ABSTRACT
RESUMEN Objetivo Estimar la capacidad predictiva de los determinantes próximos y el trabajo en la disminución de la fertilidad en mujeres peruanas en edad fértil. Métodos Análisis secundario de la Encuesta Demográfica y de Salud Familiar (ENDES) de 2014 de Perú. La muestra fue de 20 396 mujeres entre 15 y 49 años de edad con actividad sexual en las cuatro semanas previas a la entrevista realizada. La variable dependiente fue el número total de hijos nacidos vivos y las variables independientes principales incluidas, trabajo, número ideal de hijos, máximo nivel educativo alcanzado y quintiles de riqueza. Se calcularon odds ratios (OR) para estimar la fuerza de las asociaciones entre los determinantes próximos y la ocupación y la fertilidad mediante modelos de regresión logística. Se estimó la bondad de ajuste de los modelos con la prueba de Hosmer-Lemeshow y su capacidad discriminante, con curvas ROC. Resultados La fertilidad deseada (2,5 hijos por mujer) fue más alta que la real (2,1). Los principales factores asociados con la reducción de la fertilidad fueron el nivel educativo superior (OR = 0,03; IC95%: 0,02–0,04), el número ideal de hijos entre 0 y 2 (OR = 0,13; IC95%: 0,11–0,15), y el trabajo dependiente (OR = 0,31; IC95%: 0,28–0,34). El área bajo la curva de los modelos fue 0,908 (IC95%: 0,898–0,917) y 0,91 (IC95%:0,891–0,928), respectivamente. Conclusión La acción de los determinantes directos (edad de inicio de las relaciones sexuales y del matrimonio) retrasa el comienzo de la maternidad, mientras que los determinantes indirectos (mayor nivel educativo y pertenencia al quintil superior de riqueza) suponen una mayor autonomía económica, que, a su vez, se asocia con niveles bajos de fertilidad. Asimismo, cuanto mayor es la dependencia en el trabajo, menor es la fertilidad de las mujeres encuestadas.
ABSTRACT Objective To estimate the predictive capacity of proximate determinants and type of employment with respect to reduced fertility in Peruvian women of childbearing age. Methods Secondary analysis of Peru’s Demographic and Family Health Survey (ENDES) for 2014. The sample consisted of 20 396 women aged 15 to 49 years who had been sexually active during the four-week period immediately before the interview. The dependent variable was the total number of live births, and the main independent variables were type of employment, ideal number of offspring, highest educational level attained, and wealth quintile. Odds ratios (OR) were used to estimate the strength of the associations between proximate determinants and type of employment on the one hand and fertility on the other in logistic regression models. The goodness of fit of the models was estimated using the Hosmer-Lemeshow test and its discriminatory capacity, based on receiver operating characteristic curves. Results Desired fertility (2.5 children per woman) was higher than actual fertility (2.1). The factors most strongly associated with reduced fertility were higher educational attainment (OR = 0.03; 95% CI: 0.02-0.04); ideal number of offspring between 0 and 2 (OR = 0.13; 95% CI: 0.11-0.15); and dependent employment (OR = 0.31; 95% CI: 0.28–0.34). The models’ areas under the curve were 0.908 (95% CI: 0.898-0.917) and 0.91 (95% CI: 0.891-0.928), respectively. Conclusion Older age at first sexual intercourse and older age when first married (direct determinants) delay childbearing, whereas higher educational level and belonging to the highest wealth quintile (indirect determinants) indicate greater economic autonomy, which, in turn, is associated with low fertility. Similarly, the more dependent the work, the lower the fertility of the women surveyed.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Employment/classification , Infertility, Female/epidemiology , PeruABSTRACT
INTRODUCTION: Triatoma brasiliensis is the species of greatest epidemiological relevance in the semi-arid region of Brazil. This species is predominantly found in domestic environments, and it has the ability to build large colonies with high levels of natural infection via Trypanosoma cruzi. Thus, T. brasiliensis is one of the most efficient transmitters of Chagas disease (CD) to humans. Despite household spraying with residual insecticides, many areas report persistent reinfestations for reasons that remain poorly understood. Therefore, this study sought to characterize the toxicological profile of deltamethrin in T. brasiliensis from areas with persistent reinfestation in State of Ceará, Brazil. METHODS: The susceptibility reference lineage (SRL) was derived from Umari. Serial dilutions of deltamethrin were prepared and applied to the dorsal abdomen of first instar nymphs. The control group received only pure acetone. Mortality was evaluated after 72h. Qualitative tests assessed mortality in response to a diagnostic dose of 1xLD99 (0.851 nanograms of active ingredient per treated nymph) of the SRL. RESULTS: The susceptibility profile characterization of the T. brasiliensis populations revealed 50% resistance ratios (RR50) that ranged from 0.32 to 1.21. The percentage of mortality in response to the diagnostic dose was 100%. CONCLUSIONS: We demonstrated that T. brasiliensis was highly susceptible to deltamethrin. The control difficulties found might be related to the recolonization of the triatomines originating from neighboring environments and the possible operational failures related to the process of spraying that enabled specimens less susceptible to deltamethrin to survive. .
