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Yamashita Y, Yamamoto T. Effect of virtual reality self-counseling with the intimate other avatar. Sci Rep 2024; 14:15417. [PMID: 38965334 PMCID: PMC11224315 DOI: 10.1038/s41598-024-65661-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 06/21/2024] [Indexed: 07/06/2024] Open
Abstract
Virtual reality self-counseling (VR-SC) is considered an effective approach for addressing mental health problems. Previous studies have shown the effectiveness of VR-SC using Sigmund Freud's avatar as the counselor. However, considering that virtual reality (VR) enables embodied perspective-taking of another person, VR-SC using the avatar of a person who cares about the participant (an intimate person), such as a family member or friend, is considered effective because it could create warm attitudes toward the participants themselves. In this study, 60 undergraduate and graduate students were split into three conditions: VR-SC with intimate persons, VR-SC with Freud, and a control group. The intervention effects were then compared. The results showed that VR-SC with an intimate person was the most effective in improving anxiety symptoms. These results may be attributed to accepting and affirming oneself from the perspective of the intimate person's avatar and counseling oneself. This study is significant in that it is the first to conduct VR-SC with the avatar of an intimate person and compare the effects with Freud's avatar. More importantly, it showed that the same VR-SC method could have different effects depending on the avatar of the counseling partner.
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Affiliation(s)
- Yuko Yamashita
- Graduate School of Sciences and Technology for Innovation, Tokushima University, Tokushima, Japan.
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Tetsuya Yamamoto
- Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
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2
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Wang Y, Xu M, Wei Z, Sun L. Associations between workplace violence and suicidal ideation among Chinese medical staff: a propensity score matching analysis. PSYCHOL HEALTH MED 2024; 29:1020-1034. [PMID: 37656046 DOI: 10.1080/13548506.2023.2254037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 08/25/2023] [Indexed: 09/02/2023]
Abstract
Physical and mental health problems had been identified as the negative outcomes of workplace violence (WPV) against medical staff. Considering the proven associations between physical and mental health and suicidal ideation, it is reasonable to assume that WPV may associate with suicidal ideation. However, few studies were conducted to explore the relationship between WPV and their suicidal ideation against medical staff. Based on a cross-sectional design, 3, 426 medical staff working in general hospitals were interviewed in Shandong Province, China. Socio-demographic characteristics, work-related factors, psychological variables, WPV, and suicidal ideation were evaluated. Propensity score matching (PSM) was performed to explore the association between WPV and suicidal ideation. The prevalence of suicidal ideation among medical staff was 9.1% (312/3426), and 52.2% (1788/3426) of medical staff reported the WPV experience. Before PSM, we found that the association between WPV and suicidal ideation was statistically significant (aOR = 1.606, p < 0.01). After PSM, there was a statistically significant correlation between WPV and suicidal ideation (aOR = 1.525, p < 0.01). This study supported the correlations between WPV against medical staff and their suicidal ideation. The results of PSM further implied that WPV might cause suicidal ideation among medical staff. Psychological health, especially for suicidal ideation, should be paid attention for medical staff with WPV experiences.
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Affiliation(s)
- Yifan Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
- Jinan Center for Disease Control and Prevention, Jinan, China
| | - Meixia Xu
- Department of Current Situation and Policy, Shandong Women's University Jinan Shandong, Jinan, China
| | - Zhen Wei
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
| | - Long Sun
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
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Battat M, Omair N, WildAli MA, Alkaissi A, Amer R, Koni AA, Salameh HT, Zyoud SH. Assessment of depression symptoms among cancer patients: a cross-sectional study from a developing country. Sci Rep 2024; 14:11934. [PMID: 38789579 PMCID: PMC11126617 DOI: 10.1038/s41598-024-62935-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/22/2024] [Indexed: 05/26/2024] Open
Abstract
Cancer patients experience psychological symptoms such as depression during the cancer treatment period, which increases the burden of symptoms. Depression severity can be assessed using the beck depression inventory (BDI II). The purpose of the study was to use BDI-II scores to measure depression symptoms in cancer patients at a large tertiary hospital in Palestine. A convenience sample of 271 cancer patients was used for a cross-sectional survey. There are descriptions of demographic, clinical, and lifestyle aspects. In addition, the BDI-II is a tool for determining the severity of depression. Two hundred seventy-one patients participated in the survey, for a 95% response rate. Patients ranged in age from 18 to 84 years, with an average age of 47 years. The male-to-female ratio was approximately 1:1, and 59.4% of the patients were outpatients, 153 (56.5%) of whom had hematologic malignancies. Most cancer patients (n = 104, 38.4%) had minimal depression, while 22.5%, 22.1%, and 17.0% had mild, moderate, and severe depression, respectively. Education level, economic status, smoking status, and age were significantly associated with depression. The BDI-II is a useful instrument for monitoring depressive symptoms. The findings support the practice of routinely testing cancer patients for depressive symptoms as part of standard care and referring patients who are at a higher risk of developing psychological morbidity to specialists for treatment as needed.
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Affiliation(s)
- Maher Battat
- Bone Marrow Transplant and Leukemia Unit, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Nawal Omair
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Mohammad A WildAli
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Aidah Alkaissi
- Department of Nursing, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Riad Amer
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Husam T Salameh
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine.
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
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DeBeck DP, Scudder JN. An Integrated Health Belief Model: Predicting Uptake of the First COVID-19 Booster Vaccine. HEALTH COMMUNICATION 2024; 39:1102-1112. [PMID: 37128817 DOI: 10.1080/10410236.2023.2204583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Public health campaigns have turned to the Health Belief Model (HBM) as a guiding framework for the past six decades. Carpenter's 2010 HBM meta-analysis revealed important shortcomings as well as a path forward that has largely been ignored by recent COVID-19 research using this framework. Consistent with Carpenter's recommendations, this study on the uptake of the first COVID-19 booster vaccine focused on the overlooked interactional processes of the original HBM founders. Our study used SEM and Hayes's PROCESS 4.1 to explore the possibilities of the interdependent nature of the core three beliefs to form a model that is integrated. The study indicated that the core variables of the original HBM were significant predictors of the intent to take the first COVID-19 booster vaccine when considered in an interactional process framework. Our study results have implications for those designing public health advocacy campaigns regarding COVID-19 as it enters an endemic stage with future vaccines and medications.
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Ismail A, Hamdar L, Dirawi H, Kanso M, Salem I, Tamim H, Mahfoud Z. Predictors and health outcomes of tobacco smoking among the population of Gaza: A large-scale study. RESEARCH SQUARE 2024:rs.3.rs-4195976. [PMID: 38746468 PMCID: PMC11092850 DOI: 10.21203/rs.3.rs-4195976/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Tobacco smoking, a significant public health concern globally, is associated with a rise in noncommunicable diseases and preventable deaths, with pronounced impacts in conflict zones like Gaza. A study in Gaza focused on individuals over 40 years of age, aiming to identify predictors of tobacco use and its links to diseases like coronary artery disease, chronic lung disease, and stroke. The research, based on the Gaza NCD study data with 4576 participants and a 96.6% response rate, found an overall tobacco smoking prevalence of 19.4%, with higher rates among men. Adjusting for various factors, the study revealed significant associations between cigarette smoking in men and adverse health outcomes, such as coronary artery disease and chronic lung disease. However, after adjusting for independent variables, shisha smoking in men showed no association with these health outcomes. In conflict-affected regions like Gaza, this large-scale study sheds light on predictors of cigarette and shisha smoking and their impact on health outcomes, offering valuable insights for researchers, public health officials, healthcare professionals, and policymakers. The findings aid in predicting smoking prevalence, addressing current health challenges, and mitigating potential health and financial burdens associated with tobacco use in conflict zones.
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Affiliation(s)
- Ali Ismail
- American University of Beirut Medical Center
| | | | - Hiba Dirawi
- American University of Beirut Medical Center
| | | | | | - Hani Tamim
- American University of Beirut Medical Center
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Liu Z, Zou W. Breaking Taboos in Women's Reproductive Health: The Communication Strategies Used by Top OB/GYN Influencers in Chinese Social Media. HEALTH COMMUNICATION 2024; 39:685-696. [PMID: 36803354 DOI: 10.1080/10410236.2023.2181677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Numerous women struggling with health issues dare not go to the hospital due to the stigmatization of obstetric and gynecological diseases in traditional Chinese culture. Social media provide a platform for women to access health information from experts easily. Guided by the doctor-patient communication model, attribution theory, and destigmatization framework, we sought to understand the topics/diseases covered by top OB/GYN influencers on Weibo and the prevalent functions, language style, responsibility attribution, and destigmatization cues used by them. We also examined how these communication strategies predicted followers' engagement behavior. The results showed that women's childbirth-related issues received the highest exposure in the leading OB/GYN influencers' Weibo posts. Influencers' emphasis on building psychological connectedness with their followers was exhibited in the following communication strategies: avoiding using complex medical terminology, drawing equivalences between the outgroup and ingroup, and providing health information. However, using everyday language, responding to emotions, and removing blame served as the three most influential predictors of followers' engagement. Theoretical and practical implications are also discussed.
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Affiliation(s)
- Zikun Liu
- School of Journalism and Communication, Tsinghua University
| | - Wenxue Zou
- Department of Communication and Journalism, Texas A&M University
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7
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Law L, Kelly JT, Savill H, Wallen MP, Hickman IJ, Erku D, Mayr HL. Cost-effectiveness of telehealth-delivered diet and exercise interventions: A systematic review. J Telemed Telecare 2024; 30:420-437. [PMID: 35108135 DOI: 10.1177/1357633x211070721] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Telehealth is a promising tool for delivering lifestyle interventions for the management of health conditions. However, limited evidence exists regarding the cost-effectiveness of these interventions. This systematic review aimed to evaluate the current literature reporting on the cost-effectiveness of telehealth-delivered diet and/or exercise interventions. METHODS Four electronic databases (PubMed, CENTRAL, CINAHL and Embase) were searched for published literature from database inception to November 2020. This review adhered to the preferred reporting items for systematic reviews and meta-analyses guidelines and the ISPOR Criteria for Cost-Effectiveness Review Outcomes Checklist. The quality of reporting was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. The extracted data were grouped into subcategories according to telehealth modality, organised into tables and reported narratively. RESULTS Twenty-four studies of controlled trials (11 combined diet and exercise, 9 exercise-only and 4 diet-only telehealth-delivered interventions) were included for data extraction and quality assessment. Interventions were reported as cost-effective in 12 studies (50%), five studies (21%) reported inconclusive results, and seven studies (29%) reported that the interventions were not cost-effective. Telephone interventions were applied in eight studies (33%), seven studies (29%) used internet interventions, six studies (25%) used a combination of internet and telephone interventions, and three studies (13%) evaluated mHealth interventions. Quality of study reporting varied with between 54% and 92% of Consolidated Health Economic Evaluation Reporting Standards items reported. CONCLUSIONS This review suggests that telehealth-delivered lifestyle interventions can be cost-effective compared to traditional care. There is a need for further investigations that employ rigorous methodology and economic reporting, including appropriate decision analytical models and longer timeframes.
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Affiliation(s)
- Lynette Law
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Holly Savill
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Matthew P Wallen
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- School of Science, Psychology and Sport, Federation University Australia, Mount Helen, Victoria, Australia
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Erku
- Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia
| | - Hannah L Mayr
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Functioning and Health Research, Metro South Health, Queensland, Australia
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Solera-Sanchez A, Christian DL, Beltran-Valls MR, Adelantado-Renau M, Martin-Smith R, MacDonald MJ, Tyler R, Fairclough SJ. Cross-sectional and longitudinal relationships between cardiorespiratory fitness and health-related quality of life in primary school children in England: the mediating role of psychological correlates of physical activity. Perspect Public Health 2024; 144:119-128. [PMID: 36226987 DOI: 10.1177/17579139221118771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aims were (1) to analyse the cross-sectional and longitudinal associations between children's cardiorespiratory fitness (CRF) and health-related quality of life (HRQoL) and (2) to examine whether these associations were mediated by physical activity self-efficacy and physical activity enjoyment. METHODS This study involved 383 children (10.0 ± 0.5 years) recruited from 20 primary schools in northwest England. Data were collected on two occasions 12 weeks apart. The number of laps completed in the 20-m Shuttle Run Test was used as the CRF indicator. HRQoL was assessed using the KIDSCREEN-10 questionnaire. Physical activity self-efficacy and enjoyment were assessed with the social-cognitive and Physical Activity Enjoyment Scale questionnaires, respectively. Linear mixed models with random intercepts (schools) assessed associations between CRF and HRQoL cross-sectionally, and longitudinally. Boot-strapped mediation procedures were performed, and indirect effects (IE) with 95% confidence intervals (CI) not including zero considered as statistically significant. Analyses were adjusted for sex, time of the year, socioeconomic status, waist-to-height ratio, maturation, and physical activity. RESULTS CRF was cross-sectionally associated with HRQoL (β = 0.09, 95% CI = 0.02, 0.16; p = .015). In the longitudinal analysis, CRF at baseline was associated with HRQoL at 12 weeks after additionally controlling for baseline HRQoL (β = 0.08, 95% CI = 0.002; p = .15, p = .045). Cross-sectionally, physical activity self-efficacy and enjoyment acted individually as mediators in the relationship between CRF and HRQoL (IE = 0.069, 95% CI = 0.038; p = .105 and IE = 0.045, 95% CI = 0.016; p = .080, respectively). In the longitudinal analysis, physical activity self-efficacy showed a significant mediating effect (IE = 0.025, 95% CI = 0.004; p = .054). CONCLUSION Our findings highlight the influence of CRF on children's psychological correlates of physical activity and their overall HRQoL.
