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Tripathy S, Mohapatra S, Preethika A. Breast cancer awareness among women of reproductive age- a questionnaire based study. Eur J Obstet Gynecol Reprod Biol 2024; 298:153-157. [PMID: 38761530 DOI: 10.1016/j.ejogrb.2024.05.014] [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: 09/25/2023] [Revised: 03/26/2024] [Accepted: 05/12/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION Breast cancer is the most frequent cancer in women worldwide, and its prevalence is rising among younger women of reproductive age. The study aims to investigate their awareness of breast cancer risk factors, warning indicators, and preventive methods. The study also aimed to assess participants' knowledge of breast self-examination (BSE) and their practices with this crucial screening method. METHODOLOGY To achieve these goals, we used a cross-sectional survey employing a structured questionnaire. The questionnaire included multiple-choice and open-ended items about breast cancer awareness, knowledge, and practices. RESULTS There were 400 questionnaires given out to female patients attending the out-patient department, and 290 of them were completed and returned. The majority of responders to our poll, 88 %, were aware that breast cancer is the most frequent cancer in women. The fact that 57 % of the individuals never examined their own breasts is a worrying result. There was a statistically significant difference between knowledge and family history (X2 = 13.8, P < 0.001) and knowledge and schooling (X2 = 6.4,P < 0.001). Both the practise of BSE and knowledge of BC were good in respondents under the age of 45, however they differed statistically significantly (X2-2.8,P = 0.041 and X2-2.6, P = 0.001, respectively). CONCLUSION Understanding the extent of breast cancer awareness and knowledge gaps in this population is critical for planning targeted interventions and educational efforts. By identifying areas where knowledge is weak, healthcare practitioners and governments can implement policies to encourage early detection practices, reduce delays in seeking medical aid, and ultimately improve breast cancer outcomes.
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Affiliation(s)
- Saswati Tripathy
- Professor, Department of OBG, SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu 603203, India
| | - Satyajit Mohapatra
- Director, Center for Clinical Trials and Research, SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu 603203, India
| | - A Preethika
- Assistant Professor, Centre for Clinical Trials and Research, SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu 603203, India.
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Mudiope P, Mathers B, Nangendo J, Samuel M, Mutamba BB, Alamo S, Nanyenya N, Makumbi F, Laker-Oketta M, Wanyenze R. Characterising People who inject drugs, and association with HIV infection: A Situation Analysis in Kampala city, Uganda. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.31.24308282. [PMID: 38853844 PMCID: PMC11160897 DOI: 10.1101/2024.05.31.24308282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background Uganda has implemented targeted interventions to address the rising burden of injection drug use, yet barriers persist in reaching persons who inject drugs (PWID). This study describes the characteristics of people who inject drugs, physical and mental health states, and associated risk behaviors, to inform the designing of programs that are tailored to client's needs and preferences. Methods A cross-sectional survey was conducted between August and December 2023 at selected hotspots in Kampala, interviewing 499 PWID aged ≥18 years. Data was collected using a semi-structured questionnaire administered by peer educators and Uganda Harm Reduction Network (UHRN) counselors. Measurements included socio-demographics, injecting drug use and sexual risk behaviors, and medical history. HIV serostatus was dtermined by self-report and testing for participants who had no recent history of testing and consented to be tested. Binary logistic regression was used to establish the relationship between HIV infection and risky drug- and sexual behaviors of PWID. Results Participants were predominantly Ugandan (95.2%), male (73.2%), unmarried (55.9%), unemployed (81.8%), with higher levels of education and varying ages. Mental disorders were prevalent, with 48.7% reporting at least one underlying condition, including depression (30.8%) and anxiety (9.6%). Physical health issues were also noted, with reported cases of fever (32.9%), cough (32.5%), malaria (22%) and sexually transmitted infections (STIs) (15%).Regarding drug use patterns, the majority (82.6%) were introduced to drugs by close acquaintances, with 70.9% categorized as people who inject drugs. HIV prevalence among injecting drug users was 3.7%, with higher rates among females (8.4%) and non-Ugandans (16.7%). Being female and experiencing difficulty accessing sterile injection materials were associated with HIV-positive status, highlighting the complex interplay between socio-demographic factors, risk behaviors, and HIV infection among individuals with injecting drug use Disorder in Uganda. Conclusion Our study provides a comprehensive insight into the socio-demographic, mental, physical health, and HIV risk behavoir of PWID in Kampala, Uganda. The findings indicate significant vulnerabilities to injecting drug use, mental disorders, and high-risk behaviors that predispose this population to HIV infection. Despite a low HIV prevalence compared to previous estimates, the interplay between drug use, risky injecting practices, and sexual behaviors suggests an urgent need for targeted interventions to address these intertwined challenges.
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Affiliation(s)
- Peter Mudiope
- Makerere University School of Public Health, Kampala Uganda
| | - Bradley Mathers
- Global HIV, Hepatitis and Sexually Transmitted Infections Programms, World Health Organization, Geneva, Switzerland
- Kirby Institute, University of New South Wales Sydney, Sydney, Australia
| | - Joanita Nangendo
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mutyaba Samuel
- Makerere University School of Public Health, Kampala Uganda
| | | | - Stella Alamo
- United States of America Centers for Disease Control and Prevention, Kampala, Uganda
| | | | | | - Miriam Laker-Oketta
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Rhoda Wanyenze
- Makerere University School of Public Health, Kampala Uganda
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Mostofsky E, Lee IM, Buring JE, Mukamal KJ. Impact of Alcohol Consumption on Breast Cancer Incidence and Mortality: The Women's Health Study. J Womens Health (Larchmt) 2024; 33:705-714. [PMID: 38417039 DOI: 10.1089/jwh.2023.1021] [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: 03/01/2024] Open
Abstract
Background: Alcohol intake is associated with breast cancer (BC) risk, but estimates of greatest public health relevance have not been quantified in large studies with long duration. Materials and Methods: In this prospective cohort study of 39,811 women (median 25 years follow-up), we examined the association between alcohol consumption and BC incidence and mortality with adjusted hazard ratios (HRs), cubic splines, absolute risks, number needed to harm (NNH), and population-attributable fractions. Results: We documented 2,830 cases of BC, including 237 BC deaths. Each additional alcoholic drink/day was associated with a 10% higher rate (HR = 1.10, 95% confidence intervals [CIs]: 1.04-1.16) of total BC in a linear manner (p = 0.0004). The higher rate was apparent for estrogen receptor (ER)+ (HR = 1.12, 95% CI: 1.06-1.18) but not ER- tumors (HR = 0.95, 95% CI: 0.82-1.10), with a statistically significant difference between these associations (p = 0.03). We constructed models comparing BC incidence among 100,000 women followed for 10 years. Compared to a scenario where all women rarely or never consumed alcohol, we expect 63.79 (95% CI: 58.35-69.24) more cases (NNH = 1,567) had all women consumed alcohol at least monthly and 278.66 (95% CI: 268.70-288.62) more cases (NNH = 358) had all women consumed >1 drink/day. Approximately 4.1% of BC cases were attributable to consumption exceeding one drink/month. Conclusion: Alcohol consumption is associated with a linear dose-response increase in BC incidence even within recommended limits of up to one alcoholic drink/day, at least for ER+ tumors. Our estimates of risk differences, attributable fraction, and NNH quantify the burden that alcohol consumption imposes on women in the general population. ClinicalTrials.gov Identifier: NCT00000479.
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Affiliation(s)
- Elizabeth Mostofsky
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Julie Elizabeth Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kenneth Jay Mukamal
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical, School, Boston, Massachusetts, USA
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Zhao J, Wang Q, Tan AF, Loh CJL, Toh HC. Sex differences in cancer and immunotherapy outcomes: the role of androgen receptor. Front Immunol 2024; 15:1416941. [PMID: 38863718 PMCID: PMC11165033 DOI: 10.3389/fimmu.2024.1416941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 05/16/2024] [Indexed: 06/13/2024] Open
Abstract
Across the wide range of clinical conditions, there exists a sex imbalance where biological females are more prone to autoimmune diseases and males to some cancers. These discrepancies are the combinatory consequence of lifestyle and environmental factors such as smoking, alcohol consumption, obesity, and oncogenic viruses, as well as other intrinsic biological traits including sex chromosomes and sex hormones. While the emergence of immuno-oncology (I/O) has revolutionised cancer care, the efficacy across multiple cancers may be limited because of a complex, dynamic interplay between the tumour and its microenvironment (TME). Indeed, sex and gender can also influence the varying effectiveness of I/O. Androgen receptor (AR) plays an important role in tumorigenesis and in shaping the TME. Here, we lay out the epidemiological context of sex disparity in cancer and then review the current literature on how AR signalling contributes to such observation via altered tumour development and immunology. We offer insights into AR-mediated immunosuppressive mechanisms, with the hope of translating preclinical and clinical evidence in gender oncology into improved outcomes in personalised, I/O-based cancer care.
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Affiliation(s)
- Junzhe Zhao
- Duke-NUS Medical School, Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Qian Wang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Medical Oncology Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, China
| | | | - Celestine Jia Ling Loh
- Duke-NUS Medical School, Singapore, Singapore
- Sengkang General Hospital, Singapore, Singapore
| | - Han Chong Toh
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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Hennegan J, Hasan MT, Jabbar A, Jalil T, Kennedy E, Hunter E, Kaiser A, Akter S, Zaman A, Rahman MU, Dunstan L, Head A, Scott N, Weiss HA, Win TM, Melendez-Torres GJ, Than KK, Hughes CL, Grover S, Hasan M, Rashid SF, Azzopardi P. Protocol for the Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study in Khulna, Bangladesh: A Prospective cohort to quantify the influence of menstrual health on adolescent girls' health and education outcomes. BMJ Open 2024; 14:e079451. [PMID: 38604626 PMCID: PMC11015194 DOI: 10.1136/bmjopen-2023-079451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Menstrual health is essential for gender equity and the well-being of women and girls. Qualitative research has described the burden of poor menstrual health on health and education; however, these impacts have not been quantified, curtailing investment. The Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study aims to describe menstrual health and its trajectories across adolescence, and quantify the relationships between menstrual health and girls' health and education in Khulna, Bangladesh. METHODS AND ANALYSIS AMEHC is a prospective longitudinal cohort of 2016 adolescent girls recruited at the commencement of class 6 (secondary school, mean age=12) across 101 schools selected through a proportional random sampling approach. Each year, the cohort will be asked to complete a survey capturing (1) girls' menstrual health and experiences, (2) support for menstrual health, and (3) health and education outcomes. Survey questions were refined through qualitative research, cognitive interviews and pilot survey in the year preceding the cohort. Girls' guardians will be surveyed at baseline and wave 2 to capture their perspectives and household demographics. Annual assessments will capture schools' water, sanitation and hygiene, and support for menstruation and collect data on participants' education, including school attendance and performance (in maths, literacy). Cohort enrolment and baseline survey commenced in February 2023. Follow-up waves are scheduled for 2024, 2025 and 2026, with plans for extension. A nested subcohort will follow 406 post-menarche girls at 2-month intervals throughout 2023 (May, August, October) to describe changes across menstrual periods. This protocol outlines a priori hypotheses regarding the impacts of menstrual health to be tested through the cohort. ETHICS AND DISSEMINATION AMEHC has ethical approval from the Alfred Hospital Ethics Committee (369/22) and BRAC James P Grant School of Public Health Institutional Review Board (IRB-06 July 22-024). Study materials and outputs will be available open access through peer-reviewed publication and study web pages.
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Affiliation(s)
- Julie Hennegan
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Md Tanvir Hasan
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Abdul Jabbar
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Tasfiyah Jalil
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Elissa Kennedy
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Population Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Erin Hunter
- Department of Public Health Sciences, Clemson University College of Behavioral Social and Health Sciences, Clemson, South Carolina, USA
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Adrita Kaiser
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Sabina Akter
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Afreen Zaman
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Laura Dunstan
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Social and Political Sciences, University of Melboune, Melbourne, Victoria, Australia
| | - Alexandra Head
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Nick Scott
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen Anne Weiss
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Thin Mar Win
- Myanmar Country Program, Burnet Institute, Yangon, Myanmar
| | | | - Kyu Kyu Than
- Myanmar Country Program, Burnet Institute, Yangon, Myanmar
| | - Chad L Hughes
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Sonia Grover
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Sabina Faiz Rashid
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Peter Azzopardi
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Telethon Kids Institute, Adelaide, South Australia, Australia
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Frost A, Scherer E, Chung EO, Gallis JA, Sanborn K, Zhou Y, Hagaman A, LeMasters K, Sikander S, Turner E, Maselko J. Longitudinal pathways between maternal depression, parenting behaviors, and early childhood development: a mediation analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.24.24301747. [PMID: 38343808 PMCID: PMC10854292 DOI: 10.1101/2024.01.24.24301747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Maternal depression is a global public health concern with far-reaching impacts on child development, yet our understanding of mechanisms remains incomplete. This study examined whether parenting mediates the association between maternal depression and child outcomes. Participants included 841 rural Pakistani mother-child dyads (50% female). Maternal depression was measured at 12 months postpartum, parenting behaviors (warmth, stimulation, and harsh parenting) were measured at 24 months, and child outcomes (mental health, socioemotional development, and cognitive skills) were measured at 36 months. Maternal depression predicted increased harsh parenting, child mental health difficulties, and child socioemotional concerns; however, there was little evidence for parenting as a mediator between maternal depression and child outcomes. Sex-stratified results are discussed, and findings are situated in context.
