Factors associated with knowledge of diagnosis, prognosis & distress in cancer patients receiving palliative care – A retrospective cohort analysis

Background & objectives: Demographic attributes of cancer patients are associated with the awareness of diagnosis, the prognosis of cancer and their associated psychological distress. This study was aimed to assess the knowledge of diagnosis, prognosis and psychological distress among patients reporting to the pain and palliative care department in a tertiary cancer hospital, south India. Methods: Data of all patients visiting the palliative care outpatient department of a tertiary cancer centre in south India between January and June 2018 were included in the study (n=754). A structured pro forma was used to collect information on the sociodemographic details and clinical aspects and a distress thermometer was used to assess the level of distress. Information, thus collected, were analysed using descriptive statistics and logistic regression. Results: Around 16.2 per cent of the patients were unaware of their diagnosis while two third (68%) were unaware of the prognosis. More than half of the patients reported significant distress (54.1%). Gender, education, not working and being diagnosed with head-and-neck cancers were associated with knowledge of diagnosis, while educational level predicted the knowledge of prognosis. Younger age group, head-and-neck cancer, haematology cancer, state of being unaware of diagnosis and prognosis were found to be associated with distress. Interpretation & conclusions: Higher educational levels and better socio-economic status increase the likelihood of patients being aware of their diagnosis and prognosis. Being unaware of the prognosis remains associated with the higher level of distress

Artificial intelligence–based stratification of demographic, ocular surface high-risk factors in progression of keratoconus

Purpose: The purpose of this study was to identify and analyze the clinical and ocular surface risk factors influencing the progression of keratoconus (KC) using an artificial intelligence (AI) model. Methods: This was a prospective analysis in which 450 KC patients were included. We used the random forest (RF) classifier model from our previous study (which evaluated longitudinal changes in tomographic parameters to predict “progression” and “no progression”) to classify these patients. Clinical and ocular surface risk factors were determined through a questionnaire, which included presence of eye rubbing, duration of indoor activity, usage of lubricants and immunomodulator topical medications, duration of computer use, hormonal disturbances, use of hand sanitizers, immunoglobulin E (IgE), and vitamins D and B12 from blood investigations. An AI model was then built to assess whether these risk factors were linked to the future progression versus no progression of KC. The area under the curve (AUC) and other metrics were evaluated. Results: The tomographic AI model classified 322 eyes as progression and 128 eyes as no progression. Also, 76% of the cases that were classified as progression (from tomographic changes) were correctly predicted as progression and 67% of cases that were classified as no progression were predicted as no progression based on clinical risk factors at the first visit. IgE had the highest information gain, followed by presence of systemic allergies, vitamin D, and eye rubbing. The clinical risk factors AI model achieved an AUC of 0.812. Conclusion: This study demonstrated the importance of using AI for risk stratification and profiling of patients based on clinical risk factors, which could impact the progression in KC eyes and help manage them better

Demographic and population response of the threatened coral Acropora cervicornis (Scleractinia, Acroporidae) to fireworm corallivory

Introduction: The fireworm Hermodice carunculata is a widespread polychaete that can prey upon many coral species. However, few studies have examined the effect of fireworm predation on coral demographics during non-outbreak periods. Objective: To determine whether predation by H. carunculata compromised the growth, survival, and population performance of the threatened coral Acropora cervicornis. Methods: Nursery-reared coral fragments (n = 99) were fixed to the bottom of Punta Melones reef in the Island Municipality of Culebra, Puerto Rico. Predation activity and its demographic consequences on coral outplants were assessed from December 2020 to August 2022. Susceptibility to predation was compared between colonies collected directly from the reef and those originating from outside sources (e.g., coral nurseries). With the demographic data, simple size-based population matrix models were developed to 1) examine whether fireworm predation led to a significant decline in population growth rate (λ), 2) determine the demographic transition(s) that contribute the most to λ, and 3) determining the demographic transition(s) that accounted for differences in λ when comparing scenarios that considered either only predated colonies or both predated and non-predated outplants. Results: Predation increased over time, being more frequently observed in the area with the highest topographic relief and on colonies foreign to the study site. Outplants that were partially consumed grew significantly slower than non-predated colonies; however, predation did not threaten their survival. The likelihood of being attacked by the fireworm increased with branching complexity. The estimated λ for a scenario considering only predated colonies was 0.99, whereas, for a scenario where both predated and non-predated colonies were considered, λ was 0.91. Population growth, under the two scenarios, was mainly influenced by the probability of a large colony surviving and remaining at the largest size. Conclusions: Although predation can negatively impact coral growth, the relatively high survival rate of predated colonies compensates for the adverse effect. Since survival is the demographic transition that contributes most to population growth, it could be concluded that under a non-outbreak scenario, fireworm predation may not be the primary cause of A. cervicornis population decline.

Introducción: El gusano de fuego Hermodice carunculata es un poliqueto común que puede depredar muchas especies de coral. Sin embargo, pocos estudios han examinado el efecto de la depredación del gusano de fuego en la demografía de los corales durante periodos sin brotes poblacionales. Objetivo: Este estudio tuvo como objetivo determinar si la depredación por H. carunculata compromete el crecimiento, la supervivencia y el desempeño poblacional del coral amenazado Acropora cervicornis. Métodos: Fragmentos de coral criados en vivero (n = 99) se fijaron al fondo del arrecife Punta Melones en la Isla Municipio de Culebra, Puerto Rico. La actividad de depredación y sus consecuencias demográficas en los trasplantes de coral se evaluaron desde diciembre de 2020 hasta agosto de 2022. Se comparó la susceptibilidad a la depredación entre las colonias recolectadas directamente del arrecife y las que se originaron en fuentes externas (p. ej., viveros de coral). Con los datos demográficos, se desarrollaron modelos matriciales simples de población basados en el tamaño para 1) examinar si la depredación del gusano de fuego causa una disminución significativa en la tasa de crecimiento de la población (λ), 2) determinar las transiciones demográficas que más contribuyen a λ, y 3) determinar la(s) transición(es) demográfica(s) que explican las diferencias en λ al comparar escenarios que consideraron solo colonias depredadas o la combinación de colonias depredadas y no depredadas. Resultados: La depredación aumentó con el tiempo, observándose con mayor frecuencia en la zona de mayor relieve topográfico y en colonias ajenas al sitio de estudio. Los trasplantes consumidos parcialmente crecieron significativamente más lento que las colonias no depredadas; sin embargo, la depredación no amenazó su supervivencia. La probabilidad de ser atacado por el gusano de fuego aumentó con la complejidad morfológica de la colonia. El λ estimado para un escenario que consideraba solo las colonias depredadas fue de 0.99, mientras que, para un escenario en el que se consideraron tanto las colonias depredadas como las no depredadas, λ fue de 0.91. El crecimiento de la población, en ambos escenarios, estuvo influenciado principalmente por la probabilidad de que una colonia grande sobreviviera y permaneciera en el tamaño más grande. Conclusiones: Aunque la depredación puede tener un impacto negativo en el crecimiento de los corales, una tasa de supervivencia relativamente alta de las colonias depredadas compensa los efectos adversos. Dado que la supervivencia es la transición demográfica que más contribuye al crecimiento de la población, se podría concluir que, en un escenario sin brotes, la depredación por gusanos de fuego no debe ser la causa principal de la disminución de la población de A. cervicornis.