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Affiliation(s)
- A Solera-Sanchez
- LIFE Research Group, Department of Education, University Jaume I, Castellon, Spain
| | - D L Christian
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - M R Beltran-Valls
- LIFE Research Group, Department of Education, University Jaume I, Av. de Vicent Sos Baynat, s/n, Castellon 12071, Spain
| | - M Adelantado-Renau
- LIFE Research Group, Department of Education, University Jaume I, Castellon, Spain
| | - R Martin-Smith
- Movement Behaviours, Health, and Wellbeing Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
| | - M J MacDonald
- Movement Behaviours, Health, and Wellbeing Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
| | - R Tyler
- Movement Behaviours, Health, and Wellbeing Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
| | - S J Fairclough
- Movement Behaviours, Health, and Wellbeing Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
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Ballesty KL, Newton-John TR, Hennessy RM, Alperstein DM, Begley K, Bulsara SM. 'What doesn't kill you. . .': A qualitative analysis of factors impacting the quality of life of people living with HIV. J Health Psychol 2024:13591053241235091. [PMID: 38411113 DOI: 10.1177/13591053241235091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Despite viral suppression, people living with HIV (PLHIV) report lower quality of life (QoL) than the general population, negatively impacting treatment adherence and wellbeing. This qualitative study explored factors influencing QoL of PLHIV. Participants completed a QoL questionnaire, with cut-off scores used to allocate participants into Low-Moderate QoL (n = 11) or High-Very High QoL (n = 10) focus groups. Thematic analysis indicated convergence across factors perceived to impact QoL, with some notable discrepancies. Socioeconomic stability, social connection and support, maintaining good health, adaptive attitudes and reduced impact of stigma were perceived to improve QoL, while obstacles to connection, ageing and poor HIV literacy in the general population were perceived to worsen QoL in both groups. The Low-Moderate QoL group alone identified socioeconomic stressors and ongoing burden of negative life experiences worsened their QoL. Results are presented in the context of local and global HIV health strategies, with implications for clinical management noted.
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Affiliation(s)
| | | | | | | | | | - Shiraze M Bulsara
- University of Technology Sydney (UTS), Australia
- The Albion Centre, Australia
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Maraqa B, Nazzal Z, Baker NA, Khatib H, Zeyad M, Aburayyan O. Factors contributing to the rising prevalence of waterpipe smoking dependence among university students: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:164. [PMID: 38378525 PMCID: PMC10880219 DOI: 10.1186/s12909-024-05156-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Waterpipe smoking (WPS) has been associated with a variety of adverse health effects, consequences, and symptoms of nicotine dependence. This study aims to determine the prevalence of WPS dependence among Palestinian university waterpipe smoking students, their normative beliefs about WPS, and their relationship to dependence. METHODS A cross-sectional study of current WPS university students at five major Palestinian universities was conducted from September to December 2022. Participants were recruited using convenient sampling, and data collection was carried out via an interviewer-administered questionnaire. We assessed students' WPS dependence using the Lebanese Waterpipe Dependence Scale. We used the Poisson regression model with robust variance to analyze factors independently associated with high WPS dependence. RESULTS The study included 746 current WPS university students. Results revealed a high prevalence of WPS dependence, with 69.4% (95%CI: 66.0-72.7%) exhibiting high dependence. Factors contributing to high WPS dependence included dual cigarette smoking (aPR: 1.18; 95%CI: 1.12-1.25), studying medical sciences (aPR: 1.13; 95%CI: 1.10-1.18), friends' approval of WPS (aPR: 1.25; 95%CI: 1.17-1.34), daily WPS frequency (aPR: 1.98; 95%CI: 1.39-2.23), spending more than 50% of daily allowance on WPS (aPR: 1.37; 95%CI: 1.10-1.64), and morning WPS sessions (aPR: 1.97; 95%CI: 1.31-2.27). The study highlighted the influence of social factors, such as peers' approval and perceived prevalence, on WPS dependence. CONCLUSIONS WPS dependence is prevalent among university students, and it is associated with morning WPS, dual smoking, and increased WPS frequency. Notably, peer and cultural factors are essential primary motivators. As a result, it is critical to incorporate WPS considerations into Palestine's antismoking health promotion program. Therefore, it is vital to incorporate WPS into the Palestinian antismoking health promotion policy, and the health education of adolescents regarding the dangers of WPS should coincide with antismoking initiatives.
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Affiliation(s)
- Beesan Maraqa
- Department of Medicine, Faculty of Medicine, Hebron University, Hebron, Palestine
- Primary HealthCare, Ministry of Health, Hebron, Palestine
| | - Zaher Nazzal
- Community Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Noor Abu Baker
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Heyam Khatib
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Marwa Zeyad
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Omar Aburayyan
- Department of Medicine, Faculty of Medicine and Health Sciences, Al-Quds University, Al-Quds, Palestine
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Nazzal Z, Maraqa B, Azizeh R, Darawsha B, AbuAlrub I, Hmeidat M, Al-Jabari F. Exploring the prevalence, knowledge, attitudes and influencing factors of e-cigarette use among university students in Palestine: a cross-sectional study. BMJ Open 2024; 14:e080881. [PMID: 38367977 PMCID: PMC10875484 DOI: 10.1136/bmjopen-2023-080881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/31/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVES E-cigarettes have gained popularity, especially among young adults. This study aims to determine the prevalence of e-cigarette smoking, assess knowledge and attitudes and identify associated factors among Palestinian university students. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS The study was conducted among Palestinian university students in early 2023.A self-administered questionnaire was used to survey 1792 students from six Palestine universities in the West Bank. The questionnaire covered various aspects, including sociodemographic information, daily habits, exposure to smoking, attitudes and knowledge about e-cigarettes. Data were analysed using descriptive statistics, χ2 tests and multivariate regression analysis. RESULTS The study revealed a high prevalence of tobacco use (41.2%), with e-cigarette use prevalent among 19.7% of participants. Knowledge about e-cigarettes was suboptimal, with misconceptions regarding their safety and health effects. Negative attitudes towards e-cigarettes were common, and students with negative attitudes were more likely to use e-cigarettes (aOR=2.6, 95% CI: 1.9 to 3.6). Gender (aOR=2.1, 95% CI: 1.4 to 3.0), waterpipe smoking (aOR=4.5, 95% CI: 3.2 to 6.3), physical inactivity (aOR=1.4, 95% CI: 1.1 to 1.9), high coffee consumption (aOR=1.6, 95% CI: 1.1 to 2.3), spending time with friends (aOR=2.4, 95% CI: 1.5 to 3.7), having a mother who is a smoker (aOR=1.5, 95% CI: 1.1 to 2.2) and having a friend who uses e-cigarettes (aOR=1.5, 95% CI: 1.1 to 2.1) were significantly associated with e-cigarettes use. CONCLUSIONS E-cigarette use is a growing concern among Palestinian university students. Combating this trend should include educational initiatives, social interventions and policy measures to promote informed decision-making and discourage e-cigarette use. Comprehensive tobacco control programs considering various tobacco and nicotine products and involving multiple stakeholders are warranted.
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Affiliation(s)
- Zaher Nazzal
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Beesan Maraqa
- Department of Family and Community Medicine, Faculty of Medicine, Hebron University, Hebron, Palestine
- Primary Health Care, Ministry of Health, Hebron, Palestine
| | - Razan Azizeh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Bara' Darawsha
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ibraheem AbuAlrub
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mousa Hmeidat
- Department of Medicine, Faculty of Medicine, Hebron University, Hebron, Palestine
| | - Fadel Al-Jabari
- Department of Medicine, Faculty of Medicine, Hebron University, Hebron, Palestine
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El-Jardali F, Fadlallah R, Daher N. Multi-sectoral collaborations in selected countries of the Eastern Mediterranean region: assessment, enablers and missed opportunities from the COVID-19 pandemic response. Health Res Policy Syst 2024; 22:14. [PMID: 38267995 PMCID: PMC10807098 DOI: 10.1186/s12961-023-01098-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has emphasized the importance of multi-sectoral collaboration to respond effectively to public health emergencies. This study aims to generate evidence on the extent to which multi-sectoral collaborations have been employed in the macro-level responses to the COVID-19 pandemic in nine selected countries of the Eastern Mediterranean region (EMR). METHODS The study employed in-depth analytical research design and was conducted in two phases. In the first phase, data were collected using a comprehensive documentation review. In the second phase, key informant interviews were conducted to validate findings from the first phase and gain additional insights into key barriers and facilitators. We analysed the macro-level pandemic responses across the following seven components of the analytical framework for multi-sectoral collaborations: (1) context and trigger; (2) leadership, institutional mechanisms and processes; (3) actors; (4) administration, funding and evaluation; (5) degree of multi-sectoral engagement; (6) impact; and (7) enabling factors. RESULTS Governments in the EMR have responded differently to the pandemic, with variations in reaction speed and strictness of implementation. While inter-ministerial committees were identified as the primary mechanism through which multi-sectoral action was established and implemented in the selected countries, there was a lack of clarity on how they functioned, particularly regarding the closeness of the cooperation and the working methods. Coordination structures lacked a clear mandate, joint costed action plan, sufficient resources and regular reporting on commitments. Furthermore, there was no evidence of robust communication planning both internally, focused on promoting internal consensual decision-making and managing power dynamics, and externally, concerning communication with the public. Across the selected countries, there was strong representation of different ministries in the pandemic response. Conversely, the contribution of non-state actors, including non-governmental organizations, civil society organizations, the private sector, the media and citizens, was relatively modest. Their involvement was more ad hoc, fragmented and largely self-initiated, particularly within the selected middle- and low income- countries of the EMR. Moreover, none of the countries incorporated explicit accountability framework or included anti-corruption and counter-fraud measures as integral components of their multi-sectoral plans and coordination mechanisms. Key enablers for the adoption of multi-sectoral collaborations have been identified, paving the way for more efficient responses in the future. DISCUSSION Mirroring global efforts, this study demonstrates that the selected countries in the EMR are making efforts to integrate multi-sectoral action into their pandemic responses. Nevertheless, persistent challenges and gaps remain, presenting untapped opportunities that governments can leverage to enhance the efficiency of future public health emergency responses.
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Affiliation(s)
- Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Racha Fadlallah
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon.
| | - Najla Daher
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
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Gakinahe GU, Rutungwa E, Mbonyinshuti F, Kayitare E. Availability of antimalarial medicines and inventory management at the community level: a case study of Bugesera district in Rwanda. BMC Health Serv Res 2024; 24:136. [PMID: 38267916 PMCID: PMC10809492 DOI: 10.1186/s12913-024-10605-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Malaria is a public health hazard globally, with Sub-Saharan Africa accounting for more than 90% of malaria deaths, primarily affecting children under the age of five. In Rwanda, malaria interventions include the availability of antimalarial medications, notably Artemisinin-based combination treatments (ACTs) and quick diagnostic test kits (RDTs). However, the availability of antimalarial medicines and its related inventory management at community level in Rwanda has yet to be identified. METHODS The study was conducted using a descriptive cross-sectional research design. The study involved the Community Health Workers (CHWs) in Bugesera District, working as a team of one male-female pair called Binômes. CHWs provide Integrated Community Case Management (iCCM) and treatment of Malaria in the villages. The sample size was 295 and respondents were selected using convenient random sampling from 15 sectors of Bugesera District, each cell being represented. A structured research questionnaire was used to collect data. The questionnaires were filled by CHWs who were available for this study at the time of data collection. Collected data were exported to SPSS version 26 for coding and analysis. RESULTS The CHWs reported to be actively involved in managing the antimalarial medicines inventory. Overall, 64.1% of CHWs indicated that the population could easily obtain antimalarial medicines from community health workers and 31.2% attested that people could also obtain antimalarial medicines from the health centers. Majority of respondents 78% confirmed that the CHWs had the appropriate storage conditions for antimalarial medicines, while the overall stock out recorded was 3.20%. Furthermore, CHWs described some challenges, including but not limited to, lack of appropriate or dependable transportation and inappropriate medicines storage. Transportation was reported as a critical barrier for accessing antimalarial medicines. The majority, 70,85% travel on foot while 25.4% reported that CHWs walk for a distance between 1 and 2 h for resupply of antimalarial medicines. CONCLUSION This study investigated the availability of antimalarial medicines and inventory management challenges at community level in Rwanda. Addressing these challenges will reduce the rate of stockout and increase the availability of antimalarial medicine at community level. Appropriate storage, and reduction of stock out rate, will serve to strengthen the current CHWs system, and provide critical guidance for the evolution of CHWs' systems in Rwanda.
