Pub Date : 2025-06-01Epub Date: 2024-12-20DOI: 10.1016/j.dialog.2024.100201
Amit Roy
Purpose
Energy is a health issue. Energy intersects with health outcomes, as evidenced by the relationship between access to clean fuels and technologies and population health measured by life expectancy at birth.
Methods
Utilizing a comprehensive dataset spanning 190 countries from 2000 to 2022, this paper employs a range of static and dynamic panel data models to analyze this empirical relationship, while effectively managing unobserved country-specific heterogeneity and endogeneity issues.
Results
The primary finding underscores that improved access to clean fuels and technologies positively correlates with increased life expectancy for both genders, males and females, on a global scale. Additionally, the study identifies a significant negative impact of food and nutritional deficiencies on human health, while highlighting positive associations between health outcomes and increased per capita health spending, immunization rates, education levels, and access to safe drinking water and sanitation facilities.
Conclusion
Findings underscore the importance of policy interventions aimed at alleviating clean energy poverty and scaling up access to clean fuels and technologies to enhance both the duration and quality of life, thus fostering sustainable development efforts at both national and global levels.
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This bibliometric study examines the scholarly landscape of migration and women's health, analyzing 1314 Scopus-indexed articles from 462 journals published between 2000 and 2023. Findings indicate a consistent increase in research output, reflecting growing global interest in this interdisciplinary field. Geographically, high-income countries (HICs), including the United States, Canada, the United Kingdom, and Australia, dominate contributions, while low- and middle-income countries (LMICs) remain underrepresented despite hosting significant migrant populations. International collaborations play a crucial role, with key institutions such as the University of California and the London School of Hygiene and Tropical Medicine shaping research efforts. The keyword co-occurrence analysis highlights migration, gender dynamics, mental health, and reproductive health as dominant themes. Persistent gaps in mental and reproductive healthcare access for migrant women emphasize the need for trauma-informed care (TIC), mobile bilingual healthcare services, and inclusive health policies. Disparities in research funding further exacerbate global health inequities, underscoring the necessity of equitable redistribution of resources, including redirecting at least 10 % of HIC research grants to LMIC-led studies. The COVID-19 pandemic magnified pre-existing vulnerabilities, stressing the importance of multilateral collaborations and sustainable policy interventions to enhance migrant healthcare access. This study provides valuable insights into research trends, collaboration networks, and thematic focus areas, offering a foundation for future interdisciplinary research and evidence-based policymaking aimed at promoting health equity for migrant women globally.
{"title":"Migration and Women's Health Research (2000−2023): A bibliometric analysis of trends and gaps","authors":"Aasif Hussain Sheikh, Snober Hamid, Bilal Ahmad Lone, Farheena Muzaffar, Manzoor Hussain","doi":"10.1016/j.dialog.2025.100210","DOIUrl":"10.1016/j.dialog.2025.100210","url":null,"abstract":"<div><div>This bibliometric study examines the scholarly landscape of migration and women's health, analyzing 1314 Scopus-indexed articles from 462 journals published between 2000 and 2023. Findings indicate a consistent increase in research output, reflecting growing global interest in this interdisciplinary field. Geographically, high-income