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Intimate partner violence as a determinant of pregnancy termination among women in unions: evidence from the 2016-2018 Papua New Guinea Demographic and Health Survey. 亲密伴侣暴力是已婚妇女终止妊娠的决定因素:来自2016-2018年巴布亚新几内亚人口与健康调查的证据。
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-05-22 DOI: 10.1017/S002193202300007X
Williams Agyemang-Duah, Bernard Yeboah-Asiamah Asare, Collins Adu, Amma Kyewaa Agyekum, Prince Peprah

There is a demonstrated link between intimate partner violence (IPV) and pregnancy termination, and this association has received much attention in developed settings. Despite the high prevalence of IPV in Papua New Guinea (PNG), little is known about the association between these experiences and pregnancy termination. This study examined the association between IPV and pregnancy termination in PNG. The present study used population-based data from the PNG's first Demographic and Health Survey (DHS) conducted in 2016-2018. The analysis involved women aged 15-49 years who were in intimate unions (married or co-habiting). We used binary logistic regression modelling to analyse the association between IPV and pregnancy termination. Results were reported as crude odds ratios (cOR) and adjusted odds ratios (aOR) with 95% confidence intervals (CIs). Overall, 6.3% of women involved in this study had ever terminated a pregnancy, and 6 in 10 women (61.5%) reported having experienced IPV in the last 12 months preceding the survey. Of those women who experienced IPV, 7.4% had ever terminated a pregnancy. Women who had experienced IPV had a 1.75 higher odds of reporting pregnancy termination (cOR: 1.75; 95% CI: 1.29-2.37) than women who did not experience IPV. After controlling for theoretically and empirically relevant socio-demographic and economic factors, IPV remained a strong and significant determinant of pregnancy termination (aOR: 1.67, 95% CI: 1.22-2.30). The strong association between IPV and pregnancy termination among women in intimate unions in PNG calls for targeted policies and interventions that address the high prevalence of IPV. The provision of comprehensive sexual reproductive health, public education, and awareness creation on the consequences of IPV, regular assessment, and referral to appropriate services for IPV may reduce the incidence of pregnancy termination in PNG.

亲密伴侣暴力(IPV)与终止妊娠之间存在明确的联系,这种联系在发达国家受到了广泛关注。尽管IPV在巴布亚新几内亚(PNG)的流行率很高,但人们对这些经历与终止妊娠之间的关系知之甚少。本研究考察了巴布亚新几内亚IPV与终止妊娠之间的关系。本研究使用了巴布亚新几内亚2016-2018年进行的第一次人口与健康调查(DHS)的人口数据。分析对象是年龄在15-49岁之间的亲密伴侣(已婚或同居)。我们使用二元逻辑回归模型来分析IPV与终止妊娠之间的关系。结果以95%置信区间(ci)的粗优势比(cOR)和校正优势比(aOR)报告。总体而言,参与本研究的妇女中有6.3%曾终止妊娠,10名妇女中有6名(61.5%)报告在调查前的12个月内经历过IPV。在经历过IPV的女性中,7.4%曾终止妊娠。经历过IPV的妇女报告终止妊娠的几率高出1.75 (or: 1.75;95% CI: 1.29-2.37)。在控制了理论和经验相关的社会人口和经济因素后,IPV仍然是终止妊娠的重要决定因素(aOR: 1.67, 95% CI: 1.22-2.30)。巴布亚新几内亚亲密结合妇女中IPV与终止妊娠之间的密切联系要求制定有针对性的政策和干预措施,以解决IPV的高流行率。提供全面的性生殖健康、公共教育和提高对IPV后果的认识、定期评估和转介到适当的IPV服务机构,可减少巴布亚新几内亚终止妊娠的发生率。
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引用次数: 0
Determinants of unmet need for family planning: Evidence from the 2018 Turkey Demographic and Health Survey. 计划生育需求未得到满足的决定因素:2018年土耳其人口与健康调查的证据。
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-06-13 DOI: 10.1017/S0021932023000123
Zeynep Güldem Ökem, Didem Pekkurnaz