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Affiliation(s)
- Godelive Umulerwa Gakinahe
- EAC Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Eugene Rutungwa
- EAC Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
- School of Business, College of Business and Economics, University of Rwanda, Kigali, Rwanda.
| | | | - Egide Kayitare
- School of Medicine and Pharmacy, College of Medicine and health sciences, University of Rwanda, Kigali, Rwanda
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Anakwenze CP, Ewongwo A, Onyewadume L, Oyekan A, Chigbo CO, Valle L, Geng Y, Olapade P, Okwunze K, Lasebikan N, Jhingran A, Balogun OD, Ntekim A. A systematic review of endometrial cancer clinical research in Africa. Infect Agent Cancer 2024; 19:2. [PMID: 38217018 PMCID: PMC10787484 DOI: 10.1186/s13027-023-00563-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/06/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Women in Africa are experiencing a rising burden of endometrial cancer. Research and investment to improve treatment and outcomes are critically needed. We systematically reviewed and characterized endometrial cancer-related research within a clinically relevant context to help organize and assess existing endometrial cancer research in Africa. METHODS According to PRISMA guidelines, we searched online databases for published endometrial cancer articles from African countries from January 1, 2011, to July 20, 2021. Based on our inclusion and exclusion criteria, independent reviewers documented the study design, country/region, human development index, focus of research, type of interventions performed, and histologic and molecular type to illustrate the breadth of research coverage in each region. RESULTS A total of 18 research articles were included. With an average Human Development Index (HDI) in Africa of 0.536, the average HDI of the represented countries in this study was 0.709. The majority (88.9%) of prospective endometrial cancer research articles in Africa were from North Africa, with Egypt encompassing 83.3% of the papers. Most of these studies focused on endometrial cancer diagnosis. Research on the treatment of endometrial cancer is still emerging (33% of papers). Of all included articles, only 11.1% represented Sub-Saharan Africa, where the majority population of black Africans reside. CONCLUSIONS Endometrial cancer research in Africa is extremely limited, with the majority being concentrated in African countries with higher HDIs. As the incidence of endometrial cancer rises in Sub-Saharan Africa, there is a pressing need for more prospective clinical research to tackle the growing disease burden and improve outcomes.
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Affiliation(s)
| | - Agnes Ewongwo
- Department of Radiation Oncology, Stanford University, Palo Alto, CA, USA
| | | | - Ademola Oyekan
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chinelo Onwualu Chigbo
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Luca Valle
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Yimin Geng
- Research Medical Library, MD Anderson Cancer Center, Houston, TX, USA
| | - Paul Olapade
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Nwamaka Lasebikan
- Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Anuja Jhingran
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Onyinye D Balogun
- Department of Radiation Oncology, Weill Cornell Medicine, New York, NY, USA
| | - Atara Ntekim
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Harjana NPA, Nita S, Sebayang M, Mukuan OS, Widihastuti AS, Januraga PP. Intimate partner violence and factors influencing HIV status disclosure among women living with HIV in Indonesia: a cross-sectional study. AIDS Care 2023:1-12. [PMID: 38157374 DOI: 10.1080/09540121.2023.2299746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
The disclosure of HIV status poses challenges, and women living with HIV often face intimate partner violence as a result of revealing their HIV status. This study aims to investigate the prevalence of intimate partner violence and HIV status disclosure among women living with HIV in Indonesia, as well as the factors associated with disclosure. A total of 283 women with HIV participated in an online survey, and descriptive and logistic regression analyses were performed. The findings revealed that women reported experiencing physical (9.54%), sexual (6.01%), mental (23.67%), and economic (14.49%) abuse. HIV status disclosure varied among different individuals, with higher rates observed for partners (71.2%), other family members (65.02%), close friends (37.10%), and lower rates for health workers (1.77%). Factors such as employment status and partner's HIV status influenced disclosure to partners, while the duration of knowing one's HIV status, experiences of intimate partner violence, and perceived barriers influenced disclosure to both family and non-family members. To mitigate the negative consequences of HIV status disclosure, targeted health promotion efforts should prioritize partners, family members, and non-family members, focusing on enhancing knowledge and awareness about HIV, including the impact of violence.
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Affiliation(s)
- Ngakan Putu Anom Harjana
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - Sally Nita
- Jaringan Indonesia Positif, Jakarta, Indonesia
| | | | | | | | - Pande Putu Januraga
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar, Indonesia
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Damiri B, Hamayel D, Wael M. Energy drinks and waterpipe smoking associated with disordered eating habits among male Palestinian refugees. J Ethn Subst Abuse 2023:1-15. [PMID: 38148666 DOI: 10.1080/15332640.2023.2283767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
This cross-sectional study highlights the concerning relationship between stimulants, alcohol use, and weight-related problems among Palestinian refugee men in the West Bank. Self-administered questionnaires were used to gather data on stimulants and alcohol use and eating attitudes and behaviors (EAT-26). The findings revealed that many refugee men were daily cigarette (61.4%) and waterpipe smokers (15.5%), while 30.6% and 2.3% were daily energy drink and alcohol users, respectively. Moreover, most refugee men (67.3%) were obese, and 23.5% were terrified about being obese. They had disordered eating habits, including the impulse to vomit after meals (63.3%). Moreover, 30.7% scored ≥20 using EAT-26 scale, and 44.4% scored at least one positive behavior, including binge eating (40.4%), purging (10.0%), using laxatives or diet pills (8.3%), excessive exercise (30.9%), and losing weight (24.6%). The results of the adjusted binary logistic regression indicated that risk factors associated with self-induced vomiting were daily (OR = 2.71, p-value = 0.004) and weekly energy drink intake (OR = 2.41, p-value = 0.023), weekly alcohol intake (OR = 10.83, p-value = 0.036), and obesity (OR = 2.57, p-value = 0.002), while inversely associated with weekly waterpipe smoking (OR = 0.297, p-value = 0.007). Obesity was inversely associated with daily (OR = 0.146, p-value < 0.01) and weekly waterpipe smoking (OR = 0.259, p-value = 0.002), and weekly cigarette smoking (OR = 0.251, p-value < 0.01). The study underscores the urgent need for community awareness, professional evaluation, and treatment for obesity and disordered eating habits among Palestinian refugee men. It is essential to address the detrimental effects of alcohol and energy drink intake and tobacco smoking to improve the health outcomes of this vulnerable population.
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Affiliation(s)
- Basma Damiri
- Medicine & Health Sciences Faculty, Drug, and Toxicology Division, An-Najah National University, Nablus, Palestine
| | - Dalia Hamayel
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, Palestine
| | - Muhannad Wael
- Medicine & Health Sciences Faculty, Department of Medicine, An-Najah National University, Nablus, Palestine
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Zewdie A, Shitu S, Kebede N, Gashaw A, Eshetu HB, Eseyneh T, Kasahun AW. Determinants of late-stage cervical cancer presentation in Ethiopia: a systematic review and meta-analysis. BMC Cancer 2023; 23:1228. [PMID: 38097989 PMCID: PMC10720221 DOI: 10.1186/s12885-023-11728-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Behind breast, colorectal, and lung cancers, cervical cancer is the fourth most common cancer affecting females. Despite, it is a preventable form of cancer both the incidence and mortality figures reflect it as a major reproductive health problem. Late-stage cervical cancer diagnosis is associated with complicated clinical presentation which can result in short survival time and increased mortality. Several factors contribute to the late-stage presentation of cervical cancer patients. In Ethiopia nationally summarized evidence on the level and the factors contributing to late-stage cervical cancer diagnosis is scarce. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of late-stage cervical cancer diagnosis and its determinants in Ethiopia. METHOD A systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in PubMed, Embase, Google Scholar, and African Online Journal to retrieve eligible articles. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Egger's regression test were done to assess publication bias. RESULT Overall, 726 articles were retrieved and finally 10 articles were included in this review. The pooled prevalence of late-stage cervical cancer diagnosis in Ethiopia was 60.45% (95%CI; 53.04%-67.85%). Poor awareness about cervical cancer and its treatment (AOR = 1.55, 95% CI: (1.03 - 2.33, longer delay to seek care (AOR = 1.02, 95% CI: (1.01 - 1.03)) and rural residence (AOR = 2.07, 95% CI:( 1.56 - 2.75)) were significantly associated to late-stage diagnosis. CONCLUSION In Ethiopia, six in every ten cervical cancer cases are diagnosed at the late stage of the disease. Poor awareness about cervical cancer and its treatment, long patient delay to seek care, and rural residence were positively associated with late-stage diagnosis. Therefore intervention efforts should be made to improve public awareness about cervical cancer, minimize patient delay to seek care, and expand screening services specifically in the rural residing segment of the population to detect the disease early and improve survival.
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Affiliation(s)
- Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
| | - Solomon Shitu
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Anteneh Gashaw
- Department of Midwifery, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behaviour, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, PO.Box.196, Gondar, Ethiopia
| | - Tenagnework Eseyneh
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Abebaw Wasie Kasahun
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
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Awada Z, Cahais V, Cuenin C, Akika R, Silva Almeida Vicente AL, Makki M, Tamim H, Herceg Z, Khoueiry Zgheib N, Ghantous A. Waterpipe and cigarette epigenome analysis reveals markers implicated in addiction and smoking type inference. ENVIRONMENT INTERNATIONAL 2023; 182:108260. [PMID: 38006773 PMCID: PMC10716859 DOI: 10.1016/j.envint.2023.108260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 11/27/2023]
Abstract
Waterpipe smoking is frequent in the Middle East and Africa with emerging prevalence worldwide. The epigenome acts as a molecular sensor to exposures and a crucial driver in several diseases. With the widespread use of waterpipe smoking, it is timely to investigate its epigenomic markers and their role in addiction, as a central player in disease prevention and therapeutic strategies. DNA methylome-wide profiling was performed on an exposure-rich population from the Middle East, constituting of 216 blood samples split equally between never, cigarette-only and waterpipe-only smokers. Waterpipe smokers showed predominantly distinct epigenetic markers from cigarette smokers, even though both smoking forms are tobacco-based. Moreover, each smoking form could be accurately (∼90 %) inferred from the DNA methylome using machine learning. Top markers showed dose-response relationship with extent of smoking and were validated using independent technologies and additional samples (total N = 284). Smoking markers were enriched in regulatory regions and several biological pathways, primarily addiction. The epigenetically altered genes were not associated with genetic etiology of tobacco use, and the methylation levels of addiction genes, in particular, were more likely to reverse after smoking cessation. In contrast, other epigenetic markers continued to feature smoking exposure after cessation, which may explain long-term health effects observed in former smokers. This study reports, for the first time, blood epigenome-wide markers of waterpipe smokers and reveals new markers of cigarette smoking, with implications in mechanisms of addiction and the capacity to discriminate between different smoking types. These markers may offer actionable targets to reverse the epigenetic memory of addiction and can guide future prevention strategies for tobacco smoking as the most preventable cause of illnesses worldwide.
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Affiliation(s)
- Zainab Awada
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Vincent Cahais
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Cyrille Cuenin
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Reem Akika
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Anna Luiza Silva Almeida Vicente
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France; Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Maha Makki
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Zdenko Herceg
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Nathalie Khoueiry Zgheib
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Akram Ghantous
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France.
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Tirfessa D, Abebe M, Darega J, Aboma M. Dietary practice and associated factors among type 2 diabetic patients attending chronic follow-up in public hospitals, central Ethiopia, 2022. BMC Health Serv Res 2023; 23:1273. [PMID: 37978526 PMCID: PMC10657141 DOI: 10.1186/s12913-023-10293-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is affecting numerous Ethiopian populations regardless of environmental and social status. Diabetic people all over the world are commonly urged to acquire a healthy eating habit, which necessitates lifelong changes in food habits, beliefs, and meal patterns. Dietary management is considered one of the cornerstones of diabetes care, as it is an important component of the overall treatment plan. Choosing and following a healthy diet is important for everyone, especially people with diabetes. OBJECTIVE This study aims to assess dietary practices and associated factors among type 2 diabetes patients in the west Shewa Zone, Oromia Regional State, Ethiopia, in 2022. METHODS A hospital-based cross-sectional study design was conducted in West Shewa Zone public hospitals among 421 randomly selected type 2 diabetic patients from February 1 to March 30, 2022. Data were collected using a structured and pre-tested interviewer-administered questionnaire. Descriptive, bivariate, and multivariate binary logistic regression analyses were done using SPSS. RESULTS In this study, about 35.6% (95% CI: 30.9-39.9) of type 2 diabetes patients had good dietary practices. Diabetes knowledge (AOR 9 2; 95% CI 4.4-19.4), food-secured households (AOR 3.3; 95% CI 1.6-6.9), high self-efficacy (AOR 6.6; 95% CI 3.2-13.9), diabetes diet information from healthcare professionals (AOR 2.9; 95% CI 1.3-6.4), complete dietary change (AOR = 2.3; 95% CI 1.1-4.8), and female gender (AOR 3.6; 95% CI 1.6-8.1) were independent predictors of good dietary practice. CONCLUSION The proportion of patients with type 2 diabetes, who attended follow-up at West Shawa Public Hospitals and practiced good dietary habits, was low. Patients' household food insecurity, diabetes knowledge, self-efficacy, source of information on the diabetic diet, complete dietary change after diabetes diagnosis, and gender were all significantly associated with type 2 diabetic patients' dietary practices. Thus, promoting the provision of continuous, modified, and comprehensive education and advice on the importance of diabetes self-management, particularly adherence to dietary recommendations, is fundamental to decreasing the burden of diabetes complications and massive health expenses among diabetic patients.
