Regional Disparity of Physical Function Limitation Among Older Adults in Thailand.

Thailand was among the first to introduce a universal healthcare coverage among low- and middle-income countries but, regional disparities remain in the health status of people. Using the 2016 Population Change and Well-being in the Context of Ageing Societies, a nationally-representative survey, the prevalence of having limitations in physical function activities, instrumental activities of daily living, or activities of daily living were identified to estimate how each was associated with region of residence, sociodemographic and health behaviour and conditions. It was observed that living in Bangkok was associated with having limitations in any form than the other four regions of the country where generally the socioeconomic status of its older population is lower. Although higher prevalence of functional status was consistently observed in Bangkok, older people in the rural areas have a disadvantage in healthcare because of lower socioeconomic capacity and less access to healthcare facilities.

Caracterización del cáncer de mama de un servicio de salud pública del sur de Chile según edad, período 2005-2015 / Characterization of breast cancer of a public health service in southern Chile according to age, period 2005-2015

INTRODUCCIÓN: En Chile ha aumentado la morbilidad y mortalidad por el cáncer de mama (CaMa), y el Servicio de Salud de Talcahuano (SST) ha realizado acciones para pesquisarlo precozmente y cumplir con las garantías explícitas en salud (GES) OBJETIVO: Caracterizar los ingresos por CaMa del SST en el período 2005-2015. MÉTODO: Estudio transversal de 1.077 mujeres diagnosticadas con CaMa en la Unidad de Patología Mamaria (UPM) del SST. Variables: edad, tipo histológico, etapificación, tratamiento y cumplimiento de las GES. Análisis univariado y bivariado con suite estadística SPSS v25. RESULTADOS: Los casos aumentaron en todo el período de estudio, excepto en 2011. Concentrando el 35,5% en mujeres de ≥65 años. El carcinoma ductal invasor ascendió al 73,5% de los tipos histológicos, y 41,9% tenía un tamaño tumoral entre 2 y 5 cms. Las mujeres de 65 y más años presentan los porcentajes más altos en frecuencia y tamaño de tumor. El 78,6% ingresó en etapa 0 a IIB. Los tratamientos más frecuentes fueron: hormonoterapia (81,4%), radioterapia (80,1%), mastectomía parcial (69,4%), quimioterapia (56,3%) y disección axilar (55,7%). El cumplimiento de las garantías GES, es mayor en la confirmación diagnóstica (87%) que en el inicio de tratamiento (77,3%). CONCLUSIÓN: Ascendió sostenidamente el CaMa en el SST, excepto en 2011, quizás condicionado por el terremoto del año 2010. La mayoría de los ingresos lo hacen en etapas tempranas, en mujeres ≥50 años (especialmente en ≥65 más) y con tratamientos más conservadores. Existe un alto cumplimiento de las GES del CaMa en el SST.

INTRODUCTION: Breast cancer morbidity and mortality has increased in Chile, and the Talcahuano Health Service (THS) has taken measures for an early detection and complying with the country's Explicit Health Guarantees program (GES in Spanish). OBJECTIVE: To characterize admissions to the THS for breast cancer between 2005 and 2015. Methods: Cross-sectional study, consisting of 1077 women who had been diagnosed with breast cancer in the Mammary Pathologies Unit of the THS. Variables: age, histological type, staging, treatment, and GES compliance. Univariate and bivariate analysis, using SPSS v25. RESULTS: Cases increased every year but on 2011, with 35.5% of them being women aged 65 or older. Invasive ductal carcinoma accounted for 73.5% of the histological types, while 41.9% presented a tumor size of 2-5 cm. Women aged 65 and older showed the highest percentages in frequency and tumor size. 78.6% of cases were admitted while on stages 0 to IIB. Most frequent treatments were hormone therapy (81.4%), radiotherapy (80.1%), partial mastectomy (69.4%), chemotherapy (56.3%), and axillary dissection (55.7%). GES compliance was higher in the diagnosis stage (87.0%) than at the start of treatment (77.3%). CONCLUSION: Breast cancer rates have steadily increased in the THS but on 2011, which could be due to the 2010 Chile earthquake. Most admissions are women aged 50 or more (especially ≥ 65), on early stages, and under more traditional treatments. There is a high rate of GES compliance in this health service.