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Young R, Ssekasanvu J, Kagaayi J, Ssekubugu R, Kigozi G, Reynolds SJ, Wawer MJ, Nonyane BAS, Chang LW, Kennedy CE, Paina L, Anglewicz PA, Quinn TC, Serwadda D, Nalugoda F, Grabowski MK. HIV and viremia prevalence in non-migrating members of migrant households in Rakai region, Uganda: A cross-sectional population-based study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.08.23299745. [PMID: 38106065 PMCID: PMC10723567 DOI: 10.1101/2023.12.08.23299745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Introduction In sub-Saharan Africa, migrants are more likely to be HIV seropositive and viremic than non-migrants. However, little is known about HIV prevalence and viremia in non-migrants living in households with in- or out-migration events. We compared HIV outcomes in non-migrating persons in households with and without migration events using data from the Rakai Community Cohort Study (RCCS), an open population-based cohort in Uganda. Methods We analyzed RCCS survey data from one survey round collected between August 2016 and May 2018 from non-migrating participants aged 15-49. Migrant households were classified as those reporting ≥1 member moving into or out of the household since the prior survey. A validated rapid test algorithm determined HIV serostatus. HIV viremia was defined as >1,000 copies/mL. Modified Poisson regression was used to estimate associations between household migration and HIV outcomes, with results reported as adjusted prevalence ratios (adjPR) with 95% confidence intervals (95%CI). Analyses were stratified by gender, direction of migration (into/out of the household), and relationship between non-migrants and migrants (e.g., spouse). Results There were 14,599 non-migrants (7,654, 52% women) identified in 9,299 households. 4,415 (30%) lived in a household with ≥1 recent migrant; of these, 972(22%) had migrant spouses, 1,102(25%) migrant children, and 875(20%) migrant siblings. Overall, HIV prevalence and viremia did not differ between non-migrants in migrant and non-migrant households. However, in stratified analyses, non-migrant women with migrant spouses were significantly more likely to be HIV seropositive compared to non-migrant women with non-migrant spouses (adjPR:1.44, 95%CI:1.21-1.71). Conversely, non-migrant mothers living with HIV who had migrant children were less likely to be viremic (adjPR:0.34, 95%CI:0.13-0.86). Among non-migrant men living with HIV, spousal migration was associated with a non-significant increased risk of viremia (adjPR:1.37, 95%CI:0.94-1.99). Associations did not typically differ for migration into or out of the household. Conclusions Household migration was associated with HIV outcomes for certain non-migrants, suggesting that the context of household migration influences the observed association with HIV outcomes. In particular, non-migrating women with migrating spouses were more likely to have substantially higher HIV burden. Non-migrants with migrant spouses may benefit from additional support when accessing HIV services.
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Rakhshanda S, Abedin M, Wahab A, Barua L, Faruque M, Banik PC, Shawon RA, Rahman AF, Mashreky SR. Self-reported prevalence of asthma and its associated factors among adult rural population in Bangladesh: a cross-sectional study using WHO PEN protocol. BMJ Open 2023; 13:e074195. [PMID: 38070896 PMCID: PMC10729215 DOI: 10.1136/bmjopen-2023-074195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE For over a decade, the prevalence of asthma remained unchanged at around 7% in Bangladesh. Although asthma causes significant morbidity among both children and adults, updates on epidemiological data are limited on the prevalence in Bangladesh. This study attempted to determine the prevalence of asthma, and its modifiable and non-modifiable lifestyle predictors in a rural population of Bangladesh. METHOD This study was part of a cross-sectional study that applied the WHO Package of Essential Noncommunicable Disease Interventions via census in a rural area of Bangladesh, where self-reported data on asthma were recorded. Data on anthropometric measurement, sociodemographic characteristics and behavioural risk factors were collected following the standard protocol described in the WHO STEP-wise approach to surveillance (STEPS) questionnaire. Analysis included descriptive statistics to assess the prevalence of asthma and its risk factors, and binary logistic regression to determine contributing factors. RESULT The overall prevalence of asthma was 4.2%. Asthma was predominant among people above 60 years (8.4%). Higher asthma was noted among males (4.6%), self-employed (5.1%), with a family history of asthma (9.1%), with comorbidities besides asthma (7.8%) and underweight (6.0%) compared with their counterparts. The OR of having asthma was 1.89, 1.93, 1.32, 1.50, 2.60, 0.67, 0.67 and 0.78 if a respondent was 45 years old or more, married, underweight, ever smoker, with a family history of asthma, housewife, employed and consumed red meat, respectively, while considering all other variables constant, compared with their counterparts. CONCLUSION The study emphasised asthma to be a public health concern in Bangladesh, although it seems to have decreased over the last decade. Among others, red meat intake and nutritional status were strongly associated with asthma, and the linkage among these is still a grey area that needs further exploration.
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Affiliation(s)
| | - Minhazul Abedin
- Centre for Injury Prevention and Research, Bangladesh, Dhaka, Bangladesh
| | - Abrar Wahab
- Centre for Injury Prevention and Research, Bangladesh, Dhaka, Bangladesh
| | - Lingkan Barua
- Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | | | | | - Riffat Ara Shawon
- Centre for Injury Prevention and Research, Bangladesh, Dhaka, Bangladesh
| | - Akm Fazlur Rahman
- Centre for Injury Prevention and Research, Bangladesh, Dhaka, Bangladesh
| | - Saidur Rahman Mashreky
- Centre for Injury Prevention and Research, Bangladesh, Dhaka, Bangladesh
- Bangladesh University of Health Sciences, Dhaka, Bangladesh
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Accoe K, Criel B, Ag Ahmed MA, Buitrago VT, Marchal B. Conditions for health system resilience in the response to the COVID-19 pandemic in Mauritania. BMJ Glob Health 2023; 8:e013943. [PMID: 38050409 PMCID: PMC10693853 DOI: 10.1136/bmjgh-2023-013943] [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: 09/12/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
INTRODUCTION A country's ability to manage a crisis depends on its level of resilience. Efforts are made to clarify the concept of health system resilience, but its operationalisation remains little studied. In the present research, we described the capacity of the local healthcare system in the Islamic Republic of Mauritania, in West Africa, to cope with the COVID-19 pandemic. METHODS We used a single case study with two health districts as units of analysis. A context analysis, a literature review and 33 semi-structured interviews were conducted. The data were analysed using a resilience conceptual framework. RESULTS The analysis indicates a certain capacity to manage the crisis, but significant gaps and challenges remain. The management of many uncertainties is largely dependent on the quality of the alignment of decision-makers at district level with the national level. Local management of COVID-19 in the context of Mauritania's fragile healthcare system has been skewed to awareness-raising and a surveillance system. Three other elements appear to be particularly important in building a resilient healthcare system: leadership capacity, community dynamics and the existence of a learning culture. CONCLUSION The COVID-19 pandemic has put a great deal of pressure on healthcare systems. Our study has shown the relevance of an in-depth contextual analysis to better identify the enabling environment and the capacities required to develop a certain level of resilience. The translation into practice of the skills required to build a resilient healthcare system remains to be further developed.
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Affiliation(s)
- Kirsten Accoe
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bart Criel
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Belay GJ, Fentanew M, Belay M, Gobezie M, Bekele G, Getie K, Shiferaw KB, Takele MD, Cherkos K, Zemariam AB. Physical Activity and Its Associated Factors among Patients with Hypertension at Amhara Region Comprehensive Specialised Hospitals, Northwest Ethiopia: An Institutional Based Cross-Sectional Study. BMJ Open 2023; 13:e073018. [PMID: 37666550 PMCID: PMC10481733 DOI: 10.1136/bmjopen-2023-073018] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Accurate evaluation of physical activity for patients with hypertension is important to determine patients' health outcomes and intervention measures. Information about physical activity among patients with hypertension in Ethiopia is not well known. OBJECTIVE This study was aimed to assess the physical activity and associated factors among patients with hypertension. STUDY DESIGN An institution-based cross-sectional study was conducted. STUDY SETTING The study was conducted at the Tertiary Hospital Northwest, Ethiopia. OUTCOME MEASURES Physical activity was assessed by Global Physical Activity Questionnaire as the primary outcome and factors significantly associated with physical activity were secondary outcomes. PARTICIPANTS Four hundred and twenty patients with hypertension took part in the study; among those 233 were men and 187 were women. The study participants were chosen using a systematic random sampling method. SPSS V.20 statistical software was used to analyse the data. In the multivariable logistic regression analysis model, adjusted OR (AOR) with a 95% CI and p value<0.05 were used to identify the associated factors with physical activities. RESULTS Our study showed that 19.1% of study participants had inadequate physical activity, being old age with AOR: 10.27 (3.21 to 33.01), low or poor self-efficacy with AOR: 10.34 (4.89 to 21.84), poor self-rated health with AOR: 5.91 (1.73 to 20.13) and lack of adequate facilities with AOR: 4.07 (1.72 to 9.66) were significantly associated with inadequate physical activity. CONCLUSION Inadequate physical activity was detected in one-fifth of the study participants, according to our research. Being elderly, having low self-efficacy, having inadequate facilities and having poor self-rated health were all linked to inadequate physical activity.
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Affiliation(s)
- Gashaw Jember Belay
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Molla Fentanew
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Misganaw Belay
- Department of Physiotherapy, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melese Gobezie
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gebremariam Bekele
- Department of Physiotherapy, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kefale Getie
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kassaw Belay Shiferaw
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mihret Dejen Takele
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kassahun Cherkos
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
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Mphande M, Robson I, Hubbard J, Chikuse E, Lungu E, Phiri K, Cornell M, Phiri S, Coates TJ, Dovel K. Developing a male-specific counselling curriculum for HIV treatment in Malawi. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.08.23293583. [PMID: 37609294 PMCID: PMC10441488 DOI: 10.1101/2023.08.08.23293583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Men living with HIV in sub-Saharan Africa have sub-optimal engagement in antiretroviral therapy (ART) Programs. Generic ART counselling curriculum in Malawi does not meet men's needs and should be tailored to men. We developed a male-specific ART counselling curriculum, adapted from the Malawi Ministry of Health (MOH) curriculum based on literature review of men's needs and motivations for treatment. The curriculum was piloted through group counselling with men in 6 communities in Malawi, with focus group discussion (FGD) conducted immediately afterward (n=85 men) to assess knowledge of ART, motivators and barriers to care, and perceptions of the male-specific curriculum. Data were analysed in Atlas.ti using grounded theory. We conducted a half-day meeting with MOH and partner stakeholders to finalize the curriculum (n=5). The male-specific curriculum adapted three existing topics from generic counselling curriculum (status disclosure, treatment as prevention, and ART side effects) and added four new topics (how treatment contributes to men's goals, feeling healthy on treatment, navigating health systems, and self-compassion for the cyclical nature of lifelong treatment. Key motivators for men were embedded throughout the curriculum and included: family wellbeing, having additional children, financially stability, and earning/keeping respect. During the pilot, men reported having little understanding of how ART contributed to their personal goals prior to the male-specific counselling. Men were most interested in additional information about treatment as prevention, benefits of disclosure/social support beyond their sexual partner, how to navigate health systems, and side effects with new regimens. Respondents stated that the male-specific counselling challenged the idea that men were incapable of overcoming treatment barriers and lifelong medication. Male-specific ART counselling curriculum is needed to address men's specific needs. In Malawi context, topics should include: how treatment contributes to men's goals, navigating health systems, self-compassion/patience for lifelong treatment, and taking treatment while healthy.
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Zare Borzeshi E, Valizadeh M, Panahi MH, Khalili D, Mousavizadeh M, Mehrabi Y. Data-driven phenomapping for novel classification for cardiovascular outcomes compared with traditional obesity index: Tehran Lipid and Glucose Study. BMJ Open 2023; 13:e071011. [PMID: 37316323 DOI: 10.1136/bmjopen-2022-071011] [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] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE This study aimed to propose a data-driven framework for classification of at-risk people for cardiovascular outcomes regarding obesity and metabolic syndrome. DESIGN A population-based prospective cohort study with a long-term follow-up. SETTING Data from the Tehran Lipid and Glucose Study (TLGS) were interrogated. PARTICIPANTS 12 808 participants of the TLGS cohort, aged ≥20 years who have followed for over 15 years were assessed. MAIN OUTCOME MEASURES Data for 12 808 participants, aged ≥20 years who have followed for over 15 years, collected through TLGS as a prospective, population-based cohort study, were analysed. Feature engineering followed by hierarchical clustering was used to determine meaningful clusters and novel endophenotypes. Cox regression was used to demonstrate the clinical validity of phenomapping. The performance of endophenotype compared with traditional classifications was evaluated by the value of Akaike information criterion/Bayesian information criterion. R software V.4.2 was employed. RESULTS The mean age was 42.1±14.9 years, 56.2% were female, 13.1%, 2.8% and 6.2% had experienced cardiovascular disease (CVD), CVD mortality and hard CVD, respectively. Low-risk cluster compared with the high risk had significant difference in age, body mass index, waist-to-hip ratio, 2 hours post load plasma glucose, triglyceride, triglycerides to high density lipoprotein ratio, education, marital status, smoking and the presence of metabolic syndrome. Eight distinct endophenotypes were detected with significantly different clinical characteristics and outcomes. CONCLUSION Phenomapping resulted in a novel classification of population with cardiovascular outcomes, which can, better, stratify individuals into homogeneous subclasses for prevention and intervention as an alternative of traditional methods solely based on either obesity or metabolic status. These findings have important clinical implications for a particular part of the Middle Eastern population for which it is a common practice to use tools/evidence derived from western populations with substantially different backgrounds and risk profiles.
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Affiliation(s)
- Elahe Zare Borzeshi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Panahi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Mousavizadeh
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Alam F, Ali MK, Patel SA, Iqbal R. Concordance of weight status between mothers and children: A secondary analysis of the Pakistan Demographic and Health Survey VII. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.04.23289509. [PMID: 37205423 PMCID: PMC10187450 DOI: 10.1101/2023.05.04.23289509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Familial concordance of nutritional status is an emerging field of study that may guide the development of interventions that operate beyond the individual and within the family context. Little published data exist for concordance of nutritional status within Pakistani households. We assessed the associations between weight status of mothers and their children in a nationally representative sample of households in Pakistan using Demographic and Health Survey data. Our analysis included 3465 mother-child dyads, restricting to children under-five years of age with body mass index (BMI) information on their mothers. We used linear regression models to assess the associations between maternal BMI category (underweight, normal weight, overweight, obese) and child's weight-for-height z-score (WHZ), accounting for socio-demographic characteristics of mothers and children. We assessed these relationships in all children under-five and also stratified by age of children (younger than 2 years and 2 to 5 years). In all children under-five and in children 2 to 5 years, maternal BMI was positively associated with child's WHZ, while there was no association between maternal BMI and child WHZ for children under-two. The findings indicate that the weight status of mother's is positively associated with that of their children. These associations have implications for interventions aimed at healthy weights of families.