Unmet need for family planning is a valuable concept to indicate the discrepancy between women's fertility preferences and contraceptive use. Unmet need may lead to unintended pregnancies and unsafe abortions. These may result in health deterioration and reduced employment opportunities for women. The 2018 Turkey Demographic and Health Survey report indicated that the estimated unmet need for family planning doubled from 2013 to 2018, returning to the high levels of the late 1990s. Considering this unfavourable change, this study aims to investigate the determinants of unmet need for family planning among married women of reproductive age in Turkey by using the 2018 Turkey Demographic and Health Survey data. Logit model estimations revealed that women who were at older ages, more educated, wealthier, and had more than one child were less likely to have unmet need for family planning. Employment statuses of women and their spouses and place of residence were significantly associated with unmet need. Results emphasised that training and counselling to enhance the use of family planning methods should effectively target young, less educated, and poor women.

未满足的计划生育需要是一个有价值的概念,表明妇女生育偏好和避孕药具使用之间的差异。需求得不到满足可能导致意外怀孕和不安全堕胎。这可能导致妇女健康恶化和就业机会减少。2018年土耳其人口与健康调查报告显示,预计未满足的计划生育需求从2013年到2018年翻了一番,回到了20世纪90年代末的高水平。考虑到这一不利变化,本研究旨在通过使用2018年土耳其人口与健康调查数据,调查土耳其已婚育龄妇女计划生育需求未得到满足的决定因素。洛吉特模型估计显示,年龄较大、受教育程度较高、较富裕、有多个孩子的女性,未满足计划生育需求的可能性较小。妇女及其配偶的就业状况和居住地与未满足的需要有很大关系。结果强调,加强计划生育方法使用的培训和咨询应有效地针对年轻、受教育程度较低和贫穷妇女。
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引用次数: 0
A study of the effect of number of children on depression among rural older women: empirical evidence from China. 子女数量对农村老年妇女抑郁影响的研究:来自中国的经验证据。
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-09-18 DOI: 10.1017/S0021932023000172
Shuo Zhang, Hualei Yang, Zhiyun Li, Siqing Zhang, Yuanyang Wu

The association between early reproductive events and health status in later life has always been of interest across disciplines. The purpose of this study was to investigate whether there was an association between the number of children born in the early years of elderly women and their depression in later life based on a sample of older women aged 65 years and above with at least one child in rural China. Data from the Chinese Longitudinal Healthy Longevity Survey in 2018, this study used the ordinary least square method to conduct empirical research. This study has found a significant correlation between an increase in the number of children and depression in older rural women. When considering the sex of the child, the number of daughters had a greater and more significant impact on depression. Number of children may exacerbate depression of older women through declining self-rated health and reduced social activity, while increased inter-generational support alleviated depression. The association between number of children born and depression also existed in urban older women, though not significant. Therefore, it is suggested to accelerate the improvement of supporting policies related to childbirth, developing a healthy and scientific fertility culture, and improving rural maternal and child health services. Women should be assisted in balancing their roles in the family and in society, and in particular in sharing the burden of caring for children. Targeted efforts to increase old-age protection for older people.

早期生殖事件与晚年健康状况之间的关系一直是各学科的兴趣所在。本研究以中国农村地区年龄在65岁及以上且至少有一个孩子的老年妇女为样本,目的是调查老年妇女早期出生的孩子数量与她们晚年抑郁之间是否存在关联。数据来源于2018年中国健康寿命纵向调查,本研究采用普通最小二乘法进行实证研究。这项研究发现,在农村老年妇女中,儿童数量的增加与抑郁症之间存在显著的相关性。当考虑到孩子的性别时,女儿的数量对抑郁的影响更大、更显著。子女数量的增加可能会导致老年妇女自我评价健康状况下降和社会活动减少,从而加剧抑郁症,而代际支持的增加则减轻了抑郁症。在城市老年妇女中,出生孩子的数量和抑郁之间也存在关联,尽管不显著。因此,建议加快完善生育相关配套政策,发展健康科学的生育文化,完善农村妇幼保健服务。应协助妇女平衡其在家庭和社会中的作用,特别是分担照顾儿童的负担。有针对性地加强老年人养老保障。
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引用次数: 0
Life-course socio-economic status and its impact on functional health of Portuguese older adults. 葡萄牙老年人生命过程中的社会经济地位及其对功能性健康的影响。
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-06-13 DOI: 10.1017/S0021932023000093
A Henriques, L Ruano, S Fraga, S Soares, H Barros, M Talih

