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Rebryk A, Kozyatnyk I, Njenga M. Emission of volatile organic compounds during open fire cooking with wood biomass: Traditional three-stone open fire vs. gasifier cooking stove in rural Kenya. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 934:173183. [PMID: 38777046 DOI: 10.1016/j.scitotenv.2024.173183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
Cooking with wood biomass fuels releases hazardous air pollutants, including volatile organic compounds (VOCs), that often disproportionally affect women and children. This study, conducted in Kwale and Siaya counties in Kenya, employed thermal desorption gas chromatography - mass spectrometry to analyse VOC emissions from cooking with a wood biomass three-stone open fire vs. top-lit updraft gasifier stove. In kitchens with adequate ventilation, total VOC levels increased from 35-252 μg∙m-3 before cooking to 2235-5371 μg∙m-3 during open fire cooking, whereas use of a gasifier stove resulted in reduced emissions from cooking by 48-77 % (506-2778 μg∙m-3). However, in kitchens with poor ventilation, there was only a moderate difference in total VOC levels between the two methods of cooking (9034-9378 μg∙m-3 vs. 6727-8201 μg∙m-3 for the three-stone open fire vs. gasifier stove, respectively). Using a non-target screening approach revealed significantly increased levels of VOCs, particularly benzenoids, oxygenated and heterocyclic compounds, when cooking with the traditional open fire, especially in closed kitchens, highlighting the effects of poor ventilation. Key hazardous VOCs included benzene, naphthalene, phenols and furans, suggesting potential health risks from cooking. In kitchens with good ventilation, use of the gasifier stove markedly reduced emissions of these priority toxic VOCs compared to cooking with an open fire. Thus, substituting open fires with gasifier stoves could help to improve household air quality and alleviate health risks. The study revealed that VOCs were present prior to cooking, possibly originating from previously cooked food (buildup) or the outside environment. VOC emissions were also exacerbated by reduced air flow in high humidity during rainfall, suggesting an area for further research. The findings underscore the importance of adopting cleaner cooking technologies and enhancing kitchen ventilation to mitigate the impacts of VOCs in developing countries.
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Affiliation(s)
- Andriy Rebryk
- Department of Chemistry, Chemical Biological Centre (KBC), Umeå University, Linnaeus väg 6, 901 87 Umeå, Sweden
| | - Ivan Kozyatnyk
- Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Occupational and Environmental Medicine, Linköping University, 581 83 Linköping, Sweden.
| | - Mary Njenga
- Centre for International Forestry Research-World Agroforestry (CIFOR-ICRAF), 30677-00100 Nairobi, Kenya; Wangari Maathai Institute for Peace and Environmental Studies, University of Nairobi, P.O. Box 2905-0065, Nairobi, Kenya
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Di Matteo R, Bolgeo T, Dal Molin A, Bassola B, Lusignani M, Maconi A, Rasero L, Vellone E, Iovino P. Self-care behaviours and their determinants in people affected by coronary heart disease. J Clin Nurs 2024. [PMID: 38837821 DOI: 10.1111/jocn.17299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To describe self-care in Italian adults with coronary heart disease and to identify sociodemographic and clinical determinants of self-care. DESIGN This is a cross-sectional analysis of data from the Italian multicentre longitudinal study. METHODS We used the follow instruments: Self-Care of coronary heart disease inventory, Self-care Self Efficacy Scale, Charlson Comorbidity Index and Sociodemographic questionnaire. Descriptive statistics including absolute numbers, percentages, means and standard deviations were used to describe the sociodemographic and clinical characteristics of the sample, and the items. A structural equation model was fitted to understand sociodemographic and clinical variables associated with self-care, and possible effects mediated by self-efficacy. RESULTS We enrolled 427 patients. Self-care maintenance, monitoring, management and self-care self-efficacy means scores were 58.27 (SD = 20.07), 48.53 (SD = 26.97), 65.34 (SD = 22.85) and 77.16 (SD = 20.76), respectively. Except for the self-care self-efficacy scale, all the scores lay below the cut off 70 for adequacy. Older age, higher comorbidities, a higher number of stents placed, and the presence of a caregiver predicted poor self-care. CONCLUSION Self-care in Italian CHD populations is poor. Several associations were found between the dimensions of self-care and sociodemographic factors. Implications for the profession these findings are important for health care providers to plan interventions to improve self-care behaviour. IMPACT The study addressed self-care behaviours of coronary heart disease patients. Self-care was poor in this population; several associations were found between the dimensions of self-care and sociodemographic and clinical determinants. Our results can be used to support health professionals in planning interventions to improve specific self-care domains. REPORTING METHOD STROBE checklist was followed.
