Pub Date : 2024-07-01DOI: 10.1136/bmjph-2023-000302
Ichiro Tatsuno, L. Gerlier, Anamaria-Vera Olivieri, James Baker-Knight, Mark Lamotte
Obesity is associated with a significant clinical and economic burden and its prevalence has reached epidemic proportions worldwide. An ethnicity-specific impact of excess weight has been demonstrated, with Asian individuals exhibiting weight-related health problems at lower body mass indexes (BMIs) than Caucasians. We aimed to adapt the core obesity model (COM) to predict incidences of weight-associated diseases, including type 2 diabetes, acute coronary syndrome (ACS), stroke, cancers, sleep apnoea, hyperuricaemia/gout, total knee replacement (TKR) and non-alcoholic fatty liver disease (NAFLD) in a Japanese population.Literature was searched to identify studies reporting the association between risk factors and comorbidities in Japanese populations. Data were extracted to update the COM risk prediction equations. Internal and external validation were performed.Overall, good internal validity was achieved, with mild underestimation for diabetes, cardiovascular and all-cause death taken together (ordinary least squares linear regression [OLS-LRL] 0.8844), moderate overestimation of TKR and cancers (OLS-LRL 1.267) and a slight underestimation for NAFLD and hyperuricaemia (OLS-LRL 0.934). External validation results were aligned with known geographical patterns: complications occurred at lower BMI in Japanese individuals, with a threefold higher incidence of diabetes and twofold higher obstructive sleep apnoea, gout prevalence and colorectal cancer at equal BMI. Conversely, the 10-year cumulative ACS incidences predicted in a Japanese population were less than half of those in a Western population.The Japanese COM adaptation addresses ethnicity-specific patterns of overweight/obesity, with better sensitivity to lower BMIs for several associated complications. It may support regional public health policy and research.
{"title":"Assessing the health and economic burden of obesity-related complications in East-Asian populations: implementation of risk equations in the Core Obesity Model for Japan and model validation","authors":"Ichiro Tatsuno, L. Gerlier, Anamaria-Vera Olivieri, James Baker-Knight, Mark Lamotte","doi":"10.1136/bmjph-2023-000302","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000302","url":null,"abstract":"Obesity is associated with a significant clinical and economic burden and its prevalence has reached epidemic proportions worldwide. An ethnicity-specific impact of excess weight has been demonstrated, with Asian individuals exhibiting weight-related health problems at lower body mass indexes (BMIs) than Caucasians. We aimed to adapt the core obesity model (COM) to predict incidences of weight-associated diseases, including type 2 diabetes, acute coronary syndrome (ACS), stroke, cancers, sleep apnoea, hyperuricaemia/gout, total knee replacement (TKR) and non-alcoholic fatty liver disease (NAFLD) in a Japanese population.Literature was searched to identify studies reporting the association between risk factors and comorbidities in Japanese populations. Data were extracted to update the COM risk prediction equations. Internal and external validation were performed.Overall, good internal validity was achieved, with mild underestimation for diabetes, cardiovascular and all-cause death taken together (ordinary least squares linear regression [OLS-LRL] 0.8844), moderate overestimation of TKR and cancers (OLS-LRL 1.267) and a slight underestimation for NAFLD and hyperuricaemia (OLS-LRL 0.934). External validation results were aligned with known geographical patterns: complications occurred at lower BMI in Japanese individuals, with a threefold higher incidence of diabetes and twofold higher obstructive sleep apnoea, gout prevalence and colorectal cancer at equal BMI. Conversely, the 10-year cumulative ACS incidences predicted in a Japanese population were less than half of those in a Western population.The Japanese COM adaptation addresses ethnicity-specific patterns of overweight/obesity, with better sensitivity to lower BMIs for several associated complications. It may support regional public health policy and research.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1136/bmjph-2023-000561
Jennifer A. Pallin, Lauren Connell, Caroline McIntosh, Paul M. Kavanagh, S. F. Dinneen, Patricia M. Kearney, C. Buckley
To evaluate and map the evidence around diabetes-related foot screening using the World Health Organisation screening principles, which set the gold standard for determining the appropriateness of introducing population-wide screening programmes internationally.A scoping review methodology in line with Arksey and O’Malley and the Joanna Briggs Institute.Medline (EBSCO), Scopus, ScienceDirect and EMBASE between 24 May 2022 and 12 July 2022. Reference lists of the selected studies, and ‘Google’ and ‘Google Scholar’ were also searched.Inclusion criteria were informed by the principles of screening. Articles, published in English since 2000, reporting on the impact of the diabetes-related foot ulcers, effectiveness of treatment available for those identified as being at risk, reliability of screening tests for screening for the at-risk foot and the effectiveness, cost-effectiveness, safety and ethics of diabetes-related foot screening programmes were included.Data were extracted by one reviewer, with data extraction headings relating to the principles of screening. A narrative synthesis approach was used to report the information from included studies.46 articles were deemed eligible for inclusion. Diabetes-related foot ulcers are an important health condition associated with increased risk of mortality and poorer quality of life. However, there is insufficient evidence on the effectiveness of treatments to prevent disease development. Moreover, while consensus exists on what screening tools should be used to screen for risk factors, there is no agreement on threshold values. Finally, there is no available information on the potential budgetary, organisational or societal implications of a whole-population diabetes-related foot screening programme.Existing evidence does not support the introduction of an organised population-wide screening programme in the context of World Health Organisation screening principles. Further research on treatment and management strategies for the at-risk foot and of whole-population screening programmes is required.
