Unfavourable Social Factors Research Articles

Marital status, educational level, and mid-term mortality risk in 5924 patients after transcatheter aortic valve implantation.

There is scarce knowledge about the association between social factors and mid-term outcome in older patients undergoing transaortic valve implantation (TAVI). Our aim in this study is to explore associations between marital status, educational level, and mortality risk in patients after TAVI. Patients aged ≥65 who underwent TAVI in Sweden during 2014-2020 were identified from the SWEDEHEART registry. Social factors and comorbidities were collected from mandatory national registries. Cox regression models adjusted for baseline comorbidities, age, sex, year of TAVI, social factors, and smoking were used to estimate mortality risk. Median follow-up was 1.9 years (interquartile range: 0.9-3.3). Overall, 5924 patients were included (47.3% women), with a mean age of 82.1 years (standard deviation: 6.1). Of the 1410 (23.8%) deaths during follow-up, 721 (51.2%) were related to cardiovascular causes. Patients with low education (<10 years) had a higher risk of mortality than patients with the highest education level [>12 years; adjusted hazard ratio (aHR): 1.20, 95% confidence interval (CI): 1.03-1.41]. Never being married/cohabiting was associated with an increased risk of mortality in comparison with being married/cohabiting (aHR: 1.32, 95% CI: 1.05-1.65). A separate analysis of men and women showed an increased risk among never-married men (aHR: 1.63, 95% CI: 1.23-2.14) but not among never-married women (aHR: 0.85, 95% CI: 0.56-1.30). Disadvantage in social factors was associated with an increased mortality risk after TAVI in older patients. These findings emphasize the importance of developing strategies to increase health literacy and social support after TAVI in older patients with unfavourable social factors.

Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview.

Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.

Socio-psychological features in patients with pulmonary tuberculosis

BACKGROUND. The effectiveness of the therapy of patients with pulmonary tuberculosis (TB) of various categories is largely related to the psychotraumatic nature of the disease and treatment, however, their social and psychological features and the need for psychological help have not been sufficiently studied.&#x0D; OBJECTIVE. To study the socio-psychological features of patients with pulmonary TB depending on the category of the case and the terms of treatment.&#x0D; MATERIALS AND METHODS. 200 patients with pulmonary TB were interviewed anonymously, including 45 (22.5 %) – with new cases, 27 (13.5 %) – with repeated treatment, 128 (64.0 %) – with multiple drug resistance (MDR-TB), according to the special form of primary social and psychological assessment of a patient with TB – Patient Health Questionnaire (PHQ-9).&#x0D; RESULTS AND DISCUSSIONS. The difference in the presence of unfavorable social factors among TB patients of different categories was revealed: low income, unemployment, disability, bad habits, retirement age, negative social history (were in prisons, migrants or internally displaced, lack of permanent work) met 2-3 times more often among repeated cases of the disease and MDR-TB, than in patients with new cases of the disease. Depressive disorders at the initial stage of treatment were found in 95.0 % of all TB patients, and mostly the signs of depression were pronounced, as evidenced by: very low interest or satisfaction in ordinary things in 52.0 %; bad mood, depression or a feeling of helplessness in 91.5 %; difficulty falling asleep, interrupted or too long sleep in 90.0 %; a feeling of fatigue or exhaustion – loss of strength in 94.5 %; poor appetite or, on the contrary, overeating in 89.5 %; negative thoughts about oneself in 57.5 %; difficulty concentrating in 57.0 %. The duration of these symptoms for more than 7 days during the last 2 weeks in many interviewees indicates a significant expressiveness of depressive disorders in the vast majority of TB patients. The dependence of the psychological state of TB patients on the category of the case and the duration of treatment was established and statistically proven. In patients with repeated treatment and MDR-TB, symptoms of depressive disorders were not only more frequent, but also more severe than in patients with new cases. If 74.8 % of patients with repeated cases and 57.0 % of patients with MDR-TB had mild and moderate depression, then 77.8 % of patients with new cases had mild (subclinical) depression. In patients who were treated for more than 4 months, signs of depressive disorders were more pronounced compared to those who were treated for less.&#x0D; CONCLUSIONS. This study not only confirms the need for differentiated psychological support of the treatment process in phthisiology (depending on the category of the case and the duration of treatment), but also encourages the search for new approaches to the medical, social and psychological rehabilitation of TB patients, taking into account the negative impact of the war in Ukraine on the social and psychological condition of such patients and the characteristics of their management in wartime conditions. There is a need to introduce rates of psychologists and psychiatrists for constant counseling of TB patients.

