeconómico obtuvieron menores prevalencias de actividad física. En cuanto a nivel de escolaridad, las categorías de tecnólogo (58 por ciento) y secundaria (57 por ciento) alcanzaron la más alta prevalencia de cumplimiento de recomendaciones mínimas. Conclusiones: Un poco más de la mitad de la población adulta pereirana cumple las recomendaciones mínimas de actividad física predominando la actividad de intensidad moderada, no obstante, la media presenta problemas de sobrepeso y obesidad. Es importante promover la práctica de actividad física de moderada a alta intensidad e involucrar a todos los estratos socioeconómicos(AU)

Introduction: Lifestyles have a strong influence on quality of life. In turn, physical inactivity is one of the most harmful lifestyles that generates disability and lost years of life, due to its role in the genesis and exacerbation of chronic non-communicable diseases. Objective: To determine the levels of physical activity and associated factors in the adult population of Pereira municipality. Methods: Analytical cross-sectional study. It was estimated a sample of 1000 participants in the ages from 18 to 64. Physical activity levels were measured with the long version of the international questionnaire of physical activity. Bivariate analyses were performed. Results: The total number of participants was 996. The overall prevalence of compliance with recommendations in physical activity of the study was 52.9 percent, in which the domain of moderate physical activity prevailed. Subjects of higher socio-economic status obtained lower prevalences of physical activity. In terms of schooling level, the categories of technologist (58 percent) and secondary school level (57 percent) reached the highest prevalence of compliance with minimum recommendations. Conclusions: A little more than half of the adult population of Pereira meets the minimum recommendations for physical activity, predominating moderate intensity activity; however, the average presents problems of overweight and obesity. It is important to promote the practice of moderate to high intensity physical activity and involve all socio-economic strata(AU)

Determinants of Reproductive Tract Infection among married women in rural and peri-urban areas of Aligarh: A cross sectional Study

Background: Reproductive Tract Infections (RTI) have a direct impact on reproductive and child health through infertility, cancers, and pregnancy complications, and they have an indirect impact through their role in facilitating the sexual transmission of the human immunodeficiency virus. Objectives: To find the prevalence and determinants of RTI/STI among married women of reproductive age group in rural and peri-urban areas of Aligarh. Methods: The data were collected by using a pretested, semi-structured with both open and closed-ended questionnaire from 500 married women of reproductive age group. The collected data were analyzed using IBM SPSS 20.0 Proportion, frequencies, ?2, and logistic regression were used to interpret the data. Results: Prevalence of RTI/STI symptoms was found to (42.8%) in rural areas and 37.6 % in periurban areas. Strong association was found in study subjects having lower educational status, who were not using any contraceptive method, not following good menstrual hygiene, early marriage age had husband history of RTI/STI, had a history of abortion, had a history of violence, and increased parity. Conclusions: Prevalence of symptoms found to be associated with these females having low educational status, early age of marriage, high parity, partner history of reproductive Tract Infections, history of violence etc. So, there should be more focus on improvement in these factors to reduce the prevalence.

Hospitalization & health expenditure in Odisha: Evidence from National Sample Survey (1995-2014)

Background & objectives: Financing healthcare services through out-of-pocket payments is common in India. Household impoverishments due to health expenditure can be daunting, especially among the economically vulnerable households. This study investigated hospitalization and patient’s health expenditure in Odisha State in India. Methods: The national sample survey data were used to assess hospitalization and patient’s health expenditure over two time periods (1995 and 2014). Disease classification was made following International Classification of Diseases 10th revision (ICD-10). The hospitalization rate and health expenditure were estimated for infectious, cardiovascular, non-communicable, disability and other diseases. Andersen model was used to examine the determinants of healthcare expenditure. Results: Findings of the study revealed that hospitalization in Odisha increased nearly three folds and health expenditure by more than two times between 1995 to 2014. While the hospitalization for other diseases remained consistently higher, health expenditure for disability was the highest and it increased three times within the last two decades. The socio-economic and demographic divides in the hospitalization rate and health expenditure were evident. Interpretation & conclusions: Our analysis indicated that predisposing factors such as age and marital status played an important role in hospitalization whereas, enabling factors likely determined the health expenditure. There is a need to recognize the unique vulnerabilities of older population, widowed and health financial mechanism for disability-related illness.