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Affiliation(s)
- Roberta Di Matteo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Research Training Innovation Infrastructure - Department of Research and Innovation, Azienda Ospedaliero-Universitaria SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Tatiana Bolgeo
- Research Training Innovation Infrastructure - Department of Research and Innovation, Azienda Ospedaliero-Universitaria SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Health Professions' Direction, Maggiore della Carità Hospital, Novara, Italy
| | - Barbara Bassola
- School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, University of Milan, Milano, Italy
| | - Maura Lusignani
- School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, University of Milan, Milano, Italy
- Department of Biomedical Science for Health, University of Milan, Milano, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure - Department of Research and Innovation, Azienda Ospedaliero-Universitaria SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Laura Rasero
- Health Sciences Department, University of Florence, Florence, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
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Ahmad R, Haq MA, Sinha S, Lugova H, Kumar S, Haque M, Akhter QS. Red Cell Distribution Width and Mean Corpuscular Volume Alterations: Detecting Inflammation Early in Occupational Cement Dust Exposure. Cureus 2024; 16:e60951. [PMID: 38784687 PMCID: PMC11116001 DOI: 10.7759/cureus.60951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Cement dust emitted during cement manufacture consists of toxic components. Occupational cement dust exposure may cause inflammation in the human body, which may be detected early by observing changes in blood parameters such as red blood cell distribution width (RDW) and mean corpuscular volume (MCV). Objectives The study aims to observe the effect of occupational cement dust exposure on RDW and MCV. Methods This study was performed in the Department of Physiology of Dhaka Medical College, Dhaka, Bangladesh, and a factory in Munshiganj, Bangladesh, from September 2017 to August 2018. Ninety-two participants between 20 and 50 years were included (46 subjects were occupationally exposed to cement dust, and 46 were not exposed to cement dust). A pre-designed questionnaire was used for data collection. An independent sample t-test was used to analyze basic information, such as blood pressure and BMI. The multivariate regression model was used to analyze the effect of cement dust exposure on the study group. The impact of cement dust exposure duration was analyzed using the multivariate regression model. The level of significance was p < 0.05. The statistical analysis was performed using STATA-15 (StataCorp, College Station, TX), and the graphical presentation used GraphPad Prism v8.3.2. Results The cement dust-exposed participants had a significantly higher value of MCV by 1.19 fi (95% CI = 0.02, 4.84; p = 0.049) and a 5.92% increase in RDW (95% CI = 5.29, 6.55; p < 0.001) than that of the control group. Conclusion The study reveals that exposure to cement dust causes significant changes in RDW and MCV. These changes may indicate hemolysis due to inflammation.