Functional health is arguably one of the most important health indicators for older adults, because it assesses physical, cognitive and social functions in combination. However, life-course circumstances may impact this multidimensional construct. The aim of the present study was to assess the relationship between life-course socio-economic status (SES) and different dimensions of functional health in older adults. Data on 821 Portuguese adults aged 50 years and over in 2013-2015 were analysed. Life-course SES was computed using participants' paternal occupation (non-manual (nm); manual (m)) and own occupation (nm; m), resulting in four patterns: stable high (nm + nm), upward (m + nm), downward (nm + m) and stable low (m + m). Functional health included physical and mental functioning, cognitive function, handgrip strength, and walking speed. Linear (beta coefficients) and logistic regressions (odds ratios) were used to estimate the association between life-course SES and functional health.Overall, those who accumulated social disadvantage during life-course presented worse functional health than those with stable high SES (stable low - SF-36 physical functioning: β = -9.75; 95% CI: -14.34; -5.15; SF-36 mental health: β = -7.33; 95% CI: -11.55; -3.11; handgrip strength: β = -1.60; 95% CI: -2.86; -0.35; walking time, highest tertile: OR = 5.28; 95% CI: 3.07; 9.09). Those with an upward SES were not statistically different from those in the stable high SES for most of the health outcomes; however, those with an upward SES trajectory tended to have higher odds of cognitive impairment (OR = 1.75; 95% CI: 0.96; 3.19). A downward SES trajectory increased the odds of slower walking speed (OR = 4.62; 95% CI: 1.78; 11.95). A disadvantaged life-course SES impacts older adults' physical and mental functioning. For some outcomes, this was attenuated by a favourable adulthood SES but those with a stable low SES consistently presented worse functional health.

功能性健康可以说是老年人最重要的健康指标之一,因为它综合评估了身体、认知和社会功能。然而,生命过程中的环境可能会影响这个多维结构。本研究的目的是评估老年人生命历程社会经济地位(SES)与功能健康的不同维度之间的关系。对2013-2015年821名50岁及以上葡萄牙成年人的数据进行了分析。生命历程SES采用被试父亲的职业(非手工职业)计算;手工(m))和自己的职业(nm;功能健康包括身体和心理功能、认知功能、握力和步行速度。使用线性(beta系数)和逻辑回归(优势比)来估计生命过程SES与功能健康之间的关系。总体而言,那些在一生中积累社会劣势的人比那些稳定的高社会地位的人表现出更差的功能健康(稳定的低社会地位- SF-36身体功能:β = -9.75;95% ci: -14.34;-5.15;SF-36心理健康:β = -7.33;95% ci: -11.55;-3.11;握力:β = -1.60;95% ci: -2.86;-0.35;步行时间,最高分值:OR = 5.28;95% ci: 3.07;9.09)。社会经济地位较高的学生与社会经济地位稳定较高的学生在大多数健康结果上无统计学差异;然而,那些社会地位上升的人往往有更高的认知障碍的几率(OR = 1.75;95% ci: 0.96;3.19)。SES向下的轨迹增加了行走速度变慢的几率(OR = 4.62;95% ci: 1.78;11.95)。一生中处于不利地位的社会经济地位会影响老年人的身心功能。对于某些结果,良好的成年社会经济地位会减弱这种影响,但那些稳定的低社会经济地位的人始终表现出更差的功能健康。
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引用次数: 0
COVID-19 mortality among Jews in 2020: a global overview and lessons taught about the Jewish longevity advantage. 2020年犹太人COVID-19死亡率:全球概况和犹太人长寿优势的教训
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-05-15 DOI: 10.1017/S0021932023000068
L Daniel Staetsky

