Journal of Family and Community Medicine最新文献

Background: The increased use of electronic devices has caused a rise in the generation of e-waste, which is detrimental to the environment and human health. This study aimed to assess consumer awareness, perception, and disposal methods of e-waste management and its determinants in a semi-urban area of northern Tamil Nadu.

Materials and methods: It was a mixed-method approach using a sequential explanatory technique with both quantitative and qualitative methods in adult e-consumers. Quantitative data were collected from 350 participants selected via simple random sampling using score-based semi-structured questionnaire. Qualitative data were obtained purposely from eight selected consumers such as recyclers, local leaders, and importers of electronics using key informant interviews. Sociodemographic details and disposal practices were summarized as frequencies and percentages. The independent t-test and linear regression analysis were used to obtain the determinants. Qualitative data were analyzed thematically.

Results: Of the 350 participants (208 males and 142 females), the majority (76%), had good knowledge of e-waste management. Consumers (70%) predominantly had a positive perception. Selling e-wastes to scrap dealers (35%) and disposing of household wastes (21%) were common disposal methods. Male gender, higher education (≥10^th grade), and skilled and professional workers were significant determining factors of good knowledge and positive perception toward e-waste management.

Conclusion: There is a need for those in authority to pay special attention to sensitizing the public to the disposal of e-waste practices, ill effects of e-wastes, segregation at collection sites, legislations and laws on e-waste to consumers, and the establishment of disposal sites.

Background: Vaccine hesitancy is a worldwide issue. To intensify our efforts to find a solution to this problem, we need to comprehend its magnitude and underlying causes. This study aimed to determine the prevalence of influenza vaccine hesitancy and the reasons for it among healthcare workers (HCWs) and mothers of preschool children attending Zagazig Maternal and Child Healthcare (MCH) Center, Sharqia Governorate.

Materials and methods: A cross-sectional study was conducted in the Zagazig MCH Center involving 77 HCWs and 210 mothers of preschool children. Two validated questionnaires (one for HCWs and one for mothers of preschool children) were used to collect data on hesitancy to influenza vaccine. Data analysis perfomed using SPSS v 25.0. For quantitative variables, statistical significance was determined using t-test, whereas Chi-square test was employed for quantitative variables. Poisson regression model was used to determine the independent predictors of influenza vaccine hesitancy. P < 0.05 was used as a level of statistical significance.

Results: The prevalence of hesitancy to the influenza vaccine was 46.8% among HCWs and 54.3% among mothers of preschool children. Fear of side effects (42.9%) and doubt in the usefulness of the vaccine (42.1%) were the most frequent barriers. Hesitancy was significantly more prevalent in the negative-attitude HCWs (62.0%) than positive-attitude HCWs (18.5%). According to Poisson regression analysis, the age of the index child, the mothers' source of information, and the frequency of vaccination were the critical indicators of influenza vaccine hesitancy in the studied mothers.

Conclusion: Influenza vaccine hesitancy among the studied sample is high (46.8% among HCWs, and 54.3% among mothers of preschool children). Periodic health education campaigns to increase awareness and change the negative attitude about the influenza vaccine are recommended.

Background: Restless legs syndrome (RLS) is a common sensorimotor disorder during pregnancy. The purpose of this study was to assess the prevalence of RLS and explore the associated risk factors and outcomes in Omani women in the first and third trimester and at 2-week postpartum.

Materials and methods: This cross-sectional study included 305 pregnant women visiting four health centers in Muscat between May 2018 and October 2020. A structured questionnaire was used and data were collected through review of electronic records and face-to-face interviews. The International RLS Study Group criteria were used to diagnose RLS. Participants were interviewed during their first trimester, their third trimester, and at their 2-week postpartum visit. Results were presented as means and standard deviations or percentages, as appropriate. To assess the association between RLS and various variables, unpaired t-test or McNemar's test were used, as appropriate.

Results: The mean age at baseline was 29.8 ± 5.28 years. The prevalence of RLS was significantly higher in the third trimester (41.0%) than in the first trimester (15.7%) and postpartum period (15.1%) (P < 0.001), although there was no significant difference in severity. Family history and personal history of RLS were the only independent correlates of RLS (P < 0.001 and 0.002, respectively). No associations were noted with pregnancy and neonatal outcomes or other comorbidities, including anemia. However, there was a significant relationship between the development of RLS and weight gain during pregnancy (P = 0.023).

Conclusion: One in six pregnant Omani women may be at risk of RLS during the first trimester, while one in 2-3 may be at risk in the third trimester, particularly those with a personal or family history of RLS and those who gain >12 kg during pregnancy.

Background: Since the use of handheld electronic devises is prevalent among people of all ages, health organizations have specified appropriate screen times for the different age groups. The aim of this study was to investigate the prevalence of screen use and its association with sleep quality and obesity.