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Affiliation(s)
- Rahnuma Ahmad
- Physiology, Medical College for Women and Hospital, Dhaka, BGD
| | - Md Ahsanul Haq
- Biostatistics, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BGD
| | - Susmita Sinha
- Physiology, Khulna City Medical College and Hospital, Khulna, BGD
| | - Halyna Lugova
- Faculty of Medicine and Health Sciences, UCSI (University College Sedaya International) University Bandar Springhill Campus, Port Dickson, MYS
| | - Santosh Kumar
- Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Mainul Haque
- Research, Karnavati Scientific Research Center (KSRC) School of Dentistry, Karnavati University, Gandhinagar, IND
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
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Sriram S, Albadrani M. Do hospitalizations push households into poverty in India: evidence from national data. F1000Res 2024; 13:205. [PMID: 38606206 PMCID: PMC11007365 DOI: 10.12688/f1000research.145602.1] [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] [Accepted: 02/21/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction High percentage of OOP (Out-of-Pocket) costs can lead to poverty and exacerbate existing poverty, with 21.9% of India's 1.324 billion people living below the poverty line. Factors such as increased patient cost-sharing, high-deductible health plans, and expensive medications contribute to high OOP costs. Understanding the poverty-inducing impact of healthcare payments is essential for formulating effective measures to alleviate it. Methods The study used data from the 75th round of the National Sample Survey Organization (Household Social Consumption in India: Health) from July 2017-June 2018, focusing on demographic-socio-economic characteristics, morbidity status, healthcare utilization, and expenditure. The analysis included 66,237 hospitalized individuals in the last 365 days. Logistic regression model was used to examine the impact of OOP expenditures on impoverishment. Results Logistic regression analysis shows that there is 0.2868 lower odds of experiencing poverty due to OOP expenditures in households where there is the presence of at least one child aged 5 years and less present in the household compared to households who do not have any children. There is 0.601 higher odds of experiencing poverty due to OOP expenditures in urban areas compared to households in rural areas. With an increasing duration of stay in the hospital, there is a higher odds of experiencing poverty due to OOP health expenditures. There is 1.9013 higher odds of experiencing poverty due to OOP expenditures if at least one member in the household used private healthcare facility compared to households who never used private healthcare facilities. Conclusion In order to transfer demand from private to public hospitals and reduce OOPHE, policymakers should restructure the current inefficient public hospitals. More crucially, there needs to be significant investment in rural areas, where more than 70% of the poorest people reside and who are more vulnerable to OOP expenditures because they lack coping skills.
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Affiliation(s)
- Shyamkumar Sriram
- Department of Social and Public Health, Ohio University, Athens, Ohio, 45701, USA
| | - Muayad Albadrani
- Department of Family and Community Medicine, Taibah University, Medina, Al Madinah Province, Saudi Arabia
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Ezenwaka CE, Nwankwo CU, Analike RA, Moriyama M, Afonne AJ, Ottiwu PC, Onyeje BT, Okoli JN, Amaechi IA, Ahaneku GI. The Baseline Self-Efficacy Scores to Manage Chronic Diseases Amongst Nigerian Patients with Non-Communicable Diseases are Sub-Optimal. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241248102. [PMID: 38751191 PMCID: PMC11100374 DOI: 10.1177/00469580241248102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/05/2024] [Accepted: 04/02/2024] [Indexed: 05/19/2024]
Abstract
Nigeria is one of the developing countries with a major burden of non-communicable diseases (NCDs) without a disease self-management program in its healthcare system. Thus, this study was aimed to assess the baseline self-efficacy levels of Nigerian patients with chronic NCDs at tertiary level hospitals. This is a cross sectional study of 286 NCD patients attending tertiary level clinics from 26 July to 27 October 2023. Patients were interviewed on a 10 Self-Efficacy to Manage Chronic Disease (SEMCD) item scales that were considered suitable for the Nigerian population. The 10 SEMCD questions covered: (i) Exercise regularly scale, (ii) Help from community, family and friends scale, (iii) Communication with Physician scale, (iv) Manage disease scale and (v) Manage symptom self-efficacy domains. Data were analyzed both descriptively and statistically using Student's t-tests and Chi-square tests as appropriate. The results showed that more female (59.4%) than males (40.6%) attended clinics during the study, and the mean age of the patients did not differ between gender (P > .05). About 40% of all the patients manage their NCDs with medications alone, a trend that is similar in male and female patients (P > .05). While all the patients had a relatively lower self-efficacy scores under regular exercise scale (52%-55%) and manage disease symptoms scale (53%-55%), they tended toward higher self-efficacy scores under getting assistance from community, family, and friends (79%-80%) and communication with attending physicians (81%-85%). It is concluded that Nigeria literate NCD patients registered at tertiary level institution routine clinics are less than optimal in disease self-management care. We recommend that this study population will benefit from introduction and implementation of disease self-management program in the healthcare system.