An extensive body of demographic literature has described Jews as 'long-lifers'. From the mid-nineteenth century onwards, this pattern affected all age groups and was particularly well expressed among Jewish males but was also present among Jewish females. It held good independently of the Jews' socio-economic position. This became known as 'Jewish pattern of mortality'. This paper has two aims. The first aim is to show the impact of COVID-19 on Jewish mortality. This is a study of a global pandemic in the Jewish population which is, to the best of our knowledge, unique in its scope and quality. The second aim is to settle the finding of relatively high mortality from COVID-19 in certain Jewish communities ('Jewish penalty' in relation to COVID-19) with the notion of 'Jewish pattern of mortality'. The author proceeds to show that the status of Jews as a low mortality group under a Western epidemiological regime, when mortality and morbidity are dominated by non-communicable diseases, does not stand in contradiction to a higher vulnerability among Jews to coronavirus. Thus, the paper further develops understanding of mortality of Jews and serves as a contribution to ethnic and religious demography and epidemiology.

大量的人口统计学文献将犹太人描述为“长寿者”。从19世纪中期开始,这种模式影响到所有年龄组,在犹太男性中表现得尤为明显,但在犹太女性中也存在。它独立于犹太人的社会经济地位而存在。这被称为“犹太人的死亡模式”。本文有两个目的。第一个目标是展示COVID-19对犹太人死亡率的影响。这是一项关于犹太人全球流行病的研究,据我们所知,这一流行病的范围和质量都是独一无二的。第二个目标是用“犹太死亡模式”的概念来解决某些犹太社区COVID-19死亡率相对较高的发现(与COVID-19相关的“犹太惩罚”)。提交人接着指出,在西方流行病学制度下,当死亡率和发病率以非传染性疾病为主时,犹太人作为低死亡率群体的地位与犹太人更容易感染冠状病毒并不矛盾。因此,本文进一步发展了对犹太人死亡率的理解,并为种族和宗教人口统计学和流行病学做出了贡献。
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引用次数: 0
A quasi-cohort trend analysis of adult obesity in Colombia. 哥伦比亚成人肥胖的准队列趋势分析。
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-06-26 DOI: 10.1017/S002193202300010X
Paula Andrea Castro-Prieto, Jeroen Spijker, Joaquín Recaño

In Colombia, the prevalence of obesity has been increasing in recent years due to changes in dietary and nutritional patterns. While previous studies have focussed on describing obesity and its associated factors, they have mainly used a cross-sectional methodology. Accordingly, this study aims to conduct a descriptive quasi-cohort analysis to capture age-specific cohort trends in body mass index (BMI) according to sex and ethnicity (indigenous, Afro-Colombian, and the remaining population). The study utilised data from the National Survey of the Nutritional Situation in Colombia (ENSIN) conducted in 2005, 2010, and 2015 that included 214,136 individuals aged 20-64 years after screening. Data on ethnicity were only available from the 2010 and 2015 surveys. Overall, the prevalence of obesity increased by 6.1 percentage points (from 15.2% to 21.3%) between 2005 and 2015 (men from 10.4% to 15.7%; women from 18.2% to 25.7%). Among Afro-Colombians, obesity rose 6.6 percentage points (from 19.4% to 26.0%), again more so in women than in men (2015: 35.2% versus 17.8%). Among indigenous people, the proportion increased by 5.3 percentage points (from 13.5% to 18.8%), with women reporting highest rates (2015: 23.7% against 12.6% in men). Age- and cohort-specific results also indicate that recent adult cohorts are experiencing sharp increases in BMI, for example, while 25-29-year-old males born in 1975-1979 had a BMI of 24.2 kg/m2, among 40-44-year-olds of the same cohort, this equalled 26.8 kg/m2. In the case of women, these age differences in BMI among the same cohort are even greater (24.4 and 28.0 kg/m2). In summary, the results of this study indicate that Colombia is still in the early stages of the obesity transition, urging the need to monitor obesity trends in Colombia from both an age and cohort perspective. To achieve this, longitudinal surveys or repeated cross-sectional surveys like the ENSIN could be utilised.

