bluuebunny/crossref_metadata_2025 huggingface dataset:
Health system's readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey
Authors: Ghimire Umesh , Shrestha Nipun , Adhikari Bipin , Meheta Suresh , Pokharel Yashashwi , Mishra Shiva Raj
Published: March 2020

Background: The burgeoning rise of non-communicable diseases is posing a serious challenge in resource constrained health facilities of Nepal. The main objective of this study was to assess the readiness of health facilities for cardiovascular, diabetes and chronic respiratory disease services in Nepal. Methods: This study utilized data from the Nepal Health Facility Survey 2015. General readiness of 940 health facilities along with disease specific readiness for cardiovascular diseases (CVDs), diabetes and cardiorespiratory diseases (CRDs) were assessed using service availability and readiness assessment manual of the World Health Organization (WHO). Health facilities were categorized into public and private facilities.Results: Out of a total of 940 health facilities assessed, private facilities showed higher availability of items of general service readiness, except for standard precautions for infection prevention, compared to public facilities. The multivariable adjusted regression coefficients for CVDs (β=2.87, 95%CI: 2.42-3.39), diabetes (β =3.02, 95%CI: 2.03-4.49) and CRDs (β=15.95, 95%CI: 4.61-55.13) at private facilities were higher than public hospitals. Health facilities located in hills had higher readiness index for CVDs (β=1.99, 95%CI: 1.02 - 1.39). Service readiness for CVDs (β=1.13, 95%CI: 1.04-1.23) and diabetes (β=1.78, 95%CI: 1.23-2.59) were higher in the urban municipalities than in rural municipalities. Finally, disease related services readiness index was sub-optimal with some degree of variation at the province level in Nepal. Province 2 for CVDs (β=0.83, 95%CI: 0.73-0.95), and province 4 (β =1.24, 95%CI: 1.07-1.43) and province 5 (β =1.17, 95%CI: 1.02-1.34) had higher readiness index compared to province 1.Conclusions: This study found a sub-optimal readiness of services related to three NCDs at the public facilities in Nepal. Compared to public facilities, private facilities showed higher readiness score for CVDs, diabetes and CRDs. To cope up with the growing burden of NCDs, urgent improvement in health services, particularly in public facilities are critical to manage common NCDs.
Smoking habits in Syria and the influence of war on cigarette and shisha smoking.
Authors: Kakaje Ameer , Alhalabi Mohammad M , Alyousbashi Ayham , Ghareeb Ayham , Hamid Laura
Published: March 2020

Backgrounds: Shisha smoking has become an epidemic since the nineties and it adds an additional burden over cigarette smoking as it is more harmful, smoked socially and is widely accepted in many countries. We aim to discuss shisha and cigarette smoking prevalence in the Syrian community and university students with their associated risk factors and the relationship with many war factors.Methods: Online surveys were used that contained demographic and war-related questions along with cigarette and shisha smoking pattern questions.Results: The sample contained 987 responders with a mean age of 24.69, 25.7% being males, 16.4% smoking cigarettes, and 29.3% smoking shisha. Cigarette and shisha smoking was more common in males with P<0.0001 (OR, 4.762; 95% CI 3.333-6.757) and P=0.047 (OR, 1.364; 95% CI 1.003-1.855) for cigarettes and shisha respectively. Males also smoked daily, for longer years, more packs and more shisha every week than females P<0.05. However, females were more social smokers. While cigarette smoking was more prevalent in older ages, shisha was so in younger ages. Having a job, certain types of work and students at certain faculties were correlated with smoking more P<0.05. Losing someone due to the war and being distressed from war noises were also correlated with smoking. Field of education affected smoking patters as medical field students smoked fewer cigarettes and shisha while social studies students smoked more. Being a labourer, working as a clerk or in a restaurant, or as a technician was more frequently associated with smoking. However, no associations were found with SES, marital status and changing place of living due to war.Conclusions: Males tend to smoke more, heavier, more consistent, and for longer periods than females while women smoked shisha more socially. War increases smoking patterns while SES did not affect smoking in Syria. Shisha smoking increased and cigarette smoking decreased compared to previous studies and cigarette smoking remains lower than other regional countries, but shisha smoking is higher when compared to many other countries.
Association between parental separation and addictions in adolescents: results of a national Lebanese study
Authors: Jabbour Nour , Rached Vanessa Abi , Haddad Chadia , Salameh Pascale , Sacre Hala , Hallit Rabih , Soufia Michel , Obeid Sahar , Hallit Souheil
Published: March 2020