Physical recreation in the structure of students' active recreation

Background and Study Aim. The aim of the study is to generalize approaches to the concepts of physical recreation and recreational activities; reveal the directions and factors that contribute to the implementation of physical recreation; show the main provisions, means, forms, methods of physical recreation and its pedagogical principles.&#x0D; Materials and Methods. Sources of information are publications in domestic literature. A total of 26 publications were identified.&#x0D; Results. The article summarizes the experience of the authors on the problem of "Physical recreation": the concept, means, forms and methods of physical culture used in physical recreation. The basics of physical recreation of students are presented. These include: building a comprehensive program, developing valeological and recreational activities; joint creative activity of teachers and students; use of modern methods of health-forming technologies.&#x0D; Conclusions. Favorable and unfavorable social factors should be taken into account in the process of motor activity formation. In practical work, the following areas should be taken into account: hygienic, health-improving and recreational, general preparatory and medical.

Differences in Social Hardships in Women and Men with Acute Myocardial Infarction: Impact on 30-Day Readmission.

Background:Studies have shown that women with acute myocardial infarction (AMI) have a higher prevalence of unfavorable social variables then men and have a worse outcome. Less is known regarding the impact of these social variables on 30-day readmission after AMI.Materials and Methods:We analyzed adult patients with AMI enrolled in a Quality Improvement Program intended to improve the peri-discharge care of patients with an AMI, and decrease all-cause 30-day unplanned readmissions. We compared clinical and social variables by gender. Multivariate logistic regression, with separate adjustment for clinical and for social variable, was used to measure adjusted odds for readmission by gender.Results:Among 208 patients included in our project 68 (32.7%) were women. Only 30.9% of women were married or had domestic partner at the time of the interview and only 16.2% were employed. Nearly half of women (48.5%) needed help with medical care, and 39.7% of women did not speak English as their first language. These variables were significantly different by gender. Rates of 30-day readmissions were higher in women than men (22.1% vs. 7.8%, p = 0.024). After adjusting for clinical variables this difference by gender in 30-day readmissions remained significant (odds ratio [OR] 3.34 95% confidence interval [CI] 1.1–11.1, p = 0.049). However, when adjusting for social variables, this difference was no longer noted (OR 0.87 95% CI 0.27–2.78, p = 0.822).Conclusion:Women with AMI are more likely than men to have unfavorable social factors that can impact recovery from AMI and women have a higher 30-day readmission rate. The higher 30-day readmissions in women appears to be influenced by these social factors. Health care interventions aimed at reducing 30-day readmission after AMI should focus on eliciting a detailed social history and providing aid for those requiring additional social support at home.

Влияние негативного эмоционального опыта детства на криминальную активность у женщин с органическим расстройством личности

In order to study the influence of negative emotional experiences of childhood on criminal activity in women with organic personality disorder we investigated group of women, suspected or accused of crimes in criminal cases, who underwent forensic psychiatric examination (n=102) with comparison to group of women, who had not a criminal history (n=50). It is revealed that for women who have committed criminally punishable acts, negative childhood events with many psychogenic and traumatic events are of significant importance. It was revealed that the greatest importance of adverse childhood events with negative emotional experience - abuse, violence (emotional, physical, sexual) in combination with unfavorable social factors of upbringing had a significant pathoplastic and pathokinetic effect on the clinical and dynamic characteristics of the disease and to a certain extent predetermined the formation of criminal activity of this category of persons. They are more likely to have dependence on surfactants. These women were more likely to commit aggressive offenses (murder, grievous bodily harm), while the victim of these crimes was more often a partner (husband, cohabitant).