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Affiliation(s)
- Faiz Alam
- Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America
- School of Medicine, Emory University, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Mohammed K. Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia, United States of America
- Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, Georgia, United States of America
| | - Shivani A. Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, Georgia, United States of America
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
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Amone A, Gabagaya G, Wavamunno P, Rukundo G, Namale-Matovu J, Malamba SS, Lubega I, Homsy J, King R, Nakabiito C, Namukwaya Z, Fowler MG, Musoke P. Enhanced Peer-Group strategies to support prevention of Mother-to-Child HIV transmission leads to increased retention in care in Uganda: A Randomized controlled trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.15.23288495. [PMID: 37131665 PMCID: PMC10153351 DOI: 10.1101/2023.04.15.23288495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Introduction Despite scale up of Option B+, long-term retention of women in HIV care during pregnancy and the postpartum period remains an important challenge. We compared adherence to clinic appointments and antiretroviral therapy (ART) at different follow-up time points between enrolment and 24 months postpartum among pregnant women living with HIV and initiating Option B+ randomized to a peer group support, community-based drug distribution and income-generating intervention called "Friends for Life Circles" (FLCs) versus the standard of care (SOC). Methods Between 16 May 2016 and 12 September 2017, 540 ART-naïve pregnant women living with HIV at urban and rural health facilities in Uganda were enrolled in the study. Participants were randomized 1:1 to the FLC intervention or SOC and assessed for adherence to prevention of mother to child HIV transmission (PMTCT) clinic appointments at 6 weeks, 12 and 24 months postpartum, self-reported adherence to ART at 6 weeks, 6 and 24 months postpartum validated by plasma HIV-1 RNA viral load (VL) measured at the same time points, and HIV status and HIV-free survival of infants at 18 months postpartum. We used Log-rank and Chi-Square p-values to test the equality of Kaplan-Meier survival probabilities and hazard rates (HR) for failure to retain in care for any reason by study arm. Results There was no significant difference in adherence to PMTCT clinic visits or to ART or in median viral loads between FLC and SOC arms at any follow-up time points. Retention in care through the end of study was high in both arms but significantly higher among participants randomized to FLC (86.7%) compared to SOC (79.3%), p=0.022. The adjusted HR of visit dropout was 2.5 times greater among participants randomized to SOC compared to FLC (aHR=2.498, 95% CI: 1.417 - 4.406, p=0.002). Median VL remained < 400 copies/ml in both arms at 6 weeks, 6 and 24 months postpartum. Conclusions Our findings suggest that programmatic interventions that provide group support, community based ART distribution and income-generation activities may contribute to retention in PMTCT care, HIV-free survival of children born to women living with HIV, and to the elimination of mother to child HIV transmission (MTCT).
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Affiliation(s)
- Alexander Amone
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Grace Gabagaya
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Priscilla Wavamunno
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Gordon Rukundo
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Joyce Namale-Matovu
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | | | - Irene Lubega
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Jaco Homsy
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Rachel King
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Clemensia Nakabiito
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Zikulah Namukwaya
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Mary Glenn Fowler
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Philippa Musoke
- Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
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Lallukka T, Lahelma E, Pietiläinen O, Kuivalainen S, Laaksonen M, Rahkonen O, Lahti J. Trajectories in physical functioning by occupational class among retiring women: the significance of type of retirement and social and health-related factors. J Epidemiol Community Health 2023; 77:362-368. [PMID: 37028924 DOI: 10.1136/jech-2022-219963] [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: 10/19/2022] [Accepted: 03/27/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Occupational class inequalities in physical functioning and their changes after retirement are poorly understood. We examined occupational class trajectories in physical functioning 10 years before and after transition to old-age and disability retirement. We included working conditions and behavioural risk factors as covariates, given their established link to health and retirement. METHODS We used the Helsinki Health Study cohort data from surveys 2000-2002 to 2017, and included 3901 women, who were employed by the City of Helsinki, Finland, and retired during the follow-up. Mixed-effect growth curve models were used to examine changes in RAND-36 Physical Functioning subscale (range 0-100) 10 years before and after the retirement date by occupational class. RESULTS Old-age (n=3073) and disability retirees (n=828) lacked class differences in physical functioning 10 years before retirement. By retirement transition, physical functioning declined and class inequalities emerged, the predicted scores being 86.1 (95% CI 85.2 to 86.9) for higher class and 82.2 (95% CI 81.5 to 83.0) for lower class old-age retirees, and 70.3 (95% CI 67.8 to 72.9) for higher class and 62.2 (95% CI 60.4 to 63.9) for lower class disability retirees. Physical functioning declined and class inequalities slightly widened among old-age retirees after the retirement, whereas among disability retirees the decline plateaued and class inequalities narrowed over time after retirement. Physical work and body mass index somewhat attenuated the class inequalities after adjustment. CONCLUSIONS Class inequalities in physical functioning widened after old-age retirement and narrowed after disability retirement. The examined work and health-related factors contributed weakly to the inequalities.
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Affiliation(s)
- Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | | | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
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Lee H, Perosky J, Horton M, Reynolds C, Nyanplu A, Lori JR. Verbal autopsy analysis of maternal mortality in Bong County, Liberia: a retrospective mixed methods study. BMJ Open Qual 2023; 12:bmjoq-2022-002147. [PMID: 37076249 PMCID: PMC10124242 DOI: 10.1136/bmjoq-2022-002147] [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: 10/08/2022] [Accepted: 04/01/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND While the medical contributors to maternal mortality are well known, the contextual contributors are less known and understudied. Liberia has one of the highest maternal mortality rates in sub-Saharan Africa, with recent increases in maternal deaths in rural Bong County. The purpose of this study was to better classify the contextual factors leading up to maternal deaths and to develop a list of recommendations to prevent future similar deaths. METHODS A retrospective mixed method study was conducted examining 35 maternal deaths in Bong County, Liberia using verbal autopsy reports from 2019. An interdisciplinary death audit team reviewed and analysed the maternal deaths to determine the contextual causes of the maternal death. FINDINGS This study identified three contextual causes: limited resources (materials, transportation, facility, staff), inadequate skills and knowledge (staff, community, family, patient), and ineffective communication (between providers, between health facilities and hospitals, and between provider and patient/family). Of these, inadequate patient education (54.28%), inadequate staff education and training (51.42%), ineffective communication between health facilities and hospitals (31.42%), and inadequate materials (28.57%) were most frequently mentioned. CONCLUSION Maternal mortality remains an issue in Bong County, Liberia, due to addressable contextual causes. Interventions to ameliorate these preventable deaths include ensuring availability of resources and transportation through improved supply chain and health system accountability. Recurring training should be provided to healthcare workers which involves husbands, families and communities. Innovative means for providers and facilities to communicate clearly and consistently should also be prioritised to prevent future maternal deaths in Bong County, Liberia.
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Affiliation(s)
- Haeun Lee
- Center for Global Health Equity, University of Michigan, Ann Arbor, Michigan, USA
| | - Joseph Perosky
- Obstetrics and Gynecology, Michigan State Universtiy, Lansing, Michigan, USA
| | - Madison Horton
- School of Nursing, Columbia University, New York, New York, USA
| | | | | | - Jody R Lori
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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Hui L. Quantitative evaluations of variations using the population mean as a baseline for bioinformatics interpretation. PeerJ 2023; 11:e14955. [PMID: 36860762 PMCID: PMC9969859 DOI: 10.7717/peerj.14955] [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: 11/17/2022] [Accepted: 02/03/2023] [Indexed: 03/03/2023] Open
Abstract
Objective The purpose of this study were to establish a model of quantitative evaluation that uses the population mean as a baseline of variations and describe variations derived from different types and systems using new concepts. Methods The observed datasets, including measurement data and relative data, were transformed to 0-1.0 using the population mean. Datasets derived from different types (same category of dataset, different categories of datasets, and datasets with the same baseline) were transformed using different methods. The 'middle compared index' (MCI) was used to describe the change in magnitude as follows: [a/(a+b)+(1-b)/(2-a-b)-1]1.7, where 'a' represents the number after the magnitude change and 'b' represents the number before the magnitude change. Actual data were used to observe the MCI's ability to evaluate variations quantitatively. Results When the value before the magnitude change was equal to that after the magnitude change, the MCI was equal to 0; when the value before the magnitude change was equal to 0 and that after the magnitude change was equal to 1, the MCI was equal to 1. This implies the MCI is valid. When the value before the magnitude change was 0 and that after the magnitude change was 0.5, or when the value before the magnitude change was 0.5 and that after the magnitude change was 1.0, each MCI was approximately equal to 0.5. The values derived from the absolute, ratio, and MCI methods were different, indicating that the MCI is an independent index. Conclusion The MCI perfectly performs as an evaluation model using the population mean as the baseline, and it may be more a reasonable index than the ratio or absolute methods. The MCI increases our understanding of quantitative variations in evaluation measures of association using new concepts.
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Izudi J, Kadengye DT. Effect of comprehensive knowledge of HIV on risky sexual behaviours associated with HIV transmission among adult Ugandans: a propensity score-matched analysis. BMJ Open 2022; 12:e064011. [PMID: 36523239 PMCID: PMC9748972 DOI: 10.1136/bmjopen-2022-064011] [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] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate the effect of comprehensive knowledge of HIV on extramarital sexual relationships and consistent condom use. DESIGN Quasi-experimental study. SETTING 20 880 households, Uganda. PARTICIPANTS Married/cohabiting men and women, aged 15-54 years. METHODS We applied propensity score-matched analysis and defined comprehensive knowledge of HIV as knowing that consistent use of condoms during sexual intercourse and having just one faithful partner without HIV reduces the chance of getting HIV, knowing that a healthy-looking person can have HIV and rejecting two local misconceptions (HIV can be transmitted by mosquito bites and by sharing food with a person who has HIV). The primary outcome was extramarital sexual relationship defined as involvement in a sexual relationship with a partner other than a spouse or cohabiting partner, within 12 months preceding the survey. The secondary outcome was consistent condom use, defined as using a condom at every sexual intercourse with any non-spouse/non-cohabiting partner over the past 12 months. RESULTS Among 18 504 participants matched in a 1:1 ratio, comprehensive knowledge of HIV showed no effect on extramarital sexual relationships (OR 1.03, 95% CI 0.96 to 1.11) but improved consistent condom use among married/cohabiting couples in extramarital sexual relationships (OR 1.18, 95% CI 1.02 to 1.37). Among married/cohabiting men, comprehensive knowledge of HIV had no effect on extramarital sexual relationships (OR 0.95, 95% CI 0.83 to 1.08) but improved consistent use of condoms in extramarital sexual relationships (OR 1.31, 95% CI 1.04 to 1.66). However, among married/cohabiting females, there was no effect on both outcomes. CONCLUSIONS Comprehensive knowledge of HIV has no effect on extramarital sexual relationships but increases consistent condom use among those in extramarital sexual relationships. There is a need to consistently provide correct HIV prevention messages among sexually active married/cohabiting couples in Uganda.
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Affiliation(s)
- Jonathan Izudi
- Data Science and Evaluation Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Damazo T Kadengye
- Data Science and Evaluation Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya
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Mattiello R, Ospina Ayala C, Freitas Pedron F, Ferreira ICS, Lessa Gaudie Ley L, Medeiros Paungartner L, da Silva Martins M, Bagatini MA, Onofre Witt Batista N, Oliveira Machado Cecagno P, Kvitko de Moura S, López Tórrez S, Munhoz TN, Santos IS. Prevalence of self-reported lifetime medical diagnosis of depression in Brazil: analysis of data from the 2019 Brazilian National Health Survey. BMJ Open 2022; 12:e063902. [PMID: 36576186 PMCID: PMC9723899 DOI: 10.1136/bmjopen-2022-063902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To assess the prevalence of and factors associated with the lifetime medical diagnosis of depression in Brazil. DESIGN Population-based, cross-sectional study. SETTING Analysis of data from the 2019 Brazilian National Health Survey. PARTICIPANTS 90 846 individuals aged ≥15 years were included. OUTCOME MEASURE The self-reported medical diagnosis of depression at some point in one's life was the main outcome. Prevalence ratios (PRs) with 95% CIs were calculated by Poisson regression with robust variance. The independent variables included the geographical area of residence, sociodemographic characteristics, current smoking status, alcohol abuse, daily screen time, and the presence of physical disorders and mental health comorbidities. RESULTS The self-reported lifetime prevalence of medical diagnosis of depression was 9.9% (95% CI 9.5% to 10.2%). The probability of having received a medical diagnosis of depression was higher among urban residents (PR 1.23; 95% CI 1.12 to 1.35); females (2.75; 2.52 to 2.99); those aged 20-29 years (1.17; 0.91 to 1.51), 30-39 years (1.73; 1.36 to 2.19), 40-49 years (2.30; 1.81 to 2.91), 50-59 years (2.32; 1.84 to 2.93) and 60-69 years (2.27; 1.78 to 2.90) compared with those under 20 years; white-skinned people (0.69 (0.61 to 0.78) for black-skinned people and 0.74 (0.69 to 0.80) for indigenous, yellow and brown-skinned people compared with white-skinned people); those with fewer years of education (1.33(1.12 to 1.58) among those with 9-11 years, 1.14 (0.96 to 1.34) among those with 1-8 years and 1.29 (1.11 to 1.50) among those with 0 years compared with those with ≥12 years of education); those who were separated/divorced (1.43; 1.29 to 1.59), widowed (1.06; 0.95 to 1.19) and single (1.01; 0.93 to 1.10) compared with married people; smokers (1.26; 1.14 to 1.38); heavy screen users (1.31; 1.16 to 1.48) compared with those whose usage was <6 hours/day; those with a medical diagnosis of a physical disorder (1.80; 1.67 to 1.97); and individuals with a medical diagnosis of a mental health comorbidity (5.05; 4.68 to 5.46). CONCLUSION This nationwide population-based study of self-reported lifetime medical diagnosis of depression in Brazil showed that the prevalence was almost 10%. Considering the current Brazilian population, this prevalence corresponds to more than 2 million people who have been diagnosed with depression at some point in their lives.