Subject(s)
Adult , Aged , Child , Female , Humans , Infant, Newborn , Male , Middle Aged , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Health Status Disparities , Metabolic Syndrome/epidemiology , Metabolic Syndrome/etiology , Social Class , Causality , Cohort Studies , Employment/classification , United Kingdom/epidemiology , Infant, Low Birth Weight , Logistic Models , Lipoproteins, LDL/blood , Risk Factors , Socioeconomic FactorsABSTRACT
El objetivo fue examinar la relación entre clase social, riesgo psicosocial laboral y la salud autopercibida y mental en Chile. Se trata de un estudio transversal con los datos de la Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Calidad de Vida y Salud de los Trabajadores y Trabajadoras en Chile (N = 9.503). Las variables dependientes son: salud mental y salud autopercibida. Las variables explicativas son: clase social neo-marxista, factores de riesgo psicosocial y privación material. Se realizaron análisis descriptivos y de regresión logística. Existen desigualdades en la distribución de los factores exposición laboral a riesgos psicosociales, según clase social y sexo. Además, la clase social y los factores de riesgo psicosocial en el trabajo están asociados a una distribución desigual de la salud autopercibida y salud mental entre la población trabajadora en Chile. Las intervenciones en el área de la salud de los trabajadores deben considerar la clase social y los factores de riesgo psicosocial a que están expuestos los trabajadores.
The objective of this study was to analyze the association between social class and psychosocial occupational risk factors and self-rated health and mental health in a Chilean population. A cross-sectional study analyzed data from the First National Survey on Employment, Work, Quality of Life, and Male and Female Workers in Chile (N = 9,503). The dependent variables were self-rated health status and mental health. The independent variables were social class (neo-Marxist), psychosocial occupational risk factors, and material deprivation. Descriptive and logistic regression analyses were performed. There were inequalities in the distribution of psychosocial occupational risk factors by social class and sex. Furthermore, social class and psychosocial occupational risk factors were associated with unequal distribution of self-rated health and mental health among the working population in Chile. Occupational health interventions should consider workers’ exposure to socioeconomic and psychosocial risk factors.
O objetivo foi analisar a associação entre classe social, fatores psicossociais de risco laboral e saúde autopercebida e saúde mental entre a população trabalhadora chilena. Estudo transversal com os dados da Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Calidad de Vida y Salud de los trabajadores y trabajadoras en Chile (N = 9.503). As variáveis dependentes são: saúde autopercebida e saúde mental. As variáveis explicativas são a classe social (neo-marxista), os fatores psicossociais de risco laboral e privação material. Foram realizadas análises descritivas e de regressão logística. Existem desigualdades na distribuição dos fatores psicossociais de risco laboral segundo classe social e sexo. Além disso, a classe social e os fatores de risco psicossociais no trabalho estão associados a uma distribuição desigual da saúde autopercebida e saúde mental. As intervenções na área da saúde dos trabalhadores devem considerar a classe social e fatores de risco psicossociais a que os trabalhadores estão expostos.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Employment/psychology , Mental Health , Occupational Health , Occupations/classification , Social Class , Workplace/psychology , Chile , Cross-Sectional Studies , Diagnostic Self Evaluation , Employment/classification , Health Surveys , Occupations/statistics & numerical data , Risk Factors , Self Concept , Workplace/statistics & numerical dataABSTRACT
O objetivo do estudo foi analisar se o tipo de vínculo de trabalho está associado a diferenças no acesso e utilização dos serviços de saúde. Utilizando os microdados da Pesquisa Nacional por Amostra de Domicílios (PNAD/2008) foram estudados trabalhadores de 18 a 64 anos (N = 152.233), de ambos os sexos. Foram calculadas prevalências e razões de prevalência brutas e ajustadas das características de saúde dos trabalhadores por meio de regressão de Poisson. Em relação aos formais (n = 76.246), os informais (n = 62.612) e desempregados (n = 13.375) apresentaram menor escolaridade, menor renda mensal, pior estado de saúde autorreferido, maior frequência de "acamado nas duas últimas semanas", maior dificuldade de acesso e menor procura e uso dos serviços de saúde, mesmo após ajuste para sexo, faixa etária, região, escolaridade e informante. Há necessidade de políticas de saúde que diminuam a desigualdade no acesso aos serviços de saúde pelos trabalhadores informais e desempregados.