Materials and methods: This cross-sectional study was conducted on people attending three Primary Healthcare Centers in the Makkah region between January and October 2019. The three-part questionnaire filled by parents collected data on sociodemographics, parental knowledge of guidelines, and asleep quality. Data were analyzed using STATA 14.2. For continuous variables, groups were compared using t-test; Pearson Chi-squared test or Fisher's exact test, as appropriate, was employed for categorical variables.

Results: A total of 450 individuals completed the questionnaire. Children 2-12 years old spent more time and used phones, tablets, and television (TV) more frequently, while those younger than 2 or older than 12 used phones and TVs more than other devices. High body mass index was associated with the daily usage of electronic devices. Fewer hours of sleep, longer time to fall sleep, and longer hours in bed were associated with the usage of all electronic devices. Furthermore, a good knowledge of the maximum time allowed for children and teenagers and content scoring system was associated with hours slept per night, and low knowledge was associated with higher frequency of using electronic devices.

Conclusion: Children spent long periods using electronic devices, and despite knowing the guidelines, parents still allowed their children to exceed the time acceptable for the use of electronic devices, which could lead to future social problems.

Background: The study was conducted in response to the need to understand the incidence of SARS-CoV2 infection and its determinants in healthcare workers (HCWs) and describe the epidemiology and presentation of reinfection cases. Also, we intended to determine the incidence of post-vaccination infections among health care workers as well as the contributing factors.

Materials and methods: Retrospective cohort design was used to quantify the coronavirus disease (COVID-19) infection among HCWs. The study cohort was all healthcare personnel working during the month of June 2021 in a tertiary care medical college hospital. Individuals diagnosed with laboratory-confirmed positive real-time polymerase chain reaction tests for SARS-CoV-2 infection between March 20, 2020, and May 31, 2021, were included. Univariate and multivariate analysis with Cox regression model elicited potential risk factors for all infections in HCWs.

Results: A total of 2420 HCWs constituted the cohort, in which the majority were primary healthcare providers (67.1%) and others. The mean age of the cohort was 30.27 years ± 10.53 standard deviation. The cumulative incidence of infection, reinfection, and postvaccination infection was 144.6 cases, 11.4 individuals, and 66.5 per 1000 HCWs respectively. Chronic illness was significantly associated with all infections. However, males and primary-care providers had higher risk of infection, whereas among the postvaccinated participants, partial vaccination status was one of the determinants.

Conclusion: Based on the findings, we endorse stringent testing and encourage HCWs to mandatorily follow COVID-appropriate behavior even if they are completely vaccinated and after recovery from previous infection.

Background: Leadership is a wide concept that is rapidly developing. Diverse theories suggest different styles of leadership, with strong relationships between the different styles and their outcomes. The transformational style emphasizes motivating employees and encouraging them to find new ways of dealing with issues. The transactional (TL) style promotes ideas of rewards and punishments. The Laissez-faire style is characterized by relaxation and the tendency to leave things to happen with minimal interference.

Materials and methods: This is a descriptive cross-sectional study design conducted in Primary Healthcare Centers in Riyadh, Saudi Arabia. The leadership styles were assessed using a Multi-Factor Leadership Questionnaire, which identifies the different styles of leadership. SPSS v 26.0 was used for data analysis. t-test employed to compare leadership style between raters and managers. Logistics regression model used to determine the influence of leadership styles of managers. Pearson correlation coefficient determined the linear relationship between leadership styles and its domains.

Results: A total of 130 respondents (65 managers vs. 65 raters) took part. "Raters" refer to any persons other than the manager, such as a secretary, nurse, doctor. The "manager" is when the person rates himself. The global transformation mean score was 3.55, for TL it was 3.42 and for passive avoidant, the mean score was 0.93. The passive avoidant (t = 2.005; P = 0.047) and management by exception (passive) (MBEP) mean scores of raters were statistically significantly higher than managers. In the binary regression model, MBEP was the independent significant predictor of manager.

Conclusion: The perceived leadership style of Primary Healthcare Center managers was transformational but with TL. Transformational leadership was positively correlated with TL leadership but negatively correlated with passive avoidant (The Laissez-faire style). The outcome of this study demonstrated that intellectual stimulation, idealized attributes, and inspirational motivation are perhaps better than contingent reward, active management.

Background: Hypothyroidism has been described in the literature as a risk factor for coronary artery disease (CAD). An association between thyroid-stimulating hormone (TSH) levels and CAD has been confirmed. In Saudi Arabia, there has been no study on the relationship between hypothyroidism and CAD. Therefore, the aim of this study was to investigate the prevalence and risk factors of CAD in patients with hypothyroidism.