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Affiliation(s)
- Rita Mattiello
- Post-Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- School of Medicine, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Camila Ospina Ayala
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Flaviana Freitas Pedron
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Isabel Cristina Schutz Ferreira
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Laura Lessa Gaudie Ley
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Luciana Medeiros Paungartner
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Maiara da Silva Martins
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Maria Amélia Bagatini
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Naycka Onofre Witt Batista
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | | | - Sara Kvitko de Moura
- Postgraduate Program in Pediatrics and Child Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brasil
| | - Sergio López Tórrez
- School of Medicine, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tiago N Munhoz
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
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Baldewpersad Tewarie NMS, van Ham M, Wouters M, Kruitwagen R, van Driel W. Guideline adherence in ovarian cancer for surgical staging in the Netherlands. Int J Gynecol Cancer 2022; 32:1592-1598. [PMID: 36270772 DOI: 10.1136/ijgc-2022-003666] [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: 01/24/2023] Open
Abstract
OBJECTIVE Previous studies have shown low adherence to surgical staging guidelines in patients with clinical early-stage ovarian carcinoma. The aim of this study was to identify guideline adherence for surgical staging and to show the distribution of each surgical item within the study population. In addition, we examined whether regional variation in the Netherlands exists for complete surgical staging. METHODS Patients with ovarian cancer and surgical staging registered in the Dutch Gynecological Oncology Audit between January 1, 2015 and December 31, 2019 in the Netherlands were included. Complete surgical staging was defined according to the Dutch evidence-based guideline. Surgical items were ranked and illustrated. Variation in complete surgical staging for eight regional cancer networks was shown in funnel plots. Manual validation of registered data was performed in three gynecological oncology centers. RESULTS 604 patients underwent surgical staging, 365 (60%) underwent an incomplete staging procedure, 295 (81%) were registered with early-stage disease (International Federation of Gynecology and Obstetrics I-IIA) and, of these patients, 115 (39%) received adjuvant chemotherapy. Patients with incomplete surgical staging were operated more often with minimal invasive techniques (laparoscopy or robot) compared with patients in the complete staging group (p<0.001). Sampling of cytology/ascites was the most frequently lacking factor (29%). Manual validation of data in three gynecological oncology centers identified reasons for incomplete staging, the most common being 'perioperative findings' such as dense adhesions between tumor and peritoneum, consistent with advanced stage disease (≥IIA). Regional variation for complete surgical staging showed two regions performing outside the confidence intervals (12.5% and 25.5%, mean 40%). CONCLUSION Guideline adherence for staging was lower than expected and validation of data gave additional insights into the reasons that were contributing to incomplete surgical staging. Moreover, this analysis showed that regional variation for surgical staging exists, which forms a starting point to improve and harmonize staging procedures for these patients nationwide.
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Affiliation(s)
- Nishita M S Baldewpersad Tewarie
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands .,Dutch Institute for Clinical Auditing (DICA), Scientific Bureau, Leiden, The Netherlands
| | - Maaike van Ham
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michel Wouters
- Dutch Institute for Clinical Auditing (DICA), Scientific Bureau, Leiden, The Netherlands.,Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Roy Kruitwagen
- Department of Obstetrics and Gynecology, and GROW- School for Oncology and Reproduction, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Willemien van Driel
- Department of Gynecology, Amsterdam, Center of Gynecological Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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21
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Mekonnen AG, Gebeyehu BT, Woldearegay M. Experience of patients with breast cancer with traditional treatment and healers' understanding of causes and manifestations of breast cancer in North Shewa zone, Ethiopia: a phenomenological study. BMJ Open 2022; 12:e063726. [PMID: 36456000 PMCID: PMC9716934 DOI: 10.1136/bmjopen-2022-063726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Despite a high number of traditional healers (THs) who treat patients with cancer in Ethiopia, there is limited evidence that explored the lived experience of patients with breast cancer (BC) with traditional treatment and healers' understanding of the causes and manifestations of BC. DESIGN A phenomenological study design was employed. SETTING This study was conducted in the North Shewa zone in Ethiopia. PARTICIPANTS Eight in-depth interviews were conducted; four of which were with patients with BC and four with THs. Semistructured interviewing techniques were used to collect data from the two groups of respondents. All interviews were audio-recorded. The recorded data were transcribed verbatim. Coding and marking were then performed to make the raw data sortable. The marked codes were then summarised and categorised into themes. RESULTS In this study, some of THs were unaware of the main risk factors or causes of BC. They did not mention the lifestyle risk factors of BC such as smoking cigarettes, consuming alcohol and eating habits. The most common clinical manifestations noted by THs were lumps at the breast, discharge from the nipples and weakness. All of the THs got their knowledge of BC treatment from their families and through experience. Regarding the lived experience of treatment, some patients with BC perceived that traditional medicines were safer and more effective than modern treatments and they eventually referred themselves to the THs. CONCLUSIONS Although THs were unaware of the causes of BC, they were familiar with basic signs and symptoms of the disease. Patients with BC referred themselves to the THs because they preferred traditional therapies to modern ones. In order to better satisfy the unmet needs of Ethiopian women with BC, due consideration should be given to traditional treatments.
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Affiliation(s)
- Alemayehu Gonie Mekonnen
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Belete Tewabe Gebeyehu
- Department of Chemistry, College of Natural and Computational Sciences, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
| | - Mesfin Woldearegay
- Department of Biology, College of Natural and Computational Science, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
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22
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Sinha A, Puri P, Pati S. Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study. BMJ Open 2022; 12:e061154. [PMID: 36424108 PMCID: PMC9693658 DOI: 10.1136/bmjopen-2022-061154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES India, a major contributor to the global diabetes burden, is witnessing a simultaneous epidemic of obesity leading to rise in diabesity. Diabesity, the coexistence of diabetes and obesity in an individual, has emerged as a risk factor for other morbidities and hence, multimorbidity. Although diabesity has long been recognised, still, there is a poor understanding of its social determinants in India, necessary for its control. We aimed to estimate and compare the prevalence and identify social determinants of obesity, diabetes and diabesity; explore their association with other selected non-communicable diseases (NCDs) multimorbidity; and assess its outcomes among adults aged ≥45 years. DESIGN AND SETTING We undertook an observational analyses employing nationally representative data from Longitudinal Ageing Study in India, 2017-2018. PARTICIPANTS This study was conducted among n=59 073 respondents. OUTCOME MEASURES Descriptive analysis was conducted among n=59 073 respondents to determine prevalence of diabetes, obesity and diabesity. The social determinants were assessed using multinomial regression, reported as adjusted relative risk ratio (RRR). A multiple correspondence analysis generated life satisfaction. RESULTS The prevalence of obesity, diabetes, and diabesity was 21.2%, 6%, and 5.8%, respectively. We identified women (RRR: 2.16 (1.72 to 2.71)), urban residents (RRR: 3.73 (3.07 to 4.54)) and affluent groups (RRR: 3.60 (2.46 to 4.58)) had a higher likelihood of having diabesity. The association with various NCDs showed multimorbidity to be akin to the diabesity group. We observed inferior life satisfaction and significantly higher healthcare utilisation among participants with diabesity as compared with other two groups. CONCLUSION Increased obesity prevalence has led to the rise in diabesity in India. Additionally, the level of multimorbidity in this group cannot be overlooked. Rather than focusing on individual conditions, an in toto approach to multimorbidity is warranted.
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Affiliation(s)
- Abhinav Sinha
- ICMR-Regional Medical Research Centre Bhubaneswar, Bhubaneswar, Odisha, India
| | - Parul Puri
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre Bhubaneswar, Bhubaneswar, Odisha, India
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Tesfaw K, Kindie W, Mulatu K, Bogale EK. Utilisation of cervical cancer screening and factors associated with screening utilisation among women aged 30-49 years in Mertule Mariam Town, East Gojjam Zone, Ethiopia, in 2021: a cross-sectional survey. BMJ Open 2022; 12:e067229. [PMID: 36414295 PMCID: PMC9685227 DOI: 10.1136/bmjopen-2022-067229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the practice of cervical cancer screening and its associated factors among women aged 30-49 years. DESIGN Community-based cross-sectional survey. SETTING Mertule Mariam Town, Northwest Ethiopia, 1 May-20 June 2021. PARTICIPANTS Women aged 30-49 years who were living in the study area were eligible for inclusion. A systematic random sampling technique was used to select study participants. A total of 488 respondents participated in the study. Data were collected by using interviewer-administered structured questionnaires. Data were entered into EpiData V.3.1 and then exported to SPSS V.25 for analysis. Bivariable and multivariable logistic regression analyses were done. OUTCOME MEASURES Prevalence of cervical cancer screening and factors associated with screening utilisation. RESULTS The prevalence of cervical cancer screening was found to be 14.1%. Age (≤16 years) at first sexual intercourse (adjusted OR 14.89, 95% CI 6.21 to 35.74), history of sexually transmitted disease (11.65, 4.56 to 29.78), having multiple sexual partners (11.65, 4.56 to 29.78), having good knowledge about cervical cancer screening (4.72, 2.33 to 9.56) and having a family history of cervical cancer (4.72, 2.33 to 9.56) were statistically significantly associated factors for utilisation of cervical cancer screening. CONCLUSION Utilisation of cervical cancer screening was low in Northwest Ethiopia. Educational status, age at first sexual intercourse, history of multiple sexual partners, sexually transmitted disease, family history of cervical cancer and knowledge about cervical cancer screening were significant factors for utilisation of cervical cancer screening.
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Affiliation(s)
- Kinfemichael Tesfaw
- Integrated Emergency Surgery and Obstetrics, Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia
| | - Walelign Kindie
- Department of Integrated Emergency Surgery and Obstetrics, Bahir Dar University, College of Medicine and Health Sciences, Bahir Dar, Ethiopia
| | - Kebadnew Mulatu
- Department of Epidemiology and Biostatistics, Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Bahir Dar, Ethiopia
| | - Eyob Ketema Bogale
- Halth Promotion and Behavioral Sciences Department, Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Bahir Dar, Amhara, Ethiopia
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Tesfay H, Fiseha K, Abera S, Mihreteab Siele S, Tesfamariam EH, Abdu N. Self-medication with ophthalmic drugs and its associated factors among ophthalmic patients attending three hospitals in Asmara, Eritrea: a cross-sectional study. BMJ Open 2022; 12:e063147. [PMID: 36414303 PMCID: PMC9685241 DOI: 10.1136/bmjopen-2022-063147] [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] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the prevalence and practice of self-medication and its associated factors among ophthalmic patients. DESIGN An analytical cross-sectional study design was employed. SETTING Three hospitals inAsmara, Eritrea. PARTICIPANTS Samples of ophthalmic outpatients aged >18 years who visited the three hospitals in Asmara, Eritrea. Systematic random sampling was used to select the study participants. DATA COLLECTION AND ANALYSIS Data were collected from September 2021 to October 2021 in a face-to-face interview using a structured questionnaire. The collected data were double entered and analysed using CSPro (V.7.2) and SPSS (V.26), respectively. Descriptive statistics and logistic regression were performed. P values less than 0.05 were considered as significant. PRIMARY AND SECONDARY OUTCOME MEASURES Main outcome variable was practice of self-medication with ophthalmic drugs (SMOD). Secondary outcome measure was the determinants of self-medication practice. RESULTS A total of 351 participants were recruited with a response rate of 97.7%. The prevalence of SMOD was found to be 14.9% (95% CI (11.1% to 18.7%)). The most frequently preferred ophthalmic drug groups were antibiotics (63.6%), followed by corticosteroids (22.7%). The main reasons for SMOD were easy accessibility (52.9%) and previous familiarity of the eye medication (27.5%). Eye redness (n=19/51) and foreign body sensation (n=18/51) were the most self-recognised complaints that required self-medication. The most common source of information for SMOD was pharmacy professionals (41.1%). Only attitude score (Crude odds ratio (COR)= 1.25, 95% CI 1.12, 1.39) was significantly associated with the practice of SMOD at bivariate logistic regression. CONCLUSION Though the majority of respondents considered self-medication with ophthalmic drugs as inappropriate, a significant number of them practising it. This mandates relevant bodies to take stricter measures to protect the public from the misuse of eye medications.
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Affiliation(s)
- Hayleab Tesfay
- Department of Medical Sciences, Pharmacy Unit, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Kibrom Fiseha
- Department of Medical Sciences, Pharmacy Unit, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Simon Abera
- Department of Medical Sciences, Pharmacy Unit, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Senai Mihreteab Siele
- Department of Medical Sciences, Pharmacy Unit, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Eyasu H Tesfamariam
- Biostatistics and Epidemiology, Department of Statistics, College of Sciences, Mai-Nefhi, Eritrea
| | - Nuru Abdu
- Pharmacy, Adi-Tekelezan Community Hospital, Adi-Tekelezan, Eritrea
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25
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Campeau A, Tanaka M, McTavish JR, MacMillan H, McKee C, Hovdestad WE, Gonzalez A, Afifi TO, Stewart-Tufescu A, Tonmyr L. Asking youth and adults about child maltreatment: a review of government surveys. BMJ Open 2022; 12:e063905. [PMID: 36410827 PMCID: PMC9680163 DOI: 10.1136/bmjopen-2022-063905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES In this review we: (1) identify and describe nationally representative surveys with child maltreatment (CM) questions conducted by governments in low-income, middle-income and high-income countries and (2) describe procedures implemented to address respondents' safety and minimise potential distress. DESIGN We conducted a systematic search across eight databases from 1 January 2000 to 5 July 2021 to identify original studies with information about relevant surveys. Additional information about surveys was obtained through survey methods studies, survey reports, survey websites or by identifying full questionnaires (when available). RESULTS Forty-six studies representing 139 surveys (98 youth and 41 adult) conducted by governments from 105 countries were identified. Surveys implemented a variety of procedures to maximise the safety and/or reduce distress for respondents including providing the option to withdraw from the survey and/or securing confidentiality and privacy for the respondent. In many surveys, further steps were taken such as providing information for support services, providing sensitivity training to survey administrators when interviews were conducted, among others. A minority of surveys took additional steps to empirically assess potential distress experienced by respondents. CONCLUSIONS Assessing risk and protective factors and developing effective interventions and policies are essential to reduce the burden of violence against children. While asking about experiences of CM requires careful consideration, procedures to maximise the safety and minimise potential distress to respondents have been successfully implemented globally, although practices differ across surveys. Further analysis is required to assist governments to implement the best possible safety protocols to protect respondents in future surveys.