Regional differences of nucleosides and amino acids in Elaphuri Davidiani Cornu / 中国中药杂志

In order to reveal the regional characteristics of nucleosides and amino acids in Elaphuri Davidiani Cornu,39 samples of Elaphuri Davidiani Cornu collected from 4 different regions were analyzed by UPLC-QTRAP ~®/MS2 method followed by orthogonal partial least-squares discrimination analysis( OPLS-DA) and cluster analysis( CA). The results showed all the samples contained abundant nucleosides and amino acids,with the total content of 45. 09 μg·g~(-1) and 634. 80 μg·g-1,respectively. The samples presented significant regional differences in the contents of individual components,and the main differential components included Ura,Hpro,Thr,Glu,G5 P,2'-dG,Adeno,Met,Ade,Gln,Orni,Phe,2'-dA,Hit,Lys,and Ile. Among them,Ura,Met,Glu,and Ile had the highest content in the samples from Dafeng in Jiangsu,Qinhu in Jiangsu,Beijing,and Shishou in Hubei,respectively. OPLS-DA and CA demonstrated that all the samples of Elaphuri Davidiani Cornu could be divided into three categories,reflecting the regional characteristics. The results indicated that the accumulation of nucleosides and amino acids in Elaphuri Davidiani Cornu was closely related to its habitat,providing a useful reference for the research on the quality formation,quality evaluation and control,as well as the comprehensive utilization of Elaphuri Davidiani Cornu. The findings suggested that the content factors of Ura,Met,Glu,and Ile could be included into the quality standard system of Elaphuri Davidiani Cornu as the characteristics of medicinal materials from different regions.

Cross-cultural Study about Cancer and Palliative Care in the Okinawa, Tohoku, and Tokyo Metropolitan Area

Background: Consideration of cultural aspects is important in medical care. We explored regional differences in cancer and palliative care among Okinawa, Tohoku, and Tokyo metropolitan area. Methods: We conducted a questionnaire survey of physicians involved in cancer medicine from September to November 2020. A total of 11 items related to physician experiences were rated using a 5-point Likert-type scale. Results: Responses were received from 553 physicians (187 in Okinawa, 219 in Tohoku, 147 in the Tokyo metropolitan area). In Okinawa, “When patients die, it is important that all family members are present at the last moment,” “Patients/family members primarily consult the elders of the family about the medical treatments,” “Family members hope the patients die at home, because the soul will not return when they die at the hospital,” “Patients/family members get advice from religious advisors about the medical treatments,” and “Family members wish to take the patient home when he/she is about to die and to confirm death at home” were significantly more frequently observed. In Tohoku, “Patients wish to be hospitalized at a specific season” was significantly more frequently reported. In Tohoku and Okinawa, “Patients hide cancer from neighbors and relatives” and “Elderly patients do not want treatment, because they cover the living expenses and education expenses for their children and grandchildren.” were significantly more frequently experienced. Conclusion: There are regional differences in cancer and palliative care in Japan. Being sensitive to the culture of the region is needed.

The Trend in Incidence and Case-fatality of Hospitalized Acute Myocardial Infarction Patients in Korea, 2007 to 2016

Prevalence of molar incisor hypomineralization and regional differences throughout Japan

BACKGROUND@#Molar incisor hypomineralization (MIH) frequently occurs in children worldwide. However, MIH prevalence throughout Japan has not yet been investigated. The purpose of this study was to clarify MIH prevalence rates and to consider potential regional differences throughout Japan.@*METHODS@#A total of 4496 children aged 7-9 years throughout Japan were evaluated in this study. MIH prevalence rates among children were evaluated in eight regions throughout Japan. A child's residence was defined as the mother's residence during pregnancy. The localization of demarcated opacities and enamel breakdown was recorded on a standard code form using a guided record chart. Logistic regression analysis was used to evaluate whether MIH prevalence rates differed among age groups, sex, and regions.@*RESULTS@#The overall prevalence of MIH in Japan was 19.8%. The prevalence of MIH was 14.0% in the Hokkaido region, 11.7% in the Tohoku region, 18.5% in the Kanto Shin-Etsu region, 19.3% in the Tokai Hokuriku region, 22.3% in the Kinki region, 19.8% in the Chugoku region, 28.1% in the Shikoku region, and 25.3% in the Kyushu region. These regional differences were statistically significant. Moreover, MIH prevalence rates decreased with age. No significant sex differences in MIH prevalence rates were demonstrated.@*CONCLUSIONS@#To our knowledge, this is the first MIH study carried out in several regions throughout Japan. Regional differences existed in MIH prevalence rates; particularly, MIH occurred more frequently in children residing in southwestern areas than those in northeastern areas of Japan.