Prodromal Parkinson's disease and its socio-demographic characteristics among people aged 55 and above in four provinces of China / 环境与职业医学

Background China is witnessing an accelerated aging process and an increasingly serious situation of Parkinson's disease. Research on the pre-disease stage and its related influencing factors has gained more and more attention. Objective To analyze the current situation of prodromal Parkinson's disease (pPD) of people aged 55 years and above in four provinces of China, and to explore its influencing demographic and socio-economic characteristics. Methods Using the data of Community-based Cohort Study on Nervous System Disease in 2020, a total of 10724 participants with complete data on demographic and socio-economic factors and risk factors on Parkinson's disease were selected. Based on the criteria recommended by the International Parkinson and Movement Disorder Society (MDS), we evaluated risk level (i.e., post-test probability) of pPd, prevalence of possible or probable pPD, and number of pPD-related risk/prodromal markers in the participants. Multiple linear regression and multiple logistic regression models were used to analyze the influencing socio-demographic factors of risk level of pPd and prevalence of possible or probable pPD, and Poisson regression and multinomial logit regression models were used to analyze the influencing socio-demographic factors of the number of pPD-related risk/prodromal markers in the total sample, men, and women, respectively. Results The median (P25, P75) of post-test probability of pPD in 2020 was 0.78% (0.42%, 1.66%), the prevalence rate of possible or probable pPD was 0.34%, and 69.03% of the participants reported 3-5 pPD-related risk/prodromal markers. The post-test probabilities of men, those with older age, lower education level, per capita monthly household income < 1000 yuan, urban residency, or without active employment were higher (P<0.05). Men and being aged ≥ 75 years had a higher prevalence of possible or probable pPD (P<0.05). The OR of possible or probable pPD was 8.404 (95%CI: 2.839−24.879) in subjects aged ≥ 75 years versus those aged 55−64 years. Males, those without active employment, being less educated, with older age, and urban residents were more likely to report pPD-related risk/prodromal markers than those of the opposite groups (P<0.05). Conclusion Men, subjects aged ≥75 years, those with lower education level, urban residents, and those without active employment have higher risk levels of pPD and are more likely to report pPD-related risk/prodromal markers among people aged 55 years and above in the four provinces of China, poor economic situation is also associated with higher risk levels of pPD.

Perception of newly graduated physicians toward ethical education in medical schools: a Brazilian cross-sectional nationwide study

SUMMARY OBJECTIVE: The objective of this study was to evaluate fresh medical graduates' perceptions regarding the general aspects of ethics teaching in Brazilian medical schools. METHODS: A structured questionnaire was applied to 4,601 participants among the 16,323 physicians who registered in one of the 27 Regional Medical Councils of Brazil in 2015. Answers to four questions regarding general aspects of ethics education in medical school were analyzed. Sampling procedures involved two stratification variables: legal nature (public vs. private) of medical schools and monthly household income higher than 10 minimum wages. RESULTS: A large percentage of the participants had witnessed unethical behaviors during contact with patients (62.0%), toward coworkers (51.5%), and in relationships with patients' families (34.4%) over the course of their medical training. Even though most of the responders (72.0%) totally agreed that patient-physician relationship and humanities education were part of their medical school curriculum, important topics such as conflicts of interest and end-of-life education were not satisfactorily addressed in the participants' medical training. Statistically significant differences were found between the answers of public and private school graduates. CONCLUSION: Despite great efforts to improve medical ethics education, our findings suggest the persistence of deficits and inadequacies in the ethics training currently given in medical schools in Brazil. Further modifications in ethics training must be made to address the deficiencies shown in this study. This process should be accompanied by continuous evaluation.

Características demográficas y laborales del personal de enfermería con lumbalgia en hospital público de Corrientes, 2021 / Demographic and occupational characteristics of the nursing staff with low back pain in the public hospital of Corrientes, 2021

