Abstract:
BACKGROUND:Educational attainment has been shown to influence access to and quality of health care. However, the influence of educational attainment on decision-making at the end of life with possible or certain life-shortening effect (ELDs ie intensified pain and symptom alleviation, non-treatment decisions, euthanasia/physician-assisted suicide, and life-ending acts without explicit request) is scarcely studied. This paper examines differences between educational groups pertaining to prevalence of ELDs, the decision-making process and end-of-life treatment characteristics. METHOD:We performed a retrospective survey among physicians certifying a large representative sample of Belgian deaths in 2007. Differences between educational groups were adjusted for relevant confounders (age, sex, cause of death and marital status). RESULTS:Intensified pain and symptom alleviation and non-treatment decisions are more likely to occur in higher educated than in lower educated patients. These decisions were less likely to be discussed with either patient or family, or with colleague physicians, in lower educated patients. A positive association between education and prevalence of euthanasia/assisted suicide (acts as well as requests) disappeared when adjusting for cause of death. No differences between educational groups were found in the treatment goal in the last week, but higher educated patients were more likely to receive opioids in the last day of life. CONCLUSION:There are some important differences and possible inequities between educational groups in end-of-life decision-making in Belgium. Future research should investigate whether the found differences reflect differences in knowledge of and adherence to patient preferences, and indicate a discrepancy in quality of the end of life.
journal_name
BMC Public Healthjournal_title
BMC public healthauthors
Chambaere K,Rietjens JA,Cohen J,Pardon K,Deschepper R,Pasman HR,Deliens Ldoi
10.1186/1471-2458-13-1055subject
Has Abstractpub_date
2013-11-09 00:00:00pages
1055issn
1471-2458pii
1471-2458-13-1055journal_volume
13pub_type
杂志文章abstract:BACKGROUND:In resource- poor settings, verbal autopsy data are often reviewed by physicians in order to assign the probable cause of death. But in addition to being time and energy consuming, the method is liable to produce inconsistent results. The aim of this study is to evaluate the performance of the InterVA 3.2 mo...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-12-1039
更新日期:2012-11-29 00:00:00
abstract:BACKGROUND:Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainab...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-9-S1-S6
更新日期:2009-11-18 00:00:00
abstract:BACKGROUND:Physical inactivity is deemed to be the fourth leading cause for premature death. Nevertheless, only a minority of children and adolescents in Germany fulfil the guideline of the World Health Organization of at least 60 min of moderate-to-vigorous physical activity per day. Children and adolescents with a lo...
journal_title:BMC public health
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12889-019-6817-y
更新日期:2019-05-06 00:00:00
abstract:BACKGROUND:Sexual compulsivity (SC) and its relationship with unprotected intercourse (UI) have long been an intriguing topic, but its existential meaning in the management of public health or, more precisely, sexually transmitted infections (STIs) has rarely been studied to date. This study examines whether SC plays a...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-021-10186-0
更新日期:2021-01-15 00:00:00
abstract:BACKGROUND:Children and adolescents are important target groups for prevention of overweight and obesity as overweight is often developed early in life and tracks into adulthood. Research into behaviors related to overweight (energy balance-related behaviors) and the personal and environmental determinants of these beh...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-8-142
更新日期:2008-04-28 00:00:00
abstract:BACKGROUND:The burden of disease of hearing disorders among adults is high, but a significant part goes undetected. Screening programs in combination with the delivery of hearing aids can alleviate this situation, but the economic attractiveness of such programs is unknown. This study aims to evaluate the population-le...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-9-135
更新日期:2009-05-12 00:00:00
abstract:BACKGROUND:Previous studies have reported on adverse neonatal outcomes associated with parity and maternal age. Many of these studies have relied on cross-sectional data, from which drawing causal inference is complex. We explore the associations between parity/maternal age and adverse neonatal outcomes using data from...