在哥伦比亚,由于饮食和营养模式的变化,肥胖的流行率近年来一直在增加。虽然以前的研究主要集中在描述肥胖及其相关因素,但他们主要使用的是横断面方法。因此,本研究旨在进行描述性准队列分析,以捕获根据性别和种族(土著、非裔哥伦比亚人和其余人口)的体重指数(BMI)的年龄特定队列趋势。该研究利用了2005年、2010年和2015年进行的哥伦比亚全国营养状况调查(ENSIN)的数据,其中包括筛选后年龄在20-64岁之间的214,136人。有关种族的数据仅来自2010年和2015年的调查。总体而言,2005年至2015年间,肥胖患病率增加了6.1个百分点(从15.2%增加到21.3%)(男性从10.4%增加到15.7%;女性从18.2%到25.7%)。在非裔哥伦比亚人中,肥胖率上升了6.6个百分点(从19.4%上升到26.0%),女性肥胖率再次高于男性(2015年:35.2%对17.8%)。在土著居民中,这一比例增加了5.3个百分点(从13.5%增加到18.8%),其中女性报告的比例最高(2015年:23.7%,男性12.6%)。年龄和特定队列的结果也表明,最近的成人队列正在经历体重指数的急剧增加,例如,1975-1979年出生的25-29岁男性的体重指数为24.2 kg/m2,而同一队列的40-44岁男性的体重指数为26.8 kg/m2。在女性中,同一队列中BMI的年龄差异甚至更大(24.4和28.0 kg/m2)。总之,本研究的结果表明,哥伦比亚仍处于肥胖过渡的早期阶段,迫切需要从年龄和队列的角度监测哥伦比亚的肥胖趋势。要做到这一点,可以利用纵向调查或重复横断面调查,如ENSIN。
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引用次数: 0
'Vaccines are for children only'? Some institutional roots of popular scepticism about vaccines for COVID-19 in Sierra Leone. 疫苗只适合儿童"?塞拉利昂民众对 COVID-19 疫苗持怀疑态度的一些制度根源。
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2023-12-20 DOI: 10.1017/S0021932023000287
Esther Yei Mokuwa

Vaccines for COVID-19 began to be available in Africa from mid-2021. This paper reports on local reactions to the possibility of vaccination in one West African country, Sierra Leone. We show that the history of institutionalisation of vaccine is highly relevant to understanding these reactions. Given lack of testing for the disease, medical authorities could not be sure whether there was a hidden epidemic. In addition, many people associate vaccination with care of children under 5 years, and not adults, and an emphasis on vaccinating the old at first seemed strange and worrying. This paper examines evidence from ethnographic studies in two rural areas selected for varying exposure to Ebola Virus Disease (EVD), supplemented by some interviews in two provincial urban centres, Bo and Kenema. We describe local ideas about vaccination (maklet) and body marking with leaf medicine (tεwi). We asked about attitudes to the idea of COVID-19 vaccination both before and after vaccines were available. A number of reasons were given for scepticism and hesitation. These included lack of experience with vaccines for adults and lack of experience of COVID-19 as a severe disease. Medical evidence suggests the vaccination protects against serious illness, but local people had their own views about control of infection, based both recent experience (notably EVD) and the history and institutionalisation of vaccination and public health measures in Sierra Leone more broadly.