Analysis on medical service and regional differences of private hospitals in China since the new healthcare reform / 中华医院管理杂志

Objective To analyze problems in the development of medical service at private hospitals, and provide references for promoting the development of these hospitals and implementing policies for encouraging this sector′s growth. Methods The data were collected from the statistical yearbook published by the National Health Commission of the People′s Republic of China, and descriptive analysis method was used to analyze the medical service workload and medical service efficiency of private hospitals in China since the new healthcare reform. Results Private hospitals accounted for 56. 39％ of the total number of hospitals in China, accounting for 21. 69％ of beds by the end of 2016. From the perspective of medical service workload, the service volume of these hospitals had increased yet at a small pace. The number of patients and inpatients received accounted for 12. 90％ and 15. 84％ respectively of all the hospitals in China. From the point of service efficiency, by the end of 2016, the bed utilization ratio was 62. 8％, the daily medical visits to their doctors were 5. 5 persons-times, and the daily number of hospitalized beds per doctor was 2. 2 beds. These numbers lag far behind public hospitals. The development of private hospitals varied with regions in imbalance. Conclusions Improving the social image, attracting talents and improving service quality are key to improving the medical service capacity of private hospitals.

Risk and related factors on metabolic syndrome among people who had received screening on physical check-up programs, in China / 中华流行病学杂志

Objective To explore the risk of developing metabolic syndrome (MS) by using the data from cohorts involving people having received screening programs for physical check-up,in three areas of China (Beijing,Hongkong and Taiwan).Methods A total number of 6 828 non-metabolic syndromic adults,who received physical examination for the first time and with records kept for longer than 5 years (between 2004 and 2010) at the MJ centers,were recruited.Criteria developed by the Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Chinese Adults in 2007 (JCDCG-2007) was used for defining the metabolic syndrome.Cox proportional hazards regression model was used to examine the difference of the risk of developing MS among the three cohorts that received the health screening programs.Results The standardized incidence densities of MS were 3.14 per 100 person-years,2.19 per 100 person-years and 2.03 per 100 person-years in the cohorts of Beijing,Hongkong and Taiwan,respectively.After adjusting for gender,age,cigarette smoking,dietary patterns at the baseline,the HRs for people in Beijing and Hongkong were 1.60 (95％CI:1.34-1.91) and 1.08 (95％CI:0.83-1.41) respectively,in developing MS,when compared with people from Taiwan.Factors as being male,elderly,cigarette smoking,meat/food intake dietary pattern and MS components at the baseline all showed significantly positive effects on the risk of developing MS.Conclusions There were significant differences regarding the risk of developing MS among health screening people from the Beijing,Hongkong and Taiwan.Factors as being male,elderly,cigarette smoking,meat/food intake,dietary pattern and MS components at the baseline appear to be the risk factors for developing the MS.

EGFR Mutation Status among NSCLCs in Southern Shaanxi / 现代生物医学进展

Objective:To analyze the EGFR gene polymorphism in the non-small cell lung (NSCLCs) cancer in southern of Shaanxi Province.Methods:The next generation sequencing technology was used to detect the mutation of exon 18,19,20 and 21 of EGFR gene.We analyzed EGFR gene mutation rate in NSCLCs patients.233 patients was involved in our study.Results:82 cases with EGFR gene mutations was found,the mutation rate of exon18,19,20 and 21 was 1.3％,16.3％,0％ and 18％ respectively.The mutation rate of EGFR in male patients was lower (31.2％,39/125) than that of female cases (39.8％,43/108),the mutation rate of squamous cell carcinoma (22％,9/41) was lower than that of adenocarcinoma (39.1％,75/192).Conclusions:NSCLCs patients from southern Shaanxi Province had high mutation rate ofEGFR gene,and exon 19 and exon 21 mutations were in the majority.EGFR gene mutation rate was not related to gender and pathological types.