{"title":"Evaluating and mapping the evidence that screening for diabetic foot disease meets the criteria for population-wide screening: a scoping review","authors":"Jennifer A. Pallin, Lauren Connell, Caroline McIntosh, Paul M. Kavanagh, S. F. Dinneen, Patricia M. Kearney, C. Buckley","doi":"10.1136/bmjph-2023-000561","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000561","url":null,"abstract":"To evaluate and map the evidence around diabetes-related foot screening using the World Health Organisation screening principles, which set the gold standard for determining the appropriateness of introducing population-wide screening programmes internationally.A scoping review methodology in line with Arksey and O’Malley and the Joanna Briggs Institute.Medline (EBSCO), Scopus, ScienceDirect and EMBASE between 24 May 2022 and 12 July 2022. Reference lists of the selected studies, and ‘Google’ and ‘Google Scholar’ were also searched.Inclusion criteria were informed by the principles of screening. Articles, published in English since 2000, reporting on the impact of the diabetes-related foot ulcers, effectiveness of treatment available for those identified as being at risk, reliability of screening tests for screening for the at-risk foot and the effectiveness, cost-effectiveness, safety and ethics of diabetes-related foot screening programmes were included.Data were extracted by one reviewer, with data extraction headings relating to the principles of screening. A narrative synthesis approach was used to report the information from included studies.46 articles were deemed eligible for inclusion. Diabetes-related foot ulcers are an important health condition associated with increased risk of mortality and poorer quality of life. However, there is insufficient evidence on the effectiveness of treatments to prevent disease development. Moreover, while consensus exists on what screening tools should be used to screen for risk factors, there is no agreement on threshold values. Finally, there is no available information on the potential budgetary, organisational or societal implications of a whole-population diabetes-related foot screening programme.Existing evidence does not support the introduction of an organised population-wide screening programme in the context of World Health Organisation screening principles. Further research on treatment and management strategies for the at-risk foot and of whole-population screening programmes is required.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1136/bmjph-2023-000679
Marybeth Ingle, Rasha Khatib, Yuxian Du, Vesta Valuckaite, Rakesh Singh, Sheldon X Kong, Todd E. Williamson, Sarang Baman
We explore how area deprivation index (ADI), a national ranking of neighbourhood sociodemographic disadvantage is associated with chronic kidney disease (CKD) screening and development among patients with newly diagnosed hypertension (HTN) or type 2 diabetes (T2DM).Patients (n=235 208) with a new HTN or T2DM diagnosis between 2015 and 2018 in a large healthcare system were followed for 3 years to evaluate CKD screening (one estimated glomerular filtration rate and urinary albumin-to-creatine ratio) and CKD development. Multivariable logistic regression models evaluated associations between ADI quintiles with CKD screening and diagnosis.Most patients were white (57%) females (55%) with HTN (65%). Few were screened in the first year after diagnosis (17%) and 9% developed CKD within 3 years. The odds of patients being screened were 54% greater (OR 1.54; 95% CI 1.48 to 1.60) and 146% greater (OR 2.46; 95% CI 2.19 to 2.76) for developing CKD for most deprived compared with the least deprived.Patients with high ADI were more likely to be screened and almost twice as likely to develop CKD compared with the least deprived. Results highlight the importance of systematic health record data collection in large healthcare systems to evaluate social factors with health outcomes.