The aim of this study was to analyze whether job market status is associated with differences in health services access and use. Data from the Brazilian National Household Sample Survey (PNAD/2008) were used to study workers 18 to 64 years of age, both men and women (N = 152,233). Prevalence and crude and adjusted prevalence ratios for the worker's health characteristics were calculated using Poisson regression. When compared to formal workers (n = 76,246), informal workers (n = 62,612) and unemployed (n = 13,375) showed less schooling, lower monthly income, worse self-reported health status, more frequent reporting of have been "bedridden in the previous two weeks", greater difficulty in accessing health services, and lower health services seeking, even after controlling for sex, age bracket, region, schooling, and respondent. Health policies are needed to reduce inequalities in access to health services by informal workers and the unemployed.
El objetivo del estudio fue analizar si el tipo de situación en el empleo se asocia con diferencias en el acceso y utilización de los servicios de salud. Utilizando datos microeconómicos de la Encuesta Nacional por Muestra de Domicilio (PNAD/2008) se estudiaron trabajadores de 18 a 64 años (N = 152.233) de ambos sexos. Se calcularon prevalencias y razones de prevalencia ajustadas y características manifiestas de los trabajadores de la salud a través de regresión de Poisson. En situaciones de relación formal (n = 76.246), informal (n = 62.612) y desempleo (n = 13.375) contaban con menor educación; menores ingresos; peor percepción del estado de salud, una mayor incidencia de "postrado en cama las últimas dos semanas", de mayor dificultad de acceso y de disminución en la demanda y utilización de servicios de salud, incluso después de realizar ajustes por sexo, edad, región, educación, e informante. No es necesario que las políticas de salud reduzcan la desigualdad en el acceso a los servicios de salud para los trabajadores desempleados e informales.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Employment/statistics & numerical data , Health Inequities , Health Services Accessibility/statistics & numerical data , Health Services , Healthcare Disparities/statistics & numerical data , Unemployment/statistics & numerical data , Brazil/epidemiology , Cross-Sectional Studies , Employment/classification , Health Surveys , Health Services Needs and Demand/statistics & numerical data , Poisson Distribution , Prevalence , Sex Factors , Socioeconomic Factors , Unemployment/classificationABSTRACT
El trabajo infantil constituye una compleja problemática que vulnera los derechos fundamentales de la niñez y afecta el desarrollo psicofísico de niños y niñas. La Argentina ha adoptado la postura abolicionista, promoviendo su prevención y erradicación dentro de una política pública inclusiva, destinada a que todos los niños y las niñas puedan ejercer sus derechos. La Sociedad Argentina de Pediatría adhiere a esta postura y se propone, como línea de acción, la formación del equipo de salud y la difusión sobre los riesgos del trabajo infantil y las normas de seguridad del trabajo adolescente. Como pediatras debemos involucrarnos en la defensa de los derechos y capacitarnos para detectar cualquier situación de trabajo infantil, de modo de proteger la salud de los niños, niñas y adolescentes. La interacción conjunta con la familia, la comunidad y otros sectores de la sociedad fortalecerán la red necesaria que posibilite implementar las políticas de erradicación del trabajo infantil.