countries (HICs), including the United States, Canada, the United Kingdom, and Australia, dominate contributions, while low- and middle-income countries (LMICs) remain underrepresented despite hosting significant migrant populations. International collaborations play a crucial role, with key institutions such as the University of California and the London School of Hygiene and Tropical Medicine shaping research efforts. The keyword co-occurrence analysis highlights migration, gender dynamics, mental health, and reproductive health as dominant themes. Persistent gaps in mental and reproductive healthcare access for migrant women emphasize the need for trauma-informed care (TIC), mobile bilingual healthcare services, and inclusive health policies. Disparities in research funding further exacerbate global health inequities, underscoring the necessity of equitable redistribution of resources, including redirecting at least 10 % of HIC research grants to LMIC-led studies. The COVID-19 pandemic magnified pre-existing vulnerabilities, stressing the importance of multilateral collaborations and sustainable policy interventions to enhance migrant healthcare access. This study provides valuable insights into research trends, collaboration networks, and thematic focus areas, offering a foundation for future interdisciplinary research and evidence-based policymaking aimed at promoting health equity for migrant women globally.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143570545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01Epub Date: 2025-04-19DOI: 10.1016/j.dialog.2025.100218
Anita Raj , Nicole Johns , Florin Vaida , Mohan Ghule , Namratha Rao , Jay G. Silverman
<div><h3>Background</h3><div>Effective family planning interventions may have inadvertent effects on births of girls given son preference in India. We conducted 36 and 48-month follow-ups to our CHARM2 family planning study to determine long-term intervention effects on births and sex of children.</div></div><div><h3>Methods</h3><div>Our non-blinded two-armed cluster RCT randomized young married couples (<em>N</em> = 1201 couples) from 20 geographic clusters (60–61 couples per cluster) into either the CHARM2 intervention or control (referral to local care) condition. CHARM2 offers 5-session gender-synchronized family planning and gender equity counseling delivered by trained local medical providers. Data were collected at baseline in September 2018–June 2019 and then follow-ups at 9, 18, 36 and 48 months, up to September 2023. We retained 88 %–91 % of women across follow-ups with no difference in retention by treatment group. We used adjusted mixed-effects logistic regression models examining sex composition of births at each follow-up and over the total 48-month follow-up to assess differences in all births of boys and girls by treatment group. We adjusted for treatment condition, cluster, and relevant demographics in adjusted models.</div></div><div><h3>Results</h3><div>We saw no treatment effects on total births or boy births, but lower likelihood of a girl birth was seen at 9-month follow-up and for the total 48-month follow-up period. We found at 9-month follow-up a girl birth was less likely for intervention compared with control participants (7.1 % vs. 10.3 %, respectively, <em>p</em> = 0.06), and the male to female sex ratio of births born between baseline and 9-month follow-up was also significantly higher for intervention vs. comparison participants (1.50 [95 % CI 1.00–2.26] vs. 0.83 [95 % CI 0.56–1.21], <em>p</em> = 0.04). We conducted a sensitivity analysis to determine treatment effects on boy births and girl births over the 48-month follow-up and again found no effects on boy births, but a significantly lower likelihood of a girl birth for the intervention group (22 % vs 29 %, <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>The CHARM2 family planning intervention, previously demonstrating significant effects on contraceptive use and women's reproductive agency in rural India, resulted in lower likelihood of girl births over time, suggesting that family planning programs can contribute to sex ratio imbalances if broader social changes eliminating son preference and improving value of a girl child do not occur.