El dolor lumbar es una enfermedad laboral frecuente en enfermería, asociado a exigencias del cargo y múltiples causas. La intensidad varía según postura y actividad física, acompañándose de limitación dolorosa del movimiento, ser localizado, referido o irradiado. Objetivo: Determinar las características demográficas y laborales del personal de enfermería que presenta dolor lumbar de un hospital público de Corrientes, capital en el año 2021. Metodología: Diseño cuantitativo, transversal, observacional. Población 170 trabajadores de enfermería del hospital. Se incluyeron aquellos con dolor lumbar y que no cursaban enfermedades crónicas o invalidantes. Los datos se recogieron mediante cuestionario de elaboración propia, validado mediante prueba piloto. Variables: edad, género, formación en enfermería, frecuencia, intensidad y duración del dolor, principal tipo de dolor, tratamiento farmacológico y no farmacológico, principal situación generadora, tipo de trabajo realizado, turno y antigüedad laboral. Resultados: Se analizaron las respuestas de 115 trabajadores con dolor lumbar; amplitud etaria 22 a 62 años, promedio 36 años; 67% mujeres. El dolor lumbar fue diario en 22%, frecuente en 35%, ocasional en 43%. Según intensidad, 13% manifestó dolor leve, 47% moderado y 40% severo. El dolor era diario en 10% de jóvenes, en 20% de adultos jóvenes, en 45% de adultos intermedios y en 59% de adultos tardíos. En duración, el 73% lo padecía en forma aguda y el 27% crónica. En localización del dolor, el 75% indicó padecer dolor localizado y 25% irradiado. Principales situaciones generadoras de lumbalgia, 51% al movilizar pacientes, 23% al permanecer de pie, 18% al trasladar objetos pesados. En la percepción del personal sobre tipo de trabajo habitual, el 41% indicó pesado y 12% muy pesado. El 86%de los encuestados utilizó AINES. Conclusión: La intensidad del dolor lumbar es menor en el personal más joven respecto a los mayores. Los más jóvenes refieren dolor localizado, los de mayor edad dolor irradiado. El principal desencadenante del dolor lumbar es la movilización de pacientes[AU]

Low back pain is a common occupational disease in nursing, associated with the demands of the position and multiple causes. Te intensity varies according to posture and physical activity, accompanied by painful limitation of movement, being localized, referred or irradiated. Objective: To determine the demographic and labor characteristics of the nursing staff that presents low back pain in a public hospital in Corrientes, capital in the year 2021. Methodology: Quantitative, cross-sectional, observational design. Population 170 hospital nursing workers. Tose with low back pain and who did not have chronic or disabling diseases were included. Te data was collected through a self-prepared questionnaire, validated through a pilot test. Variables: age, gender, nursing training, frequency, intensity and duration of pain, main type of pain, pharmacological and nonpharmacological treatment, main generating situation, type of work performed, shif and work seniority. Results: Te responses of 115 workers with low back pain were analyzed; age range 22 to 62 years, average 36 years; 67% women. Low back pain was daily in 22%, frequent in 35%, occasional in 43%. According to intensity, 13% reported mild pain, 47% moderate and 40% severe. Pain was daily in 10% of youth, 20% of young adults, 45% of middle adults, and 59% of late adults. In duration, 73% suffered from it acutely and 27% chronically. In pain location, 75% indicated localized pain and 25% irradiated. Main situations that generate low back pain, 51% when moving patients, 23% when standing, 18% when moving heavy objects. In the perception of the personnel on the type of habitual work, 41% indicated heavy and 12% very heavy. 86% of those surveyed used NSAIDs. Conclusion: Te intensity of low back pain is lower in the younger staff compared to the older ones. Te youngest refer localized pain, the oldest radiated pain. Te main trigger of low back pain is the mobilization of patients[AU]

A lombalgia é uma doença ocupacional comum na enfermagem, associada às demandas do cargo e a múltiplas causas. A intensidade varia de acordo com a postura e atividade física, acompanhada de limitação dolorosa do movimento, sendo localizada, referida ou irradiada. Objetivo: Determinar as características demográfcas e laborais da equipe de enfermagem que apresenta lombalgia em um hospital público de Corrientes, capital no ano de 2021. Metodologia: Desenho quantitativo, transversal, observacional. População 170 trabalhadores de enfermagem hospitalar. Foram incluídos aqueles com lombalgia e que não possuíam doenças crônicas ou incapacitantes. Os dados foram coletados por meio de um questionário autoelaborado, validado por meio de um teste piloto. Variáveis: idade, sexo, formação do enfermeiro, frequência, intensidade e duração da dor, principal tipo de dor, tratamento farmacológico e não farmacológico, principal situação geradora, tipo de trabalho realizado, turno e antiguidade no trabalho. Resultados: Foram analisadas as respostas de 115 trabalhadores com lombalgia; faixa etária de 22 a 62 anos, média de 36 anos; 67% mulheres. A dor lombar foi diária em 22%, frequente em 35%, ocasional em 43%. De acordo com a intensidade, 13% relataram dor leve, 47% moderada e 40% intensa. A dor foi diária em 10% dos jovens, 20% dos adultos jovens, 45% dos adultos intermediários e 59% dos adultos tardios. Em duração, 73% sofriam agudamente e 27% cronicamente. Na localização da dor, 75% indicaram dor localizada e 25% irradiada. Principais situações que geram lombalgia, 51% ao movimentar pacientes, 23% ao fcar em pé, 18% ao movimentar objetos pesados. Na percepção do pessoal sobre o tipo de trabalho habitual, 41% indicaram pesado e 12% muito pesado. 86% dos entrevistados usaram AINEs. Conclusão: A intensidade da dor lombar é menor na equipe mais jovem em comparação com a mais velha. Os mais jovens referem dor localizada, os mais velhos referem dor irradiada. O principal desencadeador da lombalgia é a mobilização dos pacientes[AU]

Demografia da guerra: mortalidade em Porto Alegre na Guerra dos Farrapos, 1835-1845 / Demographics of war: mortality in Porto Alegre during Guerra dos Farrapos, 1835-1845

Resumo Este artigo apresenta resultados de análises relativas aos impactos da Guerra dos Farrapos (1835-1845) sobre a mortalidade na população de Porto Alegre, a partir, principalmente, da utilização de assentos de batizado e de óbito, comparando os períodos anterior e posterior ao conflito, abrangendo os anos entre 1825 e 1854. Destacam-se as perturbações nos primeiros cinco anos da guerra (1835-1840), quando a cidade enfrentou cercos impostos pelos rebeldes. Os resultados, baseados no cálculo da mortalidade infantil, entre outros indicadores, evidenciam, além das dificuldades de abastecimento e agravamento das condições sanitárias, uma grave crise de mortalidade causada por epidemia de escarlatina que atingiu duramente crianças livres e escravizadas.

Abstract This article presents an analysis of the impacts of the Guerra dos Farrapos (1835-1845) on the mortality of the population of Porto Alegre, drawing primarily on baptism and death records, comparing the periods before and after the conflict, ranging from 1825 to 1854. Anomalies can be noted in the first five years of the war, when the city was under siege from the rebels. The results, based on a calculation of infant mortality and other indicators, show not only that there were supply difficulties and deteriorated sanitary conditions, but also that mortality levels surged in response to a scarlet fever epidemic, which hit free and enslaved children particularly hard.