Influencia de los factores socioeconómicos en la ocurrencia de quemaduras en edades pediátricas / Influence of socioeconomic factors on the occurrence of burns in pediatric ages

Introducción: Los accidentes no se presentan solos, casi siempre están relacionados con un factor social y con el entorno cultural. Se plantea que las condiciones socioeconómicas impactan en la salud de las personas. Objetivos: Determinar los factores socioeconómicos que influyen en la ocurrencia de quemaduras en edades pediátricas. Métodos: Estudio descriptivo transversal realizado en la sala de Caumatología del Hospital Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, en el 2017. Se utilizó el Sistema SPSS. Se determinaron la frecuencia absoluta y el porcentaje. Resultados: El grupo de edad más afectado fueron los niños de 1-4 años. No se encontró diferencias con relación al sexo. Los líquidos hirvientes fueron el agente causal que predominó. Sobresalieron las familias con 1 o 2 hijos y de bajos ingresos. En la casuística estudiada el 71,7 por ciento de los familiares tenía escasos conocimientos sobre la prevención y primeros auxilios de las quemaduras El 41,7 por ciento de las familias tenían algún familiar que fumaba. Conclusiones: La interacción de factores sociales con factores económicos influye en la ocurrencia de quemaduras y otras afecciones en edades pediátricas, siendo los más vulnerables el grupo de 1-4 años de edad(AU)

Introduction: Accidents do not occur isolated, they are almost always related to a social factor and the cultural environment. It is proposed that socioeconomic conditions impact on people's health. Objectives: To determine the socioeconomic factors that influence the occurrence of burns in pediatric ages. Methods: Cross-sectional descriptive study conducted in the Caumatology room of Dr. Juan Bruno Zayas Alfonso Hospital, Santiago de Cuba province, in 2017. The SPSS System was used. Absolute frequency and percentage were determined. Results: The most affected age group were children aged 1-4 years. No differences were found in relation to sex. Boiling liquids were the predominant causative agent. Families with 1 or 2 children and low incomes stood out. In the case studies, 71.7 percent of the relatives had little knowledge about the prevention and first aid of burns. 41.7 percent of the families had a family member who smoked. Conclusions: The interaction of social factors with economic factors influences the occurrence of burns and other conditions in pediatric ages, being the most vulnerable the group of 1-4 years old(AU)

Age at Diagnosis for Autism Spectrum Disorders: Does it Differ by Place of Residence?

Background: Despite steady decline in the age of diagnosis (AOD) at the global level, it has not declined uniformly, and marked disparities are documented by income, education, race, and access to health care. Objectives: The objectives of the study are to examine the urban/rural disparities in the initial age of autism diagnosis and to understand the interplay of the underlying demographic and social factors. Methods: A retrospective case record review of all children who received their initial diagnosis of autism at the Pediatric Psychology Clinic (1997–2018) of a tertiary advanced pediatric center at Chandigarh was conducted. Astructured abstraction data form was used to extract demographic, socioeconomic, and clinical information from the files maintained at the clinic. Results: A total of 1321 case records were examined. The mean AOD was 4.62 years (standard deviation = 2.38) and children from rural communities were diagnosed at 4.87 years, nearly 0.35 years later than urban children (t = 2.47, P = 0.013). Results indicated that 31.1% of the variance in the AOD for children from rural areas was predicted by two variables, namely the number of children in the family and total Childhood Autism Rating Scale (CARS) score (F = 13.62, P = 0.001). For the urban sample, three variables emerged as significant predictors including the number of children in the family, total CARS score, and maternal education and these together explained 20.2% of the variance in the AOD (F = 19.60, P = 0.001). Conclusion: The public health system must be sensitized to the unmet needs of the marginalized socioeconomic groups to access diagnostic and management services in a timely manner.

Effect of life course factors on dental fear among adult dental patients attending out-reach clinics in a rural area of Southern India

Objectives: The aim of the study was to assess the effect of life course factors on dental fear among adult dental patients attending out?reach clinics in a rural area of South India. The objectives were to measure dental fear and changes in socio?economic status during the life course among the study population and to know whether social mobility reduced/increased dental fear. Methods: Dental fear scale and life course data were collected from 403 respondents. The improvement status of individual life course criteria was categorised into “less/minimal”, “stable”, or “upwardly mobile”. Results: The odds of dental fear in the group showing less or minimal upward social mobility was two times that of the stable group [p = 0.022; 95% confidence interval (C.I): 1.104–3.598], whereas the odds of dental fear in the group showing more or good upward social mobility were 4.5 times that of the stable group [p = 0.001; 95% C.I: 1.928–10.515] when adjusted for covariates, that is, participant age, gender, and education and past history of dental avoidance. Conclusion: Social mobility was found to be a risk indicator for dental fear. Dental services may have been affected even with increased standards of living because of psychological factors such as dental fear.