我们探讨了地区贫困指数（ADI）--一种全国性的邻里社会人口劣势排名--与新诊断为高血压（HTN）或2型糖尿病（T2DM）患者的慢性肾脏病（CKD）筛查和发展之间的关系。我们对2015年至2018年期间在一个大型医疗系统中新诊断为高血压或T2DM的患者（n=235 208）进行了为期3年的随访，以评估CKD筛查（一个估计肾小球滤过率和尿白蛋白-肌酐比值）和CKD发展情况。多变量逻辑回归模型评估了 ADI 五分位数与 CKD 筛查和诊断之间的关联。大多数患者为白人（57%）、女性（55%）、高血压（65%），很少有人在确诊后第一年接受筛查（17%），9%的患者在 3 年内发展为 CKD。与最贫困人群相比，最贫困人群接受筛查的几率要高出54%（OR 1.54；95% CI 1.48至1.60），而最贫困人群罹患CKD的几率要高出146%（OR 2.46；95% CI 2.19至2.76）。与最贫困人群相比，ADI高的患者接受筛查的几率更高，而罹患CKD的几率几乎是最贫困人群的两倍。研究结果凸显了在大型医疗系统中系统收集健康记录数据以评估与健康结果相关的社会因素的重要性。
{"title":"Area deprivation index predicts annual chronic kidney disease screening and chronic kidney disease development among patients with newly diagnosed hypertension and type 2 diabetes in a large midwestern health system: a retrospective cohort study","authors":"Marybeth Ingle, Rasha Khatib, Yuxian Du, Vesta Valuckaite, Rakesh Singh, Sheldon X Kong, Todd E. Williamson, Sarang Baman","doi":"10.1136/bmjph-2023-000679","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000679","url":null,"abstract":"We explore how area deprivation index (ADI), a national ranking of neighbourhood sociodemographic disadvantage is associated with chronic kidney disease (CKD) screening and development among patients with newly diagnosed hypertension (HTN) or type 2 diabetes (T2DM).Patients (n=235 208) with a new HTN or T2DM diagnosis between 2015 and 2018 in a large healthcare system were followed for 3 years to evaluate CKD screening (one estimated glomerular filtration rate and urinary albumin-to-creatine ratio) and CKD development. Multivariable logistic regression models evaluated associations between ADI quintiles with CKD screening and diagnosis.Most patients were white (57%) females (55%) with HTN (65%). Few were screened in the first year after diagnosis (17%) and 9% developed CKD within 3 years. The odds of patients being screened were 54% greater (OR 1.54; 95% CI 1.48 to 1.60) and 146% greater (OR 2.46; 95% CI 2.19 to 2.76) for developing CKD for most deprived compared with the least deprived.Patients with high ADI were more likely to be screened and almost twice as likely to develop CKD compared with the least deprived. Results highlight the importance of systematic health record data collection in large healthcare systems to evaluate social factors with health outcomes.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141276321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1136/bmjph-2023-000770
Qiuyuan Qin, Kenneth Wilkins, Sara E Jones, K. Bradwell, Lauren E. Chan, Jing Sun, Jerrod Anzalone, Qulu Zheng, Michael Liebman, Federico Mariona, Emily A. Groene Faherty, A. Challa, Elaine Hill, Rena C Patel
To evaluate the effectiveness of COVID-19 vaccinations (initial and booster) during pre-Delta, Delta and Omicron dominant periods among pregnant people via (1) COVID-19 incident and severe infections among pregnant people who were vaccinated versus unvaccinated and (2) post-COVID-19 vaccination breakthrough infections and severe infections among vaccinated females who were pregnant versus non-pregnant.Retrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative, 10 December 2020 –7 June 2022.Cohort 1 included pregnant people (15–55 years) and cohort 2 included vaccinated females of reproductive age (15–55 years).(1) COVID-19 vaccination and (2) pregnancy.Adjusted HRs (aHRs) for COVID-19 incident or breakthrough infections and severe infections (ie, COVID-19 infections with related hospitalisations).In cohort 1, 301 107 pregnant people were included. Compared with unvaccinated pregnant people, the aHRs for pregnant people with initial vaccinations during pregnancy of incident COVID-19 were 0.77 (95% CI 0.62 to 0.96) and 0.88 (95% CI 0.73 to 1.07) and aHRs of severe COVID-19 infections were 0.65 (95% CI 0.47 to 0.90) and 0.79 (95% CI 0.51 to 1.21) during the Delta and Omicron periods, respectively. Compared with pregnant people with full initial vaccinations, the aHR of incident COVID-19 for pregnant people with booster vaccinations was 0.64 (95% CI 0.58 to 0.71) during the Omicron period. In cohort 2, 934 337 vaccinated people were included. Compared with vaccinated non-pregnant females, the aHRs of severe COVID-19 infections for people with initial vaccinations during pregnancy was 2.71 (95% CI 1.31 to 5.60) during the Omicron periods.Pregnant people with initial and booster vaccinations during pregnancy had a lower risk of incident and severe COVID-19 infections compared with unvaccinated pregnant people across the pandemic stages. However, vaccinated pregnant people still had a higher risk of severe infections compared with non-pregnant females.