Objectives: to investigate the association between the divorce of parents and smoking, alcohol, and internet addiction among a representative sample of Lebanese adolescents.Methods: This study was a cross-sectional, conducted between January and May 2019 using a proportionate random sample of schools from all Lebanese Mohafazat. Out of 2000 questionnaires distributed; 1810 (90.5%) were completed and collected back.Results: The mean age was 15.42 ± 1.14 years, with 53.3% females and 74.1% smokers. In addition, 11.9% [95% CI 0.104-0.134] of the adolescents had separated/divorced parents. Divorce in parents was significantly associated with higher alcohol use disorder (Beta=8.035), higher cigarette dependence (Beta=2.767) and a higher waterpipe dependence (Beta=5.263) in adolescents. However, divorce in parents was not associated with internet addiction in adolescents.Conclusion: Parental divorce was correlated to higher alcohol and smoking, but not internet addiction among adolescents. Children whose parents are divorced should be subject to continuous follow-up by their parents and by a psychiatrist/psychologist in order not to develop any addiction that could potentially harm them.
Correlates of family planning knowledge among people in fishing communities of Lake Victoria in Uganda
Authors: Nanvubya Annet , Wanyenze R.K. , Nakaweesa T. , Mpendo J. , Kawoozo B. , Matovu F. , Nabukalu S. , Omoding G. , Kaweesi J. , Ndugga J. , Kamacooko O. , Chinyenze K. , Price M. A. , Geertruyden J.P. Van
Published: March 2020

BackgroundFamily planning (FP) is a key component in the conduct of HIV prevention trials and FP knowledge is a determinant of modern contraceptive use. Although fishing communities (FCs) participate in HIV prevention trials, knowledge about FP in this population is scarcely known. We determined correlates of FP knowledge in FCs of L. Victoria in Uganda to inform improvements in FP interventions in preparation for other HIV prevention trials.MethodsWe conducted a cross-sectional survey among participants aged 16-49 years in Kigungu and Nsazi FCs. A semi-structured questionnaire was administered to assess FP knowledge. A composite score with 5 parameters including; awareness about FP methods, knowledge about ideal number of children for a couple, knowledge about ideal birth spacing interval, knowledge about FP methods and their side effects and interval between the last 2 children was used to determine whether participant’s knowledge was or wasn’t satisfactory. Satisfactory FP knowledge was attributed to a score of ≥80% from the five parameters. We also conducted 10 in-depth interviews and 4 focus group discussions.ResultsOf the 1,410 screened participants, 95% were aware of at least one FP method while only 21% had satisfactory knowledge. Participants aged 30-39 years, those engaged in trade/business, housewives, those from Nsazi, the married or those who were divorced, separated or widowed were more likely to have satisfactory FP knowledge compared to those aged 16-29 years (aOR: 1.59 95% CI: 1.14-2.22), farmers (aOR: 3.14 95% CI: 1.21-8.17), and (aOR: 3.69 95% CI: 1.35-10.1), those from Kigungu (aOR: 1.58 95%CI: 1.09-2.30), those who were single (aOR: 6.96 95% CI: 3.42-14.13) or (aOR: 17.67 95% CI: 8.54-36.54).There were concerns about side effects and effectiveness of some modern FP methods. Misconceptions about effects of FP like sterility, cancers and foetal abnormalities were common. Cultural beliefs on contraception are key barriers to FP information.ConclusionPeople from FCs in Uganda are aware of FP but their knowledge is largely unsatisfactory. Concerns about method safety, effectiveness of some methods, misconceptions and cultural barriers exist. A FP education tool tailored for a mobile, high risk and remote population is recommended to improve FP knowledge.
Effectiveness of Interventions Based on a Comprehensive Model for Promoting Physical Activity and Improving Health-related and Fitness Indices in Employees
Authors: Rafatifard Mohammad , Mahmoodabad Seyed Saied Mazloomy , Fallahzadeh Hossein , Faramarzi Mohammad , Sadeghi Masoumeh
Published: March 2020

Purpose To reduce physical inactivity at work, today's work environments require the design of interventions that can effectively enhance the level of physical activity. The purpose of this study was to determine the effectiveness of interventions based on a comprehensive model for promoting physical activity behaviors and improving health-related and physiological physical fitness indices in administrative employees of the industrial sector.Methods In this randomized, controlled trial study that included 170 administrative employees. The intervention group was subjected to a series of interventions based on a comprehensive model for practical and physical activities for 6 months. Data collection instruments used were a demographic checklist, Baecke Habitual Physical Activity Questionnaire, health-related and physiological physical fitness testing and a researcher-developed questionnaire based on the comprehensive model constructs.Data analysis was conducted by the SPSS 21 using chi-square, independent and paired t-test, Wilcoxon-Mann-Whitney U test, and repeated measures ANOVA. The significance level was considered 95%. The mean age of the subjects was 36.99(±7.69 SD) years old and all of them were male.Results The mean total physical activity index in the intervention group at 3 and 6 months after the intervention significantly increased compared to control group. The mean values of health-related and physiological physical indices, i.e., cardiorespiratory fitness, muscular endurance, flexibility and physical composition, in intervention group significantly increased compared to control group. Conclusion Designing interventions based on a comprehensive model to examine the broader and multi-level approaches between environmental, biological and psychological factors can affect physical activity behaviors and promote health behaviors.
YouTubeTM as a source of information for Candida auris infection: A systematic review
Authors: Huang Jiangqing , Zhang Shengcen , Xiao Qirong , Cao Yingping , Li Bin
Published: March 2020