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Affiliation(s)
- Chidum E. Ezenwaka
- The University of the West Indies, St Augustine Campus, Trinidad and Tobago
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Wu XC, Yu Q, Yi Y, Maniscalco LS, Hsieh MC, Gruber D, Mendoza L, Subbiah S, Sokol T, Shrestha P, Chen VW, Mederos ET, Ochoa A. Effect of chronic disease on racial difference in COVID-19-associated hospitalization among cancer patients. J Natl Cancer Inst 2023; 115:1204-1212. [PMID: 37697664 PMCID: PMC10560601 DOI: 10.1093/jnci/djad150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Research indicates that Black cancer patients have higher rates of COVID-19 hospitalization than their White counterparts. However, the extent to which chronic diseases contribute to racial disparities remains uncertain. We aimed to quantify the effect of chronic diseases on racial disparity in COVID-19-associated hospitalization among cancer patients. METHODS We linked Louisiana Tumor Registry's data with statewide COVID-19 data and hospital in-patient discharge data to identify patients diagnosed with cancer in 2015-2019 who tested positive for COVID-19 in 2020 and those with COVID-19-associated hospitalization. Multivariable logistic regression and mediation methods based on linear structural equations were employed to assess the effects of the number of chronic diseases (0, 1-2, ≥3) and individual chronic diseases. RESULTS Of 6381 cancer patients who tested positive for COVID-19, 31.6% were non-Hispanic Black cancer patients. Compared with non-Hispanic White cancer patients, non-Hispanic Black cancer patients had a higher prevalence of chronic diseases (79.5% vs 66.0%) and higher COVID-19-associated hospitalization (27.2% vs 17.2%). The odds of COVID-19-associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio = 1.80, 95% confidence interval = 1.59 to 2.04). After adjusting for age, sex, insurance, poverty, obesity, and cancer type, number of chronic diseases explained 37.8% of the racial disparity in COVID-19-associated hospitalization, and hypertension, diabetes, and chronic renal disease were the top 3 chronic diseases explaining 9.6%, 8.9%, and 7.3% of the racial disparity, respectively. CONCLUSION Chronic diseases played a substantial role in the racial disparity in COVID-19-associated hospitalization among cancer patients, especially hypertension, diabetes, and renal disease. Understanding and addressing the root causes are crucial for targeted interventions, policies, and health-care strategies to reduce racial disparity.
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Affiliation(s)
- Xiao-Cheng Wu
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Qingzhao Yu
- Biostatistics Program, School of Public Health, LSU Health, New Orleans, LA, USA
| | - Yong Yi
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Lauren S Maniscalco
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Mei-Chin Hsieh
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - DeAnn Gruber
- Bureau of Infectious Diseases, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Lee Mendoza
- Bureau of Health Informatics, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Suki Subbiah
- Section of Hematology-Oncology, School of Medicine, LSU Health, New Orleans, LA, USA
| | - Theresa Sokol
- Bureau of Infectious Diseases, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Pratibha Shrestha
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Vivien W Chen
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Eileen T Mederos
- LSU-LCMC Health Cancer Center, Department of Interdisciplinary Oncology, LSU Health, New Orleans, LA, USA
| | - Augusto Ochoa
- LSU-LCMC Health Cancer Center, Department of Interdisciplinary Oncology, LSU Health, New Orleans, LA, USA
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Odunyemi A, Rahman T, Alam K. Economic burden of non-communicable diseases on households in Nigeria: evidence from the Nigeria living standard survey 2018-19. BMC Public Health 2023; 23:1563. [PMID: 37592334 PMCID: PMC10433548 DOI: 10.1186/s12889-023-16498-7] [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: 02/01/2023] [Accepted: 08/10/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The importance of non-communicable diseases (NCDs) in Nigeria is reflected in their growing burden that is fast overtaking that of infectious diseases. As most NCD care is paid for through out-of-pocket (OOP) expenses, and NCDs tend to cause substantial income losses through chronic disabilities, the rising NCD-related health burden may also be economically detrimental. Given the lack of updated national-level evidence on the economic burden of NCDs in Nigeria, this study aims to produce new evidence on the extent of financial hardship experienced by households with NCDs in Nigeria due to OOP expenditure and productivity loss. METHODS This study analysed cross-sectional data from the most recent round (2018-19) of the Nigeria Living Standard Survey (NLSS). Household-level health and consumption data were used to estimate catastrophic health expenditure (CHE) and impoverishing effects due to OOP health spending, using a more equitable method recently developed by the World Health Organization European region in 2018. The productivity loss by individuals with NCDs was also estimated from income and work-time loss data, applying the input-based human capital approach. RESULTS On average, a household with NCDs spent ₦ 122,313.60 or $ 398.52 per year on NCD care, representing 24% of household food expenditure. The study found that OOP on cancer treatment, mental problems, and renal diseases significantly contribute to the cost of NCD care. The OOP expenditure led to catastrophic and impoverishing outcomes for households. The estimations showed that about 30% of households with NCDs experienced CHE in 2018, using the WHO Europe method at the 40% threshold. The study also found that the cost of NCD medications was a significant driver of CHE among NCD-affected households. The results showed heterogeneity in CHE and impoverishment across states and geographical regions in Nigeria, with a higher concentration in rural and North East geopolitical locations. The study also found that 20% of NCD-affected households were impoverished or further impoverished by OOP payment, and another 10% were on the verge of impoverishment. The results showed a negligible rate of unmet needs among households with NCDs. CONCLUSIONS The study highlights the significant effect of NCDs on Nigerian households and the need for effective policy interventions to address this challenge, particularly among the poor and vulnerable.
