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Aguirre AO, Lim J, Kuo CC, Ruggiero N, Siddiqi M, Monteiro A, Baig AA, Housley SB, Recker MJ, Li V, Reynolds RM. Social Determinants of Health and Associations With Outcomes in Pediatric Patients With Brain Tumors. Neurosurgery 2024; 94:108-116. [PMID: 37526439 DOI: 10.1227/neu.0000000000002624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/25/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Social determinants of health (SDOH) are nonmedical factors that affect health outcomes. Limited investigation has been completed on the potential association of these factors to adverse outcomes in pediatric populations. In this study, the authors aimed to analyze the effects of SDOH disparities and their relationship with outcomes after brain tumor resection or biopsy in children. METHODS The authors retrospectively reviewed the records of their center's pediatric patients with brain tumor. Black race, public insurance, median household income, and distance to hospital were the investigated SDOH factors. Univariate analysis was completed between number of SDOH factors and patient demographics. Multivariate linear regression models were created to identify coassociated determinants and outcomes. RESULTS A total of 272 patients were identified and included in the final analysis. Among these patients, 81 (29.8%) had no SDOH disparities, 103 (37.9%) had 1, 71 (26.1%) had 2, and 17 (6.2%) had 3. An increased number of SDOH disparities was associated with increased percentage of missed appointments ( P = .002) and emergency room visits ( P = .004). Univariate analysis demonstrated increased missed appointments ( P = .01), number of postoperative imaging ( P = .005), and number of emergency room visits ( P = .003). In multivariate analysis, decreased median household income was independently associated with increased length of hospital stay ( P = .02). CONCLUSION The SDOH disparities are prevalent and impactful in this vulnerable population. This study demonstrates the need for a shift in research focus toward identifying the full extent of the impact of these factors on postoperative outcomes in pediatric patients with brain tumor.
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Affiliation(s)
- Alexander O Aguirre
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Jaims Lim
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Cathleen C Kuo
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Nicco Ruggiero
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Manhal Siddiqi
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
| | - Andre Monteiro
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Ammad A Baig
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Steven B Housley
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Matthew J Recker
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo , New York , USA
| | - Veetai Li
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Pediatric Neurosurgery, John R. Oishei Children's Hospital, Buffalo , New York , USA
| | - Renée M Reynolds
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA
- Department of Pediatric Neurosurgery, John R. Oishei Children's Hospital, Buffalo , New York , USA
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Bei E, Mashevich K, Rotem-Mindali O, Galin-Soibelman S, Kalter-Leibovici O, Schifter T, Vilchinsky N. Extremely Distant and Incredibly Close: Physical Proximity, Emotional Attachment and Caregiver Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148722. [PMID: 35886574 PMCID: PMC9323703 DOI: 10.3390/ijerph19148722] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 12/05/2022]
Abstract
Informal caregivers are at risk of caregiver burden, and physical proximity to the care recipient may add to this negative outcome. Yet, individual differences in emotional proximity to the care recipient such as attachment orientations may contribute to caregivers’ comfort towards different degrees of physical proximity, leading to varying levels of burden. The current study is the first to explore the role of physical proximity on caregiver burden as moderated by attachment orientations. A sample of 162 Israeli caregivers who are active users of the Camoni website completed our online survey. Sociodemographic characteristics, including a self-reported questionnaire on the physical proximity to the care recipient, were collected. Caregivers’ attachment orientations were assessed with the Experiences in Close Relationships–Relationship Structures questionnaire. Caregiver burden was assessed using the Caregiver Burden Inventory. Multiple regression and simple slope analyses were conducted. Attachment anxiety and avoidance were positively associated with burden, whereas physical proximity was not. Attachment avoidance, but not attachment anxiety, moderated the association between physical proximity and caregiver burden, with caregivers who live closer to their care recipient experiencing greater burden when high levels of avoidance were present. Our findings reveal the complex dynamics between attachment orientations and physical proximity in the context of informal care, highlighting the need for better integration of these two interlinked constructs in both care research and practice.
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Affiliation(s)
- Eva Bei
- Department of Psychology, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan 5290002, Israel; (K.M.); (S.G.-S.); (N.V.)
- Correspondence: ; Tel.: +30-69-8204-1162
| | - Karin Mashevich
- Department of Psychology, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan 5290002, Israel; (K.M.); (S.G.-S.); (N.V.)
| | - Orit Rotem-Mindali
- Department of Geography and Environment, Bar-Ilan University, Ramat Gan 5290002, Israel;
| | - Shira Galin-Soibelman
- Department of Psychology, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan 5290002, Israel; (K.M.); (S.G.-S.); (N.V.)
| | - Ofra Kalter-Leibovici
- The Gertner Institute, Sheba Medical Center, Ramat Gan 5290002, Israel; (O.K.-L.); (T.S.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv P.O. Box 39040, Israel
| | - Tami Schifter
- The Gertner Institute, Sheba Medical Center, Ramat Gan 5290002, Israel; (O.K.-L.); (T.S.)
| | - Noa Vilchinsky
- Department of Psychology, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan 5290002, Israel; (K.M.); (S.G.-S.); (N.V.)
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Sharif Nia H, Gorgulu O, Naghavi N, Robles-Bello MA, Sánchez-Teruel D, Khoshnavay Fomani F, She L, Rahmatpour P, Allen KA, Arslan G, Pahlevan Sharif S. Spiritual Well-Being, Social Support, and Financial Distress in Determining Depression: The Mediating Role of Impact of Event During COVID-19 Pandemic in Iran. Front Psychiatry 2021; 12:754831. [PMID: 34777060 PMCID: PMC8581494 DOI: 10.3389/fpsyt.2021.754831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/28/2021] [Indexed: 12/17/2022] Open
Abstract
This study investigates the relationship between spiritual well-being, social support, and financial distress with depressive symptoms due to the COVID-19 pandemic. A path analysis was used to analyze data collected from 1,156 Iranian participants via an online survey. The results showed that spiritual well-being and social support were negatively related to depressive symptoms and financial distress. The impact of COVID-19 events showed negative associations with depressive symptoms. In addition, the link between spiritual well-being and financial distress with depressive symptoms was partially mediated by the impact of events.
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Affiliation(s)
- Hamid Sharif Nia
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ozkan Gorgulu
- Department of Biostatistics and Medical Information, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
| | - Navaz Naghavi
- Taylor's Business School, Taylor's University, Subang Jaya, Malaysia
| | - María Auxiliadora Robles-Bello
- Area of Developmental and Educational Psychology, Department of Psychology, Faculty of Humanities, University of Jaén, Jaén, Spain
| | - David Sánchez-Teruel
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | | | - Long She
- Faculty of Business and Law, Taylor's University, Subang Jaya, Malaysia
| | - Pardis Rahmatpour
- Department of Nursing, School of Nursing, Alborz University of Medical Sciences, Karaj, Iran
| | - Kelly-Ann Allen
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, VIC, Australia
- Centre for Wellbeing Science, The Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC, Australia
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