Journal of Health, Population, and Nutrition最新文献

Aims: This study aims to assess the serum levels of pepsinogen (PG)I, PG II, and gastrin (G17) in patients with gastric intestinal metaplasia (GIM) and evaluate their correlation with demographic characteristics.

Methods: A total of 247 normal controls (NC) and 240 patients diagnosed with GIM were enrolled in this study. All participants underwent a gastroscopy procedure followed by pathological examination for diagnosis confirmation. The expression level of PGI, PG II, and G 17 was detected by fluorescence immunochromatography and Hp infection was detected by 13-carbon breath test. The demographic characteristics of the subjects were obtained through questionnaires.

Results: Compared to the NC group, the GIM group showed a reduction in PG II expression level [10.71(6.40,16.89) VS 9.21(6.14,14.55), p = 0.010]. GIM patients had a higher prevalence of previous Hp eradication history (14.98% VS 23.75%, p = 0.014). The low PG II group exhibited a higher incidence rate of GIM compared to the high PG II group (54.10% VS 44.44%, p = 0 0.020). In the Hp-negative(Hp-) group, there was a decrease in both PGI and PG II expression levels when compared to the Hp-positive(Hp+) group [146.73 ± 78.53 VS 125.61 ± 68.75 and 10.19(7.27, 16.58) VS 7.36(5.62,12.53), p = 0.036 and p < 0.001]. Among patients without Hp eradication history, those with low PG II levels had a higher proportion of individuals with a history of Hp eradication than those with high PG II levels (29.31% VS 3.13%, p = 0.003). Additionally, within the subgroup that underwent Hp eradication, there was a decrease in PG II expression level compared to the subgroup without Hp eradication (6.16(5.13, 7.52) VS 8.73(5.67, 13.35), p = 0.041).

Conclusion: The prevalence of GIM was significantly associated with low levels of PG II. There was a significant association between HP eradication history and the prevalence of GIM. Hp eradication history resulted in reduced expression levels of PG II in Hp- GIM patients.

Background: Smokeless tobacco (SLT) encompasses products that are not burnt but instead consumed orally or nasally. One-third of tobacco is consumed in the smokeless form in South Asia. Despite its widespread usage, there has been limited empirical research on the prevalence and factors influencing SLT consumption in Pakistan. This study aimed to provide an assessment of SLT knowledge, attitudes, and usage in Pakistan.

Methods: Using an online questionnaire, a cross-sectional survey was conducted across Pakistan. Convenience sampling was used to disseminate, and expert approval was sought followed by a pilot study to validate the questionnaire. A comprehensive questionnaire was developed using elements from the Global Adult Tobacco Survey and other tools which had previously been utilized within Pakistan. Participants' responses were described using descriptive statistics, and SPSS version 26 was used to perform linear and logistic regression. A p-value of less than 0.05 was considered statistically significant.

Results: Data was collected from 1,195 participants among which 85.86% of participants had heard of SLTs prior to the survey. Sex, province, household income and previous doctor visits were significant determinants to product knowledge through which 72.55% agreed that these products can lead to serious illnesses but 30% noted a lack of knowledge on legality. General attitudes agreed that it makes one feel unwell (44.1%), gives a sense of guilt (43.85%) and more research is needed on it (54.39%). Negative health effects were the biggest deterrent from pursuing these products for 60.33% of participants. Among significant factors influencing the use of SLTs, the greatest odds of use were found with use as an alternative to cigarettes (OR 4.45) and secondly, due to its availability in a liked flavor (OR 2.27). About 31% reported to have used the product once, with 69.82% of current users expressing a desire to quit.

Conclusions: Although adequate knowledge and aligning attitudes exist for SLTs, light is shed in the face of a sustaining public health problem. We offer important insights that can guide the creation of focused interventions meant to lower SLT use, and the health hazards associated with it in the Pakistani community by highlighting important myths, incentives, and deterrents.

Background: For mothers identified as HIV-infected, recommended infant feeding practices must prioritize the highest likelihood of ensuring HIV-free survival for their children while preserving maternal health. Consequently, understanding the feeding status during critical infancy stages, especially under the risk of HIV, plays a crucial role in enhancing the quality of life within this specific population segment. Hence, this study was conducted to assess the magnitude and associated factors of recommended infant feeding practices and its associated factors among HIV-positive mothers in Eastern Ethiopian Hospitals.

