Global health journal (Amsterdam, Netherlands)最新文献

Background

Alcohol and illicit drugs (AID) continue to be a major global health concern. Although preventable, AID is linked to millions of deaths annually worldwide. The situation is particularly grave for young people, with AID being a major direct risk factor for disability-adjusted youth life-years lost and death. It further contributes to assaults, road crashes, accidental poisoning, and suicide, leading to long-term issues and public health concerns.

Objective

This study aimed at disclosing current AID prevalence data for Argentinian, Bulgarian, Chilean and Romanian youth. It shed light on the predictors of AID in young people from those countries.

Method

The study used an online survey to gather data from people aged 18 to 25 (n = 1,297). The survey was underpinned by the theory of planned behaviour (TPB). Predictors were investigated separately for drinking alcohol and using illicit drugs.

Results

Our data revealed that across the four target countries, 49% to 90% of the participants drank alcohol, and 8% to 35% used illicit drugs in the past three months. Between 20% and 91% of them intended to drink, and between 8% and 31% intended to use illicit drugs in the following three months. Our TPB model predicted statistically significant (P < 0.001) amounts of variance in drinking alcohol (between 61% and 72%) and using illicit drugs (between 20.3% and 74.4%). Intention was consistent in significantly predicting both behaviours. Evidence around the predictive validity of self-efficacy, age and gender was mixed across the investigated countries.

Conclusion

This research provided an update on the scarce AID epidemiological data. It also supplied evidence about what theoretically-informed measures might be useful targets of interventions in the case of Argentina, Bulgaria, Chile and Romania. This new knowledge of understanding substance abuse determinants and prevalence may help researchers and practitioners better meet young people's health prevention needs.

Background

Pen-pal clubs (PPC) are used worldwide for students to learn about different cultures and other skillsets without the need for travel. Many medical students are interested in global health opportunities abroad but costs, scheduling, and other barriers allow few to participate in such experiences. It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community.

Objective

The purpose of this study is to demonstrate that an international medical student PPC improves medical students’ perspectives of cultural competency and global health engagement.

Methods

In 2021, a novel medical student PPC was established that began between an American and Japanese medical school. Following a shareholders meeting, it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences. In total, the club connected 50 American medical students and 52 medical students from 17 high- and middle-income countries. The primary form of communication was online; pen-pals were encouraged to communicate monthly using provided topics, although frequency and way of communication was their discretion. In February 2022, American PPC members were emailed a qualitative survey to assess the PPC's impact.

Results

The survey was completed by 42% of American PPC members, 95% of which were 22‒26 years. Participants were preclinical medical students, 60% whom were female and the majority either white (47%) or Asian (43%). Overall, the PPC positively influenced American medical students’ perception of global medicine, medical education, and their cultural competency after joining the PPC compared to prior (P = 0.004).

Conclusion

PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts. Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders.

Background

There are substantial regional differences in drinking alcohol in Russia, both at the population and individual levels. However, the causes of these differences have not been studied yet.

Objective

The goal of our study was to examine the effect of regional living conditions on individual alcohol consumption by the population of Russia.

Methods

For the analysis, we used data from a cross-sectional epidemiological study conducted in 2013‒2014. The final analytical sample included 18,130 people aged 25‒64 years. We conducted the interviews face to face, based on which any drinking in the last year, as well as alcohol abuse, were considered as a response. Alcohol abuse was recorded when the respondent consumed 5.75 or more grams of pure ethanol per day (75th percentile of average daily alcohol consumption among alcohol drinkers). The assessment of the regional living conditions was accomplished via integral indexing, which was previously performed based on publicly available data for 2010–2014. Associations were assessed using generalized scoring equations with unchanging standard errors. The associations were expressed by odds ratios (OR) and 95% confidence intervals (CI).

Results

Deterioration of social conditions and increase in demographic depression in the region of residence increased the odds of any drinking (OR 1.51, 95% CI: 1.33 to 1.72, P < 0.001 and OR 1.22, 95% CI: 1.05 to 1.41, P = 0.009, respectively). The odds of alcohol abuse increased with the deterioration of social living conditions and the growth of the industrial development in the region: OR 1.35, 95% CI: 1.14 to 1.59, P < 0.001 and OR 1.16, 95% CI: 1.05 to 1.28, P = 0.002, respectively.