</div></div><div><h3>Funding</h3><div>National Institutes of Health, Grant R01HD084453 Bill and Melinda Gates Foundation. INV002967. The funders had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. [<span><span>ClinicalTrials.gov</span><svg><path
在印度，由于重男轻女，有效的计划生育干预措施可能会对女孩的出生产生无意的影响。我们对CHARM2计划生育研究进行了36个月和48个月的随访，以确定长期干预对出生和儿童性别的影响。方法采用非盲双臂随机对照试验，将20个地理分组（每组60-61对）的年轻已婚夫妇（N = 1201对）随机分为CHARM2干预组和对照组（转到当地护理）。CHARM2提供由训练有素的当地医疗提供者提供的五期性别同步计划生育和性别平等咨询。在2018年9月至2019年6月期间收集基线数据，然后在9个月、18个月、36个月和48个月进行随访，直至2023年9月。在随访期间，我们保留了88% - 91%的女性保留率，不同治疗组的保留率没有差异。我们使用调整后的混合效应logistic回归模型，检查每次随访和48个月随访期间出生的性别组成，以评估治疗组所有男孩和女孩出生的差异。在调整后的模型中，我们调整了治疗条件、集群和相关人口统计数据。结果：我们没有看到治疗对总出生数或男孩出生数的影响，但在9个月的随访和48个月的随访期间，发现女孩出生的可能性较低。我们发现，在9个月的随访中，与对照组相比，女孩出生的可能性更小（分别为7.1%和10.3%,p = 0.06），在基线和9个月随访期间出生的男女性别比，干预组也显著高于对照组（1.50 [95% CI 1.00-2.26]比0.83 [95% CI 0.56-1.21], p = 0.04）。在48个月的随访中，我们进行了敏感性分析，以确定治疗对男孩出生和女孩出生的影响，再次发现对男孩出生没有影响，但干预组出生女孩的可能性显着降低（22%对29%，p = 0.03）。CHARM2计划生育干预措施在印度农村对避孕药具的使用和妇女生殖机构产生了显著影响，但随着时间的推移，该措施导致女孩出生的可能性降低，这表明，如果不发生更广泛的社会变革，消除重男轻女和提高女孩的价值，计划生育计划可能会导致性别比例失衡。美国国立卫生研究院，拨款R01HD084453比尔和梅林达·盖茨基金会。INV002967。资助者在研究的设计和实施、数据的收集、管理、分析和解释中没有任何作用；或手稿的准备、审查或批准；或决定投稿发表。[ClinicalTrials.gov标识符：NCT03514914.]
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Pub Date : 2025-06-01Epub Date: 2025-04-11DOI: 10.1016/j.dialog.2025.100215
Stephanie L. Enkel , Rebecca Dalton , Chicky Clements , Hannah M.M. Thomas , Tracy McRae , Ingrid Amgarth-Duff , Marianne Mullane , Lisa Wiese , Liam Bedford , Nina Lansbury , Jonathan R. Carapetis , Edie Wright , Asha C. Bowen
Background
Aboriginal children and families contend with higher rates of preventable infectious diseases that can be attributed to their immediate living environment. The environments in which children spend most of their time are their homes and schools. We aimed to understand the opportunities in the school setting to support student skin health and wellbeing through environmental health activities, how these activities were completed, and the barriers to their implementation.
Methods
Recognising the importance of healthy skin for educational success, this work was embedded within a larger cluster randomised stepped-wedge Trial aimed at reducing the rate of skin infections among Aboriginal children living in the Kimberley region of Western Australia by 50 %. We used qualitative data collected via a culturally appropriate yarning methodology during trial evaluation interviews. The data from 35 yarns with 41 individuals were thematically analysed.
Findings
Data indicated that schools serve as a hub of health and hygiene support and maintenance, with school staff balancing teaching responsibilities while also meeting the basic health and wellbeing needs of students. Uncertainties regarding funding and policies governing these activities remained; ongoing exploration is required.
Interpretation
Staff in remote Kimberley schools devote substantial time and resources to supporting student hygiene needs, often stepping in when health infrastructure at home is inadequate. These activities are seen as necessary to support student wellbeing and participation in learning. While schools are well-positioned to respond in this way, these responsibilities extend beyond their core role and place additional pressure on staff and budgets. There is a need to better understand how such work is resourced and to consider how policy and funding frameworks might more formally support it.