Women scientists in China: current status and aspirations.

Throughout history, gender inequality has persisted in most parts of the world. Since the founding of the People's Republic of China (PRC) in 1949, substantial progress has been made towards gender equality in China. Today, a large number of Chinese women scientists are making significant contributions to advance science. However, are they facing gender discrimination in hiring and promotion? Do they have access to the same opportunities as their male colleagues? What are the potential approaches to further promote gender equality in China's scientific community given myriad unfavorable social factors? Recently, NSR invited five Chinese female scientists and two gender experts to discuss these issues. Here are their observations and suggestions. Bing LiuProfessor at the Department of the History of Science, Tsinghua University Jun LuSenior Engineer at Beijing Institute of Tracking and Telecommunications Technology, and Deputy Chief Designer of BeiDou Grounded Test and Validation System Chih-chen WangProfessor at the Institute of Biophysics, Chinese Academy of Sciences Hongyang WangPresident of the China Women's Association for Science and Technology (CWAST), Director of the National Center for Science in Liver Cancer Xiaoyun WangC. N. Yang Professor at the Institute for Advanced Study, Tsinghua University Yan ZhengChair Professor at the School of Environmental Science and Engineering, Southern University of Science and Technology Wenpei Tang (Chair)Professor at the School of Health Humanities, Peking University

Low educational level increases functional disability risk subsequent to heart failure in Japan: On behalf of the Iwate KENCO study group.

The risk factors that contribute to future functional disability after heart failure (HF) are poorly understood. The aim of this study was to determine potential risk factors to future functional disability after HF in the general older adult population in Japan. The subjects who were community-dwelling older adults aged 65 or older without a history of cardiovascular diseases and functional disability were followed in this prospective study for 11 years. Two case groups were determined from the 4,644 subjects: no long-term care insurance (LTCI) after HF (n = 52) and LTCI after HF (n = 44). We selected the controls by randomly matching each case of HF with three of the remaining 4,548 subjects who were event-free during the period: those with no LTCI and no HF with age +/-1 years and of the same sex, control for the no LTCI after HF group (n = 156), and control for the LTCI after HF group (n = 132). HF was diagnosed according to the Framingham diagnostic criteria. Individuals with a functional disability were those who had been newly certified by the LTCI during the observation period. Objective data including blood samples and several socioeconomic items in the baseline survey were assessed using a self-reported questionnaire. Significantly associated risk factors were lower educational levels (odds ratio (OR) [95% confidence interval (CI)]: 3.72 [1.63-8.48]) in the LTCI after HF group and hypertension (2.20 [1.10-4.43]) in no LTCI after HF group. Regular alcohol consumption and unmarried status were marginally significantly associated with LTCI after HF (OR [95% CI]; drinker = 2.69 [0.95-7.66]; P = 0.063; unmarried status = 2.54 [0.91-7.15]; P = 0.076). Preventive measures must be taken to protect older adults with unfavorable social factors from disability after HF via a multidisciplinary approach.

Сравнительный анализ клинико-социальных характеристик женщин с органическим расстройством личности, совершивших и не совершавших правонарушения

In this descriptive retrospective study 102 women with organic personality disorder who underwent a forensic psychiatric examination in connection with the commission of criminal offenses, as well as 50 women with a similar psychiatric diagnosis, but without a criminal history, were examined. Among the most criminogenic social factors were identified unfavorable conditions of upbringing and living, low level of education, unemployment, antisocial environment, subjectively significant psychogenic and traumatic events, the source of which is common conflicts within the family. Severe cognitive impairment (along with the presence of emotional-volitional disorders), besides the presence of unfavorable social factors, determined the expert decision on insanity in women with a criminal history.