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Affiliation(s)
- Dureti Tirfessa
- Department of Public Health, Ambo University College of Medicine and Health Sciences, P.O Box 19, Ambo, Ethiopia
| | - Mitsiwat Abebe
- Department of Public Health, Ambo University College of Medicine and Health Sciences, P.O Box 19, Ambo, Ethiopia
| | - Jiregna Darega
- Department of Public Health, Ambo University College of Medicine and Health Sciences, P.O Box 19, Ambo, Ethiopia
| | - Mecha Aboma
- Department of Public Health, Ambo University College of Medicine and Health Sciences, P.O Box 19, Ambo, Ethiopia.
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Sharma MD, Mishra P, Ali A, Kumar P, Kapil P, Grover R, Verma R, Saini A, Kulshrestha S. Microbial Waterborne Diseases in India: Status, Interventions, and Future Perspectives. Curr Microbiol 2023; 80:400. [PMID: 37930488 DOI: 10.1007/s00284-023-03462-2] [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: 05/24/2022] [Accepted: 08/30/2023] [Indexed: 11/07/2023]
Abstract
Water plays a vital role as a natural resource since life is unsustainable without it. If water is polluted or contaminated, it results in several health issues among people. Millions of people are infected with waterborne diseases globally, and India is no exception. In the present review, we have analyzed the outbreaks of waterborne diseases that occurred in several Indian states between 2014 and 2020, identified the key infections, and provided insights into the performance of sanitation improvement programs. We noted that acute diarrheal disease (ADD), typhoid, cholera, hepatitis, and shigellosis are common waterborne diseases in India. These diseases have caused about 11,728 deaths between 2014 and 2018 out of which 10,738 deaths occurred only after 2017. The outbreaks of these diseases have been rising because of a lack of adequate sanitation, poor hygiene, and the absence of proper disposal systems. Despite various efforts by the government such as awareness campaigns, guidance on diet for infected individuals, and sanitation improvement programs, the situation is still grim. Disease hotspots and risk factors must be identified, water, sanitation, and hygiene (WASH) services must be improved, and ongoing policies must be effectively implemented to improve the situation. The efforts must be customized to the local environment. In addition, the possible effects of climate change must be projected, and strategies must be accordingly optimized.
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Affiliation(s)
- Mamta D Sharma
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Puranjan Mishra
- Institute of Bioresource and Agriculture, Hong Kong Baptist University, Hong Kong, China
| | - Aaliya Ali
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Pradeep Kumar
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Prachi Kapil
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Rahul Grover
- Shoolini Institute of Life Sciences and Business Management, The Mall, Solan, Himachal Pradesh, India
| | - Rekha Verma
- Amity School of Law, Amity University, Noida, UP, India
| | - Anita Saini
- Shoolini Institute of Life Sciences and Business Management, The Mall, Solan, Himachal Pradesh, India
| | - Saurabh Kulshrestha
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India.
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India.
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Omotoso O, Teibo JO, Atiba FA, Oladimeji T, Paimo OK, Ataya FS, Batiha GES, Alexiou A. Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions. Int J Equity Health 2023; 22:189. [PMID: 37697315 PMCID: PMC10496173 DOI: 10.1186/s12939-023-01962-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/13/2023] [Indexed: 09/13/2023] Open
Abstract
INTRODUCTION Cancer is a significant public health challenge globally, with nearly 2000 lives lost daily in Africa alone. Without adequate measures, mortality rates are likely to increase. The major challenge for cancer care in Africa is equity and prioritization, as cancer is not receiving adequate attention from policy-makers and strategic stakeholders in the healthcare space. This neglect is affecting the three primary tiers of cancer care: prevention, diagnosis, and treatment/management. To promote cancer care equity, addressing issues of equity and prioritization is crucial to ensure that everyone has an equal chance at cancer prevention, early detection, and appropriate care and follow-up treatment. METHODOLOGY Using available literature, we provide an overview of the current state of cancer care in Africa and recommendations to close the gap. RESULTS We highlight several factors that contribute to cancer care inequity in Africa, including inadequate funding for cancer research, poor cancer education or awareness, inadequate screening or diagnostic facilities, lack of a well-organized and effective cancer registry system and access to care, shortage of specialized medical staff, high costs for screening, vaccination, and treatment, lack of technical capacity, poor vaccination response, and/or late presentation of patients for cancer screening. We also provide recommendations to address some of these obstacles to achieving cancer care equity. Our recommendations are divided into national-level initiatives and capacity-based initiatives, including cancer health promotion and awareness by healthcare professionals during every hospital visit, encouraging screening and vaccine uptake, ensuring operational regional and national cancer registries, improving healthcare budgeting for staff, equipment, and facilities, building expertise through specialty training, funding for cancer research, providing insurance coverage for cancer care, and implementing mobile health technology for telemedicine diagnosis. CONCLUSION Addressing challenges to cancer equity holistically would improve the likelihood of longer survival for cancer patients, lower the risk factors for groups that are already at risk, and ensure equitable access to cancer care on the continent. This study identifies the existing stance that African nations have on equity in cancer care, outlines the current constraints, and provides suggestions that could make the biggest difference in attaining equity in cancer care.
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Affiliation(s)
- Olabode Omotoso
- Department of Biochemistry, University of Ibadan, Ibadan, Nigeria
| | - John Oluwafemi Teibo
- Department of Biochemistry, University of Ibadan, Ibadan, Nigeria.
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Festus Adebayo Atiba
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Oluwatomiwa Kehinde Paimo
- Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - Farid S Ataya
- Department of Biochemistry, College of Science, King Saud University, P.O. Box 2455, 11451, Riyadh, Saudi Arabia
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, AlBeheira, 22511, Damanhour, Egypt
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, NSW, 2770, Hebersham, Australia
- AFNP Med, 1030, Wien, Austria
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Ericson H, Geidne S. The characteristics of organized sport and physical activity initiatives for older adults in Sweden. Front Sports Act Living 2023; 5:1168312. [PMID: 37731477 PMCID: PMC10507471 DOI: 10.3389/fspor.2023.1168312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
There is a common understanding that sport and physical activity can be important to address healthy aging. There are individual-level recommendations about how much physical activity people of different ages should engage in to gain health benefits, but at the same time there are no recommendations for how organizations should organize physical activities to suit as many people as possible for as long as possible. The purpose of this study was to explore the characteristics of sport and physical activity initiatives that older adults participate in. Different ongoing sport and physical activity initiatives that involve older adults were investigated regarding their focus, organization, intensity and organizer, and in relation to their costs, booking opportunities and recruitment. The study was conducted with a cross-sectional design using the Salutogenic Physical Activity Health Resources Questionnaire (SPAHRQ). The study included 27 different initiatives with 372 participants (60% women) ranging from 60 to 96 years of age. A health-promoting, salutogenic settings-based approach, and specifically the concepts drop-in, drop-through and drop-over were used in discussing recommendations for the organization of sport and physical activity for older adults. The main findings were that who organizes the sport and physical activity initiative seems to affect the characteristics of how it is organized and what characterizes the participants in it. Despite the differing characters of sport and physical activity initiatives, the majority of older adults are recruited by internal contacts like friends and family. Which older adults participate in which initiatives is explained mostly by the age and gender of the participants. In conclusion, to attract as many older adults as possible, organizations should work with lowering the thresholds, as well as within and between, organizations, and raise the threshold for dropping out of sports and physical activity.
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Hlavin C, Sebastiani RS, Scherer RJ, Kenkre T, Bernardi K, Reed DA, Ahmed B, Courcoulas A. Barriers to Bariatric Surgery: a Mixed Methods Study Investigating Obstacles Between Clinic Contact and Surgery. Obes Surg 2023; 33:2874-2883. [PMID: 37537505 PMCID: PMC10623404 DOI: 10.1007/s11695-023-06761-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/16/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE Populations most affected by obesity are not reflected in the patients who undergo bariatric surgery. Gaps in the referral system have been studied, but there is a lack of literature investigating obstacles patients encounter after first contact with bariatric surgery clinics. We aim to identify patient populations at risk for attrition during bariatric surgery evaluation and determine patient reported barriers to bariatric surgical care. MATERIALS AND METHODS This study was a single institution, retrospective, mixed methods study from 2012 to 2021 comparing patients who underwent bariatric surgery to those that withdrew. Surveys were performed of patients who withdrew, collecting information on patient knowledge, expectations, and barriers. RESULTS This study included 5982 patients evaluated in bariatric surgery clinic. Those who attained bariatric surgery (38.8%) were more likely to be White (81.2 vs. 75.6%, p<0.001), married (48.5 vs. 44.1%, p=0.004), and employed full time (48.2 vs. 43.8%, p=0.01). They were less likely to live in an area with low income (37.1 vs. 40.7%, p=0.01) or poverty (poverty rate 15.8 vs. 17.4, p<0.001). Of the 280 survey respondents, fear of complications, length of insurance approval process, and wait time between evaluation and surgery were the most reported barriers. CONCLUSION Patients who undergo bariatric surgery were more likely to be White, married, employed full time, and reside in more resourced environments which is not reflective of communities most affected by obesity. The complexity of insurance coverage requirements was a major barrier to bariatric surgery and should be a focus of future healthcare reform.
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Affiliation(s)
- Callie Hlavin
- Department of Surgery, University of Pittsburgh, 200 Lothrop St, F677 Presbyterian Hospital, Pittsburgh, PA, 15213, USA.
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, A-1305 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA.
| | - Romano S Sebastiani
- University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA
| | - Robert J Scherer
- University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA
| | - Tanya Kenkre
- University of Pittsburgh Epidemiology Data Center, 4420 Bayard Street, Suite 600, Pittsburgh, PA, 15260, USA
| | - Karla Bernardi
- Department of Surgery, University of Pittsburgh, 200 Lothrop St, F677 Presbyterian Hospital, Pittsburgh, PA, 15213, USA
| | - Douglas A Reed
- Department of Surgery, University of Pittsburgh, 200 Lothrop St, F677 Presbyterian Hospital, Pittsburgh, PA, 15213, USA
| | - Bestoun Ahmed
- Department of Surgery, University of Pittsburgh, 200 Lothrop St, F677 Presbyterian Hospital, Pittsburgh, PA, 15213, USA
| | - Anita Courcoulas
- Department of Surgery, University of Pittsburgh, 200 Lothrop St, F677 Presbyterian Hospital, Pittsburgh, PA, 15213, USA
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Habtamu K, Teferra S, Mihretu A. Exploring the perception of key stakeholders toward khat policy approaches in Ethiopia: a qualitative study. Harm Reduct J 2023; 20:115. [PMID: 37633925 PMCID: PMC10463779 DOI: 10.1186/s12954-023-00858-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 08/23/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Khat is an amphetamine-like plant, produced and commonly chewed in Ethiopia by a large group of the population. Although significant multidimensional harms of khat use have been reported, currently, there are no policies or organized activities against khat use in Ethiopia. Therefore, the current study aimed to explore the perception of key stakeholders toward khat policy approaches for Ethiopia. METHODS A qualitative study was conducted using focus group discussion (FGD) and in-depth interview (IDI). Ten stakeholders participated in the IDIs, and another 15 individuals participated in the FGDs. Key stakeholders were appropriately mapped and purposively selected based on their experience related to khat use and khat harm reduction. Interviews and FGDs were led by the study authors and were audio-recorded. The audio-recorded data were transcribed verbatim and then translated into English language. The data were analyzed using thematic analysis approach. RESULTS Participants preferred prevention and law regulation measures for khat policy approaches for Ethiopia. Proposed prevention and law regulation measures included regulating the transportation of khat, limiting the minimum age to buy and sell khat, prohibiting khat use at some public places, banning khat advertising and promotion, and imposing excise tax. Individual level khat harm reduction strategies were also proposed to be useful. However, the participants asserted that total khat ban in Ethiopia is not likely to be feasible and acceptable. CONCLUSION Prevention, treatment or care for individuals with problematic khat use, law regulation, and harm reduction were preferred approaches by stakeholders for khat policy in Ethiopia instead of total banning.
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Affiliation(s)
- Kassahun Habtamu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Awoke Mihretu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
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Dhaliwal BK, Seth R, Thankachen B, Qaiyum Y, Closser S, Best T, Shet A. Leading from the frontlines: community-oriented approaches for strengthening vaccine delivery and acceptance. BMC Proc 2023; 17:5. [PMID: 37391823 DOI: 10.1186/s12919-023-00259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Although immunization is one of the most successful public health interventions, vaccine hesitancy and the COVID-19 pandemic have strained health systems, contributing to global reductions in immunization coverage. Existing literature suggests that involving community members in vaccine interventions has been beneficial, but efforts to facilitate community ownership to motivate vaccine acceptance have been limited. METHODS Our research leveraged community-based participatory research to closely involve the community from conception to implementation of an intervention to facilitate vaccine acceptance in Mewat District in Haryana, an area in India with extremely low vaccination coverage. Through the development of a community accountability board, baseline data collection on vaccination barriers and facilitators, and two human-centered design workshops, our team co-created a six-pronged intervention with community leaders and community health workers. This intervention included involving religious leaders in vaccine discussions, creating pamphlets of local vaccine champions for dissemination to parent and child caregivers, creating short videos of local leaders advocating for vaccines, implementing communication training exercises for community health workers, and implementing strategies to strengthen coordination between health workers and supervisors. RESULTS Post-intervention data suggested parents and child caregivers had improvements in knowledge of the purpose of vaccines and side effects of vaccines. They noted that the involvement of religious leaders was beneficial, they were more willing to travel to vaccinate their children, and they had fewer non-logistical reasons to refuse vaccination services. Interviews with community leaders and community health workers who were involved in the creation of the intervention suggested that they experienced higher levels of ownership, they were better equipped to address community concerns, and that vaccine misinformation decreased in the post-intervention period. CONCLUSION Through this unique intervention to strengthen vaccine uptake that incorporated the needs, interests, and expertise of local community members, we developed a community-driven approach to strengthen vaccine acceptance in a population with low uptake. This comprehensive approach is essential to amplify local voices, identify local concerns and advocates, and leverage bottom-up strategies to co-design successful interventions to facilitate long-term change.