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Affiliation(s)
- Aimée Campeau
- Health Promotion and Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Masako Tanaka
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Jill R McTavish
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Harriet MacMillan
- Departments of Psychiatry and Behavioural Neurosciences, and Pediatrics, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Chris McKee
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Wendy E Hovdestad
- Health Promotion and Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Tracie O Afifi
- Departments of Community Health Sciences, and Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Lil Tonmyr
- Health Promotion and Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
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26
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Bol KN, Negera E, Gedefa AG. Pregnancy among adolescent girls in humanitarian settings: a case in refugee camp of Gambella regional state, community-based cross-sectional study, Southwest Ethiopia, 2021. BMJ Open 2022; 12:e064732. [PMID: 36396321 PMCID: PMC9677029 DOI: 10.1136/bmjopen-2022-064732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the prevalence of pregnancy and associated factors among adolescent girls in Nguenyyiel Refugee Camp. DESIGN Cross-sectional study was employed to conduct this study. SETTING A community-based cross-sectional study was done in Nguenyyiel Refugee Camp. PARTICIPANTS Four hundred and fourteen adolescent girls participated in this study. The systematic random sampling technique was used to select respondents. Data were collected using a well-structured and pretested questionnaire. Pregnancy test was done using the human chorionic gonadotropin test. Bivariate and multivariate logistic regression analysis was run to identify factors associated with adolescent pregnancy. RESULTS The prevalence of pregnancy among adolescent girls in the Nguenyyiel Refugee Camp was 21.7% (95% CI: 17.6% to 25.6%). Factors associated with adolescent pregnancy were age (17-19 years) (AOR): 2.79; 95% CI: 1.55 to 5.05; educational status: primary education (AOR: 7.69; 95% CI: 3.55 to 16.68) and no formal education (AOR: 3.42; 95% CI: 1.59 to 7.36); and household living arrangement: living with none of the biological parents (AOR: 2.14; 95% CI: 1.02 to 4.49) and living with either of the biological parent (AOR: 3.71; 95% CI: 1.76 to 7.81). CONCLUSIONS AND RECOMMENDATIONS This study showed that there is a high prevalence of pregnancy among adolescent girls in the study setting. Age (17-19 years), educational status and household living arrangement (living with none of the biological parents and living with either of the biological parents) were among the factors significantly associated with adolescent pregnancy. Hence, health workers and other stakeholders in the camps should focus on strengthening adolescent sexual health education giving special attention to late adolescents, uneducated and living without biological family.
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Affiliation(s)
- Koang Nyak Bol
- Universal Health Coverage, Communicable, and Non-communicable Diseases (UCN) Cluster, Neglected Tropical Diseases (NTDs) Program, WHO, Gambella, Ethiopia
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27
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Zeinolabedini M, Heidarnia A, Shakerinejad G, Motlagh ME. Perceived job demands: a qualitative study of workplace stress in the Iranian healthcare workers (HCWs). BMJ Open 2022; 12:e061925. [PMID: 36385035 PMCID: PMC9670948 DOI: 10.1136/bmjopen-2022-061925] [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] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Work-related stress is a common risk factor among healthcare workers (HCWs). In Iran, the healthcare system has undergone extensive changes to develop services. Organisational change has led to the creation of new working conditions for HCWs. The purpose of this study is to identify job demands that health workers perceive as stressors. DESIGN As a qualitative study, semistructured interviews, a focus group, and related data were analysed both inductively and deductively with reference to the job demand component based on the job demands-resources model and MAXQDA. SETTING This investigation was conducted in 18 primary healthcare centres in Qazvin, Iran. PARTICIPANT Twenty-one female HCWs with at least 6 months of work experience and an average age of 34.4 years. RESULTS The participants identified six key elements as the stressful job demands including organisation's supervisory function, role characteristics, workload, job insecurity, client service challenges and perceived job content. CONCLUSIONS After organisational changes and development, HCWs were faced with role changes and increased workload. In addition, organisational supervision in terms of quantity and quality and lack of job security intensified the pressures. These factors led to the high level of stress among employees who dealt with people and those who perceived their job content as unfavourable. Perhaps teaching stress control skills and organisational support interventions can be useful to reduce and control stress among HCWs.
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Affiliation(s)
- Masoume Zeinolabedini
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran (the Islamic Republic of)
| | - Alireza Heidarnia
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran (the Islamic Republic of)
| | - Ghodratollah Shakerinejad
- Health Education Research Department, Academic Center for Education, Culture and Research (ACECR)-Khuzestan, Ahvaz, Iran (the Islamic Republic of)
| | - Mohammad Esmaeil Motlagh
- Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (the Islamic Republic of)
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Melkam M, Nenko G, Demilew D. Common mental disorders and associated factors among high school students in Debre Markos Town, Northwest Ethiopia: an institutional-based cross-sectional study. BMJ Open 2022; 12:e059894. [PMID: 36332965 PMCID: PMC9639070 DOI: 10.1136/bmjopen-2021-059894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Common mental disorders include anxiety, depression and somatic symptoms. These pose significant public health problems because of their serious effects on personal well-being, social and occupational functions. They also can affect the health and quality of life of people in adolescence, because this age group has been vulnerable to different factors. According to the American Psychiatry Association, more than 60% of adolescents fulfil the criteria for at least one common mental disorder. Despite the high burden of the disorders, there are limited studies in Ethiopia; therefore, this study provided the prevalence of common mental disorders among students in Ethiopia. METHODS From 5 May to 30 May 2021, an institutional-based cross-sectional study was undertaken. Simple random sampling was used to select study participants from each class level across all high schools. A self-administered survey was used that included Self-Reporting Questionnaire 20, Oslo Social Support Scale-3 and other semistructured instruments for the screening of common mental disorders. Data were checked, coded and entered into Epi-Data V.4.6.0, then exported to SPSS V.20 for analysis. Bivariable and multivariable logistic regression analyses were done to identify factors associated with common mental disorders. Adjusted ORs with 95% CIs were calculated and variables with a p value of <0.05 were considered as significantly associated with common mental disorders. RESULTS A total of 600 high school students were recruited with a response rate of 93.2%. The overall prevalence of common mental disorders among the participants was 181 (32.4%). Being female (adjusted OR (AOR)=1.93; 95% CI: 1.27 to 2.99), a family history of mental illness (AOR=2.23; 95% CI: 1.15 to 4.35), poor social support (AOR=3.14; 95% CI: 1.51 to 6.54), a history of non-physical sexual abuse (AOR=2.09; 95% CI: 1.21 to 3.62) and a history of physical sexual abuse (AOR=2.43; 95% CI: 1.29 to 4.59) were significantly associated with common mental disorders. CONCLUSION AND RECOMMENDATION The prevalence of common mental disorders was 32.4% among students; therefore, it is recommended facilitating institutional-based intervention services in the school to decrease the contributing factors for the common mental disorders.
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Affiliation(s)
- Mamaru Melkam
- Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Addis Ababa, Ethiopia
| | - Goshu Nenko
- Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Addis Ababa, Ethiopia
| | - Demeke Demilew
- Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Addis Ababa, Ethiopia
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Khalfan MA, Sasi P, Mugusi S. Factors influencing receipt of an antibiotic prescription among insured patients in Tanzania: a cross-sectional study. BMJ Open 2022; 12:e062147. [PMID: 36332955 PMCID: PMC9639089 DOI: 10.1136/bmjopen-2022-062147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES There are limited data on factors influencing antibiotic prescription among insured patients. We assessed for correlates of an antibiotic prescription among insured patients. DESIGN A cross-sectional study. SETTING The study was conducted at the National Health Insurance Fund offices, Dar es Salaam, Tanzania. DATA SOURCE We captured data from the claim forms, containing inpatient and outpatient treatment information for insured patients, for the month of September 2019. OUTCOME VARIABLE Receipt of an antibiotic prescription. EXPOSURE VARIABLES Age, sex, diagnosis, prescriber qualification, health facility level, ownership and department were exposure variables. Predictors of receipt of an antibiotic prescription were determined by Poisson regression analysis. RESULTS Of 993 analysed patients, the mean (±SD) age was 36.3 (±23.2) years, 581 (58.5%) were females and 535 (53.9%) were adults. The prevalence of antibiotic prescription was 46.4% (95% CI 42.8% to 50.0%). Strong predictors of an antibiotic prescription were being a child (1.7, 95% CI 1.3 to 2.2); acute upper respiratory tract infection (URTI) of multiple and unspecified sites (1.6, 95% CI 1.3 to 1.4); chronic rhinitis, nasopharyngitis and pharyngitis (4.0, 95% CI 2.4 to 6.4); being attended by a clinical officer (1.9, 95% CI 1.2 to 3.0); attending a health centre (1.5, 95% CI 1.1 to 2.0); attending a public facility (1.2, 95% CI 1.0 to 1.4) and visiting an inpatient department (2.0, 95% CI 1.2 to 3.4). CONCLUSIONS Among insured patients, being a child, acute URTI, being attended by a clinical officer or dental therapist, being attended by an assistant medical/dental officer, attending a health centre or a district hospital, attending a public health facility and visiting an inpatient department predicted an antibiotic prescription. Incorporation of these findings in revisions or establishment of targeted antimicrobial stewardship programmes may lead to better antibiotic prescribing practices that are critical for combating antibiotic resistance.
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Affiliation(s)
- Mohamed Ally Khalfan
- Department of Clinical Pharmacology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Philip Sasi
- Department of Clinical Pharmacology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Sabina Mugusi
- Department of Clinical Pharmacology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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Abstract
BACKGROUND It is unclear which psychological factors (stressors, emotional correlates, and psychophysiological markers) induce cancer risk. This currently limits the potential for prevention strategies. PURPOSE The aim of this review is to bring forth evidence of stress as a determinant of cancer risk from a public health perspective, written for a broad public of practitioners and scientists. METHODS Based on a semisystematic literature search, the impact of different aspects/types of stress and the potential physiological and behavioral pathways are summarized, while highlighting further research, public health and clinical implications. RESULTS Between 2007 and 2020, 65 case-control or cohort studies have been identified. Apart from overall cancer ( N = 24), 12 cancer types have been associated with psychological stress with most for breast ( N = 21), colorectal ( N = 11) and lung/prostate/pancreas cancer ( N = 8 each). Although the evidence regarding the mechanisms is still scarce, cancer development in relation to stress might be due to interacting and combined effects of different stress(or) types, but such interaction has not really been tested yet. The path from stress towards cancer incidence consists of a biological pathway with endocrinology and immunology as well as stress-induced behavioral pathways, including smoking, alcoholism, sleep disruption, an unhealthy diet, and low physical activity together with the related phenomenon of obesity. CONCLUSION Not only the stress but also the stress-induced lifestyle should be targeted for cancer prevention and treatment. Future research should include a more diverse spectrum of cancer types (not only hormonal related like breast cancer) and of stress measures while also considering behavioral covariates.
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Affiliation(s)
- Ananyaa Mohan
- Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Section, Lyon, France and Departments of
| | - Nathalie Michels
- Public Health and Primary Care
- Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Gallegos-Arreola MP, Ramírez-Patiño R, Sánchez-López JY, Zúñiga-González GM, Figuera LE, Delgado-Saucedo JI, Gómez-Meda BC, Rosales-Reynoso MA, Puebla-Pérez AM, Lemus-Varela ML, Garibaldi-Ríos AF, Marín-Domínguez NA, Pacheco-Verduzco DP, Mohamed-Flores EA. SOD2 Gene Variants (rs4880 and rs5746136) and Their Association with Breast Cancer Risk. Curr Issues Mol Biol 2022; 44:5221-5233. [PMID: 36354667 PMCID: PMC9688594 DOI: 10.3390/cimb44110355] [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: 09/26/2022] [Revised: 10/12/2022] [Accepted: 10/22/2022] [Indexed: 11/16/2022] Open
Abstract
The superoxide dismutase (SOD) is the principal antioxidant defense system in the body that is activated by a reactive oxygen species. Some variants of the SOD2 gene have been associated with cancer. The rs4880 variant was determined by PCR real-time and the rs5746136 variant by PCR-RFLP in healthy subjects and in breast cancer (BC) patients. The rs4880 and rs5746136 variants were associated with BC susceptibility when BC patients and the control group were compared for the CT, TT, CTCC, and the T alleles (p < 0.05). The CT genotype of the rs4880 variant showed significant statistical differences in patients and controls aged ≤ 45 years old, and with hormonal consumption (p < 0.05). The rs4880 variant was associated with BC patients with CTTT genotype and obesity, the presence of DM2-SAH, and a non-chemotherapy response (p < 0.05). Additionally, the rs5746136 variant was associated with susceptibility to BC with Ki-67 (≥20%), luminal A type BC, and a chemotherapy partial response (p < 0.05) in BC patients who carry TT, TC, and CTTT genotypes, respectively. The haplotype T/T (OR 1.98; 95% CI 1.20−3.26, p = 0.005) was observed to be a risk factor for BC. The rs4880 and rs5746136 variants in the SOD2 gene were associated with BC susceptibility.
