The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic

We aimed to investigate how factors such as age, education level, planned delivery method and fear of childbirth were affected in pregnant women before and during the pandemic. This cross-sectional study compared a pre-pandemic pregnant group (July 2019 and December 2019) and a pandemic group (November 2020 and May 2021) of patients at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital. A total of 696 pregnant women in their second trimester were included in the study. All of them were literate and voluntarily agreed to participate in the study. Data were collected with the Wijma delivery expectancy/experience questionnaire (WDEQ-A), and the outpatient doctor asked the questions face-to-face. The mean age of the pregnant women participating in the study was 31.6 ± 6.8 years. While the total Wijma score was 62.1 ± 25.1 in the pre-pandemic group, it was 61.3 ± 26.4 in the pandemic group, and there was no significant difference between the two groups (p = 0.738). Upon analyzing the fear of childbirth among groups based on education level, no statistically significant differences were observed between the pre-pandemic and pandemic periods within any of the groups. While 25.7% (n = 179) of all participants had a normal fear of childbirth, 22% (n = 153) had a mild fear of childbirth, 27% (n = 188) had a moderate fear of childbirth, and 25.3% (n = 176) had a severe fear of childbirth (Wijma score of 85 and above). When the pre-pandemic and the pandemic period were compared, the fear of childbirth was unchanged in pregnant women at all education levels (p = 0.079, p = 0.957, p = 0.626, p = 0.539, p = 0.202). When comparing fear of childbirth before and after the pandemic, it was found that patients with a high school education level have a significantly higher fear of childbirth. To alleviate the fear of childbirth in pregnant women who have completed high school, training or psychosocial support interventions may be prioritized.

FISSURE SEALANT IN A NUTSHELL. EVIDENCE-BASED META-EVALUATION OF SEALANTS' EFFECTIVENESS IN CARIES PREVENTION AND ARREST

OBJECTIVE

This meta-evaluation aimed to summarize all available evidence regarding different fissure sealants on occlusal caries prevention, arrest, retention rate, adverse effect, and cost-effectiveness; when compared with no intervention, other preventive or minimally-invasive procedures.

MATERIALS AND METHODS

The systematic reviews and meta-analyses were identified via four electronic databases and manual searching. Two independent reviewers performed study selection, data extraction, quality assessment with AMSTAR-2.

RESULTS

Among the 366 records yielded, 38 systematic reviews were identified as eligible 24 of them included meta-analyses. Moderate evidence has supported the efficacies of resin-based sealants (RBS) in occlusal caries prevention, arrest and cost-effectiveness compared to no interventions. Low to very low certainty of evidence suggested similar effectiveness of glass-ionomer cements in caries prevention with RBS and more superior performance of resin infiltration in arresting non-cavitated occlusal lesions.

CONCLUSION

This meta-evaluation supports the use of RBS on permanent molars to reduce occlusal caries occurrence, arrest lesion progression and alleviate oral health inequalities between individuals of different socioeconomic status. This meta-evaluation also advocates further research on glass-ionomer cements and resin infiltration with respect to their efficacies in caries prevention and arrest.

The influence of corruption on environmental sustainability in the developing economies of Southern Africa

This paper analyses the impact of corruption on environmental sustainability in all 16 countries in the Southern region of Africa from 2010-2017. The paper uses two proxies of corruption: the Corruption Index and Corruption Ranking. Using two econometric methods, namely, the Dumitrescu and Hurlin (2012) Granger causality test and the Generalised Method of Moments (GMM) techniques this study found largely congruent results on both causation and relationships, respectively. Firstly, the two indicators of corruption harmoniously show that corruption Granger causes the existing state of environmental sustainability in Southern African economies, and vice-versa. Moreover, in the short-run corruption was also found to worsen environmental sustainability for both regression models deployed using the two corruption indicators. In the long-term, the two measures of corruption conflicted with their findings. In this regard, though the relationship is contradicting in the long-run the corruption negative (becoming bad) effect of corruption ranking surpasses the corruption positive (becoming clean) effect of corruption index by nearly three times. This show how detrimental corruptible actions are to the natural environment. Overall, this paper consent to global reports explaining how Southern African environments are gradually deteriorating by putting corruption as one central practice causing extensive damage.

Health literacy in an Israeli elderly population

BACKGROUND

Health literacy is important for patients' comprehension of the health and medical messages conveyed to them and their meaning for them so that they can better manage their health. The aim of the study was to examine the level of health literacy within the elderly population. The hypothesis was that health literacy would be inadequate, and related to demographic variables.

METHOD

Sixty men and women over the age of 65 who volunteered to participate in the study completed a 13-item health literacy questionnaire.