Methods: A cross-sectional study conducted in Eastern Ethiopian Hospitals from June to July 2022 included 371 mothers of infants. Participants were selected using systematic random sampling techniques. Data was collected through pre-tested structured face-to-face interviews administered by trained interviewers. Following data collection, information was cleaned and entered using Kobo tool collection software, then exported to Statistical Package for Social Sciences (SPSS) version 25 for analysis. Binary logistic regression analysis was employed to assess the strength of association between explanatory and outcome variables. Variables with a p-value < 0.25 in univariable logistic regression analysis were considered for multivariable logistic regression analysis, and statistical significance was determined at a P-value < 0.05 with a 95% confidence interval.

Results: The magnitude of recommended feeding practice was found to be 86% (95% CI: 81.9, 89.1). HIV-positive mothers who had a child age of 0-6 months [AOR = 5.21 (95% CI: 2.54, 10.70], spontaneous vaginal delivery [AOR = 2.11 (95% CI: 1.05, 4.24], and ever provided expressed breast milk [AOR = 2.82 (95% CI: 1.33, 5.95] were significantly associated with recommended Infant feeding practice.

Conclusion: the study identified a moderate level of adherence to recommended infant feeding practices among HIV-positive mothers in Eastern Ethiopian hospitals. Key factors influencing adherence included the child's age, mode of delivery, and the provision of expressed breast milk. Target interventions to improve infant feeding practices among HIV-positive mothers, focusing on younger infants, cesarean-delivered mothers, and those not providing expressed breast milk. Strengthen counseling and education in healthcare facilities to address these significant factors and enhance adherence to recommended feeding practices.

Background: Breast cancer is a significant global health challenge, affecting millions annually and imposing a considerable burden on healthcare systems and economies worldwide. This cross-sectional study aims to determine the economic impact of breast cancer in Lorestan Province, western Iran.

Methods: A retrospective cost-of-illness analysis utilizing a cross-sectional design was performed from November 2023 to July 2024. Data were collected using patient medical records and telephonic interviews. Costs were categorized into direct medical costs, direct non-medical costs, and indirect costs. A bottom-up approach was employed for cost calculation from a societal viewpoint, with a prevalence-based analysis.

Results: The study analyzed 525 patients with an average age of 42.74 ± 11.75 years. The total economic burden of breast cancer was estimated at $5,394,409.13, with a mean of $10,275.07 per patient. Direct medical costs comprised 70.2% of the total expenses, primarily attributed to hospitalization, chemotherapy, and laboratory tests. Direct non-medical costs, including accommodation and transportation for patients and their companions, accounted for 12.5%. Indirect costs, largely stemming from productivity losses due to morbidity and mortality, represented 17.3% of the total burden.

Conclusion: Breast cancer imposes a substantial economic burden on patients and their families in Lorestan Province. Enhancing health insurance coverage, providing government subsidies for treatment, and improving healthcare infrastructure to offer advanced diagnostic and treatment options locally are critical steps to alleviate this burden. Early detection and prevention programs can facilitate earlier diagnosis and reduce treatment costs. Comprehensive policies addressing both medical and non-medical expenses are necessary to improve patients' quality of life and lessen the financial challenges associated with breast cancer in Iran.

Background: Medication reconciliation has been acknowledged as a key intervention against medication errors. More than half of the medication errors that happen during care transitions are caused by unjustified medication discrepancies and up to one-third of these mistakes may be harmful. The study aimed to evaluate the knowledge, attitude and practices (KAP) of health care providers in on medication reconciliation process, pre and post educational intervention.

Methods: A hospital-based prospective quasi-experimental pre-post intervention study was conducted from November 2023 to February 2024 among 346 healthcare professionals (medical doctors, pharmacists and nurses) practicing in King Saud Hospital (KSH), Unayzah, Saudi Arabia. The subjects were recruited using the convenience sampling method.An educational intervention workshop was conducted among the healthcare professionals. The KAP was assessed before and after the educational intervention using a content and face validated self-administered questionnaire. The statistical analyses were conducted using the Statistical Package for Social Sciences (SPSS). Wilcoxon Signed Rank Test was used to differentiate the mean response scores for knowledge, attitude, and practice domains, between pre and post intervention. Kruskal Wallis Test followed by Dunn's post hoc test was used to compare the mean response scores for knowledge, attitude and practice domains based on educational qualification and practicing experience for the pre and post-test period. The level of significance is determined at P < 0.05.

Results: There was a significant improvement in the participants' knowledge, attitude and practice after the educational intervention with mean scores of 0.72 (SD = 1.67, p < 0.0001*), 0.76 (SD = 1.97, p < 0.0001*), and 0.56 (SD = 2.05, p = 0.001*) respectively. The overall KAP scores showed a statistically significant enhancement after the education intervention with a mean score difference of 2.04 (SD = 4.76, p < 0.0001*).Our study upholds that MedRec is highly valued by the participants due to its significant role in reducing medication errors and enhancing patient safety, and that it has the ability to recognize medication discrepancies and reduce adverse drug events.