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Affiliation(s)
- Martha P. Gallegos-Arreola
- División de Genética, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social (IMSS), 44340 Guadalajara, Mexico
- Correspondence: ; Tel.: +52-33-36170060 (ext. 31936)
| | - Ramiro Ramírez-Patiño
- Departamento de Medicina y Ciencias de la Vida, Centro Universitario la Ciénega, Universidad de Guadalajara, 47810 Ocotlán, Mexico
| | - Josefina Y. Sánchez-López
- División de Genética, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social (IMSS), 44340 Guadalajara, Mexico
| | | | - Luis E. Figuera
- División de Genética, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social (IMSS), 44340 Guadalajara, Mexico
| | - Jorge I. Delgado-Saucedo
- Laboratorio de Inmunofarmacología, Departamento de Farmacología, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, 44100 Guadalajara, Mexico
| | - Belinda C. Gómez-Meda
- Departamento de Biología Molecular y Genómica, Instituto de Genética Humana “Dr. Enrique Corona Rivera”, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, 44100 Guadalajara, Mexico
| | | | - Ana M. Puebla-Pérez
- Laboratorio de Inmunofarmacología, Departamento de Farmacología, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, 44100 Guadalajara, Mexico
| | - María L. Lemus-Varela
- Departamento de Neonatología, Hospital de Pediatría, UMAE, CMNO, IMSS, 44340 Guadalajara, Mexico
| | | | - Nayely A. Marín-Domínguez
- División de Genética, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social (IMSS), 44340 Guadalajara, Mexico
| | - Diana P. Pacheco-Verduzco
- División de Genética, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social (IMSS), 44340 Guadalajara, Mexico
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Atlaw D, Sahiledengle B, Assefa T, Negash W, Tahir A, Regasa T, Tekalegn Y, Mamo A, Enegeda ZT, Solomon D, Gezahegn H, Bekele K, Zenbaba D, Desta F, Tasew A, Nugusu F, Beressa G, Shiferaw Z, Feleke Z, Regassa Z, Duguma N, Chattu VK. Incidence and risk factors of gestational diabetes mellitus in Goba town, Southeast Ethiopia: a prospective cohort study. BMJ Open 2022; 12:e060694. [PMID: 36167396 PMCID: PMC9516079 DOI: 10.1136/bmjopen-2021-060694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) is becoming a public health concern in low/middle-income countries, and is known to cause severe morbidity and mortality for mothers and newborns. However, evidence reported for the incidence and risk factors of GDM is scant in Ethiopia. We aimed to assess the incidence of, and risk factors for, GDM in Goba town, Southeast Ethiopia. DESIGN Prospective cohort study. SETTING Goba town, Southeast Ethiopia. PARTICIPANTS Four hundred eighty pregnant women on antenatal care follow-up from 30 April to 30 September 2021. PRIMARY AND SECONDARY OUTCOMES Incidence and risk factors of GDM using fasting capillary blood glucose. Log-binomial model was used to identify the risk factors of GDM. Adjusted relative risk (aRR), along with 95% CIs, were calculated to estimate the strength of associations. RESULTS The cumulative incidence rate of GDM in this study was 15.7% (95% CI: 12.3% to 19.2%). Being unemployed (aRR=2.73; 95% CI: 1.36 to 5.47), having a family history of diabetes mellitus (DM) (3.01; 2.09 to 4.35), low physical activity (2.43; 1.11 to 5.32), inadequate dietary diversity (1.48; 1.29 to 1.92), anaemia (2.51; 1.32 to 3.54) and antenatal depression (4.95; 3.35 to 7.31) were significantly associated with GDM. CONCLUSION The cumulative incidence of GDM was relatively high among the study participants. Having antenatal depression symptoms, low physical activity, inadequate dietary diversity, being unemployed, anaemia and a family history of DM were significant risk factors for GDM.
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Affiliation(s)
- Daniel Atlaw
- School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Biniyam Sahiledengle
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Tesfaye Assefa
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Wogene Negash
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Anwar Tahir
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Tadele Regasa
- School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Yohannes Tekalegn
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Ayele Mamo
- School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Zinash Teferu Enegeda
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Damtew Solomon
- School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Habtamu Gezahegn
- School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Kebebe Bekele
- School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Demisu Zenbaba
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Fikreab Desta
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Alelign Tasew
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Fikadu Nugusu
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Girma Beressa
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
- Public Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Zerihun Shiferaw
- School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Zegeye Feleke
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Zegeye Regassa
- School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Negesso Duguma
- School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Oromia, Ethiopia
| | - Vijay Kumar Chattu
- Center for Transdisciplinary Research, Saveetha Medical College and Hospitals, SIMATS, Saveetha University, Chennai 600077, India
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha 442107, India
- Department of OS& OT, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G1V7, Canada
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Zenbaba D, Yassin A, Abdulkadir A, Mama M. Geographical variation and correlates of substance use among married men in Ethiopia: spatial and multilevel analysis from Ethiopian Demographic and Health Survey 2016. BMJ Open 2022; 12:e062060. [PMID: 36153037 PMCID: PMC9511580 DOI: 10.1136/bmjopen-2022-062060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The use of substances has become one of the world's most serious public health and socioeconomic issues. Most nations in sub-Saharan Africa, including Ethiopia, are undergoing significant economic transitions, creating a favourable environment for socially destructive substance use. This study aimed to determine the geographical variation, prevalence and correlates of substance use among ever-married men in Ethiopia. DESIGN A community-based cross-sectional survey was undertaken from 18 January 2016 to 27 June 2016. DATA SOURCE Data were used from the 2016 Ethiopian Demographic and Health Survey (EDHS). DATA EXTRACTION AND ANALYSIS Data from the 2016 EDHS was used, and a total of 7793 ever-married men were involved in the analysis. The spatial autocorrelation statistic (Global Moran's I) was used to determine whether substance use was dispersed, clustered or randomly distributed. A multilevel logistic regression model was used to identify the correlates with substance use, and statistical significance was declared at p<0.05 and 95% CI. RESULTS Of all ever-married men, 72.5% (95% CI 71.5% to 73.4%) were currently using at least one of the three substances (alcohol, cigarettes and chat). The highest hotspot areas of substance use were observed in Ahmara and Tigray regions. The age (adjusted OR, AOR 1.80; 95% CI 1.32 to 2.45), educational status (AOR 0.64; 95% CI 0.51 to 0.82), occupation (AOR 1.36; 95% CI 1.05 to 1.76), watching television (AOR 1.50; 95% CI 1.25 to 1.81) and living in the city (AOR 2.25; 95% CI to 1.36 to 3.74) were individual and community-level correlates found to have a statistically significant association with substance use. CONCLUSION In this study, nearly three-fourths of married men used one of the three substances. Given these findings, it is critical to reducing the problem by improving modifiable individual-level variables such as educational status and reducing substance advertising.
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Affiliation(s)
- Demisu Zenbaba
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
| | - Ahmed Yassin
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
| | - Adem Abdulkadir
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
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Ryom K, Hargaard AS, Melby PS, Maindal HT, Bentsen P, Ntoumanis N, Schoeppe S, Nielsen G, Elsborg P. Self-reported measurements of physical literacy in adults: a scoping review. BMJ Open 2022; 12:e058351. [PMID: 36123090 PMCID: PMC9486222 DOI: 10.1136/bmjopen-2021-058351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
UNLABELLED Physical literacy (PL) is a comprehensive concept covering motivation, confidence, physical competence, knowledge and understanding of individuals' physical activity throughout life. PL has three overlapping domains, such as: an affective, a physical and a cognitive domain. So far, PL has not been measured in the adults and no complete measurement has been developed to date. OBJECTIVES The aim of this scoping review was to review existing self-reported instruments measuring different elements of domains of PL. METHOD We reviewed Education Research Complete, Cochrane, Medline, ScienceDirect, Scopus and SPORTDiscus. The reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Studies were coded using a thematic framework, which was based on the three domains of PL. The eligibility criteria were as follows: (1) age groups between 18 and 60 years; (2) meta-analyses, reviews or quantitative studies focusing on the measurement of at least one of the three domains of PL and (3) instrument that was self-reported. We finalised search on 1 August 2021 RESULTS: In total, 67 articles were identified as studies describing instruments reflecting the three domains of PL. Following full-text reading, 21 articles that met our inclusion criteria were included. Several instruments of relevance to PL are available for assessing motivation, confidence and the physical domain. However, few instruments exist that measure elements of the cognitive domain. CONCLUSION This review showed that a range of existing and validated instruments exists, covering two out of the three domains of PL, namely affective and physical domains. However, for the knowledge domain no valid measurement tools could be found. This scoping review has identified gaps in the research (namely the cognitive domain) and also a gap in the research as no measures that consider the inter-relatedness of the three domains (holistic nature of the concept).
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Affiliation(s)
- Knud Ryom
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | | | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Peter Bentsen
- Center for Clinical Research and Prevention, Bispebjerg Research Unit, Kobenhavn, Denmark
| | - Nikos Ntoumanis
- Department of Sports Science and Clinical Biomechanics, Danish Centre for Motivation and Behavior Science, University of Southern Denmark, Odense, Denmark
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | - Glen Nielsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Kobenhavns, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Kobenhavn, Denmark
| | - Peter Elsborg
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Center for Clinical Research and Prevention, Bispebjerg Research Unit, Kobenhavn, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Kobenhavn, Denmark
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Miles A, Tanenbaum B, Thompson-Ricci S. Transforming injury prevention for youth (TrIPY): an intersectionality model for youth injury prevention. Inj Prev 2022; 28:564-569. [DOI: 10.1136/ip-2022-044619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/04/2022] [Indexed: 11/05/2022]
Abstract
Injury is deadly and expensive, and rates are increasing. The cost of injury is not only a financial burden; individuals, families and communities suffer the human costs of physical and emotional injury. For children and youth in Canada, injuries are the leading cause of death and disability. However, the risk of preventable injury is not equal for all youth. The transforming injury prevention for youth (TrIPY) model aims to recognise and remediate these inequities by applying an intersectionality lens to injury prevention programming. TrIPY conceptualises injury prevention programming through an intersectionality lens. The model was developed with diverse youth in mind, and the intended users include injury prevention practitioners, partners, stakeholders, communities and decision-makers. TrIPY was designed using a transformative perspective and built on core concepts within public health, injury prevention, intersectionality, gender analysis, youth risk, health equity, and systems of privilege and oppression. TrIPY helps to analyse intersecting inequities along multiple dimensions, to improve injury prevention programmes for diverse youth with unique identities, skills and lived experiences. The end goal of implementing an intersectionality model within injury prevention is to find out who is being missed in order to address existing inequities concerning youth injury. No matter what a person’s unique social location or lived experience, they will have the opportunity to be included in prevention programming. Developing injury prevention programmes through an intersectionality lens is needed to better understand the factors that interact to influence an individual’s risk for injury. There is a need to explore the unique experiences of youth at the intersection of various identity factors, including gender, race and ethnicity, and socioeconomic status. With this knowledge, prevention programmes can be more culturally responsive, gender transformative, inclusive, accessible and engaging for diverse groups of youth.
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Okurame JC, Cannon L, Carter E, Thomas S, Elliott EJ, Rice LJ. Fetal alcohol spectrum disorder resources for health professionals: a scoping review protocol. BMJ Open 2022; 12:e065327. [PMID: 36100303 PMCID: PMC9472138 DOI: 10.1136/bmjopen-2022-065327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION People with fetal alcohol spectrum disorder (FASD) encounter a range of health and allied health providers and require specialised support to ensure health services are provided safely and effectively. Not all health professionals possess the knowledge or expertise required for the identification, assessment, referral and management of FASD. Accessible resources for understanding and managing FASD can help create awareness in health professionals and ensure patients receive the correct diagnosis and timely access to the necessary supports and services. The aim of this scoping review is to identify and analyse FASD resources for health professionals. METHODS AND ANALYSIS A comprehensive search of eight databases (MEDLINE, Scopus, PsycINFO, CINAHL, PubMED, EMBASE, Web of Science and Trip Medical Database) and nine grey literature databases (FASD Hub, NOFASD Australia, National Organisation for FASD, FASD United, HealthInfoNet, Proof Alliance, Child Family Community Australia, Foundation for Alcohol Research & Education and the Australian Department of Health websites) will be conducted using three search engines including PubMed, Ovid and Google advanced search (search dates: October 2021 to May 2022). Consultations will also be carried out with international and national experts in the diagnosis/management of FASD to obtain any additional relevant published or unpublished resources. Inclusion criteria were developed to guide the selection of resources that are publicly available, primarily focused on FASD and curated for health professionals for the identification, management or referral of FASD. Critical appraisal process will be executed using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) tool to assess the quality of selected resources. ETHICS AND DISSEMINATION Ethical approval is not required for the scoping review. Scoping review results will be presented at relevant national and international conferences and published in peer-reviewed journals. Search results will be made available to ensure reproducibility and transparency.
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Affiliation(s)
| | - Lisa Cannon
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Emily Carter
- Marulu Unit, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Kimberley, Australia
| | - Sue Thomas
- Marulu Unit, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Kimberley, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Kids Research, The Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Lauren J Rice
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Svalestuen S, Svendsen K, Eggen AE, Småbrekke L. Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study. BMJ Open 2022; 12:e058491. [PMID: 36691217 PMCID: PMC9462082 DOI: 10.1136/bmjopen-2021-058491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 08/19/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To examine the association between area-level education and the local growth trajectories in antibacterial dispensing rates in Norwegian municipalities among children under 3 years old. DESIGN Retrospective, longitudinal study using individual primary care prescription data from the Norwegian Prescription Database for the period 2006-2016. Data were collected on the date of dispensing, the type and amount of antibiotic, the patient's age, sex and municipality of residence and linked to municipality-level statistics on education available from Statistics Norway. We used multilevel growth curve modelling, with a linear trend variable modelled as a random effect and a cross-level interaction between linear trends and the proportion of the population in the municipality having received a university or college education. SETTING The local government level in Norway. The sample includes all municipalities over the study period. OUTCOME MEASURE Number of dispensed antibacterial prescriptions per 100 children in individual primary care by municipality and year. RESULTS We identified a significant negative linear trend in the square root of the dispensing rate for children under 3 years old during the period. This trend varied between municipalities. A negative cross-level interaction term between population education levels and random trends showed that municipalities with an average level of population education saw a reduction in their square root dispensing rates of -0.053 (95% CI -0.066 to -0.039) prescriptions per 100 children. Each additional percentage point in population education contributed a further -0.0034 (95% CI -0.006 to -0.001) reduction to the square root dispensing rate. CONCLUSIONS Municipalities in which a larger proportion of the local population have high educational achievements have been more successful in reducing antibacterial dispensing rates in children under 3 years old. Adopting area-level strategies and addressing local community disadvantages may help to optimise practices and prescribing patterns across local communities.
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Affiliation(s)
- Sigbjørn Svalestuen
- Department of Social Science, UiT The Arctic University of Norway, Tromso, Troms og Finnmark, Norway
| | - Kristian Svendsen
- Department of Pharmacy, UiT The Arctic University of Norway, Tromso, Troms og Finnmark, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Troms og Finnmark, Norway
| | - Lars Småbrekke
- Department of Pharmacy, UiT The Arctic University of Norway, Tromso, Troms og Finnmark, Norway
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Visscher S, van Stralen K, Toelen J, de Winter P. Parental and physician disagreement on help-seeking in paediatric case scenarios. Arch Dis Child 2022; 107:833-838. [PMID: 35351739 DOI: 10.1136/archdischild-2021-323504] [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: 11/08/2021] [Accepted: 03/04/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Whenever a child falls ill, parents need to decide whether there is a need to contact medical professionals. Parental and physician perspectives on the severity of a child's illness differ. We aimed to determine triggers for help-seeking among parents. DESIGN AND SETTING We conducted a survey study among 200 parents. In four hypothetical case scenarios, an acutely ill child was described with a baseline symptom (abdominal pain, rhinitis, headache, limping), with deterioration over time. Parents had to answer when they would contact the general practitioner. Fifty-four physicians received the same case scenarios. MAIN OUTCOME MEASURES Parents and physicians did not differ significantly in help-seeking in the abdominal pain case. In the non-urgent rhinitis case, parents sought help earlier than physicians wished them to, while in the urgent illness cases of headache and limping parents tend to seek help later than physicians wished. Rising body temperature was more alarming to parents than physicians, while loss of appetite did not concern either group. Parents did not recognise several red flags, for example, drowsiness and refusal to stand. Low educated parents and parents with a history of more frequent healthcare use were inclined to seek help earlier. IMPLICATION OF RESULTS In urgent cases, parents do not seem to recognise red flags, while some non-urgent symptoms trigger them to seek help. This reveals a need for mutual education. Physician awareness of a perception gap could help them adjust their communication and empower parents.