RESULTS

Overall, the level of health literacy among the participants was mostly inadequate. They reported difficulty in reading medical material in Hebrew and understanding the doctor, thus requiring assistance (20%); difficulty in reading medical documents, completing medical forms and understanding medical terms; difficulty in reading the leaflet attached to medications (33%), test results (40%) and medical information written in English (66%) and difficulty searching the internet for information (53.3%). The level of health literacy was associated with education while the best profile for adequate health literacy was for those who spoke Hebrew and completed secondary education.

CONCLUSIONS

Medical teams have an obligation to be alert and attentive to the level of health literacy of elderly patients and to modify communication and information to an accommodating degree, so that elderly patients can better manage their health.

The Incidence Prognosis and Risk Factors of Cognitive Impairment in Maintenance Haemodialysis Patients

OBJECTIVE

To investigate the incidence and the prognosis of cognitive impairment (CI) and to find out the risk factors associated with the outcome in maintenance haemodialysis (MHD) patients.

METHODS

Enrolled the patients who met the criteria as below: MHD (≥3 months) patients before July 2014, ≥18 years old and could carry on the cognitive function test (Montreal Cognitive Assessment [MoCA]). All enrolled patients were divided into 2 groups: CI group (MoCA < 26) and non-CI group (MoCA ≥26). All patients were followed up for 36 months. The incidence, demography data, medical history, haemodialysis data, laboratory examination and prognosis of CI in haemodialysis patients were prospectively compared and analyzed. Multivariate logistic regression analysis was used to investigate the risk factors of CI. Kaplan-Meier survival curve was used for survival analysis.

RESULTS

In the present study, 219 patients were enrolled. The ratio of male to female was 1.46: 1. Age was 60.07 ± 12.44 and dialysis vintage was 100.79 ± 70.23 months. One hundred thirteen patients' MoCA scores were lower than 26 were divided into CI group. Education status (OR 3.428), post-dialysis diastolic pressure (OR 2.234) and spKt/V (OR 1.982) were independent risk factors for CI in MHD patients. During the follow-up period, 15 patients died (13.2%) in the CI group and 5 died (4.72%) in the non-CI group (p < 0.05). The Kaplan-Meier survival curve analysis showed that the survival rate of patients with CI was lower than that of non-CI group in MHD patients during 3 years follow-up (p = 0.046).

CONCLUSION

CI is one of the most common complications in MHD patients. The mortality is high in patients who had CI. Education status, post-dialysis diastolic pressure and spKt/V are independent risk factors for CI in MHD patients.

Temporal change to self-rated health in the Swiss population from 1997 to 2012: the roles of age, gender, and education

OBJECTIVES

Our study aimed to describe the temporal changes in self-rated health status (SRH) from 1997 to 2012 in adults aged 25 to 84 residing in Switzerland, with a view to identifying groups at risk for declining health.

STUDY DESIGN

Secondary analysis of population-based cross-sectional health surveys.

METHODS

Data were collected from the cross-sectional, population-based, five-year Swiss Health Survey, from 1997, 2002, 2007 and 2012. A total of 63,861 individuals' data were included. Multilevel mixed-effect logistic regression analysis was employed to estimate the probability of very good and good health within the framework of a hierarchical cross-classified age-period-cohort model (HAPC), adjusting for education level, gender, civil status, smoking status and body mass index.

RESULTS

Individuals with higher education were substantially more likely than those with primary education to report good SRH (OR = 2.12; 95% CI = 1.93-2.33 for secondary education and OR = 3.79; 95% CI = 3.39-4.23 for tertiary education). The education effect depended on birth cohort and age: higher proportions of good SRH were reported by secondary (8%-17%) and tertiary (10%-22%) compared with primary educated individuals from the 1940 birth cohort onward; the proportion of secondary/tertiary (compared to primary) educated people reporting good SRH increased with age (by 10/11% at 45-50 years and 25/36% at 80-84 years). Gender health equality was achieved by the 1955 (primary educated) and 1960 (secondary educated) birth cohorts, while these women overtook men in reporting good SRH from the 1975 birth cohort onward. Tertiary educated younger women were significantly less likely to report good SRH than men but parity was achieved at around pension age. Similarly, gender inequality in those with primary and secondary education reduced in the younger ages to not be significant at around age 55, with women overtaking men from age 65.

CONCLUSIONS

Younger birth cohorts with lower education levels appear most vulnerable in terms of their SRH. The education effect cumulatively increases when attaining incrementally higher education levels. While women report lower health than men, gender inequality in SRH has declined and even reversed over time and is substantially linked to differences in educational status. Swiss public health strategies should particularly target the younger adults with only primary school education of both genders; for women, to combat health burdens in their early life, and men, to mitigate issues in their later life.

The risk factors for gestational diabetes mellitus: A retrospective study

OBJECTIVE

To investigate the risk factors for developing GDM among Taiwanese pregnant women.

DESIGN

A retrospective cohort and case-control study.