Analysis of medical disqualification of 1281 students recruited into Air Force youth aviation school / 军事医学

Objective To analyze the results of the final aviation medical examination of 1281 students recruited into Air Force youth aviation schools in Hunan and Hubei provinces in order to provide reference for establishing the items and standards of medical selection .Methods The data of 1281 students who participated in final aviation medical examination of Air Force youth aviation schools in 2016 were collected , who came from 28 cities in the above two provinces .The disqualification rate and related unqualified medical items were calculated , and the differences of the disqualification rate and medical geographical areas in the 28 cities were analyzed .Results According to the disqualification rate , the top five departments were ophthalmology , otolaryngology, surgery, radiology and ultrasonic departments .The top 10 unqualified items were the lack of distant vision , fundus diseases , nasal anomaly , ametropia and strabismus , spine abnormality , audition abnormality, vestibular function badness , vitreous opacity, and lens abnormalities.There was no significant difference between the 28 cities in the disqualification rate (P >0.05) or between the two provinces (P >0.05). Conclusion The results of the final aviation medical examination reflect the quality and efficiency of the initial aviation medical examination .To improve the quality of medical selection , further research is needed to set a scientific standard for the initial aviation medical examination while strengthening the scientific protection and intervention of distant vision .The efficiency of selection depends on improving the accuracy of initial aviation medical examination in nasal cavity structure, body shape ,and lens opacity .With a better understanding of the disqualification rate and abnormal items in different cities , a scientific arrangement of professional staff and technical force can make the initial aviation medical examination better, thus effectively reducing the rate of false elimination rate and misdiagnosis .

Risk and related factors on metabolic syndrome among people who had received screening on physical check-up programs, in China / 中华流行病学杂志

Objective To explore the risk of developing metabolic syndrome (MS) by using the data from cohorts involving people having received screening programs for physical check-up,in three areas of China (Beijing,Hongkong and Taiwan).Methods A total number of 6 828 non-metabolic syndromic adults,who received physical examination for the first time and with records kept for longer than 5 years (between 2004 and 2010) at the MJ centers,were recruited.Criteria developed by the Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Chinese Adults in 2007 (JCDCG-2007) was used for defining the metabolic syndrome.Cox proportional hazards regression model was used to examine the difference of the risk of developing MS among the three cohorts that received the health screening programs.Results The standardized incidence densities of MS were 3.14 per 100 person-years,2.19 per 100 person-years and 2.03 per 100 person-years in the cohorts of Beijing,Hongkong and Taiwan,respectively.After adjusting for gender,age,cigarette smoking,dietary patterns at the baseline,the HRs for people in Beijing and Hongkong were 1.60 (95％CI:1.34-1.91) and 1.08 (95％CI:0.83-1.41) respectively,in developing MS,when compared with people from Taiwan.Factors as being male,elderly,cigarette smoking,meat/food intake dietary pattern and MS components at the baseline all showed significantly positive effects on the risk of developing MS.Conclusions There were significant differences regarding the risk of developing MS among health screening people from the Beijing,Hongkong and Taiwan.Factors as being male,elderly,cigarette smoking,meat/food intake,dietary pattern and MS components at the baseline appear to be the risk factors for developing the MS.

Study on Dynamic Changes and Regional Differences of Content of Salidroside in Ligustri Lucidi Fructus inZhejiangProvince / 中国中医药信息杂志

Objective To determine content of Salidroside in Ligustri Lucidi Fructus at different growth stages and in different regions in Zhejiang Province by HPLC; To provide the basis for more rational, efficient extraction of Salidroside from Ligustri Lucidi Fructus.Methods The Kromasil C18 column (4.6 mm×150 mm, 5μm) was used with mobile phase of acetonitrile-water (10:90); flow rate was 1.0 mL/min; detection wavelength was 220 nm; column temperature was set at room temperature; injection volume was 20μL.Results Salidroside was in good linear range within 0.71–3.55μg (r=0.999 4). The recovery rate of Salidroside was 95.6%–98.6% and the average recovery rate was 96.88%, RSD was 1.32% (n=5).Conclusion The content of Salidroside in Ligustri Lucidi Fructus gradually decreased with the extending of growing season. The contents of Salidroside were different at different growth stages and in different regions.