通过(1)接种COVID-19疫苗的孕妇与未接种者之间的COVID-19事件和严重感染情况，以及(2)接种COVID-19疫苗后接种孕妇与未接种孕妇之间的突破性感染和严重感染情况，评估COVID-19疫苗（初次接种和加强接种）在孕妇的Delta、Delta和Omicron优势期接种的有效性。队列 1 包括孕妇（15-55 岁），队列 2 包括已接种疫苗的育龄女性（15-55 岁）。(在队列 1 中，纳入了 301 107 名孕妇。与未接种疫苗的孕妇相比，在德尔塔期和欧米克隆期，孕期初次接种疫苗的孕妇发生COVID-19事件的aHRs分别为0.77（95% CI 0.62至0.96）和0.88（95% CI 0.73至1.07），发生严重COVID-19感染的aHRs分别为0.65（95% CI 0.47至0.90）和0.79（95% CI 0.51至1.21）。与初次接种全部疫苗的孕妇相比，接种加强疫苗的孕妇在 Omicron 期间发生 COVID-19 的 aHR 为 0.64（95% CI 0.58 至 0.71）。在队列 2 中，共纳入了 934 337 名接种者。与接种过疫苗的非怀孕女性相比，怀孕期间初次接种过疫苗的人在Omicron期间感染严重COVID-19的aHRs为2.71（95% CI为1.31至5.60）。在大流行的各个阶段，怀孕期间初次接种过疫苗和加强接种过疫苗的孕妇与未接种过疫苗的孕妇相比，发生COVID-19感染和感染严重COVID-19的风险较低。然而，与未怀孕的女性相比，接种过疫苗的孕妇发生严重感染的风险仍然较高。
{"title":"Evaluating COVID-19 vaccine effectiveness during pre-Delta, Delta and Omicron dominant periods among pregnant people in the U.S.: Retrospective cohort analysis from a nationally sampled cohort in National COVID Collaborative Cohort (N3C)","authors":"Qiuyuan Qin, Kenneth Wilkins, Sara E Jones, K. Bradwell, Lauren E. Chan, Jing Sun, Jerrod Anzalone, Qulu Zheng, Michael Liebman, Federico Mariona, Emily A. Groene Faherty, A. Challa, Elaine Hill, Rena C Patel","doi":"10.1136/bmjph-2023-000770","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000770","url":null,"abstract":"To evaluate the effectiveness of COVID-19 vaccinations (initial and booster) during pre-Delta, Delta and Omicron dominant periods among pregnant people via (1) COVID-19 incident and severe infections among pregnant people who were vaccinated versus unvaccinated and (2) post-COVID-19 vaccination breakthrough infections and severe infections among vaccinated females who were pregnant versus non-pregnant.Retrospective cohort study using nationally sampled electronic health records data from the National COVID Cohort Collaborative, 10 December 2020 –7 June 2022.Cohort 1 included pregnant people (15–55 years) and cohort 2 included vaccinated females of reproductive age (15–55 years).(1) COVID-19 vaccination and (2) pregnancy.Adjusted HRs (aHRs) for COVID-19 incident or breakthrough infections and severe infections (ie, COVID-19 infections with related hospitalisations).In cohort 1, 301 107 pregnant people were included. Compared with unvaccinated pregnant people, the aHRs for pregnant people with initial vaccinations during pregnancy of incident COVID-19 were 0.77 (95% CI 0.62 to 0.96) and 0.88 (95% CI 0.73 to 1.07) and aHRs of severe COVID-19 infections were 0.65 (95% CI 0.47 to 0.90) and 0.79 (95% CI 0.51 to 1.21) during the Delta and Omicron periods, respectively. Compared with pregnant people with full initial vaccinations, the aHR of incident COVID-19 for pregnant people with booster vaccinations was 0.64 (95% CI 0.58 to 0.71) during the Omicron period. In cohort 2, 934 337 vaccinated people were included. Compared with vaccinated non-pregnant females, the aHRs of severe COVID-19 infections for people with initial vaccinations during pregnancy was 2.71 (95% CI 1.31 to 5.60) during the Omicron periods.Pregnant people with initial and booster vaccinations during pregnancy had a lower risk of incident and severe COVID-19 infections compared with unvaccinated pregnant people across the pandemic stages. However, vaccinated pregnant people still had a higher risk of severe infections compared with non-pregnant females.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141280648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1136/bmjph-2023-000181
Kyoko Shimamoto, Y. Ibuka
Risk perceptions and precautionary actions against COVID-19 have been reported to be generally insufficient globally, and differences by subpopulation group have been concerning, as a key driver to widening health gaps. Although a body of literature examined these key constructs, critical comparative examinations of various risk perceptions and precautionary actions by socioeconomic group are still limited in Japan and Asia.This study examines subjective and objective risk perceptions and precautionary actions against COVID-19 infection among the general working age population aged 18–59 in Japan, focusing on the differences by socioeconomic group and health status. A cross-sectional survey was conducted in March 2021, using an online self-reporting questionnaire, in selected prefectures in Japan where COVID-19 infection cases ranked the highest. Participants were randomly recruited, and quota sampling methods were employed with the weighting of the sample distribution by geographic location (n=2764).Subjective and objective risk perceptions and precautionary actions were significantly related to several of the socioeconomic variables, including gender, income, employment and household composition, as well as self-reported health status. These disparities were substantial even with the key basic preventive behaviour including mask wearing, avoidance of large gatherings and hand washing. Further, these risk perceptions and precautionary actions showed unexpected relationships with socioeconomic position and health status, contrary to existing evidence or theory, particularly among younger generations and worse health populations.This evidence suggests that risk perceptions and precautionary actions do not always seem to align, and their disparities by socioeconomic group and health status have been underscored in Japan, which may suggest complex and distinct pathways by subpopulation group. Further evidence and strategies for COVID-19 and other infectious disease prevention would be critical in transitions of the infectious disease prevention and control strategy, targeting both the high-risk population group and higher risk-taking group.