{"title":"‘Beyond core business’: A qualitative review of activities supporting environmental health within remote Western Australian schools","authors":"Stephanie L. Enkel , Rebecca Dalton , Chicky Clements , Hannah M.M. Thomas , Tracy McRae , Ingrid Amgarth-Duff , Marianne Mullane , Lisa Wiese , Liam Bedford , Nina Lansbury , Jonathan R. Carapetis , Edie Wright , Asha C. Bowen","doi":"10.1016/j.dialog.2025.100215","DOIUrl":"10.1016/j.dialog.2025.100215","url":null,"abstract":"<div><h3>Background</h3><div>Aboriginal children and families contend with higher rates of preventable infectious diseases that can be attributed to their immediate living environment. The environments in which children spend most of their time are their homes and schools. We aimed to understand the opportunities in the school setting to support student skin health and wellbeing through environmental health activities, how these activities were completed, and the barriers to their implementation.</div></div><div><h3>Methods</h3><div>Recognising the importance of healthy skin for educational success, this work was embedded within a larger cluster randomised stepped-wedge Trial aimed at reducing the rate of skin infections among Aboriginal children living in the Kimberley region of Western Australia by 50 %. We used qualitative data collected via a culturally appropriate yarning methodology during trial evaluation interviews. The data from 35 yarns with 41 individuals were thematically analysed.</div></div><div><h3>Findings</h3><div>Data indicated that schools serve as a hub of health and hygiene support and maintenance, with school staff balancing teaching responsibilities while also meeting the basic health and wellbeing needs of students. Uncertainties regarding funding and policies governing these activities remained; ongoing exploration is required.</div></div><div><h3>Interpretation</h3><div>Staff in remote Kimberley schools devote substantial time and resources to supporting student hygiene needs, often stepping in when health infrastructure at home is inadequate. These activities are seen as necessary to support student wellbeing and participation in learning. While schools are well-positioned to respond in this way, these responsibilities extend beyond their core role and place additional pressure on staff and budgets. There is a need to better understand how such work is resourced and to consider how policy and funding frameworks might more formally support it.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"6 ","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-07-26DOI: 10.1016/j.dialog.2024.100186
Biplab Kumar Datta , Shriya Thakkar
Objective
The provisions and recognition of Schedule Castes (SCs), the constitutional term for the Dalits in India, have been exclusively extended to Hindus, Buddhists, and Sikhs (HBS). Omission of Dalit Muslims and Christians (MC) from the SC category stripped them of the affirmative action benefits tied with the SC status. This study aimed to explore how such differential treatment might play a role in differential health outcomes in Dalit women in India.
Methods
Drawing data on 177,346 Dalit women, aged 20 to 49 years, from two successive nationally representative surveys, we assessed the differential likelihood of hypertension and diabetes, between MC- and HBS- Dalit women. Accounting for birth cohort-, survey wave-, and state of residence- fixed effects, along with socioeconomic conditions and cardiometabolic risk factors, we obtained adjusted odds of having hypertension and diabetes in MC women. To check the validity of our results, we conducted similar analyses using data on 170,889 Scheduled Tribe (ST) women, another marginalized group, whose ST-status recognition were not tied to religion.
Results
We found that Dalit MC women were 1.13 (95% CI: 1.03–1.25) and 1.19 (95% CI: 1.05–1.36) times more likely to have hypertension and diabetes, respectively, compared to Dalit HBS women. Conversely, no statistically significant differential likelihood of these conditions was observed between MC and HBS women in the ST sample.
Conclusion
Our investigation thus, indicated a potential link at the crossroads of religion and caste that may contribute to the health disparities among marginalized women in India.
目标印度宪法对贱民（SC）的规定和承认只适用于印度教徒、佛教徒和锡克教徒（HBS）。将达利特穆斯林和基督徒（MC）排除在在册种姓之外，使他们失去了与在册种姓身份相联系的平权行动利益。本研究旨在探讨这种差别待遇如何对印度达利特妇女的不同健康结果产生影响。方法我们从连续两次具有全国代表性的调查中提取了 177,346 名年龄在 20 至 49 岁之间的达利特妇女的数据，评估了穆斯林达利特妇女和锡克教徒达利特妇女患高血压和糖尿病的不同可能性。考虑到出生队列、调查波次和居住州的固定效应，以及社会经济条件和心脏代谢风险因素，我们得出了 MC 妇女患高血压和糖尿病的调整后几率。为了检验结果的有效性，我们利用另一个边缘化群体--170,889 名贱民部落（ST）妇女的数据进行了类似的分析，这些妇女的 ST 地位认定与宗教信仰无关。结果我们发现，与贱民 HBS 妇女相比，贱民 MC 妇女患高血压和糖尿病的几率分别高出 1.13 倍（95% CI：1.03-1.25）和 1.19 倍（95% CI：1.05-1.36）。结论因此，我们的调查表明，在宗教和种姓的交叉点上存在着一种潜在的联系，可能会导致印度边缘化妇女在健康方面的差异。
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Pub Date : 2024-12-01Epub Date: 2024-11-23DOI: 10.1016/j.dialog.2024.100200
Katrina Plamondon , Sana Z. Shahram
When it comes to advancing equity, across the health sciences, efforts repeatedly target interventions on those most burdened by inequities rather than the systems or structures that give rise to inequities. This mismatch, in and of itself, is an important determinant of equity. While many conceptual models draw collective attention to deeper, structural causes (e.g., social, political, and commercial determinants of health) as the 'what', inattention to questions of 'how'–or the collective practices that serve to connect what is known with what is done–are like a wedge holding this gap in place. In this article, we use an exaggerated metaphor of mismatched task-and-tool to provoke critically reflective dialogue about collective attachment to scholarship and practices incoherent with our own body of knowledge. We offer a set of five practices easily integrated in any aspect of work related to advancing equity, through everyday actions anyone (anywhere) can take to purposefully act from an evidence and equity-informed position.