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Affiliation(s)
- Adelakun Odunyemi
- Murdoch Business School, Murdoch University, 90 South Street, Perth, WA, 6150, Australia.
- Hospitals' Management Board, Akure, Ondo State, Nigeria.
| | - Taslima Rahman
- Murdoch Business School, Murdoch University, Perth, Western Australia, Australia
- Institute of Health Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Khurshid Alam
- Murdoch Business School, Murdoch University, 90 South Street, Perth, WA, 6150, Australia
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Antoun I, Alkhayer A, Aboud Y, Alkhayer H, Kotb A, Alkhayer A, Barker J, Somani R, Ng GA. COVID-19 inpatient treatments and outcomes during the conflict in Syria: an observational cohort study. IJID REGIONS 2023; 7:72-76. [PMID: 36593893 PMCID: PMC9797414 DOI: 10.1016/j.ijregi.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Background During the COVID-19 pandemic, countries undergoing conflict have faced difficulties in mounting an effective health response. This observational cohort study describes the treatments and outcomes for inpatients with COVID-19 in the Syrian city of Latakia. Design and methods A single-centre observational cohort study was conducted at Tishreen University Hospital, involving all patients over 18 admitted between October 1 and December 31, 2021 with a positive RT-PCR test for SARS-CoV-2. Clinical features, investigations, treatments, and outcomes were reported. Results In total, 149 patients fitted the study criteria. Only one patient was double vaccinated against COVID-19. Oxygen supplementation was required in 87% (n = 130) of participants. Invasive mechanical ventilation was required in 4% (n = 5). Therapeutic anticoagulation was administered in 97.3% (n = 144). Intravenous dexamethasone was received by 97.3% (n = 145) of participants. All patients received empiric antibiotic treatment. In-hospital mortality was 48.4% (n = 72), while only 40.9% (n = 61) were discharged during the study period. Conclusion The pandemic has placed a compromised Syrian healthcare system under more significant strain. This requires urgent international relief efforts from health agencies in order to aid the pandemic response.