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Affiliation(s)
- Baldeep K Dhaliwal
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | | | | | - Svea Closser
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tyler Best
- Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anita Shet
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hammoudi Halat D, Hallit S, Younes S, AlFikany M, Khaled S, Krayem M, El Khatib S, Rahal M. Exploring the effects of health behaviors and mental health on students' academic achievement: a cross-sectional study on lebanese university students. BMC Public Health 2023; 23:1228. [PMID: 37365573 DOI: 10.1186/s12889-023-16184-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND High academic achievement, an important determinant of future success, is known to be influenced by many factors including dietary behavior, lifestyle and mental health, among others. The objectives of the current study were to explore university students' nutritive habits, daily lifestyle, and mental status, and to scrutinize the associations between these factors and students' academic achievement. METHODS A cross-sectional study was conducted among students of a private Lebanese university, using an electronic survey. Diet, eating habits, physical activity, sleep, and smoking were evaluated, and mental health was assessed using a validated Arabic version of the combined Depression, Anxiety, Stress Score (DASS-8). Academic achievement was measured using the Subjective Academic Achievement Scale (SAAS). RESULTS A total of 1677 students participated in the questionnaire. The results of a linear regression taking the SAAS score as the dependent variable, showed that students who have a non-scientific versus scientific major (Beta = 0.53), and having breakfast ≥ 4 days per week compared to less than 2 days (Beta = 0.28) were significantly associated with higher SAAS scores. More psychological distress (Beta = - 0.06) and a higher number of days of eating out (Beta = - 0.07) were significantly associated with lower SAAS scores. CONCLUSIONS This is the first investigation on a Lebanese university students' academic success in relation to lifestyle and mental profiles. Better academic achievement was demonstrated by students having healthier dietary and lifestyle habits, as well as less distressing mental status. Such results, in light of the compounded and unprecedented crises with which Lebanon has been assailed, suggest the need to focus on promoting healthy habits among students in higher education as a possible driver of better academic success.
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Affiliation(s)
- Dalal Hammoudi Halat
- Academic Quality Department, QU Health, Qatar University, Doha, Qatar
- School of Pharmacy, Lebanese International University, Bekaa, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Samar Younes
- School of Pharmacy, Lebanese International University, Bekaa, Lebanon
| | - Mira AlFikany
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
| | - Sanaa Khaled
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
| | - Maha Krayem
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
| | - Sami El Khatib
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology (GUST), Hawally, Kuwait
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Bekaa, Lebanon
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Aziz MM, Abdelrheem SS, Mohammed HM. Stigma and discrimination against people living with HIV by health care providers in Egypt. BMC Health Serv Res 2023; 23:663. [PMID: 37340396 DOI: 10.1186/s12913-023-09676-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE HIV/AIDS has been recently increasingly observed in developing countries including Egypt. This study aimed to explore stigma and discrimination attitudes of health care providers (HCPs) in Egypt, as elimination of stigma in healthcare settings is a priority to improve case detection and management. METHODS A Google form questionnaire using the validated Arabic version of Health Care Provider HIV/AIDS Stigma Scale (HPASS) was sent to physicians and nurses of Ministry of health (MOH) hospitals and University hospitals in 10 randomly selected Governorates in Egypt. Data was collected from July to August, 2022 from 1577 physicians and 787 nurses. Bivariate and multivariable linear regression analyses were used to identify the predictors of the stigmatizing attitude of HCPs towards People living with HIV (PLHIV). RESULTS The majority of HCPs had worries about contracting HIV infection from their patients (75.8% of physicians and 77% of nurses). They believed that protective measures are not good enough to protect them from getting infected (73.9% of physicians and 74.7% of nurses). About half of the participants had worries about the safety of performing blood investigations to PLHIV (54% of physicians and 59.9% of nurses). Less than half of HCPs believed they have the right to refuse providing care to patients to protect themselves (44.6% of physicians and 50.1% of nurses). Only 10.5% of physicians and 11.9% of nurses have previously refused to provide health care to PLHIV. There was a significantly higher mean score of prejudice and stereotype among nurses compared to physicians (prejudice; 27.34 ± 7.88 vs 26.17 ± 7.5, stereotype; 18.54 ± 4.61 vs 16.43 ± 5.21, for nurses and physicians, respectively). Less years of physicians' experience (B = -0.10, p < 0.01) and rural residence (B = 1.48, p < 0.05) were significantly associated with higher prejudice score while having lower qualification (B = -1.47, p < 0.001) was significantly associated with higher stereotype score. CONCLUSION Standards of practice should be developed to adjust the services and prepare HCPs to provide medical care free from stigma and discrimination against PLHIV. Improving knowledge of HCPs regarding the methods of transmission of HIV, the use of infection control measures and the emotional factors shaping lives of PLHIV should be targeted through updated training programs. More concern should be directed to young providers in the training programs.
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Affiliation(s)
- Mirette M Aziz
- Department of Public Health & Community Medicine, Assiut University, Asyut, 71515, Arab Republic of Egypt.
| | - Shaimaa S Abdelrheem
- Department of Public Health & Community Medicine, Aswan University, Aswan, Egypt
- Armed Forces College of Medicine, Cairo, Egypt
| | - Heba M Mohammed
- Department of Public Health & Community Medicine, Assiut University, Asyut, 71515, Arab Republic of Egypt
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Dadipoor S, Heydari G, Abu-Rmeileh NM, Mohseni S, Kakhaki HES, Aghamolaei T, Shahabi N. A predictive model of waterpipe smoking cessation among women in southern Iran: application of the theory of planned behavior. BMC Public Health 2023; 23:1151. [PMID: 37316841 DOI: 10.1186/s12889-023-16053-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Today, waterpipe (WT) smoking is a rising issue worldwide, and has taken a significant and growing share of tobacco consumption in the world. Present study aimed to explore the predictors of WT cessation in the light of the theory of planned behavior (TPB). METHODS This cross-sectional analytical study was conducted in 2021-2022 using a multi-stratified cluster sampling on 1,764 women in Bandar Abbas, southern Iran. Data were collected through a reliable and valid questionnaire. The three-part questionnaire includes demographic information, behavioral information of WT smoking, and the constructs of the TPB along with an additional habit construct. Multivariate logistic regression analysis was run to model the predictor constructs of WT smoking. The data were analyzed statistically in STATA14.2. RESULTS With an increase in one attitude score, the odds of cessation increased by 31% (p < 0.001). Also, with an increase of one score in knowledge, the odds of cessation are increased by 0.05% (0.008). With an increase of one score for intention, the odds of cessation are 26% (0.000). in social norms, the odds of cessation are 0.02% (0.001). With an increase of one score in perceived control, the odds of cessation increased by 16% (0.000) and inhabit score, the odds of cessation decrease by 37% (0.000). In the model where the habit construct was present, the accuracy, sensitivity, and pseudo R2 indices were 95.69%, 77.31%, and 65%, respectively and after removing the habit construct, the so-called indices changed to 90.7%, 50.38% and 0.44%, respectively. CONCLUSIONS The present research confirmed the effectiveness of the TPB model in predicting waterpipe cessation behavior. The knowledge obtained from this research can help develop a systematic and effective intervention to facilitate waterpipe cessation. Focusing on the habit variable can play a critical role in waterpipe cessation in women.
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Affiliation(s)
- Sara Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Gholamreza Heydari
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Eshaghi Sani Kakhaki
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nahid Shahabi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Mizinduko M, Moen K, Tersbøl BP, Likindikoki SL, Mwijage AI, Leyna GH, Makyao N, Leshabari MT, Ramadhan A, Meyrowitsch DW, Lange T, Mmbaga EJ. HIV testing and associated factors among female sex workers in Tanzania: approaching the first 90% target? AIDS Care 2023; 35:850-858. [PMID: 34927487 PMCID: PMC9206036 DOI: 10.1080/09540121.2021.2014779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
Use of HIV testing services among FSW in sub-Saharan Africa (SSA) is below the desired UNAIDS target of 90%. We estimated the prevalence and factors associated with HIV testing among FSW in Dar es Salaam, Tanzania. A respondent-driven sampling method was used to recruit FSW aged 18. Modified Poisson regression models were used to determine factors associated with recent HIV testing. Of 958 surveyed FSW (median age 26 years), 85.4% (95% CI: 82.3, 88.1) reported to have ever been tested for HIV and 65.3% (95% CI: 61.2, 69.3) tested in the past 12 months. Condom use on the last day worked (prevalence ratio (PR) = 1.17; 95% CI: 0.99, 1.38), no or low self-perceived risk of HIV acquisition (PR = 1.16; 95% CI: 1.02, 1.32), having never felt stigmatized as a sex worker (PR = 1.18; 95% CI: 1.04, 1.33), and having been in contact with a peer educator (PR = 1.33; 95% CI: 1.18, 1.49) during the past year preceding the survey were associated with recent HIV testing. Interventions aiming to mitigate stigma due to sex work, improve health education to address risk perception as a barrier to HIV testing, and scaling up peer educator's engagement should be given priority.
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Affiliation(s)
- Mucho Mizinduko
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Kåre Moen
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Britt P. Tersbøl
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Samuel L. Likindikoki
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Alexander I. Mwijage
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Germana H. Leyna
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Neema Makyao
- National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Melkizedeck T. Leshabari
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Angela Ramadhan
- National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Dan W. Meyrowitsch
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Elia J. Mmbaga
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Graham SA, Auster-Gussman LA, Lockwood KG, Branch OH. Weight Loss in a Digital Diabetes Prevention Program for People in Health Professional Shortage and Rural Areas. Popul Health Manag 2023. [PMID: 37115532 DOI: 10.1089/pop.2022.0278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Individuals with prediabetes living in hard-to-reach and underserved areas experience barriers to accessing traditional in-person preventive health services. The National Diabetes Prevention Program (DPP) is a preventive health care program designed to reduce the risk of developing type 2 diabetes. Although there have been increasing numbers of remote DPPs accessible, there are little data on the clinical outcomes of digital DPPs for members living in hard-to-reach and underserved areas. This study assessed whether living in a designated Health Professional Shortage Area (HPSA) and a rural versus urban area impacted the weight loss of N = 7266 members of a fully digital program called Lark DPP. Secondary analyses included between-group comparisons of program retention and member characteristics, demographics, and socioeconomics. Percent weight loss did not differ by HPSA (P = 0.16) or rural/urban status (P = 0.15), despite greater potential barriers for members residing in HPSAs (eg, highest starting body mass index, lowest income, lowest education). Mean percent weight loss for members residing in an HPSA and rural area was mean (M) = 4.75%, standard error (SE) = 0.09; for members in a non-HPSA, rural area M = 4.96%, SE = 0.16; for members in an HPSA, urban area M = 4.55%, SE = 0.13; and for members in a non-HPSA, urban area M = 4.77%, SE = 0.13. Members of a fully digital DPP achieved weight loss that did not differ by HPSA or urban/rural designation. Fully digital programs offer a solution to reduce the risk of type 2 diabetes in areas where residents may not otherwise have access to diabetes prevention services.
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Mosisa G, Diriba DC, Tsegaye R, Kejela G, Bayisa D, Oluma A, Wakuma B, Abadiga M, Turi E, Abera T, Bayisa L, Tufa G. Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis. Matern Health Neonatol Perinatol 2023; 9:5. [PMID: 37020236 PMCID: PMC10077618 DOI: 10.1186/s40748-023-00150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/17/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa. METHODS Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I2 statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity. RESULTS Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women. CONCLUSION The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.