Analysis of regional difference in medical selection for teenager aviation school / 军事医学

Objective To discuss the reasons for the difference in the results of medical checkups for cardidates enlisted in teenager aviation classes, in order to offer tips for the establishment of regional training programs and improve the qualification rate and acceptability.Methods A total of 2894 junior high school graduates as candidates for selection to teenager aviation classes in 2015 were given a double-blind medical examination.Cross-sectional survey methodology was used to compare the differences in the results of physical examinations, for candidates from seven areas.Results The qualification rate of physical checkups in the above regions were significantly different.The regional differences in the rejection rate related to ophthalmology, surgery, neurology and ultrasound were significant(P 0.05).The vision, height and relative body mass in different regions were significantly different (P0.05).Conclusion The physical differences are the results of various factors.In order to improve the passing rate of candidats, the aviation training plan for teenager aviation classes should consider the geography, climate, socio-economic environment and the physical health of local students.We should implement training programs in line with local conditions reather than use a unified national standard.

Suicídio no Brasil, de 2000 a 2012 / Suicide in Brazil, from 2000 to 2012

Objetivos Identificar as causas e o perfil das vítimas, analisar a mortalidade nos últimos 13 anos e mapear mudanças assistenciais e socioeconômicas. Métodos Utilizaram-se dados do SIM e Datasus. Calcularam-se as proporções das causas de suicídio segundo as categorias do CID10, X60-X84, estratificando-se por lesões (X70-X84) e autointoxicações (X60-X69). Analisaram-se as incidências por raça/cor, escolaridade e faixa etária, de 2000 a 2012. Compararam-se variações na mortalidade por suicídio com mudanças regionais nos indicadores de cobertura, características socioeconômicas e demográficas. Resultados As maiores causas de suicídio foram enforcamento, lesão por armas de fogo e autointoxicação por pesticidas. Os mais acometidos foram os menos escolarizados, indígenas (132% superior à população geral) ou maiores de 59 anos (29% superior). As taxas entre homens são três vezes maiores em todas as regiões, embora tenha maior crescimento entre as mulheres (35%). A mortalidade mais elevada se encontra na região Sul (9,8/100.000) e o maior crescimento percentual, no Nordeste (72,4%). Conclusão A mortalidade por suicídio continua a crescer no país, com importantes variações regionais. A assistência à saúde também apresenta inequidades regionais, com importantes lacunas nos serviços de saúde. O Brasil ainda carece de programas governamentais que trabalhem efetivamente na prevenção do suicídio. Considera-se necessário estabelecer uma estratégia nacional de prevenção focalizando as populações de maior risco identificadas: índios, pessoas com menor escolaridade, homens e maiores de 60 anos, além da necessidade de ampliar a vigilância na comercialização ilegal de pesticidas. .

Objectives To identify the causes, the profile of the victims, and the mortality in the last 13 years, investigating the assistance and socioeconomic changes that may have influenced this outcome. Methods It was used data from the Mortality Information System, Ripsa, and Datasus. The proportions of causes of suicide were calculated according to the ICD10 categories X60-X84, stratifying by injuries (X70-X84) and self-intoxication (X60-X69). It was analyzed the incidence by race, color, education and age, from 2000 to 2012. It was compared variations in suicide mortality with regional changes in coverage indicators, socioeconomic and demographic characteristics. Results The major causes of suicide were hanging, injury by firearms and self-intoxication by pesticides. The most affected were the least educated, indigenous (132% higher than the overall population), people over 59 years (29% higher). Rates among men are three times higher than among women in all regions, though, has greater growth among women (35%). The highest mortality rate was found in the South (9.8/100,000) and the highest growth in the Northeast (72.4%) region. Conclusion Mortality from suicide continues to grow in the country, but with significant regional variations. Health care also presents regional inequities, with significant gaps in health services. Brazil still lacks government programs that work effectively in suicide prevention. It is considered necessary to build a national prevention strategy focusing on populations at greatest risk identified: Indians, people with less education, men and people over 60 years old. Besides it is necessary to expand surveillance on illegal marketing of pesticides. .