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Affiliation(s)
- Ibrahim Antoun
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, Leicester, UK
| | | | - Yalaa Aboud
- Faculty of Medicine, Tishreen University, Latakia, Syria
| | - Hiba Alkhayer
- Department of Respiratory Medicine, Tishreen University Hospital, Latakia, Syria
| | - Ahmed Kotb
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, Leicester, UK
| | - Amer Alkhayer
- Faculty of Medicine, Tishreen University, Latakia, Syria
| | - Joseph Barker
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, Leicester, UK
- National Institute for Health Research, Leicester Research Biomedical Centre, Leicester, UK
| | - Riyaz Somani
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, Leicester, UK
| | - G. Andre Ng
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK
- Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, Leicester, UK
- National Institute for Health Research, Leicester Research Biomedical Centre, Leicester, UK
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Putri NK, Laksono AD, Rohmah N. Predictors of national health insurance membership among the poor with different education levels in Indonesia. BMC Public Health 2023; 23:373. [PMID: 36810024 PMCID: PMC9945403 DOI: 10.1186/s12889-023-15292-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/20/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Indonesia has made significant progress in expanding universal health coverage (UHC) through its National Health Insurance (NHI) mechanism. However, in the context of NHI implementation in Indonesia, socioeconomic disparities caused its subpopulations to have different literacy of NHI concepts and procedures, increasing the risk of healthcare access inequities. Hence, the study aimed to analyse the predictors of NHI membership among the poor with different education levels in Indonesia. METHODS This study used the secondary dataset of the nationwide survey "Abilities and Willingness to Pay, Fee, and Participant Satisfaction in implementing National Health Insurance in Indonesia in 2019" by The Ministry of Health of the Republic of Indonesia. The study population was the poor population in Indonesia and included a weighted sample of 18,514 poor people. The study used NHI membership as a dependent variable. Meanwhile, the study analysed seven independent variables: wealth, residence, age, gender, education, employment, and marital status. In the final step of the analysis, the study used binary logistic regression. RESULTS The results show that the NHI membership among the poor population tends to be higher among those who have higher education, live in urban areas, are older than 17 years old, are married and are wealthier. The poor population with higher education levels is more likely to become NHI members than those with lower education. Their residence, age, gender, employment, marital status, and wealth also predicted their NHI membership. Poor people with primary education are 1.454 times more likely to be NHI members than those without education (AOR 1.454; 95% CI 1.331-1.588). Meanwhile, those with secondary education are 1.478 times more likely to be NHI members than those with no education (AOR 1.478; 95% CI 1.309-1.668). Moreover, higher education is 1.724 times more likely to result in being an NHI member than no education (AOR 1.724; 95% CI 1.356-2.192). CONCLUSION Education level, residence, age, gender, employment, marital status, and wealth predict NHI membership among the poor population. Since significant differences exist in all of those predictors among the poor population with different education levels, our findings highlighted the importance of government investment in NHI, which must be supported with investment in the poor population's education.
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Affiliation(s)
- Nuzulul Kusuma Putri
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia. .,The Airlangga Centre for Health Policy (ACeHAP), Surabaya, Indonesia.
| | - Agung Dwi Laksono
- The Airlangga Centre for Health Policy (ACeHAP), Surabaya, Indonesia ,National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Nikmatur Rohmah
- grid.443502.40000 0001 2368 5645Faculty of Health Science, Muhammadiyah University of Jember, Jember, Indonesia
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Kainiemi E, Saukkonen P, Virtanen L, Vehko T, Kyytsönen M, Aaltonen M, Heponiemi T. Perceived benefits of digital health and social services among older adults: A population-based cross-sectional survey. Digit Health 2023; 9:20552076231173559. [PMID: 37312955 PMCID: PMC10259144 DOI: 10.1177/20552076231173559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/17/2023] [Indexed: 06/15/2023] Open
Abstract
Objective The aim of this study was to describe the benefits of digital health and social services perceived by older adults and to examine factors associated with perceiving these benefits. Several factors related to (a) sociodemographic characteristics, (b) area of residence, (c) physical, cognitive, psychological, and social functioning, and (d) Internet use, were examined. Methods The present sample included 8019 respondents aged between 75 and 99 years. The inverse probability weighting method was used to correct for bias. Linear regression analyses were used to examine the associations. Results The ease of use of the services regardless of the time and location was perceived as the most beneficial. Convenient distance to local health or social services (parameter estimate = 0.15 [0.08-0.23]), good functional ability (PE = 0.08 [0.01-0.14]), good vision (PE = 0.15 [0.04-0.25]), ability to learn (PE = 0.05 [0.01-0.10]) and living with someone (PE = 0.08 [95% CI 0.04-0.13]) were associated with perceiving more benefits. In addition, access to the Internet (PE = 0.12 [0.06-0.19]) and independent use of the Internet (PE = 0.23 [0.17-0.29]) were associated with perceiving more benefits. Conclusions Older adults who are healthier, have a social relationship in their everyday life or have easier access to traditional services seem to perceive more benefits from digital health and social services. Digital services should be developed to correspond with special needs caused by disadvantages in health and the social environment. To facilitate the use of digital health and social services, more efforts should be made to enhance older adults' perceptions of their benefits.