Socioeconomic inequalities in the access to health services: a population-based study in Southern Brazil / Desigualdades socioeconômicas no acesso aos serviços de saúde: um estudo de base populacional no sul do Brasil

Abstract This article aims to measure socioeconomic inequalities regarding access to health services, contact with health professionals, and specific health interventions. This was a cross-sectional population-based study with individuals aged 18 years or older, living in the city of Rio Grande. The outcomes were the following: Family Health Strategy (FHS) coverage; having a health insurance plan; receiving a visit of a community health worker; medical consultation; dental consultation; dietary counseling; having a class with a physical education professional; flu vaccination; mammography, cytopathological and prostate exams. Relative and absolute measures were used to assess inequalities in the distribution of the outcomes. There was a response rate of 91% (1,300 adults were interviewed). Coverage indicators ranged from 16.1%, for having a class with a physical education professional, to 80.0% for medical consultation. FHS coverage and visit of a community health agent presented higher proportions among the poorest while outcomes regarding contact with health professionals, screening exams and flu vaccine were more prevalent among richest group. We observed low coverage levels of access to health services and professionals in addition to marked socioeconomic inequalities.

Resumo O objetivo deste artigo é mensurar desigualdades socioeconômicas no acesso a serviços de saúde, no contato com profissionais e em intervenções específicas. Estudo transversal de base populacional com indivíduos (18 anos ou mais) vivendo em Rio Grande. Os desfechos mensurados foram: cobertura da Estratégia de Saúde da Família (ESF), plano de saúde, visita do agente comunitário de saúde, consulta médica, consulta com dentista, aconselhamento nutricional, aula com professor de educação física, vacina da gripe, mamografia, exames citopatológico e de próstata. Medidas de desigualdade absolutas e relativas foram utilizadas para avaliar a distribuição dos desfechos. A taxa de resposta foi de 91% (1.300 adultos entrevistados). A cobertura dos indicadores variou de 16,1%, para ter aula com professor de educação física, a 80,0%, para consulta médica. Cobertura de ESF e visita do agente comunitário de saúde apresentaram maior proporções entre os mais pobres, enquanto desfechos de contato com profissionais de saúde, exames de rastreamento e vacina da gripe foram mais prevalentes entre os mais ricos. Foram observadas baixas coberturas de acesso aos serviços e contato com profissionais, bem como desigualdades sociodemográficas importantes.

Condiciones socioambientales y prevalencia de enfermedades de la piel en un asentamiento urbano precario de Asunción (Paraguay) / Socio-Environmental Conditions and Prevalence of Skin Diseases in a Precarious Urban Settlement in Asunción (Paraguay) / Condições socioambientais e prevalência de dermatoses em um assentamento urbano precário em Assunção (Paraguai)

Introducción: se buscó analizar la prevalencia de enfermedades dermatológicas de la población de un asentamiento urbano precario próximo al vertedero municipal de Asunción (Paraguay), atendiendo a la exposición de las condiciones socioambientales. Materiales y métodos: estudio descriptivo y transversal con una muestra no probabilística intencional que incluyó a 77 personas de entre 5 meses y 76 años. Resultados: en el momento del examen físico, el 96.2 % de las personas presentó, al menos, una lesión cutánea, y el 79.2 %, una o más enfermedades infecciosas de piel; sin embargo, el 77.9 % no había recu-rrido a consulta médica. Las más sobresalientes fueron las micosis (35.1 %), las bacterianas (35.1 %) y las ectoparasitosis (27.3 %). Se identificó que la prevalencia de enfermedades bacterianas de piel apunta a una posible mayor exposición a condiciones adversas como: un clima subtropical de altas temperaturas y húmedo, una alta relación de convivientes en el hogar por dormitorio, problemas de provisión de agua y suelos de arena en los hogares, así como un sistema de evacuación de excretas deficiente, la presencia de animales con escasa vigilancia sanitaria, la proximidad a arroyos y cauces al aire libre depositarios de materia cloacal y el impacto recurrente de raudales los días de intensa lluvia. Conclusión: los resul-tados sugieren que la alta prevalencia de enfermedades cutáneas infecciosas podría relacionarse con una mayor exposición a condiciones socioambientales locales adversas, que son factores relevantes por tener en cuenta para mejorar la atención a la salud de las enfermedades dermatológicas de la población urbana que habita en un asentamiento urbano precario