{"title":"Fishing with skis, digging with noodles: Resolving task-and-tool mismatches in efforts to advance health equity","authors":"Katrina Plamondon , Sana Z. Shahram","doi":"10.1016/j.dialog.2024.100200","DOIUrl":"10.1016/j.dialog.2024.100200","url":null,"abstract":"<div><div>When it comes to advancing equity, across the health sciences, efforts repeatedly target interventions on those most burdened by inequities rather than the systems or structures that give rise to inequities. This mismatch, in and of itself, is an important determinant of equity. While many conceptual models draw collective attention to deeper, structural causes (e.g., social, political, and commercial determinants of health) as the 'what', inattention to questions of 'how'–or the collective practices that serve to connect what is known with what is done–are like a wedge holding this gap in place. In this article, we use an exaggerated metaphor of mismatched task-and-tool to provoke critically reflective dialogue about collective attachment to scholarship and practices incoherent with our own body of knowledge. We offer a set of five practices easily integrated in any aspect of work related to advancing equity, through everyday actions anyone (anywhere) can take to purposefully act from an evidence and equity-informed position.</div></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"5 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Genomic sequencing has been an invaluable tool to determine the evolution of SARS-CoV-2. In the present study, we provided a comprehensive description of the SARS-CoV-2 variants circulated in the Philippines.
Methods
The dataset from the human COVID-19 infections was acquired by downloading the sequences and their associated metadata spanning from March 2020 to April 2024. Then, we executed several filtering criteria to acquire the final dataset for the Philippine samples and performed spatial distribution analysis and phylogenetic tree construction of the reported SARS-CoV-2 sequences.
Results
A total of 16,679,203 SARS-CoV sequences were obtained, of which 17,393 (0.10 %) were sampled in the Philippines. Western Visayas reported the highest SARS-CoV-2 sequences (21.33 %), while the Bangsamoro Autonomous Region in Muslim Mindanao reported the least (0.48 %). The phylogenetic tree revealed the evolution of the detected SARS-CoV-2 variants circulating in the Philippines with 19 A as the first reported case (based on the GISAID submission), and 24 A (JN.1) as the currently circulating variant. Omicron variants have dominated the Philippines with 21 L (Omicron, BA.2) having 5102 cases (29.33 %), followed by 22B (BA.5) having 2184 cases (12.57 %). Using Pearson's Chi-square test of independence, we showed that there is a significant association between the age-groups and gender with the detection years.
Conclusion
Altogether, this analysis showed the updated epidemiological trends of the reported SARS-CoV-2 variants in the Philippines. This increases the importance of conducting surveillance on viral infectious diseases such as COVID-19 to provide the scope and trajectory of viral spread in a country.