Trends in clinicopathological characteristics of surgically-treated lung cancer: sex-based heterogeneity / 中华胸心血管外科杂志

Objective:To explore the sex-based heterogeneity in demographic and pathological trends of lung cancer during the past 30 years.Methods:Patients with primary lung cancer who received surgical treatment in the Department of thoracic surgery, Shanghai Pulmonary Hospital Tongji University from 1989 to 2018 were retrospectively analyzed. The differences between male and female patients in age, smoking history, pathological stage and type were compared. Mann- Kendall trend test was performed for trend analysis. Results:A total of 58 433 patients were included in this study, encompassing 30 729(52.6%) men and 27 , 704(47.4%) women. Compared with male patients, female patients were younger(56.0 years old vs. 59.7 years old), and had a higher proportion of non-smokers(98.3% vs. 52.3%), stage Ⅰ lung cancers(60.6% vs. 49.3%), and adenocarcinoma(93.7% vs. 56.1%, all P-values <0.001). Trend analyses revealed that the proportion of female patients increased year by year, and surpassed males in 2015, with the current ratio of male to female being 1∶1.5. After 2013, the age of onset in females was getting younger, and the average age decreased from 58.7 years old to 54.7 years old( P=0.02). The decrease in the proportion of smoking patients was mainly reflected by male patients(from 68.5% to 31.1%, P<0.01). Stage Ⅰ lung cancers in male and females outnumbered advanced stage in 2012 and 2010, respectively, with a much higher proportion in female patients. Among male patients, adenocarcinoma has replaced squamous cell carcinoma as the most common pathological type since 2012, while in female patients adenocarcinoma remained the most common pathological type of lung cancer, and its proportion continued to increase reaching over 98%. Conclusion:A dramatic change in gender distribution was noticed during the past 30 years. Female patients became the primary population in surgically-treated lung cancers, with a trend of getting younger. The proportion of smokers and squamous cell carcinoma decreased significantly in male patients, and adenocarcinoma has become the most common pathological type of lung cancer. The proportion of stage Ⅰ lung cancers was on a dramatic rise, with the popularization of CT screening for lung cancer.

Impact of changing classification systems on prevalence and frequency distribution of odontogenic tumors in tertiary care center of Nagpur / Impacto da mudança nos sistemas de classificação sobre a prevalência e a distribuição da frequência de tumores odontogênicos em um centro de atenção terciária de Nagpur

Abstract Introduction The classification of odontogenic tumors has been revised from time to time in order to provide unified terminology. This reclassification had considerable impact on their prevalence and frequency distribution. Objectives This study was aimed to emphasize impact of changing classification systems on prevalence and relative frequency of odontogenic tumors. The secondary objective was to analyze demographics of various histological types of odontogenic tumors in comparison to published literature. Review of Indian studies (1992-2020) elaborating frequency of odontogenic tumors is summarized in the end. Methods This was a hospital-based retrospective study wherein case files of odontogenic tumors diagnosed from 1990 to 2019 period were retrieved. The classification system used originally at the time of diagnosis was retained and prevalence of odontogenic tumors in three different periods (1990-2004, 2005-2016 and 2017-2019) was compared. Further, prevalence, frequency distribution and demographics of all these tumors (1990-2019) were analyzed using latest World Health Organization 2017 classification. Results A total of 345 odontogenic tumors was diagnosed as per World Health Organization 2017 system of classification from 1990 to 2019. 96.81% tumors were benign and 3.81% constituted malignant odontogenic tumors. However, there was marked increase in prevalence of odontogenic tumors in 2005-2016 (6.2%) period as compared to 1990-2004 (3.87%) and 2017-2019 (3.47%). Ameloblastoma remained the most common tumor in three different periods, whereas keratocystic odontogenic tumor became second commonest tumor in 2005-2016 as compared to odontoma in 1990-2004 and adenomatoid odontogenic tumor in 2017-2019. Conclusions The continuous evolving systems of classification may partly be responsible for inconsistency in odontogenic tumors, with inclusion of keratocystic odontogenic tumor,and has marked impact on prevalence and frequency distribution of odontogenic tumors. The geographical variations in demographics of odontogenic tumors might reflect genetic and environment influence; however it requires elucidation by further studies.

Resumo Introdução A classificação dos tumores odontogênicos é revisada de tempos em tempos para fornecer uma terminologia unificada. Essas revisões tiveram um impacto considerável na prevalência e distribuição da frequência desses tumores. Objetivo Enfatizar o impacto da mudança dos sistemas de classificação na prevalência e frequência relativa dos tumores odontogênicos. O objetivo secundário foi analisar os dados demográficos de vários tipos histológicos de tumores odontogênicos em comparação com a literatura publicada. A revisão dos estudos indianos (1992-2020) sobre a frequência dos tumores odontogênicos é resumida no fim. Método Este foi um estudo retrospectivo com base em registro hospitalar de casos de tumores odontogênicos diagnosticados de 1990‐2019 que foram revisados. O sistema de classificação usado originalmente no momento do diagnóstico foi mantido e a prevalência de tumores odontogênicos em três períodos (1990-2004, 2005-2016 e 2017-2019) foi comparada. Além disso, a prevalência, a distribuição da frequência e os dados demográficos de todos esses tumores (1990-2019) foram analisados com a classificação mais recente da OMS de 2017. Resultados Foram diagnosticados 345 tumores odontogênicos de acordo com o sistema de classificação da OMS (2017) de 1990-2019. A ocorrência de tumores odontogênicos benignos e malignos foi de 96,81% e 3,81%, respectivamente. Contudo, houve um aumento acentuado na prevalência de tumores odontogênicos de 2005‐2016 (6,2%), comparado aos períodos de 1990‐2004 (3,87%) e 2017‐2019 (3,47%). O ameloblastoma permaneceu como o tumor mais comum em três períodos, enquanto o tumor odontogênico ceratocístico passou a ser o segundo tumor mais comum em 2005‐2016, comparado ao odontoma em 1990‐2004 e ao tumor odontogênico adenomatoide em 2017‐2019. Conclusões Os sistemas de classificação em evolução contínua podem, em parte, atribuir uma inconsistência à classificação dos tumores odontogênicos com a inclusão do tumor odontogênico ceratocístico e causar um impacto marcante na prevalência e distribuição da frequência dos tumores odontogênicos. As variações geográficas na demografia dos tumores odontogênicos podem refletir influências genéticas e ambientais, mas requerem elucidação por estudos futuros.