Introduction: This study analyzes the prevalence of dermatological diseases in the population of a precarious urban settlement near the municipal landfill of Asunción (Paraguay), in relation to expo-sure to socio-environmental conditions. Materials and methods: descriptive, cross-sectional study with a non-probabilistic purposive sample that included 77 people aged between 5 months and 76 years. Results: at the time of physical examination, 96.2% of the people presented at least one skin lesion and 79.2% one or more infectious skin diseases, but 77.9% had not consulted a doctor. The most prominent were mycoses (35.1%), bacterial (35.1%) and ectoparasitoses (27.3%). It was identified that the preva-lence of bacterial skin diseases points to possible increased exposure to adverse conditions such as: a subtropical climate with high temperatures and humidity, a high ratio of people living in the household per bedroom, water supply problems and sandy soils in homes, as well as a deficient excreta disposal system, the presence of animals with poor sanitary surveillance, proximity to streams and open-air waterways that deposit sewage and the recurrent impact of floods on days of heavy rainfall. Conclusion:the results suggest that the high prevalence of infectious skin diseases could be related to increased exposure to adverse local socio-environmental conditions, which are relevant factors to be taken into to improve the health care of skin diseases in the urban population living in a slum settlement

Introdução: este estudo analisa a prevalência de doenças dermatológicas na população de um assen-tamento urbano precário próximo ao aterro sanitário municipal de Asunción (Paraguai) em relação à exposição às condições socioambientais. Materiais e métodos: estudo descritivo, transversal, com uma amostra não-probabilística de propósito que incluiu 77 pessoas com idade entre 5 meses e 76 anos. Resultados: no momento do exame físico, 96,2% das pessoas tinham pelo menos uma lesão de pele e 79,2% tinham uma ou mais doenças infecciosas de pele, mas 77,9% não tinham consultado um médico. As mais importantes foram micoses (35,1%), bacterianas (35,1%) e ectoparasitoses (27,3%). A preva-lência de doenças bacterianas da pele foi identificada como apontando para um possível aumento da exposição a condições adversas tais como: um clima subtropical com altas temperaturas e umidade, uma alta proporção de pessoas vivendo na casa por quarto, problemas de abastecimento de água e solos arenosos nas habitações, bem como um sistema de eliminação de excrementos deficiente, a presença de animais com vigilância sanitária deficiente, proximidade a riachos e cursos de água abertos que depositam águas residuais, e o impacto recorrente de enchentes em dias de chuvas fortes. Conclusão:Os resultados sugerem que a alta prevalência de doenças infecciosas de pele pode estar relacionada ao aumento da exposição a condições sócio-ambientais locais adversas, que são fatores relevantes a serem considerados para melhorar os cuidados com doenças de pele na população urbana que vive em uma favela

Sexual behaviours and their associated factors among young people in the Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana

Objective: This paper describes sexual behaviours and their associated factors among young people. Design: The study design is cross-sectional. Setting: Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana's Shai-Osudoku and Ningo Prampram districts. Participants: Young people aged 10 to 24 years, median age 17 years. Outcome measures: Self-reported to have ever had sex, non-use of a condom at last sex, and ever been pregnant or gotten someone pregnant. Results: Of the 1689 young people; 42% reported having ever had sex, not using a condom at last sexual activity (64%), and ever been pregnant or gotten someone pregnant (41%). The proportion of non-use of condoms at last sex was high across all age groups but was highest (93%) in a small proportion of 10 to 14-year-olds who have ever had sex. Higher proportions of females than males; were reported to have ever had sex (46%), not using a condom at their last sex (66%) and ever been pregnant or getting someone pregnant (56%). Age group (20 to 24), females, primary or junior high school, living alone and lower household socio-economic status were risk factors associated with all three outcome measures. Conclusion: Risky sexual behaviour is high among young people in the Dodowa HDSS. Therefore, interventions that promote safer sexual practices and help young people make timely decisions on their sexual and reproductive health care needs are required.