Materials and methods: This cross-sectional study conducted at King Abdulaziz Medical City in Riyadh (KAMC-R), included 412 adult hypothyroid patients who were followed up between 2013 and 2018. The data was collected on demographics, CAD-related risk factors, and hypothyroidism. In addition, relevant laboratory tests, including thyroid function tests, lipid profile, and hemoglobin A1c, were collected. SPSS version 28.0 was used for data analysis. Categorical data were presented as frequencies and percentages, while mean and standard deviations were computed for the numerical data. Student's t-test used to test statistical significance for numerical variables and Chi- square test was performed to test the differences between categorical variables. Multivariate binary logistic regression was used to determine the effects of gender, BMI, family history (CAD), smoking, hypertension, and TSH on CAD.

Results: Of the 412 hypothyroid patients, 21.8% were diagnosed with CAD, with more prevalence in men (44.15%) than in women (15.4%). About 46% had hypertension, 2.2% were smokers, and 2.4% had family history of CAD. Older age was significantly associated with a higher prevalence of CAD compared to younger age groups. The mean of TSH was significantly higher in CAD patients than non-CAD patients before and at diagnosis with CAD (P < 0.001). For every 1mIU/L increase in the TSH level, the odds of developing CAD increased significantly by 4.8% (P = 0.014). The odds ratios for other CAD risk factors were 3.13 for males, 8.1 for smoking, 2.48 for hypertension, and 9.9 for family history of CAD (P < 0.05).

Conclusion: The prevalence of CAD in hypothyroid patients was higher than in the general population. TSH level was significantly associated with CAD. Male gender, older age, smoking, hypertension, family history of CAD, and high TSH level increased the likelihood of developing CAD.

Background: With growth of the use of point of care ultrasound (PoCUS) around the world, some medical schools have incorporated this skill into their undergraduate curricula. However, because of epidemiology of disease and regional differences in approaches to patient care, global application of PoCUS might not be possible. Before creating a PoCUS teaching course, it is critical to perform a needs analysis and recognize the training obstacles.

Materials and methods: A validated online questionnaire was given to final-year medical students at our institution to evaluate their perceptions of the applicability of specific clinical findings, and their own capability to detect these signs clinically and with PoCUS. The skill insufficiency was assessed by deducting the self-reported clinical and ultrasound skill level from the perceived usefulness of each clinical finding.

Results: The levels of expertise and knowledge in the 229 students who participated were not up to the expected standard. The applicability of detection of abdominal aortic aneurysm (AAA) (3.9 ± standard deviation [SD] 1.4) was the highest. However, detection of interstitial syndrome (3.0 ± SD 1.1) was perceived as the least applicable. The deficit was highest in the detection of AAA (mean 0.95 ± SD 2.4) and lowest for hepatomegaly (mean 0.57 ± SD 2.3). Although the majority agreed that training of preclinical and clinical medical students would be beneficial, 52 (22.7%) showed no interest, and 60% (n = 136) reported that they did not have the time to develop the skill.

Conclusion: Although medical students in Saudi Arabia claim that PoCUS is an important skill, there are significant gaps in their skill, indicating the need for PoCUS training. However, a number of obstacles must be overcome in the process.

Background: Road traffic injuries (RTIs) are the second leading cause of mortality in Saudi Arabia. The high rate of RTIs puts a strain on rehabilitation services. Yet, little is known of the economic burden of nonfatal RTIs and rehabilitation services. This study, therefore, aims to describe the annual rehabilitation costs associated with RTIs at a local trauma center.

Materials and methods: This study was conducted among all the 17 years or older patients hospitalized at King Abdulaziz Medical City in Riyadh following RTIs and required rehabilitation care. We included 299 patients who met the inclusion criteria and were followed for one year after discharge from the index hospital. The data was abstracted through retrospective review of patients' medical records. All rehabilitative services utilized by the healthcare system were recorded. To describe the economic burden, the mean, median, standard deviation, and interquartile range (IQR) were calculated. Total costs were aggregated for all patients to estimate overall costs.

Results: The study population was relatively young (31 years ± 14.4). The total annual rehabilitation cost of patients was Saudi Riyals (SAR) 6,113,781 (IQR: 20,589.3 - 3,125 = 17,464.3), and the average for each patient was SAR 20,447 (median = 7875). Patients aged 40-59 years and ≥60 years accounted for the highest average rehabilitation cost of SAR 31,563.99 and 32,639.21, respectively. Rehabilitation visits incurred the highest cost (mean SAR 1,494,124), followed by bed utilization which cost SAR 1,311,972 and radiology examination at SAR 1,032,261. The cost of motorcycle injuries was relatively higher (SAR 44,441.0) than other injury mechanisms.

Conclusion: This study underlines the economic burden of rehabilitation services resulting from RTIs. Public health interventions are needed to reduce the burden of RTIs by dealing with their preventable causes and improving road safety measures. These findings may be useful to policymakers and researchers to support and improve rehabilitation services in Saudi Arabia.