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Affiliation(s)
- Sarah Visscher
- Department of Pediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
| | - Karlijn van Stralen
- Department of Pediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
| | - Jaan Toelen
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Leuven Child and Youth Institute, KU Leuven, Leuven, Belgium.,Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Peter de Winter
- Department of Pediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands .,Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Leuven Child and Youth Institute, KU Leuven, Leuven, Belgium
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van Daalen KR, Kaiser J, Kebede S, Cipriano G, Maimouni H, Olumese E, Chui A, Kuhn I, Oliver-Williams C. Racial discrimination and adverse pregnancy outcomes: a systematic review and meta-analysis. BMJ Glob Health 2022; 7:bmjgh-2022-009227. [PMID: 35918071 PMCID: PMC9344988 DOI: 10.1136/bmjgh-2022-009227] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/21/2022] [Indexed: 12/27/2022] Open
Abstract
Introduction Racial discrimination has been consistently linked to various health outcomes and health disparities, including studies associating racial discrimination with patterns of racial disparities in adverse pregnancy outcomes. To expand our knowledge, this systematic review and meta-analysis assesses all available evidence on the association between self-reported racial discrimination and adverse pregnancy outcomes. Methods Eight electronic databases were searched without language or time restrictions, through January 2022. Data were extracted using a pre-piloted extraction tool. Quality assessment was conducted using the Newcastle–Ottawa Scale (NOS), and across all included studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects meta-analyses were performed on preterm birth and small for gestational age. Heterogenicity was assessed using Cochran’s χ2 test and I2 statistic. Results Of 13 597 retrieved records, 24 articles were included. Studies included cohort, case–control and cross-sectional designs and were predominantly conducted in the USA (n=20). Across all outcomes, significant positive associations (between experiencing racial discrimination and an adverse pregnancy event) and non-significant associations (trending towards positive) were reported, with no studies reporting significant negative associations. The overall pooled odds ratio (OR) for preterm birth was 1.40 (95% CI 1.17 to 1.68; 13 studies) and for small for gestational age it was 1.23 (95% CI 0.76 to 1.99; 3 studies). When excluding low-quality studies, the preterm birth OR attenuated to 1.31 (95% CI 1.08 to 1.59; 10 studies). Similar results were obtained across sensitivity and subgroup analyses, indicating a significant positive association. Conclusion These results suggest that racial discrimination has adverse impacts on pregnancy outcomes. This is supported by the broader literature on racial discrimination as a risk factor for adverse health outcomes. To further explore this association and underlying mechanisms, including mediating and moderating factors, higher quality evidence from large ethnographically diverse cohorts is needed.
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Affiliation(s)
- Kim Robin van Daalen
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | - Jeenan Kaiser
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Samuel Kebede
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York City, USA
| | | | | | | | - Anthea Chui
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Isla Kuhn
- Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Clare Oliver-Williams
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
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Kino S, Stickley A, Nishioka D, Ueno K, Saito M, Ojima T, Kondo N. Suicidal ideation and suicide attempts among older recipients of public welfare assistance in Japan. J Epidemiol Community Health 2022; 76:jech-2022-218893. [PMID: 35858764 PMCID: PMC9484371 DOI: 10.1136/jech-2022-218893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/10/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The high suicide rate among older adults is an important public health issue. Financial insecurity has been linked to suicidal behaviour. Despite this, as yet, there has been little research on suicide-related behaviours among older recipients of public welfare. This study will examine if suicidal ideation and suicide attempts are more prevalent in older recipients of public welfare assistance in Japan. METHODS This cross-sectional study analysed data from 16 135 adults aged ≥65 years who participated in the 2019 wave of the Japan Gerontological Evaluation Study. Information was obtained on receiving public welfare assistance, lifetime suicidal ideation and attempts, and a variety of covariates. Poisson regression analysis with robust variance estimates was used to examine associations. RESULTS Suicidal ideation was reported by 4.8% of the participants, while the corresponding figure for attempted suicide was 2.2%. In fully adjusted analyses public welfare recipients had an almost 1.5 times higher prevalence of lifetime suicidal ideation (prevalence ratio, PR 1.47, 95% CI 1.02 to 2.13), and an almost two times higher prevalence of attempted suicide (PR 1.91, 95% CI 1.20 to 3.04) when compared with their counterparts not receiving public welfare assistance. CONCLUSION Older recipients of public welfare have a higher prevalence of suicidal behaviour in Japan. An urgent focus is now warranted on this vulnerable population to determine the specific factors underlying this association.
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Affiliation(s)
- Shiho Kino
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Tokyo, Japan
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
| | - Andrew Stickley
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Daisuke Nishioka
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
- Department of Medical Statistics, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Keiko Ueno
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Well-Being and Society, Nihon Fukushi University, Nagoya, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Japan Agency for Gerontological Evaluation Study (JAGES Agency), Taito-ku, Tokyo, Japan
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Awawda S, Chalak A, Khader Y, Mostafa A, Abla R, Nakkash R, Jawad M, Salloum RG, Abu-Rmeileh NM. Gender differences in the price elasticity of demand for waterpipe and cigarette smoking in Lebanon, Jordan and Palestine: a volumetric choice experiment. BMJ Open 2022; 12:e058495. [PMID: 35851023 PMCID: PMC9297203 DOI: 10.1136/bmjopen-2021-058495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study assessed the extent to which the elasticity of cigarette and waterpipe tobacco products differs between men and women. We also explored the levels of substitution and complementarity in tobacco products among men and women. SETTING The study examines tobacco elasticities in three Arab countries: Lebanon, Jordan and the West Bank of Palestine. PARTICIPANTS We used data from nationally representative surveys of adults aged ≥18 years in Lebanon (n=1680), Jordan (n=1925) and Palestine (n=1679). The proportion of women was 50.0% of the sample in Lebanon and Palestine, and 44.6% in Jordan. PRIMARY AND SECONDARY OUTCOME MEASURES A zero-inflated Poisson regression model estimated own-price and cross-price elasticities for two variations of cigarettes and five variations of waterpipe tobacco products. Elasticities were measured based on eight scenarios of prices. RESULTS Demand for waterpipe tobacco products was elastic for both men and women. The cross-price elasticities in the three countries indicate the existence of substitution between cigarettes and waterpipe products and by different varieties within each of the two tobacco products. Gender differences varied across the three countries whereby higher cross-price elasticities were observed for women in Jordan and Palestine. For example, the price elasticity for discount waterpipe was -1.4 and -0.6 for women and men in Jordan, respectively. CONCLUSIONS Results on the elasticity of demand for tobacco products and the existence of substitution between tobacco products reveal the higher responsiveness of men and women to changes in tobacco prices. This should be taken into consideration in tobacco control strategies particularly when reducing tobacco consumption via taxation policies.
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Affiliation(s)
- Sameera Awawda
- Economics Department, Birzeit University, Ramallah, Palestine, State of
- Institute of Community and Public Health, Birzeit University, Ramallah, Palestine, State of
| | - Ali Chalak
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon, Beirut, Lebanon
| | - Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Aya Mostafa
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ruba Abla
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - 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, USA
| | - Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | - Ramzi G Salloum
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Niveen Me Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Ramallah, Palestine, State of
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Yun HW, Jung KJ, Jee SH, Kimm H. Overall quit in triple users of conventional cigarette, e-cigarette and heated tobacco product among healthy adults: a Korea Medical Institute health check-up study. BMJ Open 2022; 12:e051865. [PMID: 35851018 PMCID: PMC9297207 DOI: 10.1136/bmjopen-2021-051865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE While multiuse patterns of e-cigarettes (EC) or heated tobacco products (HTP) with conventional cigarettes (CC) have been reported, smoking cessation of multiusers is not well known. We aimed to analyse overall quit in triple users of CC, EC and HTP among healthy adults. METHODS A questionnaire was conducted on 89 360 adults who visited the Korea Medical Institute health check-ups in Seoul, Korea, from May 2018 to September 2019. Among 38 812 ever smokers, 9252 were ever triple users of CC, EC and HTP. Frequency and related factors of overall quit were analysed in the cross-sectional study. RESULTS The average age was 38.8±9.0 years, and 8458 (91.4%) were men. There were 5329 (57.6%) current triple users, 3547 (38.3%) single or dual product quitters and 376 (4.1%) overall quitters. Among the former triple users, the most common tobacco product use pattern was 'dual quit of EC and HTP (eg, current CC use)' both in men (21.3%) and women (26.3%). Age 60s or older (OR 8.5, 95% CI 5.2 to 13.8), women (OR 1.7, 95% CI 1.1 to 2.5), no hyperlipidaemia and married status were significantly related to overall quit. CONCLUSION The most common pathway for 'ever triple users' of the three tobacco products was 'current triple users', and the second was 'CC users'. Single or dual product quitters could continue to smoke by EC or HTP instead of quit. Further research on overall quit will be needed to develop effective regulations.
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Affiliation(s)
- Hye Won Yun
- National Cancer Control Institute, National Cancer Center, Goyang, South Korea
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Keum Ji Jung
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Heejin Kimm
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, South Korea
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Korab-Chandler E, Kyei-Onanjiri M, Cameron J, Hegarty K, Tarzia L. Women's experiences and expectations of intimate partner abuse identification in healthcare settings: a qualitative evidence synthesis. BMJ Open 2022; 12:e058582. [PMID: 35835525 PMCID: PMC9289017 DOI: 10.1136/bmjopen-2021-058582] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To explore women's experiences and expectations of intimate partner abuse (IPA) disclosure and identification in healthcare settings, focusing on the process of disclosure/identification rather than the healthcare responses that come afterwards. DESIGN Systematic review and meta-synthesis of qualitative studies DATA SOURCES: Relevant studies were sourced by using keywords to search the databases MEDLINE, EMBASE, CINAHL, PsychINFO, SocINDEX and ASSIA in September 2021. ELIGIBILITY CRITERIA Studies needed to focus on women's views about IPA disclosure and identification in healthcare settings, use qualitative methods and have been published in the last 5 years. DATA EXTRACTION AND SYNTHESIS Relevant data were extracted into a customised template. The Critical Appraisal Skills Programme checklist for qualitative research was used to assess the methodological quality of included studies. A thematic synthesis approach was applied to the data, and confidence in the findings was appraised using The Confidence in the Evidence from Reviews of Qualitative research methods. RESULTS Thirty-four studies were included from a range of healthcare settings and countries. Three key themes were generated through analysing their data: (1) Provide universal education, (2) Create a safe and supportive environment for disclosure and (3) It is about how you ask. Included papers were rated overall as being of moderate quality, and moderate-high confidence was placed in the review findings. CONCLUSIONS Women in the included studies articulated a desire to routinely receive information about IPA, lending support to a universal education approach that equips all women with an understanding of IPA and options for assistance, regardless of disclosure. Women's suggestions for how to promote an environment conducive to disclosure and how to enquire about IPA have clear implications for clinical practice.PROSPERO registration numberCRD42018091523.
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Affiliation(s)
| | - Minerva Kyei-Onanjiri
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jacqueline Cameron
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Laura Tarzia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Victoria, Australia
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Spitzer S, di Lego V, Kuhn M, Roth C, Berger R. Socioeconomic environment and survival in patients after ST-segment elevation myocardial infarction (STEMI): a longitudinal study for the City of Vienna. BMJ Open 2022; 12:e058698. [PMID: 35820761 PMCID: PMC9280908 DOI: 10.1136/bmjopen-2021-058698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study investigates the relationship between socioeconomic environment (SEE) and survival after ST-segment elevation myocardial infarction (STEMI) separately for women and men in the City of Vienna, Austria. DESIGN Hospital-based observational data of STEMI patients are linked with district-level information on SEE and the mortality register, enabling survival analyses with a 19-year follow-up (2000-2018). SETTING The analysis is set at the main tertiary care hospital of the City of Vienna. On weekends, it is the only hospital in charge of treating STEMIs and thus provides representative data for the Viennese population. PARTICIPANTS The study comprises a total of 1481 patients with STEMI, including women and men aged 24-94 years. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measures are age at STEMI and age at death. We further distinguish between deaths from coronary artery disease (CAD), deaths from acute coronary syndrome (ACS), and other causes of death. SEE is proxied via mean individual gross income from employment in each municipal district. RESULTS Results are based on Kaplan-Meier survival probability estimates, Cox proportional hazard regressions and competing risk models, always using age as the time scale. Descriptive findings suggest a socioeconomic gradient in the age at death after STEMI. This finding is, however, not supported by the regression results. Female patients with STEMI have better survival outcomes, but only for deaths related to CAD (HR: 0.668, 95% CIs 0.452 to 0.985) and other causes of deaths (HR: 0.627, 95% CIs 0.444 to 0.884), and not for deaths from the more acute ACS. CONCLUSIONS Additional research is necessary to further disentangle the interaction between SEE and age at STEMI, as our findings suggest that individuals from poorer districts have STEMI at younger ages, which indicates vulnerability in regard to health conditions in these neighbourhoods.