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Affiliation(s)
- Emma Kainiemi
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Petra Saukkonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Lotta Virtanen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tuulikki Vehko
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Maiju Kyytsönen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mari Aaltonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tarja Heponiemi
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
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Alıcı G, Genç Ö. The pattern of dyslipidemia among Somali type 2 diabetic patients: a cross-sectional study. Eur J Med Res 2022; 27:253. [PMID: 36404351 PMCID: PMC9677666 DOI: 10.1186/s40001-022-00882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a major public health concern. This study aims to determine frequency, pattern, and potential determinants of dyslipidemia among adults with type 2 DM (T2DM) at Somalia's only diabetes outpatient clinic. METHODS Five hundred twenty-nine consecutive patients with T2DM who applied to our outpatient clinic between January 2020 and June 2020 were included in this cross-sectional hospital-based study. Demographic characteristics of participants, including lipid panel, were extracted from the registry system. Correlation analysis was performed between lipid profile and related parameters. Multivariate binary logistic regression models were used to identify independent determinants of dyslipidemia for further analysis. RESULTS The overall population's mean age was 51.9 ± 12.2 years, with 177 (33.5%) males. Total and atherogenic dyslipidemias were found in 92.8% and 24.8%, respectively. The most common isolated pattern of dyslipidemia was high non-high-density lipoprotein cholesterol (non-HDL-C) (82.8%), followed by high low-density lipoprotein cholesterol (LDL-C) (72.6%), high total cholesterol (TC) (54.3%), and low HDL-C (48.3%). Females were found to have a higher prevalence of high TC (63.4% vs. 54.2%, p = 0.043) and lower HDL-C (57.4% vs. 46.3%, p = 0.016). High LDL-C with low HDL-C was the most common pattern among combined type dyslipidemias (18.1%), followed by high LDL-C with high triglyceride (TG) (17.8%), as well as low TG with low HDL-C (3.6%). Females had a higher proportion of high LDL-C with low HDL-C than males (20.3% vs. 13.6%, p = 0.036). Age, gender, body mass index, central obesity, spot urinary proteinuria, fasting blood glucose, poor glycemic control, creatinine, and Hs-CRP were all associated with different dyslipidemia patterns in multivariate logistic regression analyses. CONCLUSIONS We found that the prevalence of dyslipidemia, especially atherogenic patterns, was extremely high among Somali T2DM patients. An enhanced health policy should, therefore, be established to detect, treat and prevent dyslipidemia.
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Affiliation(s)
- Gökhan Alıcı
- Department of Cardiology, Somalia Mogadishu Türkiye Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - Ömer Genç
- Department of Cardiology, İstanbul Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
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Wu C, Liu YX, Liu TJ, Yan XL, Zhao YX, Zeng H, Zhou T, Rao P, Sun LY, Jiao Y, Xi JN. Investigation and influencing factors about well-being level of elderly chronic patients during COVID-19 postpandemic period in Beijing. Medicine (Baltimore) 2022; 101:e28976. [PMID: 35244066 PMCID: PMC8896424 DOI: 10.1097/md.0000000000028976] [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] [Received: 08/07/2021] [Accepted: 02/06/2022] [Indexed: 01/04/2023] Open
Abstract
The Corona Virus Disease 2019 (COVID-19) pandemic has huge impacts on the world, including human health and economic decline. The COVID-19 has severe infectivity, especially the elderly with chronic diseases will cause various complications after infection and accelerate the disease process. In addition, COVID-19 will also affect their mental health. Therefore, the mental health of elderly patients with chronic diseases cannot be ignored. The aim of this study was to investigate the well-being level of elderly people with chronic disease during COVID-19 postpandemic period in Beijing and analysis related influencing factors, so as to provide a basis for improving the well-being level of elderly chronic patients during the postpandemic period.Elderly patients with chronic diseases who met the inclusion criteria in 5 different administrative regions in Beijing were selected to carry out a questionnaire survey. The contents of the questionnaire included general data, the Memorial University of Newfoundland Happiness scale and the awareness situation of the COVID-19 pandemic. A total of 500 questionnaires were distributed by WeChat and 486 valid questionnaires were collected. The t test and one-way analysis of variance were used to compare Memorial University of Newfoundland Happiness scores between 2 or more groups, multiple linear regression analysis was used to conduct multiple factor analysis to explore the related factors about well-being level of elderly chronic patients.A total of 109 cases (22.43%) were evaluated high well-being level, 319 cases (65.64%) were evaluated moderate well-being level and 58 cases (11.93%) were evaluated low well-being according to the Memorial University of Newfoundland Happiness (MUNSH) scores rating. The multiple linear regression indicated that the education level, number of chronic diseases, medical expenses, frequency of children's visits, taking care of grandchildren or not, and group activity frequency significantly affected the well-being of patients with chronic diseases during COVID-19 postpandemic period in Beijing (P < .05).Most elderly patients with chronic diseases had moderate or above sense of well-being during postpandemic period, but we should still pay attention to the mental health of those elderly chronic patients with low education level, much comorbidity, more medical expenses, less visits by children, not take care of grandchildren and never participate in group activities.