COVID-19 疫苗从 2021 年中期开始在非洲上市。本文报告了西非国家塞拉利昂当地对接种疫苗可能性的反应。我们表明,疫苗制度化的历史与理解这些反应高度相关。由于缺乏对疾病的检测,医疗当局无法确定是否存在隐性流行病。此外,许多人将疫苗接种与照顾 5 岁以下儿童而非成人联系在一起,强调为老人接种疫苗起初显得奇怪而令人担忧。本文研究了在两个农村地区进行的人种学调查所获得的证据,这两个地区被选中的原因是人们对埃博拉病毒病(EVD)的接触程度不同,本文还补充了在博城和凯内马这两个省级城市中心进行的一些访谈。我们描述了当地人对疫苗接种(maklet)和用树叶药物在身体上做标记(tεwi)的看法。我们询问了在疫苗上市之前和之后人们对接种 COVID-19 疫苗的态度。怀疑和犹豫的原因有很多。其中包括缺乏为成人接种疫苗的经验,以及缺乏将 COVID-19 作为一种严重疾病的经验。医学证据表明,接种疫苗可预防严重疾病,但当地人对控制感染有自己的看法,这既基于最近的经验(特别是 EVD),也基于塞拉利昂疫苗接种和公共卫生措施的历史和制度化。
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引用次数: 0
Disentangling the link between social determinants of health and child survival in Nigeria during the Sustainable Development Goals era: a hierarchical path analysis of time-to-event outcome 在可持续发展目标时代厘清尼日利亚健康的社会决定因素与儿童生存之间的联系:从时间到事件结果的分层路径分析
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2023-12-14 DOI: 10.1017/s0021932023000305
Daniel Adedayo Adeyinka, Nazeem Muhajarine

While social determinants of health have been perennially linked to child survival in resource-limited countries, the precise and tested pathways to effect are not clearly understood. The objective of this study was therefore to identify the critical pathways as posited a priori in a model through which social factors (at maternal, household, and community levels) determine neonatal, infant, and under-five mortalities in Nigeria. Using a novel analytic approach (hierarchical path modelling for predicting accelerated failure time) to estimate (in)direct and total effects of social determinants of child survival, we analysed 30,960 live births (weighted data for representativeness), obtained from the 2016/2017 Nigeria Multiple Indicator Cluster Survey. There were three outcome variables: time until occurrence of neonatal, infant, and under-five mortalities. The independent variables were layered factors related to child, maternal, household and community. Geographical region, rurality of residence, infrastructural development, maternal education, contraceptive use, marital status, and maternal age at birth were found to operate more indirectly on neonatal, infant, and under-five survival. Child survival is due to direct effects of child’s sex (female), gestational type (singleton), birth spacing (children whose mothers delivered at least two years apart), and maternal age at delivery (20–34 years). According to the path coefficients, the indirect effects of geographical regions are the most influential determinants of child survival, accounting for 30% (neonatal), 37.1% (infant) and 39.9% (under-five) of the total effects. This study offers comprehensive set of factors, and linked pathways, at the maternal, household, and community levels that are associated with child survival in Nigeria. To accelerate progress towards Sustainable Development Goal targets for child survival and reduce geographical inequities, stakeholders should implement more impactful policies that promote maternal education, contraceptive use and improve living conditions of women (especially in rural areas of northern Nigeria). Future research should focus on identifying the most effective interventions for addressing these social determinants of child survival in Nigeria.