Conclusion: The education intervention effectively influenced the knowledge, attitude and practice of healthcare professionals regarding medication reconciliation. This study underscores the importance of continuous education and training for healthcare professionals to minimize medication discrepancies and improve patient care.

Background: Globally, obesity trends are a serious public health concern. Adolescent obesity is associated with cardiometabolic risk and metabolic disorders in adolescence and may persist into adulthood. The current study was designed to explore the Dietary Approaches to Stop Hypertension (DASH) in adolescents and its relationship with obesity, insulin resistance, metabolic syndrome (MetS), and some inflammatory biomarkers.

Methods: A total of 90 adolescents with obesity and 90 adolescents with normal weight, participated in the study. Data from a validated 168-item semi-quantitative food frequency questionnaire were used to calculate the DASH score. The association of DASH score with cardiometabolic risk factors was estimated using multivariable logistic regression models. To assess the correlation between the DASH score and dietary factor, the Pearson correlation coefficient (r) was used.

Results: Adolescents with a high DASH score had significantly higher intakes of potassium, magnesium, vitamin C, and vitamin K and lower intakes of sodium compared with those with a low DASH score (P < 0.05 ). There were no significant differences in the DASH score and its components between adolescents with and without metabolic syndrome. Adolescents with metabolic syndrome had significantly higher concentrations of triglycerides, low HDL-C, and high blood pressure compared with those without metabolic syndrome (P < 0.05). There were no significant associations between DASH score and MetS and other cardiometabolic risk factors in crude and multivariate-adjusted models. In addition, the DASH score was positively associated with potassium, magnesium, sodium, vitamins D and C, docosahexaenoic acid, and soluble fiber (P < 0.05).

Conclusion: In the current study, there was no significant association between adherence to the DASH diet and odds of metabolic syndrome, and other cardiometabolic risk factors in adolescent. Further prospective studies are needed to confirm these findings.

Trial registration: Ethics approval was obtained from the research ethics committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1397.179.).

Background: As Generation Z two-spirit, lesbian, gay, bisexual, transgender/trans, queer, intersex, asexual and others who identify as part of sexual and gender diverse communities (2SLGBTQIA +) enter adulthood, contemplation of family creation may be challenged by biological and/or social infertility. Despite some advances in societal acceptance of gender and sexual minorities, family planning and reproductive healthcare remain heteronormative. To explore reproductive decision-making and how future families are conceptualized across genders, we evaluated perceptions of Ontario, Canada non-parenting, 2SLGBTQIA + emerging adults.

Methods: An online survey, designed as mixed-methods with sex-and-gender-based analysis (SGBA +), was used to recruit childless, post-secondary students, aged 18-30 years, in May-October 2022. Survey questions were analyzed by descriptive statistics across gender groups. Open-text responses were analyzed by thematic and content analysis.

Results: Parenthood intentions, conceptualizations of future family and perceptions of ART were described by 286 2SLGBTQIA + individuals, who were primarily Caucasian, cis women (69.2%), identified as bisexual-pansexual (66.4%), and belonged to Generation Z (85%). Only 33.9% of the sample definitively wanted children, with 33.6% unsure, and 32.5% preferring to remain childless. Themes describing participants' future family visions included: (i) committed partners are family, (ii) family includes children (subtheme: adoption/fostering as options for family creation), (iii) family values include love and acceptance, (iv) chosen families, and (v) families can be childfree. ART was acceptable in the event of future infertility, with two major themes used to describe perceived barriers to ART: (i) treatment is expensive; and (ii) I may face discrimination due to my gender identity/sexual orientation. Trans men were significantly more worried about healthcare access to have a biological child (86.7%; χ²(3):16.805 p < .001) than other genders.

Conclusions: 2SLGBTQIA + respondents expanded the rigid, heteronormative nuclear family model to envision families comprised of partners, biological and adoptive/foster children, friends and chosen family. Participants across genders recognized systemic 2SLGBTQIA + discrimination, with transgender/trans respondents particularly concerned about barriers to reproductive healthcare. A better understanding of reproductive decision-making by 2SLGBTQIA + individuals can contribute to more equitable and inclusive ART healthcare.

Background: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition characterized by high morbidity and mortality rates. This study aims to assess the clinical outcomes of COPD patients after implementing an algorithm within the MyTatva app.

Methods: The study involved a sample of 10 COPD patients, evaluating key parameters such as Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity, Weight, Body Mass Index (BMI), Fat-Free Mass Index, and Distance Covered during the 6-Minute Walk Test (6MWT) before and after the algorithm's implementation in the MyTatva app. Patient satisfaction was assessed through a CSAT survey.