{"title":"Socioeconomic disparities in risk perceptions and precautionary actions against COVID-19 among the working age population aged 18–59 in Japan: a cross-sectional study","authors":"Kyoko Shimamoto, Y. Ibuka","doi":"10.1136/bmjph-2023-000181","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000181","url":null,"abstract":"Risk perceptions and precautionary actions against COVID-19 have been reported to be generally insufficient globally, and differences by subpopulation group have been concerning, as a key driver to widening health gaps. Although a body of literature examined these key constructs, critical comparative examinations of various risk perceptions and precautionary actions by socioeconomic group are still limited in Japan and Asia.This study examines subjective and objective risk perceptions and precautionary actions against COVID-19 infection among the general working age population aged 18–59 in Japan, focusing on the differences by socioeconomic group and health status. A cross-sectional survey was conducted in March 2021, using an online self-reporting questionnaire, in selected prefectures in Japan where COVID-19 infection cases ranked the highest. Participants were randomly recruited, and quota sampling methods were employed with the weighting of the sample distribution by geographic location (n=2764).Subjective and objective risk perceptions and precautionary actions were significantly related to several of the socioeconomic variables, including gender, income, employment and household composition, as well as self-reported health status. These disparities were substantial even with the key basic preventive behaviour including mask wearing, avoidance of large gatherings and hand washing. Further, these risk perceptions and precautionary actions showed unexpected relationships with socioeconomic position and health status, contrary to existing evidence or theory, particularly among younger generations and worse health populations.This evidence suggests that risk perceptions and precautionary actions do not always seem to align, and their disparities by socioeconomic group and health status have been underscored in Japan, which may suggest complex and distinct pathways by subpopulation group. Further evidence and strategies for COVID-19 and other infectious disease prevention would be critical in transitions of the infectious disease prevention and control strategy, targeting both the high-risk population group and higher risk-taking group.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141275866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1136/bmjph-2023-000749
Omar Juma Othman, E. Mashayo, Jamison Jones, Kajal Shah, Christine Graham, A. Yong, Ronnie Graham, F. Omar, V. Chan
Technological advancement in low-resource settings is opening the gateway to implementation of electronic data collection methods that improve data quality. We examined the concerns to use electronic data collection tool in Zanzibar, codeveloped a tool that addressed the concerns and evaluated the process and limitations of incorporating an electronic data collection tool aside from paper-based during a community-based study in Zanzibar.The science of improvement Plan-Do-Study-Act model guided this mixed-method participatory action research (PAR). From November 2022 to October 2023, 14 data collection team members participated in (1) a consultative workshop with a fishbone analysis to understand their hesitance to use electronic data collection tools for fieldwork (Plan); (2) developing implementation and evaluation plan for the paper-based method (Do); (3) assessing the proportion of errors and challenges faced using paper-based method (Study); and (4) codeveloping, implementing and assessing an electronic data collection tool (Act).Stakeholders were hesitant to use electronic data collection tools because of fear of lost data due to poor internet, insufficient competency with technology due to lack of training, unfamiliarity with technology in general and fear of lost wages. The study revealed that using a paper-based data collection tool during baseline was time-consuming, with 12.8% of responses being errors (2611 errors out of 20 398 responses). However, once implemented, the electronic data collection application was fast and simple, with minimal errors (0.02%). Overall, there is a need to improve devices’ storage capacity devices and provide more training.Using the PAR approach, we understood the concerns with electronic data collection tools, allowed the team to experience the challenges faced with the paper-based collection method, codeveloped an appropriate solution and changed their attitude towards using technology that could increase accuracy and efficiency of their fieldwork.
{"title":"Does electronic data collection perform better than paper-based data collection in health research fieldwork? A participatory action research in Zanzibar","authors":"Omar Juma Othman, E. Mashayo, Jamison Jones, Kajal Shah, Christine Graham, A. Yong, Ronnie Graham, F. Omar, V. Chan","doi":"10.1136/bmjph-2023-000749","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000749","url":null,"abstract":"Technological advancement in low-resource settings is opening the gateway to implementation of electronic data collection methods that improve data quality. We examined the concerns to use electronic data collection tool in Zanzibar, codeveloped a tool that addressed the concerns and evaluated the process and limitations of incorporating an electronic data collection tool aside from paper-based during a community-based study in Zanzibar.The science of improvement Plan-Do-Study-Act model guided this mixed-method participatory action research (PAR). From November 2022 to October 2023, 14 data collection team members participated in (1) a consultative workshop with a fishbone analysis to understand their hesitance to use