Conclusion

Our analysis allowed assessing the impact of the regional living conditions on individual drinking alcohol in the population of Russia.

Objective

Sub-Saharan Africa accounts for 66% of global maternal deaths. In Kenya, 362 maternal deaths occur in every 100 000 live births. Most of these deaths occur as a result of suboptimal quality care of mothers during labor, delivery, or within 24 h of delivery. This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods.

Methods

A qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants’ experiences. Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya. Eligible participants were nurse-midwives in charge of the maternity unit. The discussion was conducted in English, tape-recorded, and transcribed verbatim. Data were analyzed thematically, following Braun and Clarke 6-step framework. Nvivo version 7.0 computer software was used to facilitate this process.

Results

Two focused group discussions each involving seven participants were conducted. The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern. Further, maternal care in the two hospitals was substandard. Themes that emerged as barriers were: inadequate supplies; inadequate obstetric knowledge and skills; shortage of nurse-midwives, and inadequate support supervision. The underlying factors include inadequate funding by the county government and high staff turnover.

Conclusion

This study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care. This is mainly due to system failures and inadequate nurse-midwife numbers. Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.

Globally, there have been multiple public health emergencies in recent decades. High rates of morbidity, occasionally mortality, and economic instability are usually associated with pandemics. One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) pandemic. HIV has a disproportionately negative impact on key populations. Strong leadership, effective communication, and sound science are necessary for public health emergency (PHE) responses to be successful. These three PHE response pillars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws. In this review, we explored the importance of these three pillars of successful PHEs responses, and how they are essential to closing the gap in the HIV response among key populations. Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence. Leaders should base their choices on scientific evidence. Effective communication during PHEs should be proactive, polite, imaginative, innovative, and constructive. To address gaps in the HIV response among key populations, leaders must create a supportive environment for effective communication and scientific research, communication should be used to raise awareness of HIV and to dispel stigma and discrimination, while science should provide evidence of efficacy and effectiveness of interventions among key populations.

Objectives

The uses of devices of electromagnetic waves (EMWs) are increasing day by day. Similarly, the generation of the waves is increasing. The frequency spectrum of the generation of waves is also increased. In this manuscript, an analysis of the high frequency EMWs has been made by the electric fields generated due to the exposure of 5th generation (5 G) of mobile phones.

Methods

Due to the emission of waves from the towers, the electric field is generated around the transmission tower of mobile phones. The electric fields are computed by the power of the transmission tower. The electric fields across the biological tissues/cells are also computed when the EMWs penetrate inside the body. The electric fields are made across the organs of different depths inside the body.

Results

The induced electric fields inside the organs of the human beings are responsible for the absorption of energy from high frequency EMWs. The absorbed amount of energy from high frequency waves may become the cause of harmful effects on the life of organs of human beings.

Conclusion

In this manuscript, after analysis of the computed electric fields inside the organs of human beings, it is concluded that the EMWs of 5 G spectrum of mobile phone towers may more harmful for the life of organs as 4th generation (4 G) spectrum of mobile phone waves. The energy absorption by the 4 G spectrum is lower than 5 G spectrum due to the range of frequency of waves. The effects on the pancreas, retina, skin, intestine, spleen, stomach and uterus are more than low water content organs like nails, bone, teeth etc.

Objectives

Bangladesh stands as a prominent global consumer of tobacco, with alarming consequences on public health. The Global Adult Tobacco Survey reported that tobacco consumption claimed over 126 000 lives in 2018, contributing to 13.5% of all deaths in the country. This study aims to explore the effectiveness of higher tax rates and tobacco use regulation as control mechanisms in mitigating tobacco consumption and health care cost burden, with a particular emphasis on its implications for public health.

Methods

This study is based on the annual time series data over the period 2000–2020. The study employs the ordinary least square method to analyze the quantitative confirming the stationarity of data at level. This research uses different models to investigate individual effects and combined effects on both tobacco consumption and tobacco health care cost burden.

