Beyond individual responsibility towards healthy food choices: A qualitative study among Pakistani women in Hong Kong

While biomedical understandings of food and diet coupled with discourses on individual responsibility towards healthy food choices are nowadays prominent, other social and cultural meanings attached to food and diet are largely devalued. The limits of such a reductionist approach are more evident when related to the experiences of migrant and ethnic populations, whose alternative knowledge(s) and practices about food and health are especially neglected. A multicultural city with a public healthcare system inherited from the British colonial times and largely shaped by biomedical ideas of health, Hong Kong offers a lens into the limits of such a reductionist approach. Due to their vulnerability in the context of Hong Kong as shaped by intersecting social identities, 72 women from Pakistan were recruited to be our community partners in a community-based participatory action research project to investigate their health needs and concerns. 12 focus group discussions were conducted, exploring their experiences of "healthy" food and overweight especially related to their encounters with the Hong Kong public healthcare system, as these issues emerged as key health concerns within the community. Four major themes emerged: unmet expectations of care, health is beyond the individual, constraints to a healthy diet in the context of migration, and beyond health: food as care for diasporic women. This study highlights the limit of a reductionist approach to healthy food as merely based on nutrition and individual responsibility. It stresses the need of a counter-discourse in the field of public health, emphasizing not only alternative cultural ideas of health and food, but also enlarging the field of health in biomedical terms to embrace "care" and acknowledging the structural constraints shaping migrant and ethnic population's vulnerability in making "healthy" food choices.

Effectiveness of Interactive Digital Decision Aids in Prenatal Screening Decision-making: Systematic Review and Meta-analysis

BACKGROUND

Increasing prenatal screening options and limited consultation time have made it difficult for pregnant women to participate in shared decision-making. Interactive digital decision aids (IDDAs) could integrate interactive technology into health care to a facilitate higher-quality decision-making process.

OBJECTIVE

The objective of this study was to assess the effectiveness of IDDAs on pregnant women's decision-making regarding prenatal screening.

METHODS

We searched Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, World Health Organization International Clinical Trials Registry Platform, Google Scholar, and reference lists of included studies until August 2021. We included the randomized controlled trials (RCTs) that compared the use of IDDAs (fulfilling basic criteria of International Patient Decision Aid Standards Collaboration and these were interactive and digital) as an adjunct to standard care with standard care alone and involved pregnant women themselves in prenatal screening decision-making. Data on primary outcomes, that is, knowledge and decisional conflict, and secondary outcomes were extracted, and meta-analyses were conducted based on standardized mean differences (SMDs). Subgroup analysis based on knowledge was performed. The Cochrane risk-of-bias tool was used for risk-of-bias assessment.

RESULTS

Eight RCTs were identified from 10,283 references, of which 7 were included in quantitative synthesis. Analyses showed that IDDAs increased knowledge (SMD 0.58, 95% CI 0.26-0.90) and decreased decisional conflict (SMD -0.15, 95% CI -0.25 to -0.05). Substantial heterogeneity in knowledge was identified, which could not be completely resolved through subgroup analysis.

CONCLUSIONS

IDDAs can improve certain aspects of decision-making in prenatal screening among pregnant women, but the results require cautious interpretation.

COVID-19 Vaccination Preferences among non-Chinese migrants in Hong Kong: A Discrete Choice Experiment

BACKGROUND

Studies has shown increase COVID-19 vaccination hesitancy among migrant populations in certain settings than the general population. Hong Kong (HK) has a growing migrant population with diverse ethnic backgrounds. Apart from individual level factors little is known about the migrants' preference related to COVID-19 vaccines.

OBJECTIVE

This study aimed to investigate which COVID-19 vaccine-related attributes combined to individual factors may lead to vaccine acceptance or refusal among the migrant population in HK.

METHODS

An online discrete choice experiment (DCE) was conducted among all adults, including Chinese people, non-Chinese Asians (South, South-East and North-East Asians), and non-Asians (Europeans, Americans and Africans) migrants in HK from 26 February to 26 April 2021. The participants were recruited by quota sampling and sent a link to web-survey. The vaccination attributes included in eight choice sets in each of the four blocks were vaccine brand, safety and efficacy, vaccine uptake by people around, professionals' recommendation, vaccination venue, and quarantine exemption for vaccinated travelers. Nested logistic model and latent-class logit (LCL) model were used for statistical analysis.