SETTING

At a medical centre in Southern Taiwan.

PARTICIPANTS

The hospitalised pregnant women who were diagnosed with either GDM or normal glucose tolerance (NGT) between 1997 and 2011. The glucose tolerance test results were interpreted according to criteria established by the National Diabetes Data Group for GDM. Participants were divided into either a GDM group (case group) or a normal glucose tolerance (NGT) group (control group) in order to determine the risk factors for GDM.

MEASUREMENTS

With a retrospective chart review, data regarding demographics, a family history of diabetes, history of gestation, and physiological index for pre- and postpregnancy periods were collected. χ² tests and independent t tests were used to examine the correlations between demographic characteristics and GDM. Stepwise multivariate logistic regression was used to determine the factors associated with GDM.

FINDINGS

The results of the comparison between the GDM group (n=106) and the NGT group (n=406) showed that the risk factors for GDM were maternal age, education, a family history of diabetes, and prepregnancy body mass index (BMI).

KEY CONCLUSION AND IMPLICATION FOR PRACTICE

Older age, lower levels of education, a family history of diabetes, and higher prepregnancy BMI were significant risk factors for GDM. In addition to performing risk factor assessment, health care providers should proactively promote the importance of GDM screening to pregnant women at their first antenatal visit.

Association of low educational status with microvascular complications in type 2 diabetes: Jaipur diabetes registry

OBJECTIVE

To determine the association of educational status (ES), as marker of socioeconomic status, with the prevalence of microvascular complications in diabetes.

METHODS

Successive patients (n = 1214) presenting to our center were evaluated for sociodemographic, anthropometric, clinical, and therapeutic variables. Subjects were classified according to ES into Group 1 (illiterate, 216); Group 2 (≤ primary, 537), Group 3 (≤ higher secondary, 312), and Group 4 (any college, 149). Descriptive statistics is reported.

RESULTS

Mean age of patients was 52 ± 10 years, duration of diabetes 7 ± 7 years and 55% were men. Prevalence of various risk factors was smoking/tobacco 25.5%, obesity body mass index ≥25 kg/m(2) 64.0%, abdominal obesity 63.4%, hypertension 67.5%, high fat diet 14.5%, low fruits/vegetables 31.8%, low fiber intake 60.0%, high salt diet 16.9%, physical inactivity 27.5%, coronary or cerebrovascular disease 3.0%, and microvascular disease (peripheral, ocular or renal) in 20.7%. Microvascular disease was significantly greater in illiterate (25.9%) and low (23.6%) compared to middle (15.0%) and high (14.7%) ES groups (P < 0.05). Age- and sex-adjusted logistic regression analysis revealed that in illiterate and low ES groups respectively, prevalence of smoking/tobacco use (odds ratio 3.84, confidence interval: 09-7.05 and 2.15, 1.36-3.41); low fruit/vegetable (2.51, 1.53-4.14 and 1.99, 1.30-3.04) and low fiber intake (4.02, 2.50-6.45 and 1.78, 1.23-2.59) was greater compared to high ES. Poor diabetes control (HbA1c >.0%) was significantly greater in illiterate (38.0%), low (46.0%), and middle (41.0%) compared to high (31.5%) ES subjects (P < 0.05).

CONCLUSIONS

There is a greater prevalence of the microvascular disease in illiterate and low ES diabetes patients in India. This is associated with the higher prevalence of smoking/tobacco use, poor quality diet, and sub-optimal diabetes control.

Prevalence of toothache and associated factors: a population-based study in southeast iran

INTRODUCTION

This study was carried out to estimate toothache prevalence among adult residents in Kerman.

MATERIALS AND METHODS

This cross-sectional, population-based study was conducted among individuals aged over 18 years (n=1800). The relevant data on the prevalence of toothache and associated factors were collected by interviewing the individuals in their homes and filling out a questionnaire designed by the examiners. Prevalence of toothache and associated factors that patients recalled previous to their interview were analyzed by chi-square test and multivariate logistic regression analysis.

RESULTS

Nine hundred ninety-one individuals (55.1%) reported toothache during the 6 months before the interview. The participants who flossed daily, had regular dental visits, and had higher education showed a significantly lower prevalence of toothache (P<0.05), whereas regular tooth brushing and economic level of residency had no significant effect on the prevalence of toothache. Individuals between the ages of 26 and 45 [odds ratio (OR)=2.0], with a family size of more than 4 (OR=1.5), not using dental floss (OR=1.5), or having a mental or psychological illness (OR=1.5) were more likely to have a history of toothache.

CONCLUSION

High prevalence of toothache (more than half) among residents of Kerman shows a serious and major public health problem. Toothache prevalence in middle aged adults, lower education, bigger family size, lower dental hygiene habit and/or those having mental or psychological illness were more common in the city of Kerman.