虽然在资源有限的国家,健康的社会决定因素一直与儿童生存联系在一起,但尚未清楚了解产生影响的精确和经过检验的途径。因此,本研究的目的是确定在尼日利亚社会因素(产妇、家庭和社区层面)决定新生儿、婴儿和五岁以下儿童死亡率的模型中先验假设的关键途径。我们使用一种新的分析方法(用于预测加速失效时间的分层路径模型)来估计儿童生存的社会决定因素的直接和总影响,分析了2016/2017年尼日利亚多指标聚类调查中获得的30,960例活产婴儿(代表性加权数据)。有三个结局变量:直到新生儿、婴儿和五岁以下儿童死亡发生的时间。自变量为与儿童、母亲、家庭和社区相关的分层因素。研究发现,地理区域、居住地农村、基础设施发展、孕产妇教育、避孕药具使用、婚姻状况和孕产妇出生年龄对新生儿、婴儿和五岁以下儿童的生存有更间接的影响。儿童存活是由于儿童性别(女)、妊娠类型(单胎)、生育间隔(母亲至少间隔两年分娩的孩子)和产妇分娩年龄(20-34岁)的直接影响。根据路径系数,地理区域的间接影响是儿童生存的最具影响力的决定因素,占总影响的30%(新生儿)、37.1%(婴儿)和39.9%(五岁以下)。本研究提供了与尼日利亚儿童生存相关的孕产妇、家庭和社区层面的一系列综合因素和相关途径。为加快实现可持续发展目标中有关儿童生存的具体目标并减少地域不平等现象,利益攸关方应实施更具影响力的政策,促进孕产妇教育、使用避孕药具并改善妇女的生活条件(特别是在尼日利亚北部农村地区)。未来的研究应侧重于确定最有效的干预措施,以解决尼日利亚儿童生存的这些社会决定因素。
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引用次数: 0
Do maternal obstetric morbidity and its concomitants differ between sedente and migrant groups? The case of the Oraon populations of Eastern India. 在定居群体和移民群体之间,产妇产科发病率及其伴随因素是否不同?印度东部奥兰人的情况。
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2023-11-01 Epub Date: 2023-01-23 DOI: 10.1017/S0021932022000529
Joyeeta Thakur, Monali Goswami, Subho Roy

The state of pregnancy and child birth is a stretch of intense vulnerability and incurs reproductive cost, which is governed within a specific socio-ecological context. We asked in our research whether the obstetric morbidities at three stages: antepartum, intrapartum and postpartum, and their concomitants differed significantly between sedente and migrant populations. 403 Oraon indigenous women [203 sedente and 200 migrants] living in Eastern India were selected. Data on socio-demographic, reproductive, maternal health care services and obstetric morbidities were collected using semi structured schedules. We applied Categorical Principal Component Analysis (CATPCA) on the first three variables; PC1 and PC4 were loaded with "socio-demographic and maternal health care services" and PC2 and PC3 loaded with "socio-demographic and reproductive" variables. We applied Poisson regression to examine the determinants of obstetric morbidities. Bivariate analyses showed significant (p ≤ 0.05) sedente-migrant differences in variables related to socio-demographic, reproductive, maternal health care and obstetric morbidities. Poisson regression showed migrants were more likely (p ≤ 0.001) to experience ante and intrapartum morbidities than the sedentes, after controlling the confounders. PC1, PC2 and PC3 could significantly (p ≤ 0.05) predict ante and intrapartum morbidities. For postpartum morbidities, barring the variables related to availing of maternal health care services at the time of child delivery and post delivery, neither migration status nor any of the PCs was a significant predictor. For example, participants who delivered their child in health institutions and had episiotomy and/or caesarean delivery (p ≤ 0.01); and those who availed first PNC within the 24 hours of delivery, stayed under medical supervision after delivery for more than 48 hours and received higher coverage of PNCs were more and less likely respectively (p ≤ 0.05) to have experienced postpartum morbidities. We conclude that the maternal obstetric morbidities and their concomitants differed between sedente and migrant Oraon populations owing to their living in differential socio-ecological contexts.