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Affiliation(s)
- Getu Mosisa
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Dereje Chala Diriba
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Reta Tsegaye
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Gemechu Kejela
- Department of Public Health, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Diriba Bayisa
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Adugna Oluma
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Bizuneh Wakuma
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Muktar Abadiga
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Tesfaye Abera
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Lami Bayisa
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Girma Tufa
- Department of Midwifery, Institutes of Health Sciences, Bule Hora University, Bule Hora, Ethiopia
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Saad RK, Maiteh A, Nakkash R, Salloum RG, Chalak A, Abu-Rmeileh NME, Khader Y, Al Nsour M. Monitoring and Combating Waterpipe Tobacco Smoking Through Surveillance and Taxation. JMIR Public Health Surveill 2023; 9:e40177. [PMID: 36951907 PMCID: PMC10132023 DOI: 10.2196/40177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/31/2023] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
Waterpipe tobacco smoking (WTS) is a traditional tobacco use method that originated in the Eastern Mediterranean Region (EMR) and has resurged in recent decades. WTS rates in the EMR are the highest worldwide, especially among youth, exceeding cigarette-smoking rates in select jurisdictions. Despite its documented harm, the growing prevalence of WTS has been met with a poor regulatory response globally. At the epicenter of the WTS epidemic, countries in the EMR are in urgent need of effective tobacco control strategies that consider the particularities of WTS. A roundtable session, titled "Monitoring and Combating WTS Through Taxation and the Global Tobacco Surveillance System (GTSS)," was held as part of the 7th Eastern Mediterranean Public Health Network's regional conference. The session provided an overview of evidence to date about WTS policy control, the taxation of WTS, volumetric choice experiments for tobacco control research, and monitoring WTS patterns and control policies among adults and youth through the GTSS. The session highlighted the need to update the regulation of WTS in the current global tobacco control policy frameworks and the need for developing tailored, evidence-based, and WTS-specific regulations to complement current tobacco control policy frameworks. Raising taxes to increase the price of tobacco products is the single most effective tobacco control measure, and these taxes can fund expanded government health programs. The effectiveness of taxation can be measured via volumetric choice experiments, which allow for the estimation of a complete set of own-price and cross-price elasticities that are instrumental for fiscal policy simulations. Finally, the surveillance of WTS (for example, through the GTSS) is critical to informing policy and decision makers. The Global Youth Tobacco Survey (GYTS) and Global Adult Tobacco Survey (GATS) are 2 GTSS products that provide nationally representative data among students aged 13-15 years and persons ≥15 years, respectively.
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Affiliation(s)
- Randa K Saad
- Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Adna Maiteh
- Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Florida, FL, United States
| | - Ali Chalak
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Birzeit, Occupied Palestinian Territory
| | - Yousef Khader
- Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohannad Al Nsour
- Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
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Mei K, Kou R, Bi Y, Liu Y, Huang J, Li W. A study of primary health care service efficiency and its spatial correlation in China. BMC Health Serv Res 2023; 23:247. [PMID: 36915124 PMCID: PMC10012696 DOI: 10.1186/s12913-023-09197-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/19/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND China's primary health care system has undergone major changes since the new round of medical reform in 2009, but the current status of primary health care institution service efficiency is still unsatisfactory. The purpose of this study is to compare and evaluate the China's primary health care institution service efficiency and provide a reference for improving the efficiency and promoting the development of primary health care institution. METHODS Based on panel data of 31 provinces (municipalities directly under the central government and autonomous regions) in mainland China from 2011 to 2020, using the super efficiency slack-based measure-data envelopment analysis model, to analyze the data from a static perspective, and the changes in the efficiency of primary health care services were analyzed from a dynamic perspective by using the Malmquist index method. Spatial autocorrelation analysis method was used to verify the spatial correlation of primary health care service efficiency among various regions. RESULTS The number of Primary health care institutions increased from 918,000 in 2011 to 970,000 in 2020. The average primary health care institution service efficiency in the northeastern region including Jilin (0.324), Heilongjiang (0.460), Liaoning (0.453) and northern regions such as Shaanxi (0.344) and Neimenggu (0.403) was at a low level, while the eastern coastal regions such as Guangdong (1.116), Zhejiang (1.211), Shanghai (1.402) have higher average service efficiency levels. The global Moran's I showed the existence of spatial autocorrelation, and the local Moran's I index suggested that the problem of uneven regional development was prominent, showing a contiguous regional distribution pattern. Among them, H-H (high-efficiency regions) were mainly concentrated in Jiangsu, Anhui and Shanghai, and L-L regions (low-efficiency regions) were mostly in northern and northeastern China. CONCLUSION The service efficiency of primary health care institution in China showed a rising trend in general, but the overall average efficiency was still at a low level, and there were significant geographical differences, which showed a spatial distribution of "high in the east and low in the west, high in the south and low in the north". The northwestern region, after receiving relevant support, has seen a rapid development of primary health care, and its efficiency was steadily improving and gradually reaching a high level. The average primary health care institution service efficiency in the northeastern region including the northern region of China was at a low level, while the average efficiency in the eastern coastal region and some economically developed regions was high, which also verifies the dependence and high symbiosis of primary health care institution service efficiency on regional economy.
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Affiliation(s)
- Kangni Mei
- School of Public Health, Weifang Medical University, Weifang, 261053, Shandong, China
| | - Ruxin Kou
- School of Public Health, Weifang Medical University, Weifang, 261053, Shandong, China
| | - Yuqing Bi
- School of Public Health, Weifang Medical University, Weifang, 261053, Shandong, China
| | - Yuzhuo Liu
- School of Management, Weifang Medical University, Weifang, 261053, Shandong, China
| | - Jingwen Huang
- School of Public Health, Weifang Medical University, Weifang, 261053, Shandong, China
| | - Wei Li
- School of Public Health, Weifang Medical University, Weifang, 261053, Shandong, China.
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Dowell-Day A, Dobbins T, Chan C, Fraser D, Holt M, Vaccher SJ, Clifton B, Zablotska I, Grulich A, Bavinton BR. Attitudes Towards Treatment as Prevention Among PrEP-Experienced Gay and Bisexual Men in Australia. AIDS Behav 2023:10.1007/s10461-023-04019-x. [PMID: 36877254 PMCID: PMC10386911 DOI: 10.1007/s10461-023-04019-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/07/2023]
Abstract
The introduction of HIV pre-exposure prophylaxis (PrEP) has the potential to impact the attitudes gay and bisexual men (GBM) who consequently choose to take PrEP have towards treatment as prevention (TasP), and the extent to which they are willing to have condomless anal intercourse (CLAI) with an HIV-positive sexual partner who has an undetectable viral load (UVL). Using a cross-sectional sample from an observational cohort study conducted from August 2018 to March 2020, we examined the extent to which PrEP-experienced GBM are willing to have CLAI with a partner who has a UVL. Simple and multiple logistic regression models were used to identify associated variables. Of the 1386 participants included in the analyses, 79.0% believed in the effectiveness of TasP, and 55.3% were willing to have CLAI with a partner who has a UVL. Wiling participants were less worried about getting HIV when taking PrEP and more likely to believe in TasP. Further research is needed to better understand the gap between belief in TasP and willingness to have CLAI with a partner who has a UVL among PrEP-experienced GBM.
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Affiliation(s)
- Alexander Dowell-Day
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Timothy Dobbins
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Curtis Chan
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Doug Fraser
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Brent Clifton
- National Association of People with HIV Australia, Newtown, NSW, Australia
| | - Iryna Zablotska
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead, Australia.,Sydney Infectious Diseases Institute, University of Sydney, Westmead, Australia.,Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, Australia
| | - Andrew Grulich
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
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Tura F, Nomikos E, Betts LR. Prevalence and Predictors of Poly-Victimization of Adolescents in England and Wales. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:4688-4713. [PMID: 36036566 PMCID: PMC9900687 DOI: 10.1177/08862605221118967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study examined the change in the prevalence of adolescent poly-victimization and individual and area predictors of poly-victimization in England and Wales. The national representative longitudinal Offending, Crime and Justice Survey (2003-2006) was analyzed with data from 2,066 adolescents, aged between 10 and 18 years (mean ± SD at Time 1 = 13.08 ± 2.01), using multilevel multinomial logit models. Findings revealed that the majority of the adolescents (41.6%, 48.5%, 54.6%, 61.6%, respectively) did not experience victimization between 2003 and 2006. However, 28.3%, 25.9%, 19.5%, and 14.5% of the adolescents experienced poly-victimization (experiencing more than or equal to two types of victimizations), with a decrease of 13.8% over the 4-year period. Furthermore, some adolescents were consistent poly-victims, meaning they were poly-victims in all years that they participated in the survey. In particular, 3.57% of the adolescents who participated in the four waves of the survey were poly-victims in all years; 7.41% of the adolescents who participated in three of the four waves of the survey were poly-victims in all years; and 25.79% of the adolescents who participated in two of the four waves of the survey were poly-victims in both years. Statistically significant predictors of poly-victimization included having parents who have been in trouble with the police, offending, participating in community-related activities, being a boy, not managing income well, and living in an urban or deprived area. Offending had the greatest impact on poly-victimization. Findings highlight that adolescent poly-victimization in England and Wales decreased between 2003 and 2006 but some adolescents were more likely to experience poly-victimization due to individual, familial, and area characteristics. The findings therefore indicate that a holistic approach is needed to reduce adolescent poly-victimization and suggest that targeting area deprivation should be the priority.
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Mehari H, Haile F, Habtezghi S, Mulugeta Y, Abraham G, Berhe M, Abdu N. Determinants of Child Marriage and Its Related Adverse Health Outcomes Among Married Women in Sub-Region of Serejeka, Central Region in Eritrea: A Cross-Sectional Study. Int J Womens Health 2023; 15:215-224. [PMID: 36816453 PMCID: PMC9930585 DOI: 10.2147/ijwh.s389939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/18/2023] [Indexed: 02/12/2023] Open
Abstract
Background Child marriage is a fundamental violation of human rights that can have numerous adverse effects on girls' social, mental and physical health and wellbeing. Marriage in Eritrea relatively occurs earlier for women. This study aimed to assess the magnitude of child marriage, determinants and its related adverse health outcomes in five selected villages of the sub-region of Serejeka in Central region of Eritrea. Methods An analytical cross-sectional study was conducted among 200 married women aged 18 to 30 years who are residents of five selected villages of the sub-region of Serejeka between July 12 and August 20, 2018. The sampling design was stratified random sampling and data were collected using an interview-based questionnaire. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS (v.22). Results The prevalence of child marriage was found to be 42% [95% CI (35.1, 48.9)]. The maximum and minimum age at marriage were 14 and 29, respectively. No formal education/primary level (AOR = 22.08, 95% CI: 4.16, 117.24), junior educational level (AOR = 6.95, 95% CI: 3.48, 13.87) and decision on the marriage (AOR = 4.30, 95% CI: 1.03, 17.92) were the significant determinants of child marriage. Prolonged labour (OR = 2.81, 95% CI: 1. 32, 5.98), abortion (OR = 3.95, 95% CI: 1.63, 9.53), hemorrhage during birth (OR = 4.83, 95% CI: 1.68, 13.87), spousal violence (OR = 2.07, 95% CI: 1.15, 3.75), pressure/stress (OR = 4.83, 95% CI: 1.68, 13.87), termination of education (OR = 8.24, 95% CI: 4.35, 15.63) and stigma or isolation from their society (OR = 7.38, 95% CI: 3.03, 17.98) were significant adverse health outcomes associated with child marriage. Conclusion This study revealed that child marriage was still a common practice. It is associated with detrimental physical health, psychological well-being and socio-economic status. This mandates policy makers and program managers to focus their programs on delaying entry of children into wedlock and motherhood by providing information, education and enhancing communication with their community.
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Affiliation(s)
- Hanibal Mehari
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Feven Haile
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Sador Habtezghi
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Yuel Mulugeta
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Gebru Abraham
- School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea
| | - Michael Berhe
- National Health Observatory, Ministry of Health, Asmara, Eritrea
| | - Nuru Abdu
- School of Pharmacy, Asmara College of Health Sciences, Asmara, Eritrea
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Migueles JH, Delisle Nyström C, Dumuid D, Leppänen MH, Henriksson P, Löf M. Longitudinal associations of movement behaviours with body composition and physical fitness from 4 to 9 years of age: structural equation and mediation analysis with compositional data. Int J Behav Nutr Phys Act 2023; 20:11. [PMID: 36750838 PMCID: PMC9903529 DOI: 10.1186/s12966-023-01417-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/27/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The associations of movement behaviours (physical activity [PA], sedentary behaviour [SB], and sleep) with body composition and physical fitness from pre-school to childhood, as well as the direction of the associations, could provide important information for healthy lifestyle promotion in children. This study investigated the longitudinal and bidirectional associations of movement behaviours with body composition and physical fitness measured at 4 and 9 years of age. METHODS This longitudinal study included baseline (n = 315, 4.5 [SD = 0.1] years) and follow-up data (n = 231, 9.6 [SD = 0.1] years) from the MINISTOP study. Movement behaviours were measured for 7 days using wrist-worn accelerometers, body composition with air-displacement plethysmography, and physical fitness with the ALPHA health-related fitness test battery. Cross-lagged panel models and mediation analyses were performed in combination with compositional data analysis. RESULTS We did not observe direct associations of the movement behaviours at 4 years with either body composition or physical fitness at 9 years (all P > 0.05). However, fat mass index at 4 years was negatively associated with vigorous PA (VPA), relative to remaining behaviours (VPA, β = - 0.22, P = 0.002) and light PA (LPA), relative to SB and sleep (β = - 0.19, P = 0.016) at 9 years. VPA (relative to remaining), moderate PA (MPA) (relative to LPA, SB, and sleep), and SB (relative to sleep) tracked from 4 to 9 years (all β ≥ 0.17, all P < 0.002), and these behaviours shared variance with fat mass index (all|β| ≥ 0.19, all P < 0.019), and aerobic, motor, and muscular fitness (all|β| ≥ 0.19, all P < 0.014) at 9 years. Mediation analysis suggested that the tracking of VPA (relative to remaining behaviours) from 4 to 9 years was negatively associated with fat mass index (β ≥ - 0.45, P = 0.012), and positively with aerobic fitness at 9 years (β ≥ 1.64, P = 0.016). CONCLUSION PA and SB tracked from the pre-school years into childhood. Fat mass index at 4 years of age was negatively associated with VPA (relative to remaining behaviours) and LPA (relative to SB and sleep) at 9 years of age. The tracking of VPA was associated with lower fat mass index and higher aerobic fitness at 9 years of age. These findings suggest that higher levels of VPA in pre-school age, if maintained throughout childhood, may support the development of healthy body composition and aerobic fitness levels in later childhood.