Background: Candida auris is a novel Candida species, and has emerged globally as a multidrug-resistant health care-associated fungal pathogen. YouTubeTM (http://www.youtube.com) as the largest free video-sharing website is increasingly used to search health information. Thus, the aim of this study was to evaluate the content, reliability and quality of YouTube™ videos regarding Candida auris infection, and to identify whether it is a useful resource for people. Methods: The YouTube™ was used to search systematically for videos using the keywords: “Candida auris infection” and “Candida auris”. Strict inclusion and exclusion criteria were used to select the videos. The videos were reviewed and scored by two independent reviewers and recorded the “title”, “length”, “views”, “comments”, “dislike”, “like”, “posted days” and “category of videos”. The videos were categorized as “poor”, “good” and “excellent” by the score. The DISCERN tool was used to assess the reliability of the YouTubeTM videos. Results: Seventy-six videos were included in final analysis in our study. Most videos (59.2%, 55/76) had better quality. There were no statistically significant differences between groups in respect of the number of likes, dislikes, views, comments, percentage positivity, likebility, view rate and viewers' interaction. Length and posted days were significantly associated with the classification. The videos were categorized as “education”, “new report”, “personal experience and blog entertainment” and “interview”. Significant differences were found in the source of videos and the characteristics of the individuals appearing in a video between the groups. Conclusion: YouTubeTM has striking potential to be an effective user-friendly learning interface for people education and understanding of Candida auris infection.
The effect of health on social capital. A longitudinal observation study of the UK
Authors: Downward Paul , Rasciute Simona , Kumar Harish
Published: March 2020

Background: UK health policy increasingly focusses on health as an asset. This represents a shift of focus away from specific risk factors towards the more holistic capacity by which integrated care assets in the community support improvements in both health and the wider flourishing of individuals. Though the social determinants of health are well known, relatively little research has focussed on the impact of an individual’s health on their social outcomes. This research investigates how improved health can deliver a social return through the development of social capital. Methods: An observational study is undertaken on 25 years of longitudinal data, from 1991, drawn from the harmonised British Household Panel Survey (BHPS) and Understanding Society Survey (USS). Fixed effects instrumental variable panel data regression analysis is undertaken on individuals. The number of memberships of social organisations, as a measure of structural social capital, is regressed on subjectively measured general health and GHQ12 (Likert) scores. Distinction is drawn between males and females. Results: Improved general health increases social capital though differences exist between males and females. Interaction effects, that identify the impacts of health for different age groups, reveal that a general effect of increased health on social capital for males is enhanced as they age. However, in the case of females increases in general health increase social capital only in connection with their age group. In contrast mental illness generally reduces social capital for males and females, and these effects are reduced through aging. Conclusions: Investing in health as an asset can improve the social outcomes of individuals. Increasing the outcomes requires tailoring integrated care systems to ensure that opportunities for social engagement are available to individuals and reflect age groups. Targeting improvements in mental health is required, particularly for younger age groups, to promote social capital. The results suggest the importance of ensuring that opportunity for engagement in social and civic organisation be linked to general and mental health care support.
The evaluation of Suchana, a large-scale development program to prevent chronic undernutrition in north-eastern Bangladesh: A large scale nutrition program design
Authors: Choudhury Nuzhat , Raihan Mohammad Jyoti , Ahmed S M Tanvir , Islam Kazi Eliza , Self Vanessa , Rahman Shahed , Schofield Lilly , Hall Andrew , Ahmed Tahmeed
Published: March 2020

Background Evidence of the impact of community-based nutrition programs is uncommon for two main reasons: the lack of untreated controls, and implementation does not account for the evaluation design. Suchana is a large-scale program to prevent malnutrition in children in Sylhet Division, Bangladesh by improving the livelihoods and nutrition knowledge of very poor households.Methods Suchana is being implemented in 157 unions, the smallest administrative unit of government, in two districts of Sylhet. Suchana will deliver a package of interventions to poor people in about 40 randomly selected new unions annually over four years, until all are covered. All beneficiaries will receive the normal government nutrition services. For evaluation purposes the last 40 unions will act as a control for the first 40 intervention unions. The remaining unions will receive the program but will not take part in the evaluation. A baseline survey was conducted in both intervention and control unions; it will be repeated after three years to estimate the impact on the prevalence of stunted children and other indicators.Results This stepped wedge design has several advantages for both implementation and evaluation, as well as some disadvantages. The units of delivery are randomized, which controls for other influences on outcomes; the program supports government service delivery systems, so it is replicable and scalable; and the program can be improved over time as lessons are learned. The main disadvantages are the difficulty of estimating the impact of each component of the program, and the geographical distribution of unions, which increases program delivery costs. Stepped implementation allows a cluster randomized trial to be achieved within a large-scale poverty alleviation program.Conclusions A stepped wedge design for implementation was used which is particularly suited to evaluations of service delivery. The design allows the intervention to be phased-in and scaled-up over a period of time. The phased or ‘stepped’ process of implementation enables a cluster randomized controlled trial to be achieved without having a permanently untreated control group. However, the design does not allow to assess the impact of each individual component of intervention.
Community Dialogue Approach for addressing the drivers of antibiotic resistance in Bangladesh: a mixed methods study on developing a sustainable and scalable approach to community engagement
Authors: King Rebecca , Hicks Joseph , Rassi Christian , Shafique Muhammad , Barua Deepa , Bhowmik Prashanta , Das Mahua , Elsey Helen , Questa Kate , Fieroze Fariza , Hamade Prudence , Huque Sameena , Newell James , Huque Rumana
Published: March 2020