{"title":"Genomic analysis of the SARS-CoV-2 variants circulated in the Philippines, 2020–2024","authors":"Arnie Dimaano , Kiana Dominique Carreon , Giselle Sophia Camaya , Irvin Rondolo , Jarel Elgin Tolentino","doi":"10.1016/j.dialog.2024.100193","DOIUrl":"10.1016/j.dialog.2024.100193","url":null,"abstract":"<div><h3>Purpose</h3><p>Genomic sequencing has been an invaluable tool to determine the evolution of SARS-CoV-2. In the present study, we provided a comprehensive description of the SARS-CoV-2 variants circulated in the Philippines.</p></div><div><h3>Methods</h3><p>The dataset from the human COVID-19 infections was acquired by downloading the sequences and their associated metadata spanning from March 2020 to April 2024. Then, we executed several filtering criteria to acquire the final dataset for the Philippine samples and performed spatial distribution analysis and phylogenetic tree construction of the reported SARS-CoV-2 sequences.</p></div><div><h3>Results</h3><p>A total of 16,679,203 SARS-CoV sequences were obtained, of which 17,393 (0.10 %) were sampled in the Philippines. Western Visayas reported the highest SARS-CoV-2 sequences (21.33 %), while the Bangsamoro Autonomous Region in Muslim Mindanao reported the least (0.48 %). The phylogenetic tree revealed the evolution of the detected SARS-CoV-2 variants circulating in the Philippines with 19 A as the first reported case (based on the GISAID submission), and 24 A (JN.1) as the currently circulating variant. Omicron variants have dominated the Philippines with 21 L (Omicron, BA.2) having 5102 cases (29.33 %), followed by 22B (BA.5) having 2184 cases (12.57 %). Using Pearson's Chi-square test of independence, we showed that there is a significant association between the age-groups and gender with the detection years.</p></div><div><h3>Conclusion</h3><p>Altogether, this analysis showed the updated epidemiological trends of the reported SARS-CoV-2 variants in the Philippines. This increases the importance of conducting surveillance on viral infectious diseases such as COVID-19 to provide the scope and trajectory of viral spread in a country.</p></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"5 ","pages":"Article 100193"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772653324000297/pdfft?md5=c2d3976b5c454541656dc2dae68e0f59&pid=1-s2.0-S2772653324000297-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Breaking barriers: A gender-based quota system in nursing school admission in Bangladesh","authors":"Shimpi Akter , Masuda Akter , Sopon Akter , Humayun Kabir","doi":"10.1016/j.dialog.2024.100196","DOIUrl":"10.1016/j.dialog.2024.100196","url":null,"abstract":"","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"5 ","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-06-06DOI: 10.1016/j.dialog.2024.100183
Karla Loss , Wilson Fandino , Bassel Almarie , Blanca Bazan-Perkins , Julia Minetto , Nadine Aranis , Thiago Monaco , Aisha Aladab , Kevin Pacheco-Barrios , Felipe Fregni
Purpose
The globally increasing older population raises concerns about age-related conditions, including cognitive impairment and depressive symptoms. In Latin America, nearly one-third of the population is affected by either of these conditions. However, data investigating the association between cognitive impairment and depressive symptoms, particularly in Brazil, are limited to small-scale studies that have not carefully examined the critical effects of variables such as education level and socioeconomic status on this relationship. We aimed at exploring this association in a representative population-based cohort.
Methods
We used the Brazilian Longitudinal Study of Aging (ELSI-BRAZIL) database to examine the relationship between depressive symptoms and cognitive impairment in Brazilian older adults, adjusted for potential confounders. Direct acyclic graphs and multivariable linear regression were used to build our model. Depressive symptoms were measured using a short version of the Center for Epidemiologic Studies Scale (CES D-8), and combined memory recall test as a surrogate of cognitive impairment.
Results
The study included 8280 participants. Only education level was identified as a confounder for the relationship between memory loss and depressive symptoms. After adjusting for age, sex, and education level, there was strong evidence for a negative association between depressive symptoms and memory performance. For every 5-unit increase in the CES D-8 score, there was a reduction in memory capacity, translating to a loss of approximately one word in the combined words recall test (mean − 0.18, 95% CI -0.22; −0.15, P < 0.001). In addition, we found strong evidence for an interaction between socioeconomic status and depressive symptoms. Subjects belonging to medium socioeconomic status (SES) showed more pronounced memory decline, when compared to those with lower SES (mean − 0.28, 95% CI -0.42 to −0.14, P < 0.001).
