Journal of Education and Health Promotion最新文献

Emerging evidence claims the vascular benefits of varied frequency and duration of physical activity (PA) breaks, whereas the efficacy of varied intensity remains unexplored. We aimed to collate and summate the studies investigating the PA breaks at various intensities on vascular protection. Seven electronic databases were searched for potential studies till Jan 31, 2022. The eligible studies should have administered PA breaks of differing intensities in prolonged sitting postures and explored regional vascular changes [flow mediated dilation (FMD), shear stress, diameter, and blood flow] using ultrasound and novel outcome markers. Two independent reviewers assessed the studies for eligibility after abstract and full-text screen, and appropriate data were extracted to summarise vascular protective effects with PA breaks. Our findings reveal adverse regional vascular outcomes with prolonged sitting (FMD ≈ -1.5%, diameter ≈ -0.06 mm), whereas PA breaks of any intensity were found to improve endothelial functions (FMD ≈ +0.5%, diameter ≈ +0.1 mm, shear ≈ +13 s^-1) and mitigate the adverse effects associated with prolonged sitting. Compared with high-intensity activity, low-intensity PA breaks alleviate arterial stiffness and endothelial dysfunction risks.

Background: There is limited data on sleep, physical activity, and health-related behaviors among the general public during Ramadan, particularly during the COVID-19 pandemic. This study aimed to assess the factors associated with sleep and physical activity changes among Nigerian Muslims during Ramadan fasting.

Materials and methods: A nationwide web-based cross-sectional study was conducted among Nigerians aged ≥18 years who performed diurnal fasting during Ramadan. The target sample size was obtained using Fisher's formula, and snowball sampling was employed. Adapted versions of the International Physical Activity Questionnaire Short Form and Copenhagen Psychosocial Questionnaire II were used to evaluate sleep and physical activity. Correlates of change in physical activity and sleep quality were assessed using logistic regression analysis.

Results: Seven hundred and seventy individuals participated in the study. During Ramadan, 39.1% (95% confidence interval (CI): 35.6%-42.6%) reported decreased physical activity, and 56.6% (95% CI; 53.0%-60.2%) stated having self-reported good sleep. The independent correlates of physical activity were female sex (adjusted odds ratio (aOR):0.5, 95% CI: 0.4-0.8), having very good sleep (aOR: 0.4, 95% CI: 0.2-0.7), and obesity (aOR: 2.0, 95% CI: 1.1-3.7). In addition, factors associated with improved self-reported sleep quality were perceived good health state (aOR: 8.8, 95% CI: 1.1-72.4), sleeping 7-9 h per day (aOR: 5.5, 95% CI: 2.6-10.3), and sleeping for over 9 h per day (aOR: 4.6, 95% CI: 2.1-14.1).

Conclusions: Although physical activity decreased by about a third, over half of the respondents lost weight and slept well during Ramadan. Strategies to include intermittent fasting in positive lifestyle changes could improve the health and well-being of the population.

Narrative assessments in medical education have a broad scope and they extend way beyond the boundaries and limitations of traditional grading methods. Acknowledging the merits of narrative assessments in the making of a complete healthcare professional, every institution should aim to structurally introduce these forms of qualitative assessments within their set-ups. Although narrative assessments offer multiple merits, we cannot ignore the presence of the challenges that are linked with them and there is an immense need to address these potential challenges, and we will essentially require thoughtful planning, regular training of teachers, and consistent efforts to refine the process of narrative assessments. In conclusion, in the field of medical education, narrative assessment has significant scope and merits to offer to facilitate the growth of medical students. However, we must be systematic in our approach to integrate these assessments in a meaningful manner and take specific measures to overcome the associated challenges.

Background: India faces a critical challenge with 5.8 million annual deaths from non-communicable diseases (NCDs). Maharashtra, where NCDs constitute 66% of the disease burden. The youth, lacking awareness, are vulnerable. Vitalizing communities against NCD risk factors (V-CaN) melawa, inspired by the "Pandharpur Wari" pilgrimage, aims to bridge implementation gaps and empower communities. "Arogya chi wari" integrates health practices with cultural events, offering a unique approach. Photo documentation from V-CaN melawa becomes a powerful tool for assessing community engagement qualitatively. The aim of the study was to qualitatively analyze photos from V-CaN melawas, exploring community engagement in health promotion against NCD risk factors.

Materials and methods: V-CaN melawas were organized in the field practice area of the department of community medicine. These melawas were part of the cluster randomized field trial named V-CaN, which is being implemented in a rural area of the Wardha district of Maharashtra. The V-CaN days, also known as melawas, were organized with the aim of facilitating behavioral change among participants. A qualitative study using photo content analysis was conducted, reviewing 2000 pictures from 59 V-CaN melawas. Thematic content analysis was employed, with researchers selecting 61 photos based on uniqueness.