Background Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example. Methods The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards on the appropriate use of antibiotics; undertaking detailed exploratory research through a) a qualitative study to explore the most appropriate mechanisms through which to embed the intervention within the existing health system and community infrastructure, and to understand patterns of knowledge, attitudes and practice regarding antibiotics and antibiotic resistance; and b) a household survey – which drew on the qualitative findings - to quantify knowledge, and reported attitudes and practice regarding antibiotics and antibiotic resistance within the target population; and c) drawing on appropriate theories regarding change mechanisms and experience of implementing community engagement interventions to co-produce the intervention processes and materials with key stakeholders at policy, health system and community level. Results A community engagement intervention was co-produced and was explicitly designed to link into existing health system and community structures and be appropriate for the cultural context, and therefore have the potential to be implemented at scale. We anticipate that taking this approach increases local ownership, as well as the likelihood that the intervention will be sustainable and scalable. Conclusions This study demonstrates the value of ensuring that a range of stakeholders co-produce the intervention, and ensuring that the intervention is designed to be appropriate for the health system, community and cultural context.
The association between metabolic syndrome and elevated serum alanine transaminase levels in an indigenous population in Northern Taiwan: a community-based study
Authors: Chen Yi-Fang , Lin Yen-An , Yeh Wei-Chung , Tsao Yu-Chung , Li Wen-Cheng , Chen I-Ju , Chen Jau-Yuan
Published: March 2020

Background: Metabolic syndrome (MetS), a prevalent health condition in Taiwan, places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. Nevertheless, only limited studies about MetS have been conducted among indigenous peoples in Taiwan; these studies identified a high prevalence of MetS among an indigenous population, which encouraged us to investigate further. Thus, our study aims to determine the prevalence of MetS among the indigenous Taiwanese population and to explore the relationship between MetS and associated risk factors, especially serum alanine transaminase (ALT). Methods: This is an observational, population-based, cross-sectional study that was conducted in remote villages of an indigenous community in northern Taiwan between 2010 and 2015. A total of 454 participants, 47.36% male and 52.64% female, were eligible for analysis. The participants underwent anthropometric assessment and measurements of blood pressure, serum triglyceride levels, fasting plasma glucose levels, serum HDL-C levels and serum ALT levels. MetS was defined based on the revised NCEP/ATPIII criteria from Taiwan Health Promotion Administration. Results: A total of 454 participants were included in the analysis. There were 277 people with MetS and 177 people without. The prevalence of MetS was 61.01%. The average age was 49.50 years old. People with MetS had a significantly higher ALT level (average 31.21±25.00 U/L vs. 23.29±15.98 U/L, p<0.001) than those without MetS. In addition, the chi-square comparison showed that participants with abnormal ALT levels (>36 U/L) had a tendency towards a higher prevalence of MetS (76.7% vs. 57.3%, p=0.001) than those with normal ALT levels (≤36 U/L). The adjusted odds ratio (OR) of abnormal ALT levels for MetS was 2.58 (95% CI=1.23-5.44, p=0.01). The area under the ROC curve (AUC) of the ALT level was 0.63 (95% CI=0.58-0.68, p<0.001), which showed that the ALT level was positively associated with MetS. Conclusions: The overall prevalence of MetS was 61.01% in the highland indigenous population in Taiwan, which suggests an unignorable health problem that should actively be addressed. Furthermore, these findings indicated that higher serum ALT levels (>36 U/L) were associated with an increased risk of MetS.
Housing First, Connection Second: The Impact of Professional Helping Relationships on the Developmental Trajectories of Housing Stability for People Facing Severe and Multiple Disadvantage
Authors: Sandu Rebeca Denisa , Anyan Frederick , Stergiopoulos Vicky
Published: March 2020