Сравнительный анализ клинико-социальных характеристик у женщин с органическим расстройством личности, совершивших и не совершавших правонарушения

In this descriptive retrospective study 102 women with organic personality disorder who underwent a forensic psychiatric examination in connection with the commission of criminal offenses, as well as 50 women with a similar psychiatric diagnosis, but without a criminal history, were examined. Among the most criminogenic social factors were identified unfavorable conditions of upbringing and living, low level of education, unemployment, antisocial environment, subjectively significant psychogenic and traumatic events, the source of which is common conflicts within the family. Severe cognitive impairment (along with the presence of emotional-volitional disorders), besides the presence of unfavorable social factors, determined the expert decision on insanity in women with a criminal history.

Abstract 130: Social Factors Influence Readmission Rates in Women with Acute Myocardial Infarction

Background: Studies have shown that women with acute myocardial infarction (AMI) have a higher prevalence of unfavorable social variables than men and have a worse outcome. Less is known regarding the impact of these social variables on 30-day all-cause readmission after AMI. Methods: We analyzed adult patients with AMI enrolled in a Quality Improvement Program aimed to decrease 30-day all-cause readmission after AMI. We compared clinical and social variables by sex using Pearson Chi Squared and Cramer’s V test. Multivariate linear regression was used to measure adjusted odds for 30-day all-cause readmission by sex. Results: Among 173 patients included in our project, 54 (31.2%) were women. Table 1 depicts the clinical and social variables in women and men. Only 33.3% of women were married or had domestic partner and less than one fourth were employed. Nearly half of women needed help at home, and nearly half of women did not speak English as their first language. These variables were significantly different by sex. The 30-day all-cause readmission was higher in women than men (20.4% vs 7.6%, p=0.03). After adjusting for clinical and social variables this difference by sex in 30-day all-cause readmission was no longer noted (OR 1.1, 95% CI 0.33-3.74, p=0.86). Conclusion: Women with AMI are more likely than men to have unfavorable social factors that can impact recovery from AMI, and women have a higher 30-day all-cause readmission rate. The higher readmission rate in women appears to be influenced by these social factors. Healthcare interventions aimed at reducing 30-day all-cause readmission after AMI should focus on providing assistance for those requiring additional social support at home.

Abstract P331: Unfavorable Social Factors Increased the Risk of Future Disability Subsequent to Heart Failure in Elderly Japanese Community Dwellers: The Iwate KENCO Study Group

Introduction: The risk factors that contribute to future disability after heart failure (HF) are poorly understood. The aim of this study was to determine the risk factors of future disability subsequent to HF in the general elderly population in Japan. Hypothesis: We assessed the hypothesis that unfavorable social factors after than traditional cardiovascular risk factors contribute to an increased risk for disability after HF. Methods: The subjects were community-dwelling elderly individuals aged 65 years or older without a history of cardiovascular diseases. We defined disabled subjects as individuals who had been newly certified by the long-term care insurance (LTCI) system during the observation period. HF was diagnosed according to the Framingham diagnostic criteria. After excluding subjects who received LTCI without HF (n= 2,305) and subjects who had already received LTCI prior to HF onset (n=33), we classified the remaining subjects (n= 4,644) into 3 groups: event-free (no LTCI and no HF; n= 4,548, mean age = 70.1 years at the baseline survey), no LTCI after HF (n= 52, mean age = 72.3 years) and LTCI after HF (n= 44, mean age =74.6 years). We determined the multivariate-adjusted odds ratio (OR) for having each risk factor (male gender, age (increment of years), unmarried status, less educational years (&lt;7 years), no job status, smoking, drinking, hypertension, diabetes mellitus and dyslipidemia) in the latter two groups (reference: event-free) using polytomous logistic regression analysis. Results: The median follow-up period was 10.6 years (49,133 person-years), and the median period [interquartile range] from the incidence of HF to the certification for LTCI was 1.3 [0.3- 4.7] years. Significantly associated risk factors were more advanced age (OR [95% confidence intervals]:1.18 [1.10-1.25]), unmarried status (2.29 [1.14- 4.63]), less educational years (3.36 [1.72-6.55]) and regular drinking (2.58 [1.13- 5.88]) in the group of LTC after HF, while the risk factor was more advanced age (1.08 [1.02-1.15]) in the group of no LTCI after HF. Conclusion: The results suggested that unfavorable social risk factors such as unmarried status, shorter education period and regular drinking strongly contributed to the higher risk of disability subsequent to HF, while those unfavorable risk factors did not contribute to the risk of incident HF without LTCI. Preventive measures must be taken to protect elderly individuals with unfavorable social factors from disability after HF via a multidisciplinary approach.