RESULTS

A total of 208 migrant participants were included with a response rate of 62.1%. Among migrants, participants with longer local residential years (27.7% for 10+ years, 20.6% for 7-9 years, 6.7% for 4-6 years, and 9.7% for below 3 years; P=.03), lower education level (28.3% vs 13.9%, P=.01) and lower income (25.2% vs 13.2%, P=.04) were more likely to refuse COVID-19 vaccination irrespective of vaccination attributes. BioNTech vaccine compared with Sinovac (adjusted odds ratio [AOR]: 1.75, 95% confidence interval [CI]: 1.14-2.68), vaccine with 90% (AOR: 1.44, 95%CI: 1.09-1.91) and 70% efficacy(AOR: 1.21, 95%CI: 1.03-1.44) compared with 50%, vaccine with fewer serious adverse events 1/100,000 compared with 1/10,000 (AOR: 1.12, 95%CI: 1.00-1.24) and quarantine exemption for cross-border travelers(AOR: 1.14, 95%CI: 1.01-1.30) were the vaccine attributes that could increase the likelihood of vaccination among migrants. For individual-level factors, the full-time housemakers (AOR: 0.44, 95%CI: 0.29-0.66), those with chronic conditions (AOR: 0.61, 95%CI: 0.41-0.91) and more children, and those frequently received vaccine-related information from workplace (AOR: 0.42, 95%CI: 0.31-0.57) were found reluctant to accept the vaccine. those with higher income (AOR: 1.79, 95%CI: 1.26-2.52), knowing anyone infected with COVID-19 (AOR: 1.73, 95%CI: 1.25-2.38), having greater perceived susceptibility of COVID-19 infection (AOR: 3.42, 95%CI: 2.52-4.64), received influenza vaccine (AOR: 2.15, 95%CI: 1.45-3.19), and frequently received information from social media (AOR: 1.52, 95%CI: 1.12-2.05) were more likely to accept the vaccine.

CONCLUSIONS

This study implies that migrants have COVID-19 vaccination preference heterogeneity and more targeted and tailored approaches are needed to promote vaccine acceptance for different subgroups of migrant population in Hong Kong. Vaccination promotion strategies are needed for low education and low income migrant groups, migrants with chronic diseases, working migrant population, housemakers and parents.

CLINICALTRIAL

Maternity care experience of Pakistani ethnic minority women in Hong Kong

Background

Persistent inequalities in maternity care experience and outcomes exist globally for ethnic minority (EM) and migrant women. Despite the fact that this is an important research area, no prior study has been done in Hong Kong (HK) to examine maternity care experience of EM women.

Objectives

To investigate maternity care experience of Pakistani EM women (both local born and immigrants) during pregnancy, birth and after birth in hospital in HK. An evaluation of their satisfaction and factors predicting satisfaction with care during the three phases of maternity care was included in the study.

Methods

A cross sectional survey was conducted among Pakistani EM women who had given birth in HK in last 3 years, using a structured questionnaire by a bilingual interviewer, from April to May 2020. Counts and percentages were used to describe all categorical variables. Association between predictor variables and overall satisfaction was assessed by bivariate analysis and multiple logistic regression.

Results

One hundred and twenty questionnaires were completed. Almost 60 percent of the women were very satisfied with the overall care. More than half of the women described the care they received as kind, respectful and well communicated. After adjusting for age and parity, HK born Pakistani women expressed relatively less satisfaction with care, especially during pregnancy and labor and birth, as compared with Pakistan born women. Women with conversational or fluent English-speaking ability also felt comparatively less satisfied particularly from intrapartum and postnatal care in hospital. Education level had a negative association with satisfaction with care during pregnancy.

Conclusions

Maternity care providers should take into account the diversity of EM women population in HK. Our findings suggest that effective communication and care that can meet individual needs, expectations, and values is imperative to improve experience and quality of maternity care for EM women in HK.

Multilevel Determinants of COVID-19 Vaccine Uptake Among South Asian Ethnic Minorities in Hong Kong: Cross-sectional Web-Based Survey

BACKGROUND

The COVID-19 pandemic continues to have a disproportionate effect on ethnic minorities. Across countries, greater vaccine hesitancy has been observed among ethnic minorities. After excluding foreign domestic helpers, South Asians make up the largest proportion of ethnic minorities in Hong Kong. It is necessary to plan for COVID-19 vaccination promotional strategies that cater to the unique needs of South Asians in Hong Kong.

OBJECTIVE

This study investigated the prevalence of COVID-19 vaccine uptake among a sample of South Asians in Hong Kong. We examined the effects of sociodemographic data and factors at individual level (perceptions), interpersonal level (information exposure on social media), and sociostructural level (cultural) based on the socioecological model.

METHODS

A cross-sectional web-based survey was conducted on May 1-31, 2021. Participants were South Asian people aged 18 years or older living in Hong Kong; able to comprehend English, Hindi, Nepali, or Urdu; and having access to a smartphone. Three community-based organizations providing services to South Asians in Hong Kong facilitated the data collection. The staff of the community-based organizations posted the study information in WhatsApp groups involving South Asian clients and invited them to participate in a web-based survey. Logistic regression models were fit for data analysis.