'Gift with a price tag': Nigerian egg donors' knowledge, experiences and motivations

Research around the world has indicated that the demand for egg donation has grown considerably among young females. This study qualitatively examines the knowledge, experiences, and motivations of young egg donors at a Nigerian health facility. Indepth interviews were conducted in Igbo and English with consenting thirty-one egg donors attending a fertility clinic in Anambra State, south-eastern Nigeria. Data were collected and analysed to generate themes with the aid of NVivo 10 software. Three themes were identified from the participants' motivations and include (a) monetary (93.6%), (b) altruistic (3.2%), and (c) both monetary and altruistic reasons (3.2%). Findings highlighted that the differences were based on a variety of reasons in Nigeria. All the participants were literate and single, and the majority received payment. The majority (77.4%) of those who received payment mentioned that the payment was not worth the donation program. The participants preferred to be anonymous because they had not discussed their donation with their family members, and the non-acceptance of egg donation program by the Nigerian society. Given that the market for egg donation has become a common method of infertility management in Nigeria, our findings have important implications for practices, policy actions, and future research. (Afr J Reprod Health 2022; 26[6]:64-79).

Características sociodemográficas en cuidadores principales de pacientes operados de cáncer de cerebro / Socio-demographic characteristics in primary caregivers of patients with brain cancer surgery

RESUMEN Introducción: la atención al enfermo es llevada a cabo por una secuencia específica de la familia, por lo que esta es considerada un cuidador principal. Objetivo: describir las características sociodemográficas en cuidadores principales de pacientes operados de cáncer de cerebro. Materiales y métodos : se realizó un estudio descriptivo, retrospectivo, en un universo de 128 cuidadores principales de pacientes operados de cáncer de cerebro en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, entre 2016 y 2018. Criterio de inclusión: cuidadores que residían en la provincia y aceptación del consentimiento informado. Se excluyeron familiares de pacientes que fallecieron durante la investigación. Se aplicaron cuestionarios y entrevistas para caracterizar los resultados. Los mismos se analizaron en frecuencias absolutas, relativas, porcentual, en paquete estadístico de SPSS versión 20.0 en Windows. Resultados : predominó el sexo femenino (79,68 %). El 100 % de los cuidadores principales residían en casa del enfermo. Prevaleció el nivel de escolaridad de técnico medio (35,93 %); 88,28 % de los cuidadores mantenían vínculo laboral, y 41,40 % eran hermanas de los enfermos. Dentro de las necesidades de aprendizaje del cuidador, el déficit de conocimientos sobre la enfermedad constituyó el 73,43 %. Conclusiones: imperó el género femenino en los cuidadores con vínculo laboral, y con mayor incidencia las hermanas. Se evidenció la complejidad del cuidado en el hogar de los pacientes con secuelas, minusvalía progresiva producidas por la enfermedad, y que generalmente la mujer asume con más facilidad (AU).

ABSTRACT Introduction: the care of the patient is carried out by a specific sequence of the family, catalogued as a main caregiver. Objective: to describe the socio-demographic characteristics in main caregivers of patients who underwent a brain cancer surgery. Materials and methods: a retrospective, descriptive study was carried out in a universe of 128 main caregivers of patients who underwent brain cancer surgery in the University Hospital Faustino Perez Hernandez, of Matanzas, from 2016 until 2018. Inclusion criteria: caregivers living in the province of Matanzas and giving the informed consent. The relatives of patients who died during the research were excluded. Interviews were made and questionnaires applied to characterize the results. They were analyzed in absolute, relative, and percentage frequencies in statistical packet Windows SPSS, 20.0. Results: female sex predominated (79.68%). 100% of main caregivers lived in the house of the patient. The technician scholarship predominated (35.93%); 88.28% of the caregivers kept their employment bonds, and 41.40% were patients' sisters. The deficit of knowledge on the disease was 73.43% of the caregiver learning necessities. Conclusions: female genre prevailed in caregivers with employment bonds, with higher incidence of sisters. It was evidenced the complexity of home care of the patients with sequels, progressive disabilities caused by the disease, generally assumed more easily by women (AU).

Una mirada demográfica a la población infantil afectada por la COVID-19 en Cuba / A demographic look to the children´s population affected by COVID-19 in Cuba

Introducción: La población en los grupos de edades más bajos no ha constituido un grupo vulnerable ante los efectos de la COVID-19. No obstante, se considera importante explicar el estado de la enfermedad en este grupo de edad. Objetivo: Caracterizar demográficamente la población infantil afectada por la COVID-19 en Cuba, desde el 11 de marzo hasta el 22 de junio de 2020. Métodos: Estudio descriptivo de corte transversal. Se incluyeron en el estudio 246 niños de 0-18 años de edad cumplida contagiados con la COVID-19 en Cuba. Las variables de estudio fueron: provincia de residencia, sexo, edad, tipo de contagio, número de contactos y letalidad. Los resultados se presentan mediante tasas y porcentajes principalmente. Resultados: Los diagnosticados con la COVID-19 en Cuba, de 0 a 18 años, representan el 10,6 por ciento del total de confirmados. El 50,4 por ciento son del sexo masculino y el 49,6 por ciento del femenino. La tasa de incidencia a nivel nacional es aproximadamente de 10,63 infantes de 0 a 18 años infectados con la COVID-19, por cada 100 000 habitantes del grupo de edad. El 5,7 por ciento del total de enfermos analizados corresponde a niños menores de un año de edad. Conclusiones: Hasta el 22 de junio de 2020 se han enfermado en Cuba 246 niños de 0 a 18 años de edad. Las mayores cifras se concentran en el sexo masculino, en el subgrupo de 15-18 años de edad y en las provincias La Habana y Villa Clara(AU)