Results: Following the implementation of the MyTatva care plan, significant improvements were observed in several key clinical outcomes for COPD patients. FEV1 increased from a median of 3.24-2.0 L (p = 0.0379), while weight and BMI decreased significantly, with a reduction in weight from a median of 86-70 kg (p = 0.0007) and a corresponding decrease in BMI from 28.43 to 24 kg/m² (p = 0.0031). The distance covered during the 6MWT also improved from 420 to 568 m (p = 0.0019). The participation of 10 COPD patients in surveys yielded an overall CSAT score of 85%, indicating a high level of satisfaction with the MyTatva app.

Conclusion: The comprehensive features and functionalities of the MyTatva app, combined with the personalized care plan and real-time feedback mechanisms, have led to substantial clinical improvements in COPD management. These findings highlight the promise of this innovative digital therapeutic approach in addressing chronic respiratory conditions.

Background: Rabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Rabies remains a major public health problem in Egypt, with an estimated 60 people dying annually from the disease.

Aim: The aim of this study was to assess the effect of preventive program on mothers' awareness for prevention of rabies.

Study design: Quasi-experimental research design was utilized in this study.

Setting: This study was conducted at three major Maternal and child centers (Botors, Embaby and Segar) in Tanta City.

Sample: A total sample of 150 mothers who attended the child clinic with children aged 6-12 years.

Tools: Researchers developed three tools for data collection. The tools underwent content validity assessment, and their internal consistency was evaluated using Cronbach's alpha coefficient. Structured interviewing questionnaire for assessment of mothers' knowledge, attitudes and practices regarding rabies Tool I, Mothers' knowledge regarding rabies questionnaire. This tool consisted of two parts: demographic characteristics of the studied mothers and mothers' knowledge about rabies. Tool II, Rabies attitudinal Likert scale. Tool III, Mothers reported practice Questionnaire.

Results: From the obtained results, it was found that, a statistically significant correlation was found between mothers' total knowledge scores, attitude and total practice scores, both before and after the implementation of the rabies prevention program.

Conclusion: It was concluded that the rabies- preventive health program had a positive impact on mother's knowledge, attitude and practices regarding rabies. The mean knowledge score improved from 14.08 before preventive program to 20.90 one month posttest. Negative attitude of the studied mothers was 48% before program but it reduced to 1.3% one month after preventive program. Only 13.35% of the participants had satisfactory level of practice before program and increased to 83.30% one month posttest.

Recommendations: Dissemination of the program through mass media campaigns and community outreach activities to enhance public knowledge, improve attitudes, and promote better practices regarding rabies prevention and control measures.

Background: Food neophobia, characterized by the fear of unfamiliar foods, can be influenced by environmental, cultural, and genetic factors, leading to decreased consumption of novel or diverse foods. Understanding the impact of Mediterranean diet adherence and eating disorders on dietary behaviors is crucial, particularly for young adults who are developing lifelong eating patterns.

Methods: The aim of this study was to investigate the relationships among food neophobia, Mediterranean diet adherence, and eating disorders in university students aged 18-24 years. A cross-sectional study was conducted with 1277 students (67.2% female) via an online questionnaire to assess sociodemographic characteristics, food neophobia (Food Neophobia Scale, FNS), Mediterranean diet adherence (KIDMED), and eating disorder risk (Eating Disorder Examination Questionnaire, EDE-Q).

Results: Most participants (67.7%) had a normal body mass index (BMI), 19.3% were classified as overweight, and 3.7% were classified as obese. Compared with male students, female students had significantly higher FNS scores (40.8 ± 9.21) (38.5 ± 10.97, p < 0.05), indicating greater food neophobia among women. Similarly, men's EDE-Q scores (3.5 ± 3.32) were significantly lower than those of women (4.4 ± 4.05, p < 0.05). Most participants (69.5%) did not experience food neophobia, and underweight individuals (11.0%) were more neophobic than obese individuals (4.4%). No significant differences were observed according to BMI (p > 0.05). A positive correlation was found between age and KIDMED adherence, whereas a negative correlation was observed between BMI and EDE-Q scores regarding food neophobia. The effects of BMI on food neophobia and the risk of eating disorders were found to vary by sex.

Conclusions: These findings suggest that food neophobia may harm Mediterranean diet adherence and increase the risk of eating disorders among university students. Targeted interventions addressing food neophobia could promote healthier eating habits, such as the Mediterranean diet, thereby reducing disordered eating behaviors and associated risks. Further research is needed to confirm these findings, improve population nutritional habits and mental health outcomes, and develop effective public health strategies.