Conclusions
In adults aged over 50, after adjusting for sex, age, and educational level, a 5-unit increase in CES D-8 score is associated with loss of one point in the combined memory recall test. This association seems to be confounded by educational level and significantly modified by socioeconomic status.
目的 全球老年人口不断增加，引发了人们对老年相关疾病的关注，包括认知障碍和抑郁症状。在拉丁美洲，近三分之一的人口受到这两种疾病的影响。然而，有关认知障碍和抑郁症状之间关系的调查数据，尤其是在巴西，仅限于小规模研究，没有仔细研究教育水平和社会经济地位等变量对这种关系的关键影响。我们利用巴西老龄化纵向研究（ELSI-BRAZIL）数据库研究了巴西老年人抑郁症状与认知障碍之间的关系，并对潜在的混杂因素进行了调整。我们使用直接非循环图和多变量线性回归来建立模型。抑郁症状采用流行病学研究中心量表（CES D-8）的简易版进行测量，并将综合记忆回忆测试作为认知障碍的替代指标。只有教育水平被认为是影响记忆力减退与抑郁症状之间关系的混淆因素。在对年龄、性别和教育水平进行调整后，有确凿证据表明抑郁症状与记忆力之间存在负相关。CES D-8 分数每增加 5 个单位，记忆能力就会下降，这意味着在综合单词回忆测试中大约会损失一个单词（平均值-0.18，95% CI -0.22; -0.15，P <0.001）。此外，我们还发现了社会经济地位与抑郁症状之间相互作用的有力证据。与社会经济地位较低的受试者相比，社会经济地位中等的受试者的记忆力下降更为明显（平均值-0.28，95% CI -0.42至-0.14，P< 0.001）。这种关联似乎受到教育水平的影响，并因社会经济地位而显著改变。
{"title":"The impact of education level and socioeconomic status on the association between depressive symptoms and memory in an older population in Latin America: An exploratory analysis from the Brazilian Longitudinal Study of Aging (ELSI-BRAZIL)","authors":"Karla Loss , Wilson Fandino , Bassel Almarie , Blanca Bazan-Perkins , Julia Minetto , Nadine Aranis , Thiago Monaco , Aisha Aladab , Kevin Pacheco-Barrios , Felipe Fregni","doi":"10.1016/j.dialog.2024.100183","DOIUrl":"https://doi.org/10.1016/j.dialog.2024.100183","url":null,"abstract":"<div><h3>Purpose</h3><p>The globally increasing older population raises concerns about age-related conditions, including cognitive impairment and depressive symptoms. In Latin America, nearly one-third of the population is affected by either of these conditions. However, data investigating the association between cognitive impairment and depressive symptoms, particularly in Brazil, are limited to small-scale studies that have not carefully examined the critical effects of variables such as education level and socioeconomic status on this relationship. We aimed at exploring this association in a representative population-based cohort.</p></div><div><h3>Methods</h3><p>We used the Brazilian Longitudinal Study of Aging (ELSI-BRAZIL) database to examine the relationship between depressive symptoms and cognitive impairment in Brazilian older adults, adjusted for potential confounders. Direct acyclic graphs and multivariable linear regression were used to build our model. Depressive symptoms were measured using a short version of the Center for Epidemiologic Studies Scale (CES D-8), and combined memory recall test as a surrogate of cognitive impairment.</p></div><div><h3>Results</h3><p>The study included 8280 participants. Only education level was identified as a confounder for the relationship between memory loss and depressive symptoms. After adjusting for age, sex, and education level, there was strong evidence for a negative association between depressive symptoms and memory performance. For every 5-unit increase in the CES D-8 score, there was a reduction in memory capacity, translating to a loss of approximately one word in the combined words recall test (mean − 0.18, 95% CI -0.22; −0.15, <em>P</em> < 0.001). In addition, we found strong evidence for an interaction between socioeconomic status and depressive symptoms. Subjects belonging to medium socioeconomic status (SES) showed more pronounced memory decline, when compared to those with lower SES (mean − 0.28, 95% CI -0.42 to −0.14, <em>P</em> < 0.001).</p></div><div><h3>Conclusions</h3><p>In adults aged over 50, after adjusting for sex, age, and educational level, a 5-unit increase in CES D-8 score is associated with loss of one point in the combined memory recall test. This association seems to be confounded by educational level and significantly modified by socioeconomic status.</p></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"5 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772653324000194/pdfft?md5=21de359521041bee9f35146287736e7e&pid=1-s2.0-S2772653324000194-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-20DOI: 10.1016/j.dialog.2024.100187