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Affiliation(s)
- Chen Wu
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Yu-Xuan Liu
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Tie-Jun Liu
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Xu-Ling Yan
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Yu-Xi Zhao
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Hong Zeng
- Beijing Municipal Health Commission, Beijing, China
| | - Tian Zhou
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Ping Rao
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | | | - Yang Jiao
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Jia-Ning Xi
- Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
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Hu H, Jian W, Fu H, Zhang H, Pan J, Yip W. Health service underutilization and its associated factors for chronic diseases patients in poverty-stricken areas in China: a multilevel analysis. BMC Health Serv Res 2021; 21:707. [PMID: 34275449 PMCID: PMC8286576 DOI: 10.1186/s12913-021-06725-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/01/2021] [Indexed: 12/17/2022] Open
Abstract
Background Underutilization of health services among chronic non-communicable disease sufferers, especially for hypertension (HBP) and diabetes mellitus (DM), was considered as a significant contributing factor to substantial cases in terms of both avoidable morbidity and mortality. However, evidence on health services underutilization and its associated factors in poverty-stricken areas remain scarce based on previous literature. This study aims to describe health services underutilization for people diagnosed with chronic diseases in impoverished regions and to identify its associated factors, which are expected to provide practical implications for the implementations of interventions tailored to the specific needs of disadvantaged residents in rural China to achieve effective utilization of health services in a timely manner. Methods Data were collected from a cross-sectional survey conducted through face-to-face interviews among 2413 patients from six counties in rural central China in 2019. The Anderson behavioral model was adopted to explore the associated factors. A two-level logistic model was employed to investigate the association strengths reflected by adjusted odds ratios (AOR) and 95% confidence intervals in forest plots. Results On average, 17.58% of the respondents with HBP and 14.87% with DM had experienced health services underutilization during 1 month before the survey. Multilevel logistic regression indicated that predisposing factors (age), enabling factors (income and a regular source of care), and need factors (self-reported health score) were the common predictors of health service underutilization both for hypertensive and diabetic patients in impoverished areas, among which obtaining a regular source of care was found to be relatively determinant as a protective factor for health services underutilization after controlling for other covariates. Conclusions Our results suggested that the implementation of a series of comprehensive strategies should be addressed throughout policy-making procedures to improve the provision of regular source of care as a significant determinant for reducing health services underutilization, thus ultimately achieving equal utilization of health services in impoverished regions, especially among chronic disease patients. Our findings are expected to provide practical implications for other developing countries confronted with similar challenges resulting from underdeveloped healthcare systems and aging population structures. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06725-5.
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Affiliation(s)
- Haiyan Hu
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, China.,Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Weiyan Jian
- School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100871, China
| | - Hongqiao Fu
- School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100871, China
| | - Hao Zhang
- Harvard T.H. Chan School of Public Health, No. 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Jay Pan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, China. .,Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, China.
| | - Winnie Yip
- Harvard T.H. Chan School of Public Health, No. 665 Huntington Avenue, Boston, MA, 02115, USA
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