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Affiliation(s)
- Sonja Spitzer
- Department of Demography, University of Vienna, Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Wien, Austria
| | - Vanessa di Lego
- Vienna Institute of Demography, Austrian Academy of Sciences, Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Wien, Austria
| | - Michael Kuhn
- Vienna Institute of Demography, Austrian Academy of Sciences, Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Wien, Austria
- Economic Frontiers Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Christian Roth
- Department of Internal Medicine II, Cardiology, Medical University of Vienna, Wien, Austria
| | - Rudolf Berger
- Department of Internal Medicine II, Cardiology, Medical University of Vienna, Wien, Austria
- Department of Internal Medicine I, Cardiology and Nephrology, Hospital of St. John of God, Eisenstadt, Austria
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Amaral JMX, Kimergård A, Deluca P. Prevalence of anabolic steroid users seeking support from physicians: a systematic review and meta-analysis. BMJ Open 2022; 12:e056445. [PMID: 35788077 PMCID: PMC9255415 DOI: 10.1136/bmjopen-2021-056445] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To estimate the overall prevalence of androgenic-anabolic steroids (AAS) users seeking support from physicians. Secondary objectives are to compare this prevalence in different locations and among subpopulations of AAS users, and to discuss some of the factors that could have influenced the engagement of AAS users with physicians. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, PsycINFO, Web of Science and SciELO were searched in January 2022. ELIGIBILITY CRITERIA Quantitative and qualitative studies reporting the number of AAS users who sought support from physicians, with no restrictions of language or time of publication. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed the quality of studies, including publication bias. A random-effects meta-analysis was performed to estimate the overall prevalence of AAS users seeking support from physicians, followed by pooled prevalence rates by studies' location and the subpopulation of AAS users. RESULTS We identified 36 studies published between 1988 and 2021, involving 10 101 AAS users. The estimated overall prevalence of AAS users seeking support from physicians is 37.12% (95% CI 29.71% to 44.52%). Higher prevalence rates were observed in studies from Australia (67.27%; 95% CI 42.29% to 87.25%) and among clients of the needle and syringe exchange programme (54.13%; 95% CI 36.41% to 71.84%). The lowest prevalence was observed among adolescent AAS users (17.27%; 95% CI 4.80% to 29.74%). CONCLUSION Our findings suggest that about one-third of AAS users seek support from physicians, with remarkable differences between locations and subpopulations of AAS users. Further studies should investigate the factors influencing the engagement of AAS users with physicians. PROSPERO REGISTRATION NUMBER CRD42020177919.
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Affiliation(s)
| | - Andreas Kimergård
- Addictions, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Paolo Deluca
- Addictions, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
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Mengistu ST, Ghebremeskel GG, Rezene A, Idris MM, Tikue TG, Hamida ME, Achila OO. Attrition and associated factors among children living with HIV at a tertiary hospital in Eritrea: a retrospective cohort analysis. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001414. [PMID: 36053603 PMCID: PMC9252199 DOI: 10.1136/bmjpo-2022-001414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/16/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Reducing attrition in paediatric HIV-positive patients using combined antiretroviral therapy (cART) programmes in sub-Saharan Africa is a challenge. This study explored the rates and predictors of attrition in children started on cART in Asmara, Eritrea. METHODS This was a retrospective cohort study using data from all paediatric patients on cART between 2005 and 2020, conducted at the Orotta National Referral and Teaching Hospital. Kaplan-Meier estimates of the likelihood of attrition and multivariate Cox proportional hazards models were used to assess the factors associated with attrition. All p values were two sided and p<0.05 was considered statistically significant. RESULTS The study enrolled 710 participants with 374 boys (52.7%) and 336 girls (47.3%). After 5364 person-years' (PY) follow-up, attrition occurred in 172 (24.2%) patients: 65 (9.2%) died and 107 (15.1%) were lost to follow-up (LTFU). The crude incidence rate of attrition was 3.2 events/100 PY, mortality rate was 2.7/100 PY and LTFU was 1.2/100 PY. The independent predictors of attrition included male sex (adjusted HR (AHR)=1.6, 95% CI: 1 to 2.4), residence outside Zoba Maekel (AHR=1.5, 95% CI: 1 to 2.3), later enrolment years (2010-2015: AHR=3.2, 95% CI: 1.9 to 5.3; >2015: AHR=6.1, 95% CI: 3 to 12.2), WHO body mass index-for-age z-score <-2 (AHR=1.4, 95% CI: 0.9 to 2.1), advanced HIV disease (WHO III or IV) at enrolment (AHR=2.2, 95% CI: 1.2 to 3.9), and initiation of zidovudine+lamivudine or other cART backbones (unadjusted HR (UHR)=2, 95% CI: 1.2 to 3.2). In contrast, a reduced likelihood of attrition was observed in children with a record of cART changes (UHR=0.2, 95% CI: 0.15 to 0.4). CONCLUSION A low incidence of attrition was observed in this study. However, the high mortality rate in the first 24 months of treatment and late presentation are concerning. Therefore, data-driven interventions for improving programme quality and outcomes should be prioritised.
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Affiliation(s)
- Samuel Tekle Mengistu
- General Medicine, Nakfa Hospital, Ministry of Health Northern Red Sea Branch, Nakfa, Eritrea .,Medicine, Orota School of Medicine and Dentistry, Asmara, Eritrea
| | - Ghirmay Ghebrekidan Ghebremeskel
- General Medicine, Nakfa Hospital, Ministry of Health Northern Red Sea Branch, Nakfa, Eritrea.,Medicine, Orota School of Medicine and Dentistry, Asmara, Eritrea
| | - Aron Rezene
- Maternity Health, Edaga Hamus Hospital, Ministry of Health Maekel Branch, Asmara, Eritrea
| | - Mahmud Mohammed Idris
- Department of Pediatrics and Child Health, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Tsegereda Gebrehiwot Tikue
- Department of Pediatrics and Child Health, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Mohammed Elfatih Hamida
- Unit of Medical Microbiology, Orotta College of Medicine and Health Sciences (OCMHS), Asmara, Eritrea
| | - Oliver Okoth Achila
- Unit of Clinical Laboratory Science, Orotta College of Medicine and Health Sciences (OCMHS), Asmara, Eritrea
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Jain V, Clarke J, Beaney T. Association between democratic governance and excess mortality during the COVID-19 pandemic: an observational study. J Epidemiol Community Health 2022; 76:jech-2022-218920. [PMID: 35768188 PMCID: PMC9271843 DOI: 10.1136/jech-2022-218920] [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: 03/01/2022] [Accepted: 06/19/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Excess mortality has been used to assess the overall health impact of COVID-19 across countries. Democracies aim to build trust in government and enable checks and balances on decision making, which may be useful in a pandemic. But during the pandemic, they have been criticised as being hesitant to enforce restrictive public health measures. METHODS Through linking open-access datasets we constructed univariable and multivariable linear regression models investigating the association between country V-Dem Liberal Democracy Indices (LDI), representing strength of democratic governance and excess mortality rates, from January 2020 to September 2021. We adjusted for several important confounders and conducted a range of sensitivity analyses to assess the robustness of our findings. RESULTS Across 78 countries, 4.19 million deaths million excess deaths were recorded. On multivariable regression, a one-point increase in V-Dem LDI was associated with a decrease in excess mortality of 2.18 per 100 000 (p=0.004), after accounting for age, gender, wealth and universal health coverage. This association was only partially attenuated by COVID-19 vaccination rates and remained robust in all sensitivity analyses. CONCLUSIONS Democratic governance may have played an important role in mitigating the overall health impact of COVID-19 across countries. This study strengthens the case to broaden the scope of traditional pandemic risk assessment and discussions on preparedness.
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Affiliation(s)
- Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Jonathan Clarke
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Thomas Beaney
- Department of Primary Care and Public Health, Imperial College London, London, UK
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Corso M, DeSouza A, Brunton G, Yu H, Cancelliere C, Mior S, Taylor-Vaisey A, MacLeod-Beaver K, Côté P. Integrating Indigenous healing practices within collaborative care models in primary healthcare in Canada: a rapid scoping review. BMJ Open 2022; 12:e059323. [PMID: 35710234 PMCID: PMC9207893 DOI: 10.1136/bmjopen-2021-059323] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES In November 2020, a series of reports, In Plain Sight, described widespread Indigenous-specific stereotyping, racism and discrimination limiting access to medical treatment and negatively impacting the health and wellness of Indigenous Peoples in British Columbia, Canada. To address the health inequalities experienced by Indigenous peoples, Indigenous healing practices must be integrated within the delivery of care. This rapid scoping review aimed to identify and synthesise strategies used to integrate Indigenous healing practices within collaborative care models available in community-based primary healthcare, delivered by regulated health professionals in Canada. ELIGIBILITY CRITERIA We included quantitative, qualitative and mixed-methods studies conducted in community-based primary healthcare practices that used strategies to integrate Indigenous healing practices within collaborative care models. SOURCES OF EVIDENCE We searched MEDLINE, Embase, Indigenous Studies Portal, Informit Indigenous Collection and Native Health Database for studies published from 2015 to 2021. CHARTING METHODS Our data extraction used three frameworks to categorise the findings. These frameworks defined elements of integrated healthcare (ie, functional, organisational, normative and professional), culturally appropriate primary healthcare and the extent of community engagement. We narratively summarised the included study characteristics. RESULTS We identified 2573 citations and included 31 in our review. Thirty-nine per cent of reported strategies used functional integration (n=12), 26% organisational (n=8), 19% normative (n=6) and 16% professional (n=5). Eighteen studies (58%) integrated all characteristics of culturally appropriate Indigenous healing practices into primary healthcare. Twenty-four studies (77%) involved Indigenous leadership or collaboration at each phase of the study and, seven (23%) included consultation only or the level of engagement was unclear. CONCLUSIONS We found that collaborative and Indigenous-led strategies were more likely to facilitate and implement the integration of Indigenous healing practices. Commonalities across strategies included community engagement, elder support or Indigenous ceremony or traditions. However, we did not evaluate the effectiveness of these strategies.
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Affiliation(s)
- Melissa Corso
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Astrid DeSouza
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Ginny Brunton
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
- EPPI-Centre, UCL Institute of Education, University College London, London, UK
| | - Hainan Yu
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Carolina Cancelliere
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | - Silvano Mior
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
- Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Anne Taylor-Vaisey
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
| | | | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada
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Osei TB, Mank I, Sorgho R, Nayna Schwerdtle P, Hövener C, Fischer F, Razum O, Danquah I. Aetiological research on the health of migrants living in Germany: a systematic literature review. BMJ Open 2022; 12:e058712. [PMID: 35701052 PMCID: PMC9198788 DOI: 10.1136/bmjopen-2021-058712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Germany has become an important immigration country and health services need to adopt to meet the needs of an increasingly multicultural population. For public health planning, it is essential to understand the aetiology of health problems among migrant populations. The main objective was to systematically identify, evaluate and synthesise population-based studies that investigated exposure-outcome relationships among migrant groups in Germany. METHODS In November 2019, we searched PubMed and LIVIVO, and updated this search in November 2020, to identify peer-reviewed publications that fulfilled our eligibility criteria: English or German language; study on disease aetiology among major migrant groups in Germany, according to the latest microcensus; publication date from inception to 01 November 2020 and observational or experimental study designs. For quality appraisal, we used the Critical Appraisal Skills Programme checklists. Outcomes under investigation were categorised according to the WHO major disease groups, and their associations with risk factors were synthesised as a heat map. RESULTS Out of 2407 articles retrieved, we included 68 publications with a total number of 864 518 participants. These publications reported on cross-sectional data (n=56), cohort studies (n=11) and one intervention study. The population groups most frequently studied were from the Middle East (n=28), Turkey (n=24), sub-Saharan Africa (n=24), Eastern Europe (n=15) and the former Soviet Union (n=11). The outcomes under study were population group specific. There were consistent associations of demographic and socioeconomic factors with ill health among migrants in Germany. DISCUSSION In this systematic review, we observed low risk of bias in two-thirds of the studies. There is an increasing body of evidence for aetiological research on migrants' health in Germany. Still, the directions of associations between a wide range of risk factors and major disease groups seem only partially understood. PROSPERO REGISTRATION NUMBER CRD42018085074.
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Affiliation(s)
- Tracy Bonsu Osei
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Isabel Mank
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- German Institute for Development Evaluation, Bonn, Nordrhein-Westfalen, Germany
| | - Raissa Sorgho
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Patricia Nayna Schwerdtle
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Florian Fischer
- Institute of Public Health, Charité-Universitaetsmedizin Berlin, Berlin, Germany
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
| | - Oliver Razum
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
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Evans RL, Harris B, Onuegbu C, Griffiths F. Systematic review of educational interventions to improve the menstrual health of young adolescent girls. BMJ Open 2022; 12:e057204. [PMID: 35676001 PMCID: PMC9185475 DOI: 10.1136/bmjopen-2021-057204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To systematically review interventions that include an element of menstrual education delivered to young adolescent girls. DESIGN This was a systematic review and meta-analysis. Selected articles were quality assessed using the Mixed Methods Appraisal Tool quality appraisal checklist. A meta-analysis was conducted on a subset of articles, and the effect size of the intervention was calculated using Cohen's d. A logic model was constructed to frame the effect of menstrual education interventions on menstrual health. SETTING Papers reporting on interventions in high-income and low-income and middle-income countries were sought. INFORMATION SOURCES Seven electronic databases were searched for English-language entries that were published between January 2014 and May 2020. PARTICIPANTS The interventions were aimed at younger adolescent girls aged 10-14 years old. INTERVENTIONS The interventions were designed to improve the menstrual health of the recipients, by addressing one or more elements of menstrual knowledge, attitude or practices (KAP). ELIGIBILITY CRITERIA Interventions that had not been evaluated were excluded. PRIMARY AND SECONDARY OUTCOMES The most common type of output was a difference in knowledge or skill score ascertained from a pre and post test. Some studies measured additional outcomes, such as attitude or confidence. RESULTS Twenty-four eligible studies were identified. The number of participants varied from 1 to 2564. All studies reported improvements in menstrual KAP. The meta-analysis indicates that larger effect sizes were attained by those that encouraged discussion than those that distributed pamphlets. CONCLUSIONS Education interventions are effective in increasing the menstrual knowledge of young adolescent girls and skills training improves competency to manage menstruation more hygienically and comfortably. Interactive interventions are more motivating than didactic or written. Sharing concerns gives girls confidence and helps them to gain agency on the path to menstrual health. TRIAL REGISTRATION NUMBER For this review, a protocol was not prepared or registered.
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Affiliation(s)
- Rebecca Lane Evans
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Bronwyn Harris
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Chinwe Onuegbu
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Frances Griffiths
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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