Introduction: The population in lower age groups has not been a vulnerable group to the effects of COVID-19. However, it is considered important to do a review of the disease´s state in this age group. Objective: Characterize demographically the children´s population affected by COVID-19 in Cuba, from March 11 to June 22, 2020. Methods: Descriptive cross-sectional study. 246 children aged 0-18 who were infected with COVID-19 in Cuba were included in the study. The study variables were: province of residence, sex, age, type of contagion, number of contacts and lethality. Results are presented by rates and percentages, mainly. Results: Those diagnosed with COVID-19 in Cuba, in the ages from 0 to 18 years, account for 10.6 percent of the total confirmed. 50.4 percent are male and 49.6 percent female. The incidence rate at the national level is approximately 10.63 infants aged 0 to 18 infected with COVID-19 per 100,000 inhabitants of the age group. 5.7 percent of the total number of patients tested represents children under one-year-old. Conclusions: Until June 22, 2020, 246 children aged 0 to 18 have got ill in Cuba. The highest numbers are concentrated in the male sex, in the subgroup of 15-18 years old, and in the provinces Havana and Villa Clara(AU)

Características sociodemográficas, hábitos de vida e critérios do paciente para a escolha do cirurgião plástico / Sociodemographic characteristics, lifestyle habits, and criteria of the patient for the choice of the plastic surgeon

Introdução: No mundo todo, estima-se que aproximadamente 11 milhões de cirurgias plásticas sejam realizadas a cada ano. Indivíduos com diferentes necessidades e perfis sociodemográficos distintos têm utilizado meios semelhantes na busca dos prestadores de serviços médicos, modificando as relações de consumo. Assim, faz-se necessária uma análise mais detalhada sobre as características dos consumidores dos serviços de saúde relacionados à cirurgia plástica e sobre os fatores que impactam em sua tomada de decisão, uma vez que os pacientes e seus familiares precisam se sentir seguros ao buscar tratamento médico e os profissionais devem ser os facilitadores desse processo. Métodos: Trata-se de um estudo de vida real, prospectivo, observacional e descritivo, conduzido em um único centro hospitalar. Foram incluídos na amostra 501 pacientes submetidos a cirurgias plásticas, no período de junho a novembro de 2017, realizadas exclusivamente por cirurgiões especialistas pela Sociedade Brasileira de Cirurgia Plástica (SBCP). Foram avaliadas as características sociodemográficas, hábitos de vida e os critérios para a escolha do cirurgião. Resultados: A amostra foi composta predominantemente por mulheres adultas jovens, pardas, casadas, com índice de massa corpórea (IMC) normal, nível superior de escolaridade e pertencentes à alta classe média, cuja maioria mostrou-se fisicamente ativa e não revelou qualquer vício. O critério mais utilizado para a escolha do cirurgião plástico foi a indicação de amigos ou familiares. Conclusão: Este estudo produziu resultados confiáveis para a descrição das características sociodemográficas e hábitos de vida dos pacientes, permitindo identificar o fator mais relevante na escolha do cirurgião plástico.

Introduction: Around the world, approximately 11 million plastic surgeries are estimated to be performed each year. Individuals with different needs and sociodemographic profiles have used similar means to search for medical service providers, modifying consumer relations. Thus, is necessary a more detailed analysis of consumers' characteristics of health services related to plastic surgery and the factors that impact their decision-making, since patients and their families need to feel safe when seeking medical treatment, and professionals should be the facilitators of this process. Methods: This is a real-life, prospective, observational, and descriptive study conducted in a single hospital center. We included in the sample 501 patients submitted to plastic surgeries, from June to November 2017, performed exclusively by specialist surgeons by the Sociedade Brasileira de Cirurgia Plástica (SBCP). Sociodemographic characteristics, life habits, and criteria for the surgeon's choice were evaluated. Results: The sample consisted predominantly of young, brown, married adult women with average body mass index (BMI), higher education level, and belonging to the upper-middle class, most of whom were physically active and did not reveal any bias. The most used criterion for choosing the plastic surgeon was the indication of friends or family. Conclusion: This study produced reliable results for describing patients' sociodemographic characteristics and life habits, allowing the identification of the most relevant factor in the plastic surgeon's choice.

Demographics and outcome of patients with congenital haemophilia in Sarawak, Malaysia

@#Introduction: Sarawak has a population that is geographically and characteristically widely varied. This study aimed to determine the demographic profile of patients in Sarawak, Malaysia. Materials and Methods – A cross-sectional study was conducted in 2019 at four major haemophilia treatment centres in Kuching, Sibu, Bintulu and Miri Hospitals, Sarawak. Demographic and clinical data were collected with consents from patients. Results and Discussion: Ninety-six haemophilia patients were identified - 79(82.3%) haemophilia A(HA) and 17(17.7%) haemophilia B(HB). Severe haemophilia patients were noted in 45.6% (36/79) of HA and 64.7% (11/17) of HB. In all 44.3% of the HA and 52.9% of the HB population had no identifiable family history of haemophilia. Two-thirds of the patients with severe HA were on prophylaxis [24/36 (66.7%)] and only onethird [4/11 (36.4%)] in severe HB. Inhibitors developed in 9/79 (11.4%) of the HA population [3/79 (3.8%) high responders]. The median inhibitor titre was not significantly different between the different treatment groups – on demand versus prophylaxis (1.0BU versus 2.0BU; z statistic -1.043, p-value 0.297, Mann-Whitney test). None of the patients developed inhibitory alloantibodies to factor IX. Four HA patients (5.1%) underwent immune tolerance induction where one case had a successful outcome. Three severe HA patients received emicizumab prophylaxis and showed remarkable reduction in bleeding events with no thromboembolic events being reported. One female moderate HA patient received PEGylated recombinant anti-haemophilic factor. Eleven patients underwent radiosynovectomy. One mild HB patient succumbed to traumatic intracranial bleeding. Our data reported a prevalence (per 100,000 males) of 5.40 cases for all severities of HA, 2.46 cases for severe HA; 1.16 cases for all severities of HB, and 0.75 cases for severe HB. The overall incidence of HA and HB was 1 in 11,500 and 1 in 46,000, respectively. Conclusion: This study outlines the Sarawakian haemophilia landscape and offers objective standards for forward planning. Shared responsibilities among all parties are of utmost importance to improve the care of our haemophilia population.