Cáncer de mama en Chile: mortalidades comparada: niveles nacional, regional y comunal, 1990-2011: análisis programático / National and regional mortality rates due to breast cancer in Chile from 1990 to 2011

Introducción: Son habituales las variaciones de frecuencia geográfico-poblacionales en muchas enfermedades y países o regiones, diferencias que pueden orientar sobre sus causas. En Chile faltan estudios recientes sobre cáncer de mama con esta perspectiva. Material y Método: Estudio descriptivo-analítico de mortalidad para niveles nacional: 2011 (8.711.546 mujeres), regional o Servicio de Salud Sur-Oriente (SSM-SO) (800.341) y dos comunas, Puente Alto y La Florida (374.886 y 199.243). Se analizaron tasas crudas, ajustadas y específicas por grupos quinquenales de edad, últimos 22 años (1990-2011). Resultados: Tasa cruda de mortalidad nacional sube en forma constante e importante (20 por ciento), de 12-13 por 100.000 hasta 15,7 por 100.000 mujeres (2009). Tasas crudas del SSMSO son más bajas. Mortalidad por cáncer mamario está disminuyendo en las mujeres jóvenes (30-34; 35-39; 40-44; 45-49), excepto las muy jóvenes (25-29) en ambos niveles: nacional y regional. Mortalidad comunal es más alta en comuna de La Florida. Estadíos avanzados III y IV que habían descendido en el SSMSO hasta bajo 20% del total de pacientes han ido subiendo hasta 28,3 por ciento (22,4+5,9) el 2009, cercano al nivel nacional estable del 29-30 por ciento. Esto coincide con alza de su mortalidad, además de hacerse próxima a la del país, comprobando hipótesis. Conclusiones: La creciente mortalidad por cáncer de mama en Chile derivaría de alta frecuencia mantenida de estadíos avanzados y del envejecimiento poblacional. Sin embargo, las mujeres senescentes no están consideradas en el programa nacional. Debería ampliarse pesquisa de este cáncer elevando edad a través de las enfermeras en la atención primaria y estudiar causas del aumento de estadíos avanzados en el SSMSO y sus diferencias comunales.

Background: Population or geographical differences in prevalence are observed for many diseases. These variations may give clues about the causes of the diseases. Aim: To study the geographical distribution of mortality for breast cancer in Chile. Material and Methods: Information was obtained from databases available at the Chilean Ministry of Health and the National Institute of Statistics. Crude and adjusted mortality rates during the period 1990-2011 were calculated according to quinquennial age groups, for two municipalities of Metropolitan Santiago. Results: In the study period, the crude mortality rates increased by 20%, from 12-13/100,000 women in 1990 to 15.7/100,000 women in 2009. Mortality is decreasing in women aged 30 to 49 years. This is not the case for women aged 25 to 29 years. Mortality is higher in La Florida Municipality. In South-Oriental Santiago, the frequency of advanced stages of the disease (III or IV), which initially were reduced to 20%, have steadily increased to 28.3% in 2009, a figure similar to the national frequency of 29 to 30%. This higher frequency of advanced stages coincides with the rise in mortality. Conclusions: The increasing mortality due to breast cancer would be secondary to the high frequency of advanced stages and population aging. However, older women are not considered in the national breast cancer program. Their inclusion should be considered.

Fatores associados a morar sozinho e suas diferenças regionais em idosos residentes de Porto Alegre e Manaus / Factors associated with living alone and its regional differences in elderly people residing in Porto Alegre and Manaus

Objetivos: verificar se características sociodemográficas, estilo de vida e estado da saúde estão associados ao fato de o idoso morar sozinho, analisando amostras populacionais de duas capitais brasileiras de regiões distintas, Porto Alegre e Manaus, e as possíveis diferenças entre seus residentes. Metodologia: fora realizada análise secundária de dados de dois estudos transversais com base populacional – realizados nas cidades citadas, em 2006 – que utilizaram idênticas metodologias e instrumentos de pesquisa. Modelos de regressão logística utilizaram a variável dependente morar sozinho, dicotômica. A amostra total foi de 1547 idosos (com idade igual ou superior a 60 anos) de ambos os sexos: 1078 em Porto Alegre e 469 em Manaus; 291 idosos moravam sozinhos (Manaus 39, Porto Alegre 252). Resultados: fatores significativamente relacionados com a chance maior de morar sozinho foram: ser mulher, ter renda individual de dois ou mais salários mínimos, ter menor número de filhos e receber ajuda para “habitação”. A idade da aposentadoria foi fator preditor significativo somente em idosos de Porto Alegre, enquanto a escolaridade foi significativa somente para Manaus. Estado de saúde, autopercepção de saúde e prevalência de comorbidades não foram fatores significativos para morar sozinho nas duas cidades. Conclusões: fatores socioeconômicos são preditores importantes para o idoso residir sozinho. Contrário ao que se supunha, ter pior estado de saúde não foi importante. Observamos mais idosos morando sozinhos em Porto Alegre, sendo estes influenciados por terem se aposentado com maior idade. Já em Manaus, ser alfabetizado foi um fato significante para morar sozinho.