Child labor is a complex problem that violates the fundamental rights of children and affects their psychophysical development. Child labor affects 215 million children in the world and 115 million perform activities defined as the "worst forms of child labor". Most child labor is in agriculture (60%), where the majority are unpaid family workers, compared to 26% in services and 7% in industry. Argentina has adopted the abolitionist position, promoting prevention and eradication within an inclusive public policy aimed to all children can exercise their rights. The Sociedad Argentina de Pediatría endorses this approach and proposes a course of action: the health team training, and dissemination of the risks of child labor and occupational teenager safety standards. As pediatricians we must be involved in defending children rights, and be able to detect any situation of child labor, and protect the health of children and adolescents. The joint interaction with family, community and other sectors of society will strengthen the network needed to implement child labor erradication policies.
Subject(s)
Adolescent , Child , Female , History, 16th Century , History, 17th Century , History, 19th Century , History, 20th Century , Humans , Male , Child Advocacy , Employment , Social Problems , Argentina , Agriculture/statistics & numerical data , Child Development/physiology , Child Welfare/history , Employment/classification , Employment/history , Employment/legislation & jurisprudence , Social Problems/legislation & jurisprudence , Social Problems/prevention & controlABSTRACT
OBJECTIVES: This study examined the trends in gender disparity in the self-rated health of people aged 25 to 64 in South Korea, a rapidly changing society, with specific attention to socio-structural inequality. METHODS: Representative sample data were obtained from six successive, nationwide Social Statistics Surveys of the Korean National Statistical Office performed during 1992 to 2010. RESULTS: The results showed a convergent trend in poor self-rated health between genders since 1992, with a sharper decline in gender disparity observed in younger adults (aged 25 to 44) than in older adults (aged 45 to 64). The diminishing gender gap seemed to be attributable to an increase in women's educational attainment levels and to their higher status in the labor market. CONCLUSIONS: The study indicated the importance of equitable social opportunities for both genders for understanding the historical trends in the gender gap in the self-reported health data from South Korea.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Age Factors , Data Collection , Educational Status , Employment/classification , Health Status Disparities , Republic of Korea , Sex Factors , Social Change , Social Class , Women's Health/trends , Women's Rights/trendsABSTRACT
OBJECTIVES: We examined gender differential changes in employment-related health inequalities according to occupational position (professional/nonprofessional) in South Korea during the last decade. METHODS: Data were taken from four rounds of Social Statistical Surveys of South Korea (1995, 1999, 2003, and 2006) from the Korean National Statistics Office. The total study population was 55435 male and 33 913 female employees aged 25-64. Employment arrangements were divided into permanent, fixed-term, and daily employment. RESULTS: After stratification according to occupational position (professional/nonprofessional) and gender, different patterns in employment - related health inequalities were observed. In the professional group, the gaps in absolute and relative employment inequalities for poor self-rated health were more likely to widen following Korea's 1997 economic downturn. In the nonprofessional group, during the study period, graded patterns of employment-related health inequalities were continuously observed in both genders. Absolute health inequalities by employment status, however, decreased among men but increased among women. In addition, a remarkable increase in relative health inequalities was found among female temporary and daily employees (p = 0.009, < 0.001, respectively), but only among male daily employees (p = 0.001). Relative employment-related health inequalities had clearly widened for female daily workers between 2003 and 2006 (p = 0.047). The 1997 Korean economic downturn, in particular, seemingly stimulated a widening gap in employment health inequalities. CONCLUSIONS: Our study revealed that whereas absolute health inequalities in relation to employment status increased in the professional group, relative employment-related health inequalities increased in the nonprofessional group, especially among women. In view of the high concentration of female nonstandard employees, further monitoring of inequality should consider gender specific patterns according to employee's occupational and employment status.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Economic Recession , Employment/classification , Health Status Disparities , Prejudice , Republic of Korea , Sex Factors , Women's Health/economicsABSTRACT
Presenta datos sobre la Encuesta Integrada de Hogares correspondiente a agosto 1997 - julio 1998. Ofreceinformación integrada del bienestar de los hogares, enfatizando a la educación formal y no formal de todos los miembros de cada hogar