Results

The study finds a negative relationship between tobacco tax rate and tobacco consumption. More specifically, the higher tax rate of tobacco (low (β = −0.3495), medium (β = −0.2319), high (β = −0.9033), premium (β = −0.7322), filtered (β = −0.2114), and non-filtered (β = −0.3452) categories) is significant to reduce tobacco use at 1% level of significance. The study finds similar results when it applied tobacco retail price instead of tobacco tax rate as the independent variable. Finally, the study investigates the impact on health care cost through tobacco consumption, tobacco control law, growth rate, export-import, and tobacco production. The results indicate that tobacco consumption, export-import, and tobacco production increases health care cost burden while tobacco use regulatory decreases it. By reducing tobacco consumption, higher taxes and tobacco use regulation contribute to alleviating the burden on the healthcare system, promoting healthier lifestyles, and aligning with global health objectives.

Conclusions

Higher tax rate on tobacco products is necessary to increase the retail price so that tobacco users cannot consume tobacco. Specific tax and uniform tax base are needed so that tobacco users cannot switch to lower priced brands. Tobacco control laws need to revised and proper implementation should be ensured as well, to achieve the goal of tobacco free Bangladesh by 2040. Tobacco-related diseases, responsible for a significant proportion of deaths in the country, could witness a considerable decline with the successful implementation of higher tax rates and tobacco use regulation. This study provides insights that not only contribute to the economic discourse but also accentuate the broader public health benefits arising from effective tobacco taxation policies.

Objective

Afghanistan has witnessed a long-lasting 4-decade armed conflict, which together with high levels of poverty and interpersonal violence, resulted in high incidence and prevalence of mental disorders in general population, including children and adolescents. Until mid-2018, there was neither mental health care facility nor a child psychiatrist in Afghanistan. Here, we report the establishment of the first children and adolescents’ mental health center (CAMHC) in Herat province of Afghanistan.

Methods

In July 2018, CAMHC was initiated at Mental Health Training Center – Herat. CAMHC was initially planned by the International Assistance Mission (IAM) and Herat Public Health Directorate; and financially supported by the Tearfund UK, the United Methodist Committee on Relief and Tearfund Australia. The target population of CAMHC was children and adolescents in Herat and neighboring provinces, healthcare professionals, staff of government and non-governmental organizations, school teachers and community leaders.

Results

A group of eight mental health professionals were trained and made the interdisciplinary board for diagnosis and management of mental disorders in children and adolescents. During the initial three-year period, 2 448 patients, including 1 264 (51.6%) boys and 1 184 (48.4%) girls, presented with mental disorders to CAMHC. Diagnosis and management of mental disorders were performed according to standard international protocols. Eighteen awareness-raising seminars were held; 2 000 leaflets, 10 000 posters, and 30 000 brochures were prepared and distributed; and two short video clips were produced and broadcast via IAM website, social media and local TV channels. A database was developed to house for project data, assessment of outcomes and reporting to stakeholders.

Conclusion

Establishment of CAMHC resulted in significant achievements in diagnosis and management of mental disorders among children and adolescents, healthcare staff capacity building, and awareness-raising about mental disorders. Data obtained in CAMHC offers government, mental health professionals and the community the opportunity of improving mental health in the region.

Introduction

The utilization of facility delivery is crucial to achieve sustainable development goals by reducing maternal and neonatal deaths. This study aimed to compare the distributions and determinants of childbirth in health facilities in urban and rural regions of Bangladesh.

Methods

Cross-sectional data from the 2017‒2018 Bangladesh Demographic and Health Survey were analyzed. Multilevel logistic regression was applied.

Results

A total of 4 751 women were included in the analyses. Only 50% of childbirths took place in health facilities, 63.4% and 44.6% in urban and rural regions, respectively. Overall, the odds of the association between facility delivery and the studied factors were similar. Multiparous women had significantly lower odds of facility delivery in both rural (adjusted odds ratio [AOR] = 0.3, 95% confidence interval [CI]: 0.2 to 0.5) and urban (AOR = 0.2, 95% CI: 0.1 to 0.5) regions. In both regions, women with higher education levels, highly educated husbands, antenatal care (ANC), and higher wealth indexes had significantly higher odds of facility delivery.

Conclusion

Several common associated factors were identified. However, differences were observed regarding distributions of these factors. The differences in facility delivery utilization could result from lower ANC utilization, socioeconomic status, and transportation facilities in rural regions than urban regions; therefore, improving these conditions could increase facility delivery in these regions.