Background . This study sought to establish the impact of professional helping relationships on the developmental trajectories over 24 months of housing stability for 2,141 people facing severe and multiple disadvantage using data from the Housing First controlled trial in Canada. Method: The study used a mixed method design. Latent growth curve and growth mixture models assessed the impact of working alliance across the sample as a whole and within subgroups with different patterns of housing stability. Thematic analysis explored the factors that may affect the quality of working alliances within different subgroups. Results: Three distinct trajectories of housing stability emerged (i.e., Class 1: “sharp, sustained, gradual decline”; Class 2: “hardly any time housed”; Class 3: “high, sustained, and gradual decline”) with professional helping relationships having different effects in each. The analysis revealed structural and individual circumstances that may explain differences among the classes. Conclusions: The findings underscore the role of the relationships, as distinct from services, in major interventions for highly disadvantaged populations, and draws new attention to the temporal patterns of responses to both the quality of relationship and targeted interventions. Keywords: relationships, Housing First, sub-groups, housing stability, severe and multiple disadvantage
Supplementing Substance Use Prevention with Sexual Health Education A Partner-Informed Approach to Intervention Development
Authors: Powell Terrinieka W , Jo Meghan , Smith Anne D. , Marshall Beth D. , Thigpen Santha , Offiong Asari , Geffen Sophia R.
Published: March 2020

Background Threats to adolescent health have been shown to co-occur and influence one another. Supplementing substance use prevention with sexual health education would allow educators to address the risk and protective factors that influence both health issues. This streamlined approach may minimize the inefficiencies of multi-session, single-purpose interventions. Methods LifeSkills Training (LST) for middle school is a skills-based cognitive behavioral prevention program delivered over three years during grades 6-8, with a focus on substance use and violence prevention. This paper describes the development of a supplemental sexual and reproductive health (SRH) unit for the middle school LST curriculum, in partnership with content experts and school personnel. This partner-informed approach took place across three key phases: 1) formative insights, 2) unit development, and 3) pilot implementation. Result The final supplemental SRH unit is ten 45-minute sessions offered to 7 th and 8 th grade students and includes a set of learning objectives that are aligned with individual sessions. The supplemental SRH unit also mirrors existing LST modules in length, flow, layout, facilitator instructions, focus on prevention, and utilization of a student workbook. Conclusions Our findings suggest that there is great potential in partnering with content experts and school personnel to develop supplemental materials for existing interventions. This collaborative approach resulted in a set of sessions that are medically accurate and developmentally appropriate. This partnership approach may serve as a model for future researchers and practitioners aiming to extend the reach of existing evidence-based programs.
Non-Communicable Disease and the Need to Strengthen Prehospital Care: Experience from Kigali, Rwanda
Authors: Rosenberg Ashley , Mukagasasira Jacqueline , Turikumana Verene , Dworkin Myles , Nsengimana Vizir , Bailey Pamela , Kankindi Eugenie , Niyonsaba Mediatrice , Nkeshimana Menelas , Uwitonze Jean Marie , Kabagema Igance , Dushime Theophile , Jayaraman Sudha
Published: March 2020

Background Non-communicable diseases (NCDs) are increasing in incidence in low-and middle-income countries (LMICs). Many NCDs present as emergencies which require emergency response. We aimed to review NCDs transported by Service d’Aide Medicale Urgente (SAMU), the public ambulance service in Rwanda.Methods Descriptive analysis of a REDCap database was performed for medical cases between December 2012 to May 2016 and compared to non-medical cases. Student’s t-test, ANOVA, and chi square test were run with p < 0.05 considered significant.Results A total of 832 patients were seen. 51% were female, and the average age was 57 years old + 22. Cardiac indications were most common (52%) followed by diabetic complications (22%), cancer (16%) and stroke (10%). Patients with NCDs were more likely to be tachycardic, HR>100 bpm (OR 2.61 [P<0.001]), hypoxic with SPO2 <90% (OR 3.28 [P<0.0001]), hypotensive with blood pressure <100 mmHg (OR 2.65 [P<0.0001]), and tachypneic with respiratory rate >20 breaths per minute (OR 2.06 [P<0.0001]).Conclusions Access to emergency services is essential for NCD management. Compared to other emergencies treated by SAMU in Kigali, Rwanda, the NCD cohort had a higher acuity despite being a smaller proportion. As NCDs increase, investment in robust prehospital care will have substantial value in LMICs.
Factors associated with cyber-victimization among immigrants and non-immigrants in Canada: A cross-sectional nationally-representative study.
Authors: Kenny Kathleen , Merry Lisa , Douglas Brownbridge A. , Urquia ML
Published: March 2020