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Affiliation(s)
- Jairo H. Migueles
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, 141 52 Huddinge, Sweden ,grid.4489.10000000121678994PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Christine Delisle Nyström
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, 141 52 Huddinge, Sweden
| | - Dorothea Dumuid
- grid.1026.50000 0000 8994 5086Alliance for Research in Exercise, Nutrition and Activity, Allied Health & Human Performance, University of South Australia, Adelaide, SA Australia ,grid.1026.50000 0000 8994 5086University of South Australia, Adelaide, SA Australia
| | - Marja H. Leppänen
- grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - Pontus Henriksson
- grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Marie Löf
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, 141 52 Huddinge, Sweden ,grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
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Zhang H, Xu Z. The correlation between physical inactivity and students' health based on data mining and related influencing factors. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:6735-6750. [PMID: 37161126 DOI: 10.3934/mbe.2023290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The sedentary behavior among college students has become one of the most important factors affecting the development of physical and mental health. Chronic lack of physical activity may lead to health problems such as decreased physical fitness, and increased psychological disorders. In the post-epidemic era, it is necessary for college students to have a strong immune system, and a strong body cannot be achieved without regular leisure physical activity. Therefore, it is necessary to explore the relationship between relevant health factors and physical activity. This paper presents an optimized COM-B model. And the experimental results show that the optimized model is well applied in describing the current situation of physical activity participation among college students, analyzing the distribution characteristics of socio-demographic variables related to physical activity, and exploring the correlation between physical activity and the subhealth status of college students.
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Affiliation(s)
- Hanying Zhang
- College of Sports and Arts, Guangzhou Sport University, Guangzhou 510500, Guangdong, China
| | - Zhongqiu Xu
- College of Sports and Arts, Guangzhou Sport University, Guangzhou 510500, Guangdong, China
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TOMKO C, MUSCI RJ, KAUFMAN MR, UNDERWOOD CR, DECKER MR, SHERMAN SG. Mental health and HIV risk differs by co-occurring structural vulnerabilities among women who sell sex. AIDS Care 2023; 35:205-214. [PMID: 36102030 PMCID: PMC10011022 DOI: 10.1080/09540121.2022.2121374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/25/2022] [Indexed: 10/14/2022]
Abstract
Female sex workers (FSW) experience many structural vulnerabilities (SV; e.g., violence, economic insecurity) which contribute to increased risk of HIV and mental distress. However, little research has examined how SV co-occur to shape HIV risk, and none have studied mental distress. Among FSW (n = 385) in Baltimore, Maryland, latent class analysis of five binary indicators (housing insecurity; financial dependence on others; client-perpetrated physical or sexual violence; food insecurity) determined classes of SV and differential HIV risk behavior and mental health outcomes. A 3-class model fit the data best: minimal SV (i.e., low probabilities of all indicators); material needs (i.e., housing, food insecurity); and high SV (i.e., high probability of all indicators). Compared to minimal SV, high SV and material needs had significantly greater adjusted probability of drug injection and poorer adjusted depression, post-traumatic stress disorder, and mental distress scores. The high SV class had significantly higher probability of reporting condomless sex with clients compared to material needs and minimal SV. Results show the deleterious effect of co-occurring SV on HIV risk behaviors among FSW with particular emphasis on co-occurring food and housing insecurities. This is the first study of co-occurring SV on mental health outcomes in this key population.
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Affiliation(s)
- Catherine TOMKO
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rashelle J. MUSCI
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michelle R. KAUFMAN
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carol R. UNDERWOOD
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michele R. DECKER
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Susan G. SHERMAN
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Chirtkiatsakul B, Jani R, Hairi FM, Talib MA. Attitudes and practices related to smoking among university students in Thailand. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 36723413 DOI: 10.1080/07448481.2022.2163853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/14/2022] [Accepted: 12/25/2022] [Indexed: 06/18/2023]
Abstract
Objective: To investigate attitudes and practices toward smoking among university students and to identify associated factors. Methods: A cross-sectional study was conducted among 1,299 students from five public universities in Thailand. Factor analysis and multiple regression were used for analysis. Results: A higher score of anti-smoking attitude was associated with female gender, majoring in science, living on campus, having a father with primary or secondary school, and those whose father was employed in the private sector. A more positive perceptions about smoking was associated with male gender, having a family income of 30,001-50,000 baht, and having a smoking friend. High positive preventive practice score was associated with those who came from rural areas, having a mother who was self-employed, and having a smoking family member. Conclusions: Although students showed strong anti-smoking attitudes, their preventive practices were poor. These findings should be taken into consideration when developing preventive smoking programs.
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Affiliation(s)
- Busaban Chirtkiatsakul
- Department of Economics and Applied Statistics, Faculty of Business and Economics, Universiti Malaya, Kuala Lumpur, Malaysia
- Prince of Songkla University, Pattani, Thailand
| | - Rohana Jani
- Ungku Aziz Centre for Development Studies, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Muzalwana Abdul Talib
- Department of Economics and Applied Statistics, Faculty of Business and Economics, Universiti Malaya, Kuala Lumpur, Malaysia
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Ertürk Zararsız G, Bolat S, Cephe A, Kochan N, Yerlitaş SI, Doğan HO, Zararsız G. Validation of low-density lipoprotein cholesterol equations in pediatric population. PeerJ 2023; 11:e14544. [PMID: 36627923 PMCID: PMC9826611 DOI: 10.7717/peerj.14544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/18/2022] [Indexed: 01/07/2023] Open
Abstract
Several studies have shown a high prevalence of dyslipidemia in children. Since childhood lipid concentrations continue into adulthood, recognition of lipid abnormalities in the early period is crucial to prevent the development of future coronary heart disease (CHD). Low density lipoprotein cholesterol (LDL-C) is one of the most used parameters in the initiation and follow-up of treatment in patients with dyslipidemia. It is a well known fact that LDL-C lowering therapy reduces the risk of future CHD. Therefore, accurate determination of the LDL-C levels is so important for the management of lipid abnormalities. This study aimed to validate different LDL-C estimating equations in the Turkish population, composed of children and adolescents. A total of 3,908 children below 18 years old at Sivas Cumhuriyet University Hospital (Sivas, Turkey) were included in this study. LDL-C was directly measured by direct homogeneous assays, i.e., Roche, Beckman, Siemens and estimated by Friedewald's, Martin/Hopkins', extended Martin-Hopkins' and Sampson's formulas. The concordances between the estimations obtained by the formulas and the direct measurements were evaluated both overall and separately for the LDL-C, triglycerides (TG) and non-high-density lipoprotein cholesterol (non-HDL-C) sublevels. Linear regression analysis was performed and residual error plots were generated between each estimation and direct measurement method. Coefficient of determination (R 2) and mean absolute deviations were also evaluated. The overall concordance of Friedewald, Sampson, Martin-Hopkins and the extended Martin-Hopkins formula were 64.6%, 69.9%, 69.4%, and 84.3% for the Roche direct assay, 69.8%, 71.6%, 73.6% and 80.4% for the Siemens direct assay, 66.5%, 68.8%, 68.9% and 82.1% for the Beckman direct assay, respectively. The extended Martin-Hopkins formula had the highest concordance coefficient in both overall and all sublevels of LDL-C, non-HDL-C, and TG. When estimating the LDL-C categories, the highest underestimation degrees were obtained with the Friedewald formula. Our analysis, conducted in a large pediatric population, showed that the extended Martin-Hopkins equation gives more reliable results in estimation of LDL-C compared to other equations.
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Affiliation(s)
- Gözde Ertürk Zararsız
- Department of Biostatistics, Erciyes University, Kayseri, Turkey,Drug Application and Research Center (ERFARMA), Erciyes University, Kayseri, Turkey
| | - Serkan Bolat
- Department of Biochemistry, Cumhuriyet University, Sivas, Turkey
| | - Ahu Cephe
- Rectorate, Erciyes University, Kayseri, Turkey
| | - Necla Kochan
- Izmir Biomedicine and Genome Center, Izmir, Turkey
| | - Serra Ilayda Yerlitaş
- Department of Biostatistics, Erciyes University, Kayseri, Turkey,Drug Application and Research Center (ERFARMA), Erciyes University, Kayseri, Turkey
| | - Halef Okan Doğan
- Department of Biochemistry, Cumhuriyet University, Sivas, Turkey
| | - Gökmen Zararsız
- Department of Biostatistics, Erciyes University, Kayseri, Turkey,Drug Application and Research Center (ERFARMA), Erciyes University, Kayseri, Turkey
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Alharbi AS. Immune fitness and lifestyle habits of Saudi medical students: a cross sectional study. PeerJ 2023; 11:e14363. [PMID: 36627921 PMCID: PMC9826612 DOI: 10.7717/peerj.14363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/18/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Immune function reaches an optimum level in young adults. However, young adults are more likely to adopt potentially harmful habits that may pose a risk to their long-term health and immune fitness, and which eventually may put a substantial burden on the healthcare system. This study aimed to assess the status of medical students' immune fitness, using the immune status questionnaire (ISQ) and exploring the association with the commonly adopted lifestyle habits hypothesized to have an impact on immune functions. Methods A descriptive, cross-sectional study was conducted among preclinical students attending the medical school of King Abdulaziz University. An online self-reported questionnaire was used to assess the immune status (ISQ), perceived (momentary) immune fitness, general health, lifestyle habits and students' perception of these lifestyle-associated impacts on immune fitness. Descriptive, Spearman's correlation and stepwise linear regression analyses were performed. Results In a pooled sample of 211 participants, the overall ISQ score was 6.00 ± 5.0 with statistically significant abnormally lower scores in females (ISQ 5.00 ± 5.0, p < 0.001). 49.29% of respondents experienced poor immune fitness as measured by the ISQ (<6). The ISQ score was significantly correlated with fast and fatty food consumption (p = 0.003), daytime sleepiness (p = 0.001), and BMI subgroups (p = 0.028) negatively and positively correlated with adherence to a program of exercise (p = 0.005). A total of 41.23% of participants who reported a normal immune health, rated at ≥6 were graded below 6 on the ISQ score. Only 62.6% of students were able to correctly identify the effects of fast and fatty food consumption on immune fitness. Conclusion Poor immune fitness was common among medical students in KAU and associated significantly with their adopted lifestyle habits. Although, other factors can be significant contributors, biased immune health perception and lack of awareness of these lifestyle-associated impacts on immune fitness and general health may hinder the adoption of healthier habits. Immune biomarkers should be implemented in future work.
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Affiliation(s)
- Azzah S. Alharbi
- Medical Microbiology and Parasitology Department, Faculty of Medicine, King Abdul Aziz University, Jeddah, Saudi Arabia,Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Curran K, Piyasena P, Congdon N, Duke L, Malanda B, Peto T. Inclusion of diabetic retinopathy screening strategies in national-level diabetes care planning in low- and middle-income countries: a scoping review. Health Res Policy Syst 2023; 21:2. [PMID: 36593508 PMCID: PMC9808973 DOI: 10.1186/s12961-022-00940-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/15/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Diabetes is a major public health concern, with approximately 80% of the burden falling on low- and middle-income countries (LMICs). Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes, and early detection through diabetic eye screening programmes is essential to prevent visual impairment and blindness. Careful planning at a national level is crucial for effective implementation of such programmes. METHODS A scoping review was conducted, and the protocol was published previously to explain the methods in detail. Data were collected from databases and searches, including grey literature. Furthermore, consultations were conducted with key informants from LMICs. RESULTS Lower-middle-income countries (29/50, 58%) and upper-middle-income countries (27/59, 45.8%) are making more progress than low-income countries (4/29, 13.8%) in terms of DR policy planning. However, no identified data for published policies have actually implemented national DR policies. Compared to low-income and lower-middle-income countries, upper-middle-income countries are making the most progress in implementing national diabetic eye screening programmes; however, their progress is still slow, with only 5/59 (8.5%) having such programmes. CONCLUSION There are significant gaps in the literature, with no data reported for 78/138 (56.5%) LMICs. Further research is clearly needed to support and document DR policy development in LMICs.