Dr. Francisco Rojas Ochoa: actor, testigo y gloria de la salud pública cubana / Dr. Francisco Rojas Ochoa: actor, witness and glory of Cuban public health

El Dr. Francisco Rojas Ochoa fue un intelectual pleno, poseedor de una sensibilidad artística realmente formidable. Sus aportes más notables trascendieron el marco de la ciencia. Desde muy temprano, comprendió la importancia de cuidar la calidad del dato primario como pilar de las estadísticas de salud; defendió infatigablemente los principios de la Salud Pública Cubana, se sumó al combate decidido contra la pseudociencia, cultivó la demografía, las técnicas de dirección administrativa y, sobre todo, la ética médica. Desplegó una valiosa contribución a la Historia de la Medicina y la Salud Pública. No tuvo formación estadística, pero sí un poderoso sentido común que le permitía apropiarse de los resultados de esta disciplina, para cuya interpretación práctica demostraba gran destreza. Durante toda su vida publicó decenas de artículos científicos y numerosos libros. La etapa más fructífera la desarrolló en el marco de diversas instituciones académicas, entre ellas, nuestra actual Escuela Nacional de Salud Pública. Su última publicación, considerada entre las más destacadas, fue Actor y Testigo, constituye un verdadero testamento intelectual(AU)

Dr. Francisco Rojas Ochoa distinguished himself by a full intellectual conviction and a really formidable artistic sensitivity. His most outstanding contributions went beyond the framework of science. Very early in his life, he realized the importance of caring for the quality of primary data as a pillar of health statistics; he tirelessly defended the principles of the Cuban Public Health, joined the decided combat against pseudoscience, developed demography and management techniques and, above all, he safeguarded the principles of medical ethics. He made a significant contribution to the History of Medicine and Public Health. Dr. Rojas Ochoa did not have statistical formation, but he actually had a powerful common sense that allowed him to benefit from its results, demonstrating great skill for their interpretation. During all his life, he published lots of scientific articles and many books. His most fruitful period was specially developed within the framework of several academic institutions, among them, our National School of Public Health. His last publication, which is considered one of the most outstanding, is "Actor y Testigo", a genuine intellectual testament that reveals both privileged spaces as reflected in its title(AU)

Prevalence and Associated Risk Factors of Dehydration among Pregnant Women in Southern Nigeria

Background:Despite available evidences that pregnant women are specific vulnerable target population for dehydration and the importance of adequate hydration to both the mother and the developing fetus, studies assessing the prevalence and associated risk factors of dehydration among pregnant women are limited.Aim:The aim of the present study was to determine the prevalence and associated risk factors of dehydration among pregnant women in Uyo metropolis, Southern Nigeria. Methods:A total of 316 pregnant women from selected obstetric centers in Uyo Metropolis met the inclusion criteria and were evaluated for socio-demographics, lifestyle-related behaviors and urinary specific gravity using standard instruments. Mean values were calculated and used for the determination of the hydration status of the participants. Univariate analysis was used to assess the relationship between socio-demographic variables and lifestyle related behaviours and prevalence of dehydration. Multiple logistic regression analysis was used to determine odds ratios (ORs) and 95% confidence interval for factors associated with dehydration in pregnancy Results:About 14.6% of the pregnant women were dehydrated, and factors associated with high prevalence of dehydration were age between 26 and 35 years, being married, urban residence, acquiring a tertiary education and income between 20,000 and 50,000 naira. Others were, null-parity, third trimester of pregnancy, physically active, poor dietary habits, alcohol consumption, inadequate water intake and short sleep duration. Inadequate water intake (1-2 cups of water) (OR=6.10,C.I=2.029-18.360) or 5-7cups of water(OR=4.04,C.I=1.385-11.785), consumption of mostly high carbohydrate diets (OR=3.55,C.I=1.003-12577), consumption of mostly high protein diets (OR=3.25,C.I=1.893-11.844) and craving for strange foods(OR=3.71, C.I=1.563-8.81) significantly increased the odds for dehydration among the participants.Conclusion:Demographic, obstetric and lifestyle-related factors drive the high prevalence of dehydration among pregnant women and should be considered in designing intervention programs to prevent dehydration among pregnant women in our communities

Vulnerabilidad al estrés en pacientes adultos hipertensos / Vulnerability to the stress in hypertensive adult patients

RESUMEN Introducción: En la hipertensión, el estrés constituye un factor sicosocial de riesgo. Objetivo: establecer la relación entre vulnerabilidad al estrés con variables sociodemográficas y clínicas en pacientes hipertensos adultos del Policlínico Santa Cruz. Métodos: Estudio descriptivo, transversal. El universo lo conformaron 65 hipertensos, diagnosticados de enero a junio del 2019. La muestra intencional fue de 58 hipertensos. Para la recogida de información se emplearon: la Historia Clínica Individual y familiar y el Test de Vulnerabilidad al Estrés. Resultados: Predominio del 70,7 % de hipertensos en la tercera subetapa de la adultez, supremacía femenina (69,0 %); la mayoría con secundaria básica terminada (36,2 %); casados (44,8 %) y trabajadores estatales (51,7 %); predominaron los fumadores (81 %); prevaleció la hipertensión arterial grado II (69 %) y dieron cumplimiento al tratamiento el 53,4 %. La mayoría presentó vulnerabilidad al estrés (65,5%); mejor representado en la tercera subetapa de la adultez (81,6 %), mujeres (63,2 %), con secundaria básica terminada (39,5 %), casados (42,1 %), trabajador estatal (55,3 %), fumadores (76,3 %), con hipertensión arterial grado II el 76,3 %; cumplieron el tratamiento siempre el 55,3 %; presentaron nivel vulnerable al estrés el 68,4 % de los hipertensos. Existió asociación entre el nivel seriamente vulnerable al estrés y la escolaridad primaria (p= 0,007). La mayoría de los hipertensos presentaron vulnerabilidad al estrés. El nivel vulnerable al estrés predominó; mejor representado en la tercera subetapa de la adultez, en las mujeres, los fumadores, los hipertensos grado II y los que siempre cumplían con el tratamiento. Existió asociación entre el nivel seriamente vulnerable al estrés y la escolaridad primaria.