Objectives There is a paucity of research on patterns of cyber-victimization in minority groups, including immigrants. This study aimed at identifying individual, interpersonal and contextual characteristics associated with cyber-victimization among immigrants and non-immigrants.Methods We drew on nationally representative data from adolescents and adults in the Canadian General Social Survey on victimization (2014). Multivariable logistic regression was employed to identify potential factors associated with cyber-victimization in the last 12 months, stratified by immigrant status and sex.Results Among 27,425 survey respondents, the weighted prevalence of cyber-victimization in the last 12 months was 2.1% among immigrants and 2.3% among non-immigrants. Cyber-victimization rates differed significantly by sex among immigrants (2.8% for males vs. 1.4% for females), but not among non-immigrants (2.1% for males vs. 2.4% for females). While most other factors associated with cyber-victimization were similar for immigrants and non-immigrants, we found pronounced associations of past child maltreatment (adjusted prevalence odds ratio [aPOR] 4.85, 95% confidence interval [CI] 2.76, 8.52) and residence in an unwelcoming neighbourhood (aPOR 5.08, 95% CI 2.44, 10.55) with cyber-victimization among immigrants that were diminished or absent among non-immigrants. Additionally, sex-stratified analyses among immigrants showed cyber-victimization to be strongly associated with having a mental health condition (aPOR 3.50, 95% CI 1.36, 8.97) among immigrant males only, and with perceived discrimination (aPOR 4.08, 95% CI 1.65, 10.08), as well as being under 24 years old (aPOR 3.24, 95% CI 1.09, 9.60) among immigrant females.Conclusions Immigration status and sex were differentially associated with cyber-victimization. Findings support the salience of a social-ecological perspective and gender-stratified analyses to better elucidate complex pathways linking cyber-victimization to potential gender-based health inequities among immigrants.
Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community based cross sectional study
Authors: Murarkar Sujata Kapil , Gothankar Jayashree Sachin , Doke Prakash , Pore Prasad , Lalwani Sanjay , Dhumale Girish , Quraishi Sanjay , Patil Reshma Sudhir , Waghachavare Vivek , Dhobale Randhir , Rasote Kirti , Palkar Sonali , Malshe Nandini
Published: March 2020

Background Undernutrition among under five children in India is a major public health problem. In India almost 60 million children are underweight. Despite India’s growth in economy, child mortality rate due to undernutrition is still high in both urban and rural area. Studies that focuses on undernutrition in urban slums are scarce. Hence present study was carried out to measure all forms of undernutrition like underweight, stunting and wasting. Methods A community based cross sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state,India. All 2,929 mothers of under five children from these clusters were included in the study. Data was collected by house to house survey by interviewing mothers of underfive children.Odds ratio was calculated to determine association between the variables. Results Total 3,671 under five children were covered. Mean age of the children was 2.38 years (± SD 1.365).Stunting (45.9%) was found to be the commonest form of undernutrition among under five children, followed by underweight (35.4%), and wasting (17.1%). Sex of the child (urban slum; OR=1.32, rural area OR=1.63) birth order (rural area; OR= 0.47), immunization status (urban slum; OR=0.23) exclusive breast feeding (urban slum; OR=0.51), childhood infections like diarrhea(rural area OR= 1.69) acute respiratory tract infection (ARI) (rural area OR= 0.82), economic status of the family, (urban slum OR= 1.32), maternal age (P = 0.001)and maternal education(P <0.001) had either positive or negative influence on nutritional status of the children from urban slums and rural area. Conclusion Undernutrition in the form of underweight and stunting is more prevalent than wasting in the urban slum and rural area. It was related to sex of the child, economic status of the family, partial immunization of the child, ARI (Past 1 month) and maternal education. Improvement of immunization of under five children and maternal education will improve the nutritional status of the child. Trial registration-This article is part of baseline data of the project, hence not related to trial registration. After baseline data principal investigator had done trial registration retrospectively.
Are social media use disorders associated with higher addictions (alcohol, smoking and waterpipe) among Lebanese adults?
Authors: Awad Emmanuelle , Hallit Rabih , Haddad Chadia , Akel Marwan , Obeid Sahar , Hallit Souheil
Published: March 2020

Background: Since cigarette and waterpipe smoking and alcohol use are on the rise in Lebanon, with no studies on their association with social media use, it was deemed interesting to conduct such a research in the country. The purpose of this study was to evaluate the correlation between social media use disorder, alcohol use disorder and smoking addiction through both cigarettes and waterpipe among a sample of Lebanese adults.Methods: This cross-sectional study was carried out between January and April 2019. It enrolled 461 residents of the community randomly selected from Lebanon's Mohafazat in a proportionate rate.Results: The results showed that 107 (23.7%) participants were classified as having social media use disorder. The results of a stepwise linear regression showed that higher social media use disorder score (Beta=0.17), higher alcohol addiction (Beta=0.20), higher cigarette smoking addiction (Beta=0.31) and higher insomnia (Beta=0.05) were significantly associated with more waterpipe addiction. The social media use disorder was not significantly associated with the cigarette dependence and alcohol use disorder.Conclusion: Our results revealed a significant association between social media use disorder and waterpipe smoking dependence. This study findings might serve as a starting point towards the development and implementation of anti-smoking waterpipe awareness campaigns, similar to those negatively representing cigarette smoking.
The Perspectives of Adolescents on Smoking Habits as a Reference for the Prevention Program
Authors: Fithria Fithria , Adlim Muhammad , Jannah Syarifah Rauzatul , Tahlil Teuku
Published: March 2020