A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England

ObjectivesTo explore how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. We explored women's perceptions of deinfibulation, caesarean section and vaginal delivery;...

Psychiatric comorbidity and gender difference among treatment‐seeking heroin abusers in Taiwan

The objectives of the present study were to estimate the psychiatric comorbidity of Taiwanese heroin users seeking treatment and to identify the gender differences in psychiatric comorbidity and drug use behavior. Subjects were interviewed using a structured questionnaire on drug use behavior and the Mini International Neuropsychiatric Interview for psychiatric disorders. Of the subjects, 58.5% of the male and 62.5% of the female subjects had at least one non-substance-use axis I psychiatric disorder or antisocial personality disorder. Compared to male subjects, female subjects were younger, were less educated, had higher rates of unemployment and had earlier onset of illicit drug use. Female subjects were 11-fold more likely than male subjects to exhibit suicidal behavior. Among heroin abusers in the present study, female subjects were more widely exposed to unfavorable social factors and had substantially higher incidence of suicidal behavior than male subjects. Drug treatment centers should be aware of these gender differences and pay particular attention to comorbid depressive disorders and suicidal behavior of female heroin abusers.

Neurologic and neuropsyhologic manifestations of specific learning disorders in children

There were studied clinical and neuropsyhologic specific learning disorders of secondary school children from the 1st to the 5th forms with the aim of finding out the main prognostically unfavourable factors of disgraphia and dislexia development. The specific learning disorders are stable. Regress of symptoms up to the 5th form took place only in 4 children. 50% of schoolchildren got secondary neurotic complaints. The prognostically unfavourable learning disorders are the following symptoms: phenomen of reflecting writing (observed in 1-2 forms of school), disorders of space impression, of aural perception (including phonematic hearing). Most patients had a combination of residually organic lesions of brain, family hystory with dysgraphia and unfavourable social factors.

Non-insulin-dependent diabetes mellitus and depression in a middle-aged Finnish population.

A hypothesis of a psychosocial origin of depression in diabetic persons (mainly patients with non-insulin-dependent diabetes mellitus, NIDDM) was tested. The population consisted of all the 1008 persons born in 1935 and living in a Finnish city (Oulu) on 1 October 1990. Data were collected in two phases. A screening for NIDDM and a collection of back ground data were carried out in the first phase. Oral glucose tolerance tests (OGTTs) were performed in the second phase in order to detect those with previously undiagnosed NIDDM, and depressive symptoms were measured with the Zung Self-Rating Depression Scale (ZSDS). Participants who scored 45 raw sum points or more were considered as suffering from depression. All those who were aware of their diabetes before the second phase were considered as previously diagnosed diabetics. Depression (raw sum score 45 points or more on the ZSDS) was associated with previously diagnosed diabetes mellitus, while it was not associated with undiagnosed diabetes. The sum scores on the ZSDS did not differ significantly from each other in the groups classified according to diabetic status. This finding was explained by the sum score of the ZSDS among the previously diagnosed diabetics, which had a skewed distribution towards higher sum scores. Among the previously diagnosed diabetic patients, all those who were depressed were on sick leave or retired, while the corresponding proportion for non-depressed patients was 52% (P = 0.009). The number of diagnosed diseases was higher among the former than the latter group (P = 0.025). Severe depressive symptoms were not associated with a more serious metabolic disease, but they tended to be associated with a great number of diagnosed diseases and with being on sick leave or retired. The results showed that the impact of diabetes mellitus itself on depression was not strong. Depression was not connected to elevated fasting blood glucose levels, but instead to a great number of diagnosed diseases and unfavourable social factors, such as being on sick leave or retired, which suggests a psychosocial origin of depression in NIDDM patients.