ABSTRACT Introduction: In the hypertension, the stress constitutes a psychosocial risk factor. Objective: To establish the relation between vulnerability to the stress with socio-demographics and clinical variables in adult hypertensive patients of the General hospital Santa Cruz. Methods: Descriptive, transverse study. The universe was constituted of 65 hypertensive patients, diagnosed from January until June, 2019. The intentional sample was 58 hypertensive patients. For the information collection, it was used: the Individual and familiar Case history and the Test of Vulnerability to the Stress. Results: Predominance 70.7 % of hypertensive patients in the third sub-stage of the adulthood, feminine supremacy (69.0 %); the majority with secondary school finished (36.2 %); married (44.8 %) and state workpeople (51.7 %); there prevailed the smokers (81 %); the arterial hypertension grade II prevailed (69 %) and they fulfilled the treatment 53.4 %. The majority presented vulnerability to the stress (65.5 %); better represented in the third sub-stage of the adulthood (81.6 %), women (63.2 %), with secondary school finished (39.5 %), married (42.1 %), state worker (55.3 %), smokers (76.3 %), with arterial hypertension grade II 76.3 %; they always fulfilled the treatment 55.3 %; they presented vulnerable level to the stress 68.4 % of the hypertensive patients. Association existed between the level seriously vulnerably to the stress and the primary schooling (p = 0.007). Discussion: Most of the hypertensive patients presented vulnerability to the stress. The vulnerable level to the stress prevailed; better represented in the third sub-stage of the adulthood, in the women, the smokers, hypertensive grade II and those who were always fulfilled with the treatment. Association existed between the level seriously vulnerably to the stress and the primary schooling.

Amputation demographic assessment at Saiful Anwar hospital: 5 years of study

Background: Loss of limbs occurs due to different causes and has increased in many countries. This has large economic, physical and social impacts. This study investigates the demographics of patients undergoing amputation at Saiful Anwar Hospital Malang.Methods: This retrospective study was done from January 2014 to December 2018. The patient demographics included age, sex, organ amputation, etiology and amputation level. A total of 479 patients were studied in the study.Results: The average amputation value was 95.8 per year and varied from 72 to 134. The average age of the subjects was 44 years. Of all patients, 311 were male (64.93) and 168 women (35.07), 236 of amputations (49.27%) were major and 243 (50.73%) were minor.Conclusions: The main cause of amputation is trauma and most often is the amputation of the lower extremity. In trauma patients, the average age is 29 years. This result shows the same characteristic in the cause of amputation as in many other developing countries based on some studies. Trauma is the most common cause of amputation in Malang.

Demographics and Clinical Profile of Orofacial Cleft in International Islamic University Malaysia from 2009 until 2018

@#Orofacial clefts (OFC) are the most common craniofacial anomalies. There is no published data regarding the demographic of OFC cases seen in International Islamic University Malaysia (IIUM), since the establishment of the IIUM Multi-Disciplinary Cleft Team (IIUM-MDCT). The present study aimed to build a database on demographic profile of OFC cases seen in IIUM from 2009 until 2018. Data from all registered OFC cases were obtained from the medical records. Birth prevalence was tabulated against the population statistics for the period, obtained from the Department of Statistics Malaysia. A total of 20 cases were seen over the period of nine years. The registry recorded about 60% of females and 40% of males. Age distribution was 40% below the age of 10 years old, 40% between 11 to 20 years old and 20% of 21 years old and above. As for race, 90% were Malay, 5% were Chinese and Indian, respectively. Majority of patients (75%) were from Kuantan, 10% from Kemaman and 5% from Pekan, Kuala Terengganu and Kota Bharu, respectively. The most common OFC was cleft lip and palate (80%), followed by cleft palate (15%) and facial cleft (5%). The LAHSHAL classification was recorded with 75% of cases were unilateral, of which 73% affecting the left side. Other health anomalies were recognised in 45% of cases and 20% of them has family history of cleft. The present study could provide a baseline information on the status of OFC patients seen by IIUM-MDCT.

Valoración de las Características Laborales de los Estudiantes del Último Año de la Facultad de Odontología de la Universidad de Buenos Aires / Assessment of the Job Characteristics of the Final Year Students of the Faculty of Dentistry, University of Buenos Aires

Objetivos: Identificar las características sociodemográficas y la situación laboral de los estudiantes del último año de la Carrera. Un grupo de 145 alumnos, de un total de 174 inscriptos en la asignatura de Odontología Integral Niños del último año de la Carrera, respondieron a un cuestionario anónimo y voluntario, para indagar sobre edad, sexo, nacionalidad, estado civil, lugar de residencia primario, núcleo de convivencia, condición laboral, familiares odontólogos. La información de las variables fue ingresada a una base de datos para su análisis estadístico. Los resultados arrojaron edad media: 27±5 años, 80.68% femeninos, 8.27% extranjeros latinoamericanos. Según los listados de inscripción definitivos de la Cátedra, solo el 19.32% se encontraban cursando la Carrera en el tiempo previsto. Respecto a la condición laboral, 49% refieren que trabajan 20.5±10,9 horas semanales. De éstos, el 49,31% considera que el trabajo tiene mucha relación con la carrera. En relación a las dificultades horarias para cursar, el 17,8% consideró que siempre las tiene y el 39,7% muchas veces. La edad entre quienes trabajan y no lo hacen no presentó diferencias p=0.1593. En conclusión, casi la mitad de los estudiantes del último año de la carrera conjugan sus estudios con algún tipo de trabajo remunerado. Si bien pareciera que existe compatibilización con el desempeño de la actividad laboral, deberán enfatizarse las estrategias que permitan minimizar las dificultades que se presentan al momento de la cursada (AU)