Background: Religious factor has been used in tobacco control campaign but due to different perception among the Muslim scholars that might induce on the followers then, the control program strategics is still interesting to study. This qualitative research is, therefore aimed to explore the perspective of Muslim adolescents on smoking habits, as a reference in developing effective prevention intervention programs.Methods: Three Focus Group Discussion (FGD) sets, consisting of a total of 24 junior high school students were the main source data for this phenomenological qualitative study. The discussion guide was developed by researchers, based on the reviewed literature and validated by experts. The research finding was analyzed by using an inductive-content method with systematical steps based on the stages of qualitative data analysis.Results: Adolescent perspectives on smoking were grouped into two themes that were (a) perception, which encompasses three sub-themes consisting of smoking as the social habit, the contradictive feeling, and the Islamic perspective, (b) Smoking-related factors involving peer pressure, the parents’ smoking status, curiosity and masculinity.Conclusion: The results indicated that adolescents consider smoking as a social habit with the existence of contradictive feelings. Their Islamic perspective believes that smoking is preferable but not forbidden by religion thought. The smoking habit also was stimulated by pressure from their smoker-peer, immitating their smoker-parents, being curiosity and feeling masculinity. We suggested the health proffesionals who intersted in developing smoking prevention programs to consider about the adolescent perspective about smoking habit. So, the prevention program will be more effective and culturally appropriate for adolescents.
Identifying Community Physical Activity and Health Resources by Utilizing Members of a Physical Activity Network
Authors: Sedney Cara L. , Haggerty Treah , Zizzi Sam , Dekeseredy Patricia
Published: March 2020

Background: Back pain is one of the leading causes of health care expenditure in the US and is linked to an increased body mass index. Many evidence-based modalities for the prevention and treatment of back pain closely mirror recommendations for weight loss and include physical activity and health maintenance activities (PAHM). Collaboration was sought with the West Virginia Physical Activity Network (WVPAN) leadership to ascertain community assets, and perceptions of the use of PAHM in the treatment of back pain by WVPAN members. Methods: Participants for the study were recruited from the West Virginia Physical Activity Network. This grassroots organization is filled with volunteers from various sectors who have either signed up via email or liked the WVPAN Facebook page. This network was purposely selected as the study population because of the statewide reach and their familiarity with resources in their local communities. A brief survey instrument was designed to gather their scaled perceptions about various treatment modalities related to back pain, and to gather their local knowledge related to specific providers in their communities. In addition, participants were given a free text box to list any local assets or resources for the nine treatments listed, and county of residence, and the nature of their connection to the physical activity network. Descriptive analyses were used to describe overall patterns of survey data. The qualitative data were compiled manually by the research team to show themes of specific treatments mentioned across different parts of the state. Results: Participants overwhelmingly supported physical therapy, flexibility training, yoga, and core strengthening as treatments for back pain. The majority of respondents were “undecided” about other treatments such as cognitive behavioral therapies and acupuncture. Conclusions: The implementation of PAHM interventions in communities could help treat patients with back pain, and may reduce reliance on the pharmacological treatment for back pain. The current study’s data support the feasibility of such approaches in many West Virginia counties. Also, local resources, needs, and context can be gleaned from community leader surveys utilizing previously developed infrastructure for PAHM promotion. Key Words: physical activity, capacity building, rural health, collaborative research
The effects of socio-cultural factors on medical college students' self-rated health status and health-promoting lifestyles in Eritrea: A cross-sectional study
Authors: Abraham Isayas Afewerki , Zhang Xufu , Dagnew Zewdi Amanuel , Tesfamariam Eyasu H. , Beraki Ghirmay Ghebreigziabher , Achila Oliver Okoth , Dai Ying-chun
Published: March 2020

