ABSTRACT
Breast and cervical cancers are among the leading causes of female mortality. The reasons that make women adhere, or not, to screening guidelines are not only related to individual and health characteristics but are also placed in a wider social and cultural context. Social capital might facilitate the dissemination of relevant knowledge of and the adherence to cancer screening guidelines. This cross-sectional study explored the associations of individual-level social capital with breast and cervical cancer screening and the knowledge for the existence of relevant screening tests (Pap test and mammography) in the municipality of Gorgolaini, a rural area in Crete, Greece. A random sample of 131 of the 592 women of the 2001 electoral register were invited to participate in the study and 125 completed the Social Capital Questionnaire and two questions on self-reported health knowledge and behaviour (participation rate 95.4%). Women were eligible to participate if they were aged 35-75, had lived in the area for the last 10 years and were of Greek origin. Multiple logistic regressions were performed to establish associations among each social capital factor (total, participation in the community, value of life, tolerance for diversity, feelings of safety, family/friends connections) and knowledge of and adherence to breast and cervical cancer screening guidelines after adjustment for confounders. Our results suggest that early detection of breast and cervical cancers may be facilitated when taking into account the social context of the population.
Subject(s)
Breast Neoplasms/diagnosis , Early Detection of Cancer/psychology , Patient Compliance/psychology , Social Capital , Uterine Cervical Neoplasms/diagnosis , Adult , Aged , Cross-Sectional Studies , Early Detection of Cancer/statistics & numerical data , Female , Greece/epidemiology , Health Knowledge, Attitudes, Practice , Humans , Logistic Models , Mammography/psychology , Mammography/statistics & numerical data , Middle Aged , Papanicolaou Test/psychology , Papanicolaou Test/statistics & numerical data , Patient Compliance/statistics & numerical data , Rural Population/statistics & numerical dataABSTRACT
PURPOSE: Antenatal maternal mental health has been identified as an important determinant of postpartum depression (PPD). We investigated the occurrence of depression both antenatally and postnatally and examined whether maternal trait anxiety and depression during pregnancy were associated with PPD at 8 weeks postpartum in a prospective mother-child cohort (Rhea Study) in Crete, Greece. METHODS: 438 women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Trait subscale of the State-Trait Anxiety Inventory (STAI-Trait) questionnaires assessing antenatal depression and anxiety, respectively, during the third trimester of pregnancy as well as the EPDS at 8 weeks postpartum. RESULTS: The prevalence of women with probable depression (EPDS score ≥13) was 16.7 % at 28-32 weeks of pregnancy and 13.0 % at 8 weeks postpartum. A per 5 unit increase in the STAI-Trait subscale increased the odds for PPD by 70 % (OR = 1.70, 95 % CI 1.41, 2.05), whereas a per unit increase in EPDS during pregnancy increased the odds for PPD by 27 % (OR = 1.27, 95 % CI 1.19, 1.36). CONCLUSIONS: Our findings suggest that antenatal maternal psychological well-being has a significant effect on PPD, which might have important implications for early detection during pregnancy of women at risk for postpartum depression.
Subject(s)
Anxiety/epidemiology , Depression, Postpartum/epidemiology , Depression/epidemiology , Mothers/psychology , Pregnancy Complications/epidemiology , Adult , Animals , Anxiety/diagnosis , Anxiety/psychology , Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , Depression/diagnosis , Depression/psychology , Depression, Postpartum/diagnosis , Depression, Postpartum/psychology , Female , Greece/epidemiology , Humans , Mental Health , Personality Inventory , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/psychology , Pregnancy Trimester, Third , Prenatal Care , Prevalence , Prospective Studies , Psychiatric Status Rating Scales , Risk Factors , Surveys and QuestionnairesABSTRACT
BACKGROUND: Crete has been of great epidemiological interest ever since the publication of the Seven Countries Study. In 1988 a well-defined area of rural Crete was studied, with only scarce signs of coronary heart disease (CHD) despite the unfavorable risk profile. The same population was re-examined twelve years later aiming to describe the trends of CHD risk factors over time and discuss some key points on the natural course of coronary heart disease in a rural population of Crete. METHODS AND RESULTS: We re-examined 200 subjects (80.7% of those still living in the area, 62.4 +/- 17.0 years old). The prevalence of risk factors for CHD was high with 65.9% of men and 65.1% of women being hypertensive, 14.3% of men and 16.5% of women being diabetic, 44% of men being active smokers and more than 40% of both sexes having hyperlipidaemia. Accordingly, 77.5% of the population had a calculated Framingham Risk Score (FRS) > or = 15%, significantly higher compared to baseline (p < 0.001). The overall occurrence rate for CHD events was calculated at 7.1 per 1000 person-years (95% confidence interval: 6.8-7.3). CONCLUSION: The study confirms the unfavorable risk factor profile of a well defined rural population in Crete. Its actual effect on the observed incidence of coronary events in Cretans remains yet to be defined.