journal_title:BMC public health
pub_type: 杂志文章,meta分析
doi:10.1186/1471-2458-13-S3-S2
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Access to washroom facilities and a place to dispose of menstrual waste are prerequisites for optimal menstrual hygiene management in schools. Like other low- and middle-income countries, Bangladeshi schools lack facilities for girls to change and dispose of their menstrual absorbents. We explored existing s...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-020-09413-x
更新日期:2020-09-07 00:00:00
abstract:BACKGROUND:Interventions that promote health and wellbeing among young adults are needed. Such interventions, however, require measurement tools that support intervention planning, monitoring and evaluation. The primary purpose of this study is to describe the process in developing a framework for a Canadian post-secon...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-019-7255-6
更新日期:2019-07-11 00:00:00
abstract:BACKGROUND:Cervical cancer is the sixth most common cause of cancer among Korean women and is one of the most preventable cancers in the world. This study aimed to investigate the change in cervical cancer screening rates, the level of socioeconomic disparities in cervical cancer screening participation, and whether th...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-13-553
更新日期:2013-06-06 00:00:00
abstract:BACKGROUND:Homeless veterans are at high risk for co-occurring disorders (COD), defined as mental illnesses that include at least one alcohol or other drug use disorder and at least one non-drug related mental disorder. However, epidemiological studies examining the prevalence of COD and associated mental health status...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-018-5700-6
更新日期:2018-06-18 00:00:00
abstract:BACKGROUND:Upper extremity injuries account for a large proportion of attendances to the Emergency Department. The aim of this study was to assess population-based trends in the incidence of upper extremity injuries in the Dutch population between 1986 and 2008, and to give a detailed overview of the associated health ...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-13-531
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Human immunodeficiency virus (HIV) testing is a crucial strategy for HIV prevention. HIV testing rates remain low among men who have sex with men (MSM) in China. Digital network-based secondary distribution is considered as an effective model to enhance HIV self-testing (HIVST) among key populations. Digital...
journal_title:BMC public health
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12889-020-09048-y
更新日期:2020-06-12 00:00:00
abstract:BACKGROUND:Based on Basic Health Research (RISKESDAS) conducted by Ministry of Health, Indonesia, prediabetes prevalence tends to increase from 2007 until 2018. The numbers are relatively higher in rural than those in urban area despite of small discrepancies between the two (~ 2-4%). The purpose of this study was to i...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-020-09592-7
更新日期:2020-10-06 00:00:00
abstract:BACKGROUND:In 1996, Brazil became the first developing country to provide free, universal access to HAART, laboratory monitoring, and clinical care to any eligible patient. As of June 2014, approximately 400,000 patients were under treatment, making it the most comprehensive HIV treatment initiative implemented thus fa...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-015-1530-y
更新日期:2015-03-07 00:00:00
abstract:BACKGROUND:This study explored the association of unemployment and an increased risk of receiving disability pension, and the possibility that this risk is attributed to municipality-specific characteristics. METHODS:A cohort of 7,985 40-42 year olds was followed for 18 years in national registers, identifying new epi...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-12-148
更新日期:2012-02-28 00:00:00
abstract:BACKGROUND:We investigated the patient- and treatment-system dependent factors affecting treatment outcome in a two-year cohort of all treated culture-verified pulmonary tuberculosis (TB) cases to establish a basis for improving outcomes. METHODS:Medical records of all cases in 1995 - 1996 were abstracted to assess ou...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-7-291
更新日期:2007-10-14 00:00:00
abstract:BACKGROUND:Little is known about preschool parents' cognitions, barriers, supports and modeling of key obesogenic behaviors, including breakfast, fruit and vegetable consumption, sugary beverage intake, feeding practices, portion sizes, active playtime, reduced screen-time, sleep and selection of child-care centers wit...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-015-1554-3
更新日期:2015-02-26 00:00:00
abstract:BACKGROUND:Vaccination and screening are forms of primary and secondary prevention methods. These methods are recommended for controlling the spread of a vast number of diseases and conditions. To determine the most effective preventive methods to be used by a society, multi-level models have shown to be more effective...