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Affiliation(s)
- Katie Curran
- grid.4777.30000 0004 0374 7521Centre for Public Health, Institute of Clinical Science, Queen’s University Belfast, Block A, Royal Victoria Hospital, Belfast, BT12 6BA Northern Ireland UK
| | - Prabhath Piyasena
- grid.4777.30000 0004 0374 7521Centre for Public Health, Institute of Clinical Science, Queen’s University Belfast, Block A, Royal Victoria Hospital, Belfast, BT12 6BA Northern Ireland UK ,grid.466905.8Directorate of Policy Analysis and Development, Ministry of Health, Columbo, Sri Lanka
| | - Nathan Congdon
- grid.4777.30000 0004 0374 7521Centre for Public Health, Institute of Clinical Science, Queen’s University Belfast, Block A, Royal Victoria Hospital, Belfast, BT12 6BA Northern Ireland UK ,grid.12981.330000 0001 2360 039XZhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, China ,Orbis International, New York, USA
| | - Lisa Duke
- grid.433853.a0000 0004 0533 3621International Diabetes Federation, Brussels, Belgium
| | - Belma Malanda
- grid.433853.a0000 0004 0533 3621International Diabetes Federation, Brussels, Belgium
| | - Tunde Peto
- grid.4777.30000 0004 0374 7521Centre for Public Health, Institute of Clinical Science, Queen’s University Belfast, Block A, Royal Victoria Hospital, Belfast, BT12 6BA Northern Ireland UK ,grid.412915.a0000 0000 9565 2378Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, UK
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Family support and medication adherence among residents with hypertension in informal settlements of Nairobi, Kenya: a mixed-method study. J Hum Hypertens 2023; 37:74-79. [PMID: 35046496 DOI: 10.1038/s41371-022-00656-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 01/31/2023]
Abstract
Suboptimal medication adherence is a major barrier to hypertension control in Kenya, especially among informal urban settlement areas (sometimes referred to as "slums"). The few studies that have specifically explored medication adherence among this population have received discordant results, implying that additional factors which influence medication adherence merit further investigation. This study explores the relationship between family support and medication adherence among people with hypertension in informal settlements in Nairobi, Kenya. We conducted a quantitative survey followed up by semi-structured qualitative interviews. The sampling frame comprised two health facilities in informal settlement areas of the Korogocho neighborhood and participants were recruited via convenience sampling. We performed multiple logistic regressions for quantitative data and thematic analysis for qualitative data. A total of 93 people participated in the survey (mean age: 57 ± 14.7, 66% female). Most participants reported high family support (82%, n = 76) and suboptimal medication adherence (43% by the Morisky Scale; 76% by the Hill-Bone Scale), with no significant associations between family support and medication adherence. During interviews, many participants reported they lacked health knowledge and education. We suggest that the lack of health knowledge among this population may have contributed to a failure for family support to meaningfully translate into improvements in medication adherence. Our results underscore the need for further research to improve hypertension control among this uniquely disadvantaged population, especially with respect to the possible mediating influence of health education on family support and medication adherence.
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Shaji P, Singh M, Sahu B, Arulappan J. Effectiveness of Nurse-led Lifestyle Modification Intervention on Obesity Among Young Women in India. SAGE Open Nurs 2023; 9:23779608231186705. [PMID: 37520681 PMCID: PMC10373117 DOI: 10.1177/23779608231186705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/26/2023] [Accepted: 06/17/2023] [Indexed: 08/01/2023] Open
Abstract
Background Obesity management in young women necessitates interventions that include dietary modification and physical exercise. High-intensity lifestyle modification is effective in managing obesity in young women. Objectives The study determined the effectiveness of a nurse-led lifestyle modification intervention (NLLMI) on obesity among young women in India. Methods The study adopted a quasi-experimental pre- and post-interventional control group research design. The study was conducted among obese young women in the communities of Jabalpur, Madhya Pradesh, India. The participants were selected using convenient sampling technique. The sample included 150 women in the study group and 150 in the control group. The NLLMI comprising of exercises and dietary modifications were taught to the participants for 30 min three times a week for 24 weeks. Thereafter, they were encouraged to follow the diet and perform the exercises on their own for the next 12 weeks. Practice diary was maintained by the participants and they were encouraged to continue the intervention through the phone. The participants in the control group did not engage in the NLLMI until the post-test. However, they did receive the same NLLMI after the trial was over. Results There was a high statistically significant difference (p = 0.001) between the study group and the control group the after 12th and 24th weeks of NLLMI. The study group had a significant reduction in BMI after the intervention. Conclusions Young obese women may benefit from a NLLMI if they regularly follow the healthy eating habits and physical exercise.
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Affiliation(s)
- Princey Shaji
- Department of Obstretics and Gynecology, Jabalpur Institute of Nursing Science and Research, Jabalpur, India
| | | | - Bharti Sahu
- Department of Obstetrics & Gynecology, Netaji Subhash Chandra Bose Medical College, Jabalpur, India
| | - Judie Arulappan
- Department of Maternal and Child Health, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
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The value of walking: a systematic review on mobility and healthcare costs. Eur Rev Aging Phys Act 2022; 19:31. [PMID: 36581809 PMCID: PMC9798720 DOI: 10.1186/s11556-022-00310-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/03/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The ability to walk is an important indicator of general health and mobility deficits have wide-ranging economic implications. We undertook a systematic review to elucidate the impact of walking parameters on health care costs. METHODS: Publications reporting on associations between health care costs and walking parameters were identified by a systematic literature search in MEDLINE, Embase, and manual reference screening, following the PRISMA reporting guidelines. First, titles and abstracts were screened by two independent reviewers followed by a review of the full articles if they met the inclusion criteria. Costs were converted to US-Dollars with inflation adjustment for 2021. A narrative synthesis was performed. RESULTS: Ten studies conducted between 2001 and 2021 fulfilled the inclusion criteria. Assessment of walking ability was carried out via patient reported outcomes, performance tests, or using wearable digital devices. Walking more than one hour per day, a faster walking speed and the ability to walk without impairments are associated with significant lower health care costs. A higher number of steps per day is associated with significant lower costs in two simulation studies, while in the study using a digital device, taking more than 10,000 steps per day is not significantly associated with lower direct costs. The heterogeneity of mobility assessments and of economic analyses both precluded a quantitative synthesis. CONCLUSION Cross-sectional and observational studies from this systematic review suggest a significant association of better walking performance with lower health care costs. Future health economic research and health technology assessments should use quantifiable mobility outcomes when evaluating new drugs or non-pharmacological interventions.
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Mesfin Z, Ali A, Abagero A, Asefa Z. Dengue Fever Outbreak Investigation in Werder Town, Dollo Zone, Somali Region, Ethiopia. Infect Drug Resist 2022; 15:7207-7217. [PMID: 36514800 PMCID: PMC9741851 DOI: 10.2147/idr.s368562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Background Dengue fever (DF) is a mosquito-borne disease caused by the dengue virus. DF is endemic to many tropical and subtropical countries around the world. In Ethiopia, DF emerged in 2013 and caused a serious public health problem. Objective We investigated the outbreak to describe by time, place, person, and to identify risk factors associated with the outbreak in Werder town, Dollo Zone, Somali Region, Ethiopia. Methods Descriptive and case-control studies (1:2 ratio) were conducted. We used the World Health Organization (WHO) case definition to identify cases in Werder town from December 10, 2020, to January 4, 2021. Controls were selected from the same town that did not suffer from DF. Serum samples were tested by reverse transcription polymerase chain reaction (RT-PCR) to detect the dengue virus and to identify serotypes. A structured questionnaire was used to collect socio-demographic, behavioural, and environmental characteristics. Results We identified a total of 57 cases and 114 controls. The overall attack rate was 334.41/100,000 with a zero case fatality rate. Six out of twenty serum samples tested positive for the DEN-3 serotype. In multivariate analysis, not hearing of DF (Adjusted odd ratio (AOR): 2.2, 95% CI: 1.015-4.701), not knowing the mode of transmission (AOR: 2.9, 95% CI: 1.338-6.831), not using long-lasting insecticidal net (LLITN) (AOR: 4.4, 95% CI: 1.592-12.330) and not spraying insecticide (AOR: 3.6, 95% CI: 1.591-8.098) were statistically significant risk factors associated with DF outbreak. However, wearing long sleeves (AOR: 0.435, 95% CI: 0.206-0.918) was a protective factor for the DF outbreak. Conclusion DF outbreak in Werder town has been confirmed. The present study provides evidence-based information regarding the identified risk factors that have contributed to the occurrence of DF outbreaks. We recommended implementing vector control measures and strengthening dengue surveillance systems is strongly advised.
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Affiliation(s)
- Zerihun Mesfin
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Livestock and Fishery Resource Sector, Ministry of Agriculture, Addis Ababa, Ethiopia
| | - Ahmed Ali
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abdulnasir Abagero
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zewdu Asefa
- Department of Early Warning and Information System Management Centre for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Casali N, Feraco T, Meneghetti C. Character strengths sustain mental health and post-traumatic growth during the COVID-19 pandemic. A longitudinal analysis. Psychol Health 2022; 37:1663-1679. [PMID: 34288790 DOI: 10.1080/08870446.2021.1952587] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has brought negative and positive changes in the general population, with some people experiencing post-traumatic growth after the first wave. Little research has focused, however, on personal factors potentially helping individuals cope with COVID-related difficulties. This study investigates the relations between character strengths, mental health, and post-traumatic growth. DESIGN Longitudinal (T1: April 2020; T2: December 2020-January 2021). MAIN OUTCOME MEASURES 254 Italian adults (54 males; mean age = 36.05, SD = 14.04) completed questionnaires on character and mental health at T1, and on mental health and post-traumatic growth at T2. RESULTS General mental health was worse at T2 than at T1. Structural equation modelling showed that character, as a whole, had a significant direct effect on post-traumatic growth and mental health at T2, and an indirect effect mediated by post-traumatic growth. Furthermore, regression analyses evidenced that the virtue of transcendence was uniquely related to mental health at T2, while humanity was specifically associated with post-traumatic growth (after accounting for the other virtues). CONCLUSION Individuals' character strengths related to their mental health and post-traumatic growth during the COVID-19 pandemic, with evidence of post-traumatic growth mediating the relation between character and mental health.
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Affiliation(s)
- Nicole Casali
- Department of General Psychology, University of Padova, Padova, Italy
| | - Tommaso Feraco
- Department of General Psychology, University of Padova, Padova, Italy.,Pentathlon Srl, Naples, Italy
| | - Chiara Meneghetti
- Department of General Psychology, University of Padova, Padova, Italy
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Abreu Minero V, Best D, Brown L, Patton D, Vanderplasschen W. Differences in addiction and recovery gains according to gender – gender barriers and specific differences in overall strengths growth. Subst Abuse Treat Prev Policy 2022; 17:21. [PMID: 35287696 PMCID: PMC8919581 DOI: 10.1186/s13011-022-00444-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/12/2022] Open
Abstract
Background There is growing evidence on the importance of a gendered understanding of recovery. Gender differences have been reported in relation to the nature and extent of substance use, pathways to and through substance use disorder and recovery capital acquisition and maintenance. There is little existing research on factors associated with recovery capital growth by gender. Methods The current paper uses the European Life in Recovery database to assess specific domains of the Strengths and Barriers Recovery Scale (SABRS) that best predict growth of recovery capital amongst people in recovery from drug addiction. The 1313 participants were drawn from the REC-PATH study and recruited by the Recovery Users Network (RUN) from across Europe. Bivariate and multivariate analyses were performed to identify relationships between specific SABRS items and gender, as well as differences in the dimensions of the SABRS scale most likely to predict recovery capital growth by gender. Results Between their time in active addiction and in recovery, females show greater growth in strengths, despite females reporting fewer recovery strengths during active addiction than males, and males have greater reductions in barriers to recovery compared to females. Multivariate analyses show that strengths specifically related to prosocial meaningful activities are found to be highly significant for growth of recovery capital amongst males, whereas strengths related to both prosocial meaningful activities and general health management seem particularly relevant for growth of recovery capital amongst females. Conclusions We conclude that this further demonstration of gender differences in recovery pathways should suggest gender-specific approaches adopted in recovery community organisations to address these different needs.
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Prevalence and associated factors of stunting, wasting and underweight of children below five using quintile regression analysis (PDHS 2017-2018). Sci Rep 2022; 12:20326. [PMID: 36434025 PMCID: PMC9700674 DOI: 10.1038/s41598-022-24063-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
The objective of the current study is to identify the risk factors for malnutrition among the age of under-five children's in Pakistan. This is secondary data analysis for the data taken from Pakistan Demographic and Health Survey (PDHS 2017-18) and was analyzed by implementing quantile regression analysis. The sample size included 12,708 alive children in the study, for which the data collection period was from November 22, 2017, to April 30, 2018. The prevalence of malnutrition among boys is high (51.2%). Older age mother's children have more prevalence of malnutrition (20.7%). A child born with small body size (underweight: Q0.25: - 0.625; Q0.50: - 0.623; Q0.75: - 0.426 and wasting: Q0.50: - 0.513); having uneducated mother (underweight: Q0.25: - 0.387; Q0.50: - 0.247; Q0.75: - 0.328), belonged to a poor household (underweight: Q0.50: - 0.251),residing in rural areas (underweight: Q0.25: - 0.443), not following properly breastfeeding practices (underweight: Q0.50: - 0.439; Q0.75: - 0.438) have negative effect on different measures of malnutrition and this effect is significantly raises across different quantiles of stunting , wasting and underweight (at p value < 0.01 and < 0.05). Older age mother (stunting: Q0.50: 0.777; Q0.75: 1.078; underweight Q0.20: 0.568; Q0.50: 0.429; Q0.75: 0.524) and higher birth order number (stunting: Q0.50: 0.415; Q0.75: 0.535), have a positive effect on three measures of under-nutrition and this effect is gradual raises at different quantile of stunting, wasting and underweight. Elder and smoker mothers were proved associated risk factors of both stunting and being underweight in Pakistan. Moreover, Proper breastfeeding practices, better economic status, average or above the average birth weight of the child, and milk consumption are found protective factors against stunting, wasting, and underweight children in Pakistan.
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