Objectives: To verify whether if socio-demographic characteristics, lifestyle and health status contribute to the status of living alone in population samples from two distinct Brazilian capitals, Porto Alegre and Manaus, and the possible differences between its residents. Methods: We performed a secondary analysis of comparative data from two cross-sectional population-based studies, conducted in the cities of Porto Alegre and Manaus, in 2006, that used identical methodologies and research tools. Logistic regression models used living alone as dichotomous dependent variable. The total sample was 1547 elderly ( 60 years old) of both sexes: 1078 in Porto Alegre and 469 in Manaus. There were 291 elderly living alone (Manaus 39, Porto Alegre 252). Results: Factors significantly associated with greater chance of living alone were: being female, having individual income of two or more minimum wages, fewer children and receiving help for “housing”. The retiring age was a significant predictor only in the elderly of Porto Alegre, while scholarity was significant only for the city of Manaus. Health status, self-assessment of health and comorbidities were not significant predictors of living alone in both cities. Conclusions: socioeconomic factors are important predictors of living along among elderly. Contrary to popular belief, having poor health status was not an important factor. We observed a higher frequency of elderly living alone in Porto Alegre, city were retiring at older age was a significant predictor. Being literate was a significant predictor for elderly living alone only in Manaus.

The Impact of Health Investment Income Growth and Research on Rural-Urban Differences and Regional Differences / 中国卫生经济

Objective: To study the impact of the residents’ health investment income growth, and analyze rural-urban differences and regional differences. Methods: According to the provincial panel data from 1996 to 2011, two-way fixed effects model ( Two-way FE) is established in empirical analysis. Results: Health investment has positive effects on the income growth of residents, but rural-urban differences and regional differences exist. The health investment income growth effect of rural area is higher than urban, and the effect of western area is higher than the east. Conclusion: While improving the level of urban medical health investment, it needs to focus on health investment in rural and western area. To make the health investment on income growth effect play its work efficiently, and narrow the rural-urban income gap and regional income gap.

Folate status in the red blood cell and related geographical differences among 810 with 65- to 74- year-old population of two counties in Southern and Northern China / 中华流行病学杂志

Objective To assess the red blood cell (RBC) folate status among Chinese elderly population and its geographical differences between Southem and Northern regions,and to evaluate the correlation between RBC and plasma folate.Methods This study was conducted in two counties of Jiangsu and Hebei provinces of China.A total of 810 individuals aged 65-74 years were recruited.RBC folate in blood samples was measured by microbiological assay.Data on RBC folate was log-transformed before analysis.Means of RBC folate concentration were compared by t-test,and the prevalence rates of RBC folate deficiency for different characteristics were compared by x2 test.Results The geometric mean ofRBC folate concentration was 1083.3 nmol/L(95％CI:1034.11134.8) among the Southerners and 489.1 nmol/L (95％CI:466.7-512.6) among the Northerners,with the former being 2.2 times of the latter (t=23.684,P＜0.001 ).The prevalence rates of RBC folate deficiency were 1.0％ in the South and 28.9％ in the North (x2=124.06,P＜0.001).The concentrations of RBC folate were positively correlated with plasma folate (r=0.49,P＜0.001 ).After adjustment for region,sex,age,BMI,education,exposure to tobacco smoking and alcohol consumption,the correlation remained significant (r=0.38,P＜0.001 ).Conclusion In 810 Chinese elderly population aged 65-74 from the two counties,Southerners had a higher RBC folate concentration and a lower deficiency prevalence than those in the Northerners.The RBC folate concentration was positively associated with plasma folate.