Results: Six major themes emerged: health promotion, health system involvement, intersectoral coordination, inclusiveness, community resource mobilization, and innovation. Examples include nutrition exhibitions, health screenings, and innovative games.

Conclusions: The analysis showcases diverse community participation in V-CaN melawas, emphasizing inclusivity, collaboration, and innovation. While qualitative, the study lays the foundation for future quantitative assessments of the intervention's impact on health outcomes and community attitudes.

Background: Cardiovascular diseases (CVDs) are the leading cause of cardiac arrest (CA), which are presented as sudden cardiac arrest (SCA) and sudden cardiac death (SCD). To assess the impact of CPR duration on the functional outcome, level of independence, and survival among patients with in-hospital cardiac arrest (IHCA).

Material and methods: This prospective longitudinal pilot study was conducted at a tertiary care hospital in South India. Data were collected using consecutive sampling techniques from nine patients with IHCA, and outcomes were measured using the cerebral performance category (CPC) and Katz level of independence (LOI) during the immediate post-CPR, 30^th day, and 90^th day. Based on the principles of pilot study design, descriptive statistics was used to analyze the results. Inferential statistics analysis was not applicable based on the sample size of the pilot study.

Results: Nine patients were included in this pilot study. The mean and median age of the patients were 48.11 ± 8.66 (46, IQR, 32-67 years) and 77.8% were male patients. The primary medical diagnosis was cardiology and neurology conditions among 44.4% and 22.2% of patients. The mean and median CPR duration was 12.11 ± 4.59 minutes (IQR, 8-15.50) and 44.4% achieved a return of spontaneous circulation (ROSC) with a mean ROSC time of 5.56 ± 7.418. The mean CPC score in the immediate post-CPR period and 30^th day was 4 ± 1.732 and 4.56 ± 1.33, with mortality of 66.7% and 33.3% survivors in the immediate post-CPR period. While the mean LOI score among the survivors during the immediate post-CPR and 30^th day was zero and four. which highlights the complete dependency of patients during the immediate post-CPR with significant improvement by the 30^th day and unchanged until the 90^th day.

Conclusions: The overall mortality and survival were 88.8% and 11.1%, respectively, by the 90^th day. The pilot study is feasible at the end of the study. However, due to the difficulty in obtaining CA, an additional tertiary hospital was included in the larger study.

Background: Mothers who experience unplanned pregnancies tend to show less maternal attachment to the fetus, which can lead to diminished self-care during pregnancy, and affect well-being of the fetus. Consequently, unintended pregnancies are associated with heightened maternal and fetal consequences due to mothers' negligence. Hippotherapy intervention has emerged as a viable approach to enhance maternal-fetal communication. The ultimate goal of this study was to broaden our current understanding of haptotherapy's impact on maternal-fetal attachment in unplanned pregnancies.

Materials and methods: This field trial research was conducted at comprehensive health centers in Isfahan using convenient sampling method. The study consisted of two groups of mothers, each consisting of 33 individuals with unplanned pregnancies between 20 to 24 weeks. The experimental group received haptotherapy intervention for 10 weeks, while the control group received standard pregnancy care. For data collection the participants were given demographic and fertility questionnaire prior to the study, and Cranley's maternal-fetal attachment questionnaire both before and after the study. Moreover, T-test, Mann-Whitney U test, and Chi-square test were used for data analysis.

Results: Prior to the intervention, there was no significant difference in the average maternal-fetal attachment scores between the experimental and control groups (P = 0.56). However, a significant increase became apparent after the intervention. The experimental group exhibited a significant improvement in the mean attachment scores compared to their pre-intervention levels (t=-9.20, P = 0<0.001). In contrast, the control group's score remained unchanged, with no significant difference observed (=1.69, P = 0.1).

Conclusion: Haptotherapy has been found to enhance maternal-fetal attachment in mothers experiencing unplanned pregnancies. This valuable intervention is recommended as an innovative and secure approach in maternal health care services to help reduce the potential complications associated with such pregnancies.

Background: Lower limb varicose veins (LLVVs) are a common problem that mostly occurs among healthcare professionals, especially nurses. While the direct cause of LLVVs is not known at present, its predictors have been identified in the literature. The objective of this study is to identify the predictors of LLVVs among nurses in Jordan.

Materials and methods: This cross-sectional descriptive study was carried out in Jordan in the period between August 2022 and December 2022. This study was carried out on 407 nurses. The participants were recruited in the study using convenience sampling. LLVVs and predictors were analyzed using binominal logistic regression. The percentage of having LLVVs was 30.7%.