electronic data collection tools for fieldwork (Plan); (2) developing implementation and evaluation plan for the paper-based method (Do); (3) assessing the proportion of errors and challenges faced using paper-based method (Study); and (4) codeveloping, implementing and assessing an electronic data collection tool (Act).Stakeholders were hesitant to use electronic data collection tools because of fear of lost data due to poor internet, insufficient competency with technology due to lack of training, unfamiliarity with technology in general and fear of lost wages. The study revealed that using a paper-based data collection tool during baseline was time-consuming, with 12.8% of responses being errors (2611 errors out of 20 398 responses). However, once implemented, the electronic data collection application was fast and simple, with minimal errors (0.02%). Overall, there is a need to improve devices’ storage capacity devices and provide more training.Using the PAR approach, we understood the concerns with electronic data collection tools, allowed the team to experience the challenges faced with the paper-based collection method, codeveloped an appropriate solution and changed their attitude towards using technology that could increase accuracy and efficiency of their fieldwork.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141274475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1136/bmjph-2023-000762
Michael Reaume, Ricardo Batista, Ewa Sucha, Michael Pugliese, Rhiannon Roberts, E. Rhodes, Emily Seale, Claire E. Kendall, Lise M. Bjerre, Louise Bouchard, Sharon Johnston, Manish Sood, Denis Prud’homme, Douglas G. Manuel, P. Tanuseputro
As the world’s linguistic diversity continues to increase at an unprecedented rate, a growing proportion of patients will be at risk of experiencing language barriers in primary care settings. We sought to examine whether patient–family physician language concordance in a primary care setting is associated with lower rates of hospital-based healthcare utilisation and mortality.We conducted a population-based retrospective cohort study of 497 227 home care recipients living in Ontario, Canada. Patient language was obtained from home care assessments while physician language was obtained from the College of Physicians and Surgeons of Ontario. We defined primary care as language concordant when patients and their rostered family physicians shared a mutually intelligible language, and we defined all other primary care as language discordant. The primary outcomes were Emergency Department (ED) visits, hospitalisations and death within 1 year of index home care assessment.Compared with non-English, non-French speakers who received language-discordant primary care, those who received language-concordant primary care experienced fewer ED visits (53.1% vs 57.5%; p<0.01), fewer hospitalisations (35.0% vs 37.6%; p<0.01) and less mortality (14.4% vs 16.6%; p<0.01) during the study period. In multivariable regression analyses, non-English, non-French speakers had lower risks of ED visits (adjusted hazard ratio [aHR] 0.91, 95% CI 0.88 to 0.94), hospitalisations (aHR 0.94, 95% CI 0.90 to 0.98) and death (aHR 0.87, 95% CI 0.82 to 0.93) when they received language-concordant primary care. For francophones, the risk of experiencing an ED visit, a hospitalisation or death was not impacted by the language of their family physician.Patient–family physician language concordance is associated with a lower risk of adverse outcomes in non-English and non-French speakers. Optimising the delivery of language-concordant care could potentially result in significant decreases in the use of acute healthcare services and mortality at the population level.
随着世界语言多样性以前所未有的速度持续增长，越来越多的患者将面临在初级医疗环境中遭遇语言障碍的风险。我们试图研究在初级医疗机构中，患者与家庭医生语言的一致性是否与较低的医院医疗使用率和死亡率有关。我们对居住在加拿大安大略省的 497 227 名家庭护理对象进行了一项基于人群的回顾性队列研究。患者的语言来自于家庭护理评估，而医生的语言则来自于安大略内科和外科医生学院。当患者和他们名册上的家庭医生使用一种双方都能听懂的语言时，我们将初级护理定义为语言一致，而将所有其他初级护理定义为语言不一致。与接受语言不一致初级医疗服务的非英语、非法语人士相比，接受语言一致初级医疗服务的患者在研究期间的急诊就诊率较低（53.1% vs 57.5%；p<0.01），住院率较低（35.0% vs 37.6%；p<0.01），死亡率较低（14.4% vs 16.6%；p<0.01）。在多变量回归分析中，非英语、非法语使用者在接受语言一致的初级医疗服务时，其急诊室就诊风险（调整后危险比 [aHR] 0.91，95% CI 0.88 至 0.94）、住院风险（aHR 0.94，95% CI 0.90 至 0.98）和死亡风险（aHR 0.87，95% CI 0.82 至 0.93）均较低。对于讲法语的人来说，急诊室就诊、住院或死亡的风险并不受家庭医生语言的影响。优化提供语言一致的医疗服务有可能显著降低急诊医疗服务的使用率和人口死亡率。
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Pub Date : 2024-05-01DOI: 10.1136/bmjph-2023-000681
Philip Apraku Tawiah, Emmanuel Appiah-Brempong, Paul Okyere, Mary Eyram Ashinyo
This study aims to determine the prevalence and predisposing factors of a needlestick injury (NSI) among healthcare support staff in the Greater Accra region, Ghana.An analytical cross-sectional survey was carried out from 30 January 2023 to 31 May 2023, involving 10 major health facilities. A multistage sampling method was adopted. The data analyses were performed using STATA V.15 software. χ2, Fisher’s exact and Mann-Whitney U tests were used to identify the preliminary association between the outcome variables and predisposing factors. Log-binomial regression analyses were used to confirm factors associated with NSI at a significance level of p<0.05.The study was conducted among 149 healthcare support staff. The 1-year exposure to NSI was 68 (45.6%) (95% CI (37.5% to 54.0%)). Being a healthcare assistant (APR=2.81 (95% CI 1.85 to 4.25)), being married (APR=0.39 (95% CI 0.25 to 0.63)), being a supervisor (APR=0.34 (95% CI 0.20 to 0.57)), had training on standard precaution (APR=0.27 (95% CI 0.14 to 0.57)) and non-existence of needlestick reporting system (APR=0.46 (95% CI 0.29 to 0.74)) were significantly associated with NSI.The prevalence of NSI was high compared with other regional studies, and the risk factors were related to sociodemographic, behavioural and organisational factors. The study recommends guidelines that are geared towards NSI exposure among healthcare support staff.