怀孕和分娩是一种极度脆弱的状态,会产生生殖成本,这是在特定的社会生态背景下决定的。我们在研究中询问了顺产人群和流动人群在产前、产中和产后三个阶段的产科疾病及其伴随因素是否存在显著差异。403名居住在印度东部的奥兰土著妇女[203名塞登特人和200名移民]被选中。使用半结构化时间表收集社会人口、生殖、产妇保健服务和产科疾病的数据。我们对前三个变量进行了分类主成分分析(CATPCA);PC1和PC4加载了“社会人口和孕产妇保健服务”,PC2和PC3加载了“社交人口和生殖”变量。我们应用泊松回归来检验产科疾病的决定因素。双变量分析显示,在与社会人口统计学、生殖、孕产妇保健和产科疾病相关的变量中,长期移民存在显著差异(p≤0.05)。泊松回归显示,在控制混杂因素后,迁移者比顺产者更有可能(p≤0.001)经历产前和产时疾病。PC1、PC2和PC3可显著(p≤0.05)预测产前和产时的发病率。对于产后疾病,除了与分娩时和产后获得孕产妇保健服务有关的变量外,移民状况和任何个人电脑都不是一个重要的预测因素。例如,在卫生机构分娩并进行了会阴切开术和/或剖腹产的参与者(p≤0.01);而那些在分娩后24小时内首次使用PNC、分娩后在医疗监督下停留超过48小时并接受更高PNC覆盖率的人,分别有更多和更少的可能出现产后疾病(p≤0.05)。我们得出的结论是,由于生活在不同的社会生态环境中,塞登特人和移民奥兰人的孕产妇产科疾病及其伴随因素存在差异。
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引用次数: 0
Age-incidence and prevalence of HIV among intact and circumcised men: an analysis of PHIA surveys in Southern Africa. 完整男性和包皮环切男性中HIV的年龄发病率和流行率:对南部非洲PHIA调查的分析。
IF 1.5 3区 社会学 Q1 Medicine Pub Date : 2023-11-01 Epub Date: 2022-10-26 DOI: 10.1017/S0021932022000414
Michel Garenne

The study investigates the statistical relationship between male circumcision and HIV prevalence in Africa, in the context of the Voluntary Medical Male Circumcision (VMMC) campaigns in place since 2008. Data from the Population-based HIV Impact Assessment (PHIA) surveys conducted in African countries in 2017-2018 were utilized. Six countries with high HIV prevalence, low traditional circumcision and large VMMC programs were selected: Eswatini, Lesotho, Malawi, Namibia, Zambia, Zimbabwe. The statistical analysis investigated the relative risk (RR) of HIV prevalence by circumcision status (circumcised vs intact) among men age 20-59, and the age-incidence of HIV in the two groups among men age 20-49, defined as the linear-logistic slope of the relationship between prevalence and age. Results show that the standardized RR was not different from 1 at older ages (50-59): RR = 0.923, 95% CI = 0.769-1.108, P = 0.390. Furthermore, the age-incidence was at least as high or higher among the circumcised groups than among the intact groups. The standardized RR was lower than 1 at younger ages, and this could be explained by selection biases. HIV prevalence at age 40-59 (27.3%) was also the same in the four groups of circumcision status (intact, traditional, medical, unknown). Results matched earlier observations made in South Africa that circumcised and intact men had similar levels of HIV infection. The study questions the current strategy of large scale VMMC campaigns to control the HIV epidemic. These campaigns also raise a number of ethical issues.

这项研究在2008年以来开展的自愿医疗男性包皮环切术(VMMC)运动的背景下,调查了非洲男性包皮环切除术与艾滋病毒流行率之间的统计关系。利用了2017-2018年在非洲国家进行的基于人口的艾滋病毒影响评估(PHIA)调查的数据。选择了六个艾滋病毒感染率高、传统包皮环切术低和大规模VMMC项目的国家:斯威士兰、莱索托、马拉维、纳米比亚、赞比亚和津巴布韦。统计分析调查了20-59岁男性的包皮环切状态(包皮环切与完整)导致HIV流行的相对风险(RR),以及20-49岁男性中两组HIV的年龄发病率,定义为流行率与年龄之间的线性逻辑斜率。结果显示,标准化RR与老年人(50-59岁)的1无差异:RR=0.923,95%CI=0.769-1108,P=0.390。此外,包皮环切组的年龄发病率至少与完整组一样高或更高。标准化RR在年轻时低于1,这可以用选择偏差来解释。40-59岁年龄段的HIV感染率(27.3%)在四组包皮环切状态(完整、传统、医学、未知)中也是相同的。结果与南非早期的观察结果相吻合,即接受包皮环切术和完整男性的艾滋病毒感染水平相似。该研究对目前大规模VMMC运动控制艾滋病毒流行的策略提出了质疑。这些运动还提出了一些道德问题。
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引用次数: 0
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Journal of Biosocial Science
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