Melody Boudreaux Nelson , Michelle F. Lamendola-Essel , Aaron Odegard , Stephanie Whitehead , Dana Powell Baker , Joy Nakitandwe
Under the collective weight of growing test volume, staffing constraints, and Medicare reimbursements cuts, an enhancement-based, alternative payment structure focused on rewarding the laboratory's care delivery efforts via benchmarking is appealing. However, achieving a value-based payment model requires the development of an inclusive laboratory care delivery model (LCDM) framework. Today, a holistic, practical LCDM framework for laboratory medicine does not exist. However, such creation is essential for establishing unifying tenants of practice for value-tracing by which standardized key performance and population health indicators can be derived. LAB-CARES is the first step in formulating an LCDM with the primary objective of defining and streamlining the processes and strategies necessary to deliver and articulate the value of diagnostic excellence across the healthcare system. The goal of LAB-CARES is to maximize efficiencies, enhance quality, disseminate clinical expertise, increase patient safety, and promote integrative practice. LAB-CARES is designed to improve an individual patient's quality of life (longitudinal laboratory results – beyond one test) and their surrounding communities (e.g., through surveillance and prevention – beyond one patient). Further professional conversation and efforts are paramount to integrate LAB-CARES as a formalized structure within the healthcare landscape.
{"title":"The hierarchy of needs for laboratory medicine requires a foundational care delivery model","authors":"Melody Boudreaux Nelson , Michelle F. Lamendola-Essel , Aaron Odegard , Stephanie Whitehead , Dana Powell Baker , Joy Nakitandwe","doi":"10.1016/j.dialog.2024.100187","DOIUrl":"10.1016/j.dialog.2024.100187","url":null,"abstract":"<div><p>Under the collective weight of growing test volume, staffing constraints, and Medicare reimbursements cuts, an enhancement-based, alternative payment structure focused on rewarding the laboratory's care delivery efforts via benchmarking is appealing. However, achieving a value-based payment model requires the development of an inclusive laboratory care delivery model (LCDM) framework. Today, a holistic, practical LCDM framework for laboratory medicine does not exist. However, such creation is essential for establishing unifying tenants of practice for value-tracing by which standardized key performance and population health indicators can be derived. LAB-CARES is the first step in formulating an LCDM with the primary objective of defining and streamlining the processes and strategies necessary to deliver and articulate the value of diagnostic excellence across the healthcare system. The goal of LAB-CARES is to maximize efficiencies, enhance quality, disseminate clinical expertise, increase patient safety, and promote integrative practice. LAB-CARES is designed to improve an individual patient's quality of life (longitudinal laboratory results – beyond one test) and their surrounding communities (e.g., through surveillance and prevention – beyond one patient). Further professional conversation and efforts are paramount to integrate LAB-CARES as a formalized structure within the healthcare landscape.</p></div>","PeriodicalId":72803,"journal":{"name":"Dialogues in health","volume":"5 ","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772653324000236/pdfft?md5=574c40e0129cadff23485b250e928653&pid=1-s2.0-S2772653324000236-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142075967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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