本研究旨在确定加纳大阿克拉地区医护辅助人员针刺伤（NSI）的发生率和诱发因素。研究于 2023 年 1 月 30 日至 2023 年 5 月 31 日进行了一项横断面分析调查，涉及 10 家主要医疗机构。调查采用了多阶段抽样方法。数据分析采用 STATA V.15 软件进行。采用 χ2、费雪精确检验和曼-惠特尼 U 检验来初步确定结果变量与易感因素之间的关联。对数二项式回归分析用于确认与 NSI 相关的因素，显著性水平为 p<0.05。一年内发生 NSI 的人数为 68 (45.6%) (95% CI (37.5% to 54.0%))。身为医护助理（APR=2.81 (95% CI 1.85 to 4.25)）、已婚（APR=0.39 (95% CI 0.25 to 0.63)）、主管（APR=0.34 (95% CI 0.20 to 0.57)）、接受过标准预防培训（APR=0.27 (95% CI 0.14 to 0.57)）和不存在 NSI 风险。与其他地区的研究相比，NSI 的发生率较高，风险因素与社会人口、行为和组织因素有关。该研究建议制定针对医护辅助人员的 NSI 风险指南。
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Pub Date : 2024-05-01DOI: 10.1136/bmjph-2023-000496
N. Akter, B. Banu, S. Chowdhury, T. T. Tabassum, S. Hossain
Implementation of National Tobacco Control Laws (NTCLs) in university settings was found to be worse in Bangladesh.This study aimed to depict the compliance status of tobacco control laws (TCLs) and the associated factors following the university setting approach in Bangladesh.This cross-sectional study was conducted with a mixed-method approach among the 385 students (quantitative method), 10 teachers and 10 administrative staff (qualitative method) of Northern University Bangladesh. Data were collected through mobile phone calling (quantitative) and in-depth interviews method (qualitative). Appropriate ethical issues were addressed. Logistic regression analysis was performed to find out the determinants. The study revealed non-satisfactory compliance with TCLs among 56.4% of study subjects which was strongly supported by the outcome of the qualitative approach. Predominant non-satisfactory compliance was found through the explorations of the conditions of buying and selling tobacco (78.4%), pasting no-smoking signage (3.2%), antitobacco advertisement within the university (34.8%) and specific university policy to implement NTCL. Non-satisfactory compliance was found significant among the younger aged (≤21 years: COR/p=2.74/0.01; 95% CI 1.27 to 5.92) from the first-year group (adjusted odds ratio (AOR)/p=2.28/0.02; 95% CI 1.15 to 4.49) who had moderate nicotine dependency (AOR/p=4.04/0.01; 95% CI 1.28 to 12.74), poor knowledge on TCLs (AOR/p=3.57/0.02; 95% CI 1.28 to 9.95) and the respondents who suggested family guidance (AOR/p=1.77/0.06; 95% CI 0.97 to 3.22) might be a sustainable way to minimise tobacco consumption in the university setting.The study revealed some crucial factors for the non-satisfactory compliance status towards TCLs in the university setting. This empirical outcome and evaluation strategy can guide to plan of future large-scale studies, which may lead to implementing effective intervention programmes focusing on the development of a tobacco-free environment in the university setting.
本研究旨在描述孟加拉国大学对烟草控制法（TCL）的遵守情况及其相关因素。本研究采用混合方法对孟加拉国北方大学的 385 名学生（定量方法）、10 名教师和 10 名行政人员（定性方法）进行了横断面研究。数据通过手机电话（定量法）和深度访谈法（定性法）收集。适当处理了伦理问题。为找出决定因素，进行了逻辑回归分析。研究结果显示，56.4% 的研究对象对 TCL 的遵守情况不满意，定性方法的结果也有力地证明了这一点。不满意遵守情况主要是通过调查买卖烟草的条件（78.4%）、粘贴禁烟标识（3.2%）、校内反烟草广告（34.8%）和实施非烟草控制目标的具体大学政策发现的。研究发现，年龄较小（≤21 岁：COR/p=2.74/0.01；95% CI 1.27 至 5.92）的一年级学生（调整后的几率比（AOR）/p=2.28/0.02；95% CI 1.15 至 4.49）对尼古丁有中度依赖（AOR/p=4.04/0.01；95% CI 1.28 至 12.74）、对烟草控制标签了解不多（AOR/p=3.本研究揭示了大学环境中烟草控制吸烟依从性不理想的一些关键因素。这一实证结果和评估策略可为今后的大规模研究计划提供指导，从而实施有效的干预计划，在大学环境中营造无烟环境。
{"title":"Compliance status of tobacco control laws in the university setting of Bangladesh: an analytical study followed a mixed-method approach","authors":"N. Akter, B. Banu, S. Chowdhury, T. T. Tabassum, S. Hossain","doi":"10.1136/bmjph-2023-000496","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000496","url":null,"abstract":"Implementation of National Tobacco Control Laws (NTCLs) in university settings was found to be worse in Bangladesh.This study aimed to depict the compliance status of tobacco control laws (TCLs) and the associated factors following the university setting approach in Bangladesh.This cross-sectional study was conducted with a mixed-method approach among the 385 students (quantitative method), 10 teachers and 10 administrative staff (qualitative method) of Northern University Bangladesh. Data were collected through mobile phone calling (quantitative) and in-depth interviews method (qualitative). Appropriate ethical issues were addressed. Logistic regression analysis was performed to find out the determinants. The study revealed non-satisfactory compliance with TCLs among 56.4% of study subjects which was strongly supported by the outcome of the qualitative approach. Predominant non-satisfactory compliance was found through the explorations of the conditions of buying and selling tobacco (78.4%), pasting no-smoking signage (3.2%), antitobacco advertisement within the university (34.8%) and specific university policy to implement NTCL. Non-satisfactory compliance was found significant among the younger aged (≤21 years: COR/p=2.74/0.01; 95% CI 1.27 to 5.92) from the first-year group (adjusted odds ratio (AOR)/p=2.28/0.02; 95% CI 1.15 to 4.49) who had moderate nicotine dependency (AOR/p=4.04/0.01; 95% CI 1.28 to 12.74), poor knowledge on TCLs (AOR/p=3.57/0.02; 95% CI 1.28 to 9.95) and the respondents who suggested family guidance (AOR/p=1.77/0.06; 95% CI 0.97 to 3.22) might be a sustainable way to minimise tobacco consumption in the university setting.The study revealed some crucial factors for the non-satisfactory compliance status towards TCLs in the university setting. This empirical outcome and evaluation strategy can guide to plan of future large-scale studies, which may lead to implementing effective intervention programmes focusing on the development of a tobacco-free environment in the university setting.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141044640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1136/bmjph-2023-000781
Yi Yang, Yuan Li, Shuangfeng Fan, Jia He, Jing Xi, S. He
The number of newly reported older (≥50 years old) people living with HIV/AIDS in China has been steadily increasing, and heterosexual transmission has been identified as the major route.In this study, based on biopsychosocial model, a case–control study (74 cases vs 296 controls) was applied to find out predictors (21 potential ones) of HIV infection among older men from rural China. Binary logistic regression with backward selection was applied.Out of 21 potential predictors of HIV infection, 4 were confirmed: receiving HIV-related health education (HRHE) (OR 0.449, 95% CI 0.238 to 0.848), self-reported homosexual identity (16.517 (95% CI 1.073 to 254.182)), visiting female sex workers (FSW) (58.427 (95% CI 7.895 to 432.403)), complete non-overlap of intimate social network and sexual network (2.912 (95% CI 1.372 to 6.177)), partial overlap (3.334 (95% CI 1.536 to 7.236)).Findings from this study suggest current comprehensive prevention and control services need to be strengthened to provide effective HRHE including condom use to older men and help them to improve condom use, especially during visiting FSW and among self-reported homosexual older men. Moreover, increasing intimacy in their sexual relationships is necessary.
本研究基于生物-心理-社会模型，采用病例对照研究（74 例病例与 296 例对照），找出中国农村老年男性 HIV 感染的预测因素（21 个潜在预测因素）。在 21 个潜在的 HIV 感染预测因子中，有 4 个得到了证实：接受 HIV 相关健康教育（HRHE）（OR 0.449，95% CI 0.238 至 0.848）、自述的同性恋身份（16.517（95% CI 1.073 至 254.182））、探访女性性工作者（FSW）（58.427（95% CI 7.895 至 432.403））、亲密社交网络与性网络完全不重叠（2.912（95% CI 1.073 至 2.912））、亲密社交网络与性网络完全不重叠（2.本研究结果表明，目前的综合预防和控制服务需要得到加强，以便为老年男性提供有效的包括安全套使用在内的生殖健康和保健服务，并帮助他们提高安全套的使用率，尤其是在探访FSW和老年男性同性恋者时。此外，增加他们性关系中的亲密程度也是必要的。
{"title":"Homosexual identity and network overlap predictors of HIV infection among older men from rural China: a case–control study","authors":"Yi Yang, Yuan Li, Shuangfeng Fan, Jia He, Jing Xi, S. He","doi":"10.1136/bmjph-2023-000781","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000781","url":null,"abstract":"The number of newly reported older (≥50 years old) people living with HIV/AIDS in China has been steadily increasing, and heterosexual transmission has been identified as the major route.In this study, based on biopsychosocial model, a case–control study (74 cases vs 296 controls) was applied to find out predictors (21 potential ones) of HIV infection among older men from rural China. Binary logistic regression with backward selection was applied.Out of 21 potential predictors of HIV infection, 4 were confirmed: receiving HIV-related health education (HRHE) (OR 0.449, 95% CI 0.238 to 0.848), self-reported homosexual identity (16.517 (95% CI 1.073 to 254.182)), visiting female sex workers (FSW) (58.427 (95% CI 7.895 to 432.403)), complete non-overlap of intimate social network and sexual network (2.912 (95% CI 1.372 to 6.177)), partial overlap (3.334 (95% CI 1.536 to 7.236)).Findings from this study suggest current comprehensive prevention and control services need to be strengthened to provide effective HRHE including condom use to older men and help them to improve condom use, especially during visiting FSW and among self-reported homosexual older men. Moreover, increasing intimacy in their sexual relationships is necessary.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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