Result: Results showed that having a family history of LLVVs and older age were significant predictors of developing LLVVs among both male and female nurses. For male nurses, longer shift hours were a significant independent predictor of developing LLVVs, where increased number of deliveries, less sitting time, and increased weight were significant independent predictors of developing LLVVs among female nurses.

Conclusion: This study highlighted the predictors of LLVVs among nurses, which can be considered in improving the lifestyle and quality of life of nurses in the long term.

Background: Diabetes self-management education and support (DSMES) is an approach to improve preventive practices and behaviors with a focus on decision-making, problem-solving, and self-care. The present study was designed to appraisal structural standards of Diabetes Self-Management Education (DSME) in Isfahan province.

Materials and methods: The sample size included 170 files of patients with diabetes in 31 diabetes education units. The data collection tools were a checklist with 62 items and a questionnaire. Data was collected via observation and interview. In each diabetes education unit, theresearcherfirst observed the physical space and equipment of the classroom and completed the relevant items in the checklist. Then participated in one individual and one group education session and completed the checklist withthe relevant items. At the end of the session, the researcher completed the questionnaire by interviewing the educator. The collected data were described using SPSS version 21 software.

Results: Regarding the characteristics of educators. All of them had started working as an educator without completing the diabetes education courseandabout a third of them had less than one year of work experience (29%) in diabetes units. Regarding physical space, about 90% of the education units had proper lighting, cooling and heating devices, and less than half (48.4%) had proper ventilation. In 3.2% of diabetes units, educators had access to the Internet. In none of the diabetes education units(%0), there was an up-to-date and evidence-based documented curriculum.

Conclusion: The results of the present study showed serious challenges in the field of the structure of DSMES in the diabetes education units of Isfahan province. Considering the necessity and critical importance of diabetes education, policymakers in the field of diabetes management can benefit fromthese results for planning to help improve this situation.

Background: The role of health-related behaviors, particularly eating behavior, in the health of middle-aged individuals in the workplace is crucial. This qualitative study aimed to gain a deeper understanding of the challenges and barriers to healthy eating behaviors in the industrial workplace from the perspectives of middle-aged workers and employers.

Methods: Semi-structured interviews were conducted with 15 participants, including 5 workers aged 35 to 59 years, 3 nutrition experts, 2 health, safety and environment (HSE) experts, and 5 employers from industrial workplaces in Tehran, Iran. Purposeful sampling was used to select participants who could provide meaningful insights into the research question. The data were analyzed using Graneheim and Lundman approach with MAXQDA software.

Results: The study revealed three main themes that hindered healthy eating behaviors in the workplace: (i) the absence of organizational structures for well-being and health, including sub-themes such as the lack of health-oriented organizational policies, inaccessibility to healthy nutritional resources, and restrictive rules, (ii) the pressure of organizational social norms, including sub-themes such as the impact of friendship networks and colleagues, and the effect of workplace culture, and (iii) the lack of a supportive learning environment for healthy behavior, including sub-themes such as the impact of poor interactions and the absence of supportive training.

Conclusion: The findings highlight the need for workplace health programs that address the identified challenges and promote healthy eating behaviors among middle-aged workers. Implementing health-focused policies and fostering a workplace environment that encourages nutritious food choices can enhance the overall health and well-being of workers and potentially lead to healthy aging in the future.

Background: Fear of childbirth (FOC) is one of the common reasons for choosing cesarean delivery without medical indications. The present study aimed to assess the effect of childbirth scenario-based educational intervention on FOC in primiparous women.

Materials and methods: This study was conducted on 72 primiparous women attending comprehensive health care centers in Qazvin, Iran, in 2021. Participants were randomly placed in the control group (n = 38) and the intervention group (n = 34). The participants in the intervention group read the booklet of childbirth scenarios once a week for eight weeks. Data were collected using the demographic-fertility questionnaire and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) before the intervention, eight weeks after the intervention, and the first week after delivery. Data analysis was carried out using independent t-test, Chi-square, Fisher's exact, repeated measures analysis of variance (ANOVA), and analysis of covariance (ANCOVA).

Results: By controlling the FOC scores before the intervention, the mean total FOC scores eight weeks after the intervention and in the first week after delivery in the intervention group were significantly 34 units (95% CI: 27.3-40.7) and 22.9 units (95% CI: 14.6-31.1) lower than the control group respectively (P < 0.001).

Conclusion: Based on the results, childbirth scenario-based intervention can effectively reduce FOC among primiparous women. Healthcare providers, especially midwives, can benefit from applying childbirth scenario-based intervention in prenatal care to reduce the FOC of pregnant women.