Lecciones aprendidas de dos grandes estudios epidemiológicos de enfermedades cardio-cerebro-vasculares en las que ha participado Colombia: [editoriales] / Lessons learned from two large epidemiological studies of cardiovascular and cerebrovascular diseases in which Colombia took part: [editorial]

Dos recientes estudios epidemiológicos de gran envergadura en los que participó Colombia, el INTERHEART y el INTERSTROKE, demostraron que en Latinoamérica en general y en Colombia en particular, el principal factor de riesgo para la presentación de infarto agudo del miocardio y accidente cerebro vascular isquémico y hemorrágico es la obesidad abdominal, a diferencia del resto del mundo donde el principal factor de riesgo fue el aumento en las concentraciones plasmáticas del colesterol total y del colesterol LDL, en el primer caso, y la hipertensión arterial, en el segundo. Estos datos dan soporte a la propuesta de que en Latinoamérica la transición rápida de los modelos económicos experimentados en los últimos años junto con la urbanización acelerada son la causa del explosivo aumento de la obesidad abdominal, la diabetes mellitus tipo 2 y las enfermedades cardio-cerebro-vasculares.

Two recent large-scale epidemiological studies, INTERHEART and INTERSTROKE in which Colombia took part, demonstrated that in Latin America in general and particularly in Colombia, the main risk factor for the presentation of acute myocardial infarction and ischemic, and hemorrhagic stroke was the abdominal obesity in contrast to the rest of the world where the main risk factor was increase in plasma concentrations of total cholesterol and LDL-cholesterol for myocardial infarction, and hypertension for stroke . These data give support to the proposal that in Latin America the rapid transition in economic models experienced in the last years together with the fast urbanization has led to an explosive increase in abdominal obesity, diabetes mellitus type 2, and cardiovascular and cerebrovascular diseases.

Consumo de bebidas alcohólicas y ambiente social. Un enfoque multinivel / Alcohol consumption and social context. A multilevel approach

Objetivos: Tradicionalmente las variaciones en el consumo de bebidas alcohólicas se han estudiado en términos de las características individuales. Con este estudio nos propusimos valorar la contribución de los factores contextuales en conjunto con los individuales, en la cantidad de bebidas alcohólicas que los individuos consumen. Métodos: Se midieron variables en 2 niveles: individual y contextuales (vecindarios). Las primeras se obtuvieron de una muestra representativa de la población mayor de 15 años del municipio 10 de Octubre y las contextuales mediante entrevistas con los representantes del gobierno de las áreas del municipio. Se usaron 3 modelos multiniveles: modelo nulo, modelo de interceptos aleatorios y modelo de coeficientes dependientes. Resultados: Existen diferencias regionales en el consumo de bebidas alcohólicas y estas diferencias persisten después de ajustar por las características individuales, por lo que se le pueden atribuir a los contextos. De los factores contextuales estudiados, 4 tienen influencia directa en la cantidad de bebidas alcohólicas que los individuos consumen y 2 de ellos interactúan con la situación laboral de las personas. Por ejemplo, las personas que están desocupadas consumen más que las que tienen alguna ocupación, pero los desocupados que viven en vecindarios con numerosos puntos de venta de bebidas alcohólicas, consumen más que los desocupados que viven en vecindarios con menos puntos de venta. Conclusiones: Los modelos multiniveles son una herramienta importante que permiten estudiar los efectos individuales y contextuales que se relacionan con el consumo de bebidas alcohólicas. Los resultados de la aplicación de una estrategia de modelación multinivel sugieren que los factores individuales y contextuales desempeñan un papel importante en la estructuración del consumo de bebidas alcohólicas.

Objectives: Traditionally the variations in alcohol consumption have been studied in terms of individual characteristics. In the present study we intended to assess the contribution of contextual factors and individual factors as well, in the units of alcohol consumed per person per. Methods: We measured variables in two levels: individual and contextual (neighborhoods). The first ones were obtained by means of a cross-sectional survey of people 15 years an older in Havana City. Contextual variables were obtained through interviews with the representatives of the local government in the city. Three multilevel models were used: null model, random intercept models and dependent coefficients model. Results: Our findings suggest that there are variations in the average number of units consumed among neighborhoods and these differences persist after adjusting for individual characteristics; so part of the variations can be attributed to the contexts. Six contextual factors were studied. Four have direct influence in the average number of units consumed and two of them interact with the economic situation of the respondents. For example, people that are unoccupied consume more than those that have an occupation; but the unoccupied ones that live in neighborhoods with numerous alcohol outlets consume more than the unoccupied ones that live in neighborhoods with less alcohol outlets. Conclusions: The results suggest that individual and contextual factors play an important role in structuring the patterns of alcohol consumption in order to design better health promotions and prevention strategies. The high-level alcohol drinkers tend to group in neighborhoods with a large number of alcohol outlets.