Features of the course of pregnancy and childbirth in women under 18 years of age

The frequency of pregnancy in minors has increased over the past decade, which can be explained by both biological (acceleration) and unfavorable social factors. Undoubtedly, the influence of early sexual activity, pregnancy, abortion and childbirth on the formation of the adolescent's reproductive system is sharply negative. Gestogenic contraceptives fix the anovulatory orientation of the menstrual cycle, which leads to dysfunctional bleeding. An abortion in puberty threatens infertility. The mental trauma that a socially immature person receives is also great. Often a young pregnant woman does not understand what happened to her. More worried are parents who want to terminate their daughter's pregnancy at all costs. The school also sharply negatively relates to the accomplished fact.

Relationship of growth and psychoneurologic status of 2-year-old children of birthweight 500–999 g

There were 257 liveborn infants of birthweight 500–999 g born in one tertiary centre in the 5 1 4 years commencing January 1977; 86 (33.5%) survived to 2 years of age, corrected for prematurity and 83 86 (96.5%) were fully assessed. The prevalence of cerebral palsy was 10 83 (12%) and 17 83 (20%) had a major impairment. The distribution of weights and heights for 2-year-old boys and girls was significantly lower than for the standard population, as was the head circumference distribution for boys; the distribution of the Mental Developmental Index (Bayley Scales) was not related to the head circumference or body weight at two years or to head-circumference/bodyweight or height ratios. At birth measurements of weight, length and head circumference were under the 3rd percentile for 13 86 (15%), 9 86 (10.5%) and 9 86 (10.5%) respectively. By 2 years of age, weight, length and head circumference were under the 3rd percentile in 23 83 (27.7%), 26 83 (31.3%) and 4 83 (4.8%) respectively. 12 children who were SGA at birth were fully assessed at 2 years; the group of 6, who continued with poor postnatal weight gains (under the 3rd percentile) had the highest rate of major impairment but included were the only extremely SGA twins and the only two major malformations in the study. We found no association of other health problems or unfavourable social factors with poor postnatal growth or impaired outcome.

Prediction of educational achievement, behaviour and health at school using information from infancy health service.

The study is a 12-year follow-up of all risk-children (652) and a random sample of control-children (626) born during 1968 in a delimited geographical area (Aarhus county). Information from the infancy period was obtained from the health nurses' schematic records and were concerned with family background variables, life events which had occurred during the first year of life, perinatal risk-factors and indices of health care during the first year of life. Information at 12 years of age was obtained through the records in the school health service. Multivariate predictor analyses were performed. Significant educational difficulties, which 16.6% experienced, were pronouncedly predicted from indices of low socio-economic status, child abuse and neglect and male sex. The prevalences at 12 years of age of mental disorders psychosomatic (6.7%), behaviour disorder (3.3%), and mental retardation (1.3%) were predictable from indices of social and psychosocial stress including the health nurses' assessment of inadequate care during infancy period, but with some differences among the diagnostic groups. The results show that unfavourable social factors, psychosocial stress and inadequate care are informative variables for delimitation of risk-groups in infancy.

Juvenile Delinquency in Buffalo and its Prevention

This study had its beginning in 1934 with a survey on juvenile delinquency, a problem Which has been perplexing parents, welfare and religious workers for years. In spite of enormous costs, the most important aspect of the problem is its manifestations inasmuch as delinquent-mindedness is often thought to be the product of one 's environment. Since a clinical study of the individual delinquent was not possible, this study is concerned with the relative degree of change, if any, among the given factors in general and juvenile delinquency in particular as tracted in 1934; what is being done about the problem wherever it is revealed; what is being done to prevent the problem and what more can be done in the light of present machinery. It is to be noted that reference is made to Tract 14 only because it is the center of the slum area and rates highest in all unfavorable factors. But all of these factors exist to almost the same degree in peripheral tracts with constituency of other racial and ethnic groups. And although delinquents are found in each residential tract, the rate is highest where the unfavorable social factors are most concentrated. In spite of the milieu in which they find themselves, the trend among colored children is noteworthy and itself warrants investigation.