RESULTS

Among 245 participants, 81 (33.1%) had taken at least one dose of the COVID-19 vaccine (one dose, 62/245, 25.2%; and both doses, 19/245, 7.9%). After adjusting for significant background characteristics, cultural and religious reasons for COVID-19 vaccine hesitancy were associated with lower COVID-19 vaccine uptake (adjusted odds ratio [AOR] 0.83, 95% CI 0.71-0.97; P=.02). At the individual level, having more positive attitudes toward COVID-19 vaccination (AOR 1.31, 95% CI 1.10-1.55; P=.002), perceived support from significant others (AOR 1.29, 95% CI 1.03-1.60; P=.03), and perceived higher behavioral control to receive COVID-19 vaccination (AOR 2.63, 95% CI 1.65-4.19; P<.001) were associated with higher COVID-19 vaccine uptake, while a negative association was found between negative attitudes and the dependent variable (AOR 0.73, 95% CI 0.62-0.85; P<.001). Knowing more peers who had taken the COVID-19 vaccine was also associated with higher uptake (AOR 1.39, 95% CI 1.11-1.74; P=.01). At the interpersonal level, higher exposure to information about deaths and other serious conditions caused by COVID-19 vaccination was associated with lower uptake (AOR 0.54, 95% CI 0.33-0.86; P=.01).

CONCLUSIONS

In this study, one-third (81/245) of our participants received at least one dose of the COVID-19 vaccine. Cultural or religious reasons, perceptions, information exposure on social media, and influence of peers were found to be the determinants of COVID-19 vaccine uptake among South Asians. Future programs should engage community groups, champions, and faith leaders, and develop culturally competent interventions.

Green and facile synthesis of cerium doped Ni3Fe electrocatalyst for efficient oxygen evolution reaction

Electrochemical water splitting is the most promising pathway to produce high-purity hydrogen to alleviate global energy crisis. This reaction demands inexpensive, efficient and robust electrocatalyst for its commercial use. Herein, we demonstrate an effective, facile and scalable method for the synthesis of cerium doped Ni3Fe nanostructures as an electrocatalyst for oxygen evolution reaction (OER) by following simple chemical bath deposition route. The different molar ratios (3, 6 and 12 mM) of cerium in the chemical bath were used to study its effect on the structural and the electrochemical properties of the Ni3Fe nanostructured films. Doping of cerium contents induced variations in the morphology of deposited Ni3Fe nanostructures. The optimized electrocatalyst Ni3Fe/Ce-6 yielded high surface area catalyst nanosheets uniformly deposited on three-dimensional conductive scaffold to ensure increase in the exposure of doped Ni3Fe catalytic sites with high electrical conductivity. As a result, this earth-abundant electrocatalyst affords high OER performance with a small overpotential of 310 mV versus reversible hydrogen electrode (RHE) at 10 mA cm-2 and retains good stability up to ~ 10 h in alkaline electrolyte. This scalable strategy has great potential in future advancement of efficient and low-cost electrocatalysts for their large-scale application in energy conversion systems.                     KEY WORDS: Oxygen evolution, Electrocatalyst, Ni3Fe nanostructures, Cerium, Alkaline electrolyte   Bull. Chem. Soc. Ethiop. 2020, 34(2), 353-363 DOI: https://dx.doi.org/10.4314/bcse.v34i2.12

The effect of Nanocrystalline cellulose/Gum Arabic conjugates in crosslinked membrane for antibacterial, chlorine resistance and boron removal performance

In this work, we developed hybrid membranes integrated with Nanocrystalline cellulose (NCC)/Gum Arabic (GuA) conjugates using crosslinked Poly (vinyl alcohol) (PVA) as a matrix phase with the addition of PEO-PPO-PEO block copolymer that insured pore formation. At first, the NCC was prepared from microcrystalline cellulose via acid hydrolysis process. The performance property of hybrid NCC/GuA was measured using boron removal. The results showed that the rejection capability enhanced as compared to the control membranes, especially at 0.1wt% of NCC the selectivity is up to 92.4% with the flux rate of 21.3L/m².h. Moreover, the GuA in NCC/GuA conjugate significantly enhances the antibacterial activity by hindering the bacterial attachment to the surface as both of them carry the negative charge. Also by providing the active sites responsible for hydrogen bonding thus enhancing the hydrophilic character resulted in increased permeation flux rate. Therefore, the NCC/GuA conjugated membranes have great potentials for boron removal.