Background: Sub-optimal health status (SHS) and unhealthy lifestyle among college students have become a major focus for research on public health worldwide. Hence, this study was designed to assess the effects of socio-cultural factors on medical college students' self-rated health status (SRH) and health-promoting lifestyles (HPL) in Eritrea.Methods: A descriptive cross-sectional study was conducted at Orotta School of Medicine (OSM), using a self-administered questionnaire. Data was collected from all medical students who had fulfilled the inclusion criteria using Sub-Optimal Health Measurement Scale (SHMS V1.0) and Health-Promoting Lifestyle Profile-II (HPLP-II) scale questionnaires. Independent samples t-test, ANOVA, Chi-square test, Pearson’s correlation coefficient and Binary multivariate logistic regression were performed. Data analysis was undertaken using SPSS version 22.Results: The overall SRH was significantly higher among college students with BMI of 25 to 29.9 (M=88.23, SD=6.28) as compared to <18.5 (p=0.027) and 18.5 to 24.9 (p=0.027). Moreover, physiological subscale of SRH was significantly related to gender (M males= 88.96 Vs M females= 85.41, p=0.001) and monthly stipend (M income = 89.52 Vs M no-income = 87.28, p=0.040). On the other hand, physical activity of HPL was found to vary by gender (M males= 2.12 Vs M females=1.87, p=0.005) and alcohol consumption (M drinkers= 2.22 Vs M non-drinkers = 1.99, p=0.016). Nutrition differences of HPL were observed in BMI of 25 to 29.9 (M =2.40, p=0.028), internship students (M=2.15, p=0.027), and monthly income (M=2.11, p=0.029). The overall SRH was significantly correlated with the overall HPL (r=0.493, p<0.001). In-addition, students who had good and excellent HPL had self-rated themselves as almost five times (AOR=4.97, 95% CI: 1.28, 19.32), and were 3.73 times (AOR=3.73, 95% CI: 1.09, 12.80) healthier than those who had poor HPL, respectively.Conclusions: Based on our study, gender, BMI and monthly stipend play a major role in the SRH whereas gender, alcohol consumption, BMI, study year and monthly stipend play a major role in the HPL. Moreover, there was a significant correlation between SRH and HPL in this study. Therefore, our findings provide evidence that support the role of socio-cultural influences’ on SRH and HPL of medical students.
Our First Review in 12 Years: An Evaluation of Effectiveness of Root Cause Analysis in Hong Kong Public Hospitals
Authors: Kwok Andy Yick Ting , Mah Alastair Pui Yan , Pang Katherine Mo Ching
Published: March 2020

Background: To evaluate the effectiveness of root cause analysis (RCA) and propose possible ways to enhance its effectiveness in Hong Kong public hospitals. Methods: A retrospective cross-sectional study was performed across 43 public hospitals and institutes in Hong Kong, reviewing RCA reports of all Sentinel Events and Serious Untoward Events within a two-year period. The incident nature, types of root causes and strengths of recommendations were analysed. The RCA recommendations were categorised as ‘strong’, ‘medium’ or ‘weak’ strengths utilizing the US’s Veteran Affairs National Center for Patient Safety action hierarchy. Results: A total of 214 reports from October 2016 to September 2018 were reviewed. These reports generated 504 root causes, averaging 2.4 per RCA report, and comprising 282 (49%) system, 233 (46%) staff behavioural and 22 (4%) patient factors. There were 658 recommendations identified in the RCA reports with an average of 3.1 per RCA. Of these, 18 (2%) recommendations were rated strong, 116 (15%) medium and 626 (82%) weak. Most recommendations were related to ‘training and education’ (466, 61%), ‘additional study/review’ (104, 14%) and ‘review/enhancement of policy/guideline’ (39, 5%). Conclusions: This study provided insights about the effectiveness of RCA across all public hospitals in Hong Kong. The results showed a high proportion of root causes were attributed to staff behavioural factors and most of the recommendations were weak. The reasons include the lack of training, tools and expertise, appropriateness of panel composition, and complicated processes in carrying out large scale improvements. The Review Team suggested conducting regular RCA training, adopting easy-to-use tools, enhancing panel composition with human factors expertise, promoting an organization-wide safety culture to staff and aggregating analysis of incidents as possible improvement actions.
Study of Influential Factors of Provincial Health Expenditure -Analysis of Panel Data After the 2009 Healthcare Reform in China
Authors: Hou Ji-Fei , Zhang Yun , Liu Yan-Zheng , Li Jing , Wang Yue
Published: March 2020

Background Healthcare Expenditure(HE) has increased substantially in all countries. Since the health system reform and health policy environment differ from each country, it is necessary to analyze the motivations of HE in a specific country. Methods The objective of this study is to analyze the influential factors of Provincial total HE (PTHE) per capita in China by using panel data across 31 provinces(including provinces, autonomous regions, and municipalities, all called provinces in here) from 2009-2016 at the country level. Generalized Method of Moments (GMM) and robust estimators were used to identify the influential factors of PTHE per capita. Results Economic factors explain most of the variation of PTHE per capita. But Out-Of-Pocket Payments(OOP) as a percentage of Total Health Expenditure(THE) is associated with PTHE per capita negatively and Government Health Expenditure(THE) as a percentage of Gross Domestic Product(GDP) have no statistical significance. The results also show that health expenditure in China reacts more to the rate of infectious diseases compared with the Proportion of the Population Aged 65 and Over (POP65), which impacts PTHE per capita positively. As for the number of beds per 10,000 population and mortality, their coefficients are small with no statistical significance. Conclusions In response to these ﬁndings, we conclude that the impact of the increasing OOP diminish the PTHE. Furthermore, we do not get a significant correction between health outcomes and health supply with PTHE. Policymakers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.