journal_title:BMC public health
pub_type: 杂志文章,评审
doi:10.1186/s12889-016-3802-6
更新日期:2016-11-17 00:00:00
abstract:BACKGROUND:The use of health care services is influenced by various factors, including demographic, social, economic, and health status factors. This study aimed to identify the factors that influence health care use in health insurance subscribers and medical aid beneficiaries in Korea. METHODS:A total of 11,793 subj...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-020-09073-x
更新日期:2020-07-20 00:00:00
abstract:BACKGROUND:Neonatal sepsis causes 0.5 million deaths annually, mostly in low resource settings. Babies born in African rural homes without running water or toilet facilities are especially vulnerable. Alcohol-based hand rub (ABHR) may be used by mothers and carers as an alternative to hand washing with soap to prevent ...
journal_title:BMC public health
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12889-018-6201-3
更新日期:2018-11-20 00:00:00
abstract:BACKGROUND:Despite sub-Saharan Africa [SSA] constituting just 12% of the world's population, the region has the highest burden of HIV with 70% of HIV infection in general and 80% of new infections among young people occuring in the region. Diverse intervention programmes have been implemented among young people but wit...
journal_title:BMC public health
pub_type: 杂志文章,评审
doi:10.1186/s12889-017-4729-2
更新日期:2017-09-18 00:00:00
abstract:BACKGROUND:The evidence linking stress to hypertension has been scarcely documented in population-based studies. METHODS:Participants were selected through a multi-stage probability sampling and interviewed at home, being submitted to measures of demographics, anthropometrics, blood pressure (BP), and risk factors for...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-8-357
更新日期:2008-10-15 00:00:00
abstract:BACKGROUND:Many children and young people experiencing mental health difficulties (MHD) do not access care, often due to inadequate identification. Schools have a unique potential to improve early identification; however, evidence is limited regarding the acceptability of school-based identification programmes. This st...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-018-6279-7
更新日期:2018-12-22 00:00:00
abstract:BACKGROUND:Alcohol is a Class-1 carcinogen but public awareness of the link between alcohol and cancer is low. The news media is a popular, readily-accessible source of health information and plays a key role in shaping public opinion and influencing policy-makers. Examination of how the link between alcohol and cancer...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-017-4569-0
更新日期:2017-07-24 00:00:00
abstract:BACKGROUND:Schistosomiasis is a parasitic disease that occurs in the tropics and subtropics. The mainstay of control is preventive chemotherapy with praziquantel. In Africa, an estimated 230 million people require preventive chemotherapy. In western Côte d'Ivoire, infections with Schistosoma mansoni are widespread. To ...
journal_title:BMC public health
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2458-14-1290
更新日期:2014-12-17 00:00:00
abstract:BACKGROUND:Diarrhea prevalence increases from around the time that complementary foods are introduced. Improving caregiver's hand hygiene during food preparation could reduce complementary food contamination and enteric pathogen transmission. Washing hands with soap is more common when water and soap are together at a ...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/s12889-017-4316-6
更新日期:2017-05-05 00:00:00
abstract:BACKGROUND:Cycling is important for health, transport, environmental and economic reasons. Newspaper reporting of cycling reflects and can influence public and policy maker attitudes towards resource allocation for cycling and cycling infrastructure, yet such coverage has not been systematically examined. METHODS:The ...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-10-371
更新日期:2010-06-25 00:00:00
abstract:BACKGROUND:This study explored community perceptions of cultural beliefs and practices that may increase sexual risk behaviour of adolescents, to understand more about meaning they hold within the culture and how they expose adolescent orphans and non-orphans to higher risks in a high HIV and teenage pregnancy prevalen...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-14-84
更新日期:2014-01-27 00:00:00
abstract:BACKGROUND:US Asian women with early-stage breast cancer are more likely to receive a modified radical mastectomy (MRM) than White women, contrary to clinical recommendations regarding breast conserving treatment (BCT). METHODS:We surveyed physicians regarding treatment decision-making for early-stage breast cancer, p...
journal_title:BMC public health
pub_type: 杂志文章
doi:10.1186/1471-2458-9-246
更新日期:2009-07-17 00:00:00