Pub Date : 2018-01-01DOI: 10.21767/2049-5471.1000e26
A. Kamimura, S. Panahi
According to Healthy People 2020, community-based programs help in disease prevention, the improvement of health, and the promotion of quality of life. The article entitled “Barriers and Facilitators to Healthy Lifestyle among Refugees Resettled in the United States” described community-based healthy lifestyle education classes for refugees resettled in the US and examined barriers and facilitators to the maintenance of a healthy lifestyle. Refugees resettled in the US often experience poor diet, and physical inactivity, and increased risks for chronic conditions such as cardiovascular disease.Community-based healthy lifestyle programs would be beneficial in order to improve lifestyles of individuals with refugee background. This article describes an innovative community approach to deliver healthy lifestyle education to individuals with refugee background.
{"title":"Community Health Care: An Essential Tool to Improve Population Health","authors":"A. Kamimura, S. Panahi","doi":"10.21767/2049-5471.1000e26","DOIUrl":"https://doi.org/10.21767/2049-5471.1000e26","url":null,"abstract":"According to Healthy People 2020, community-based programs help in disease prevention, the improvement of health, and the promotion of quality of life. The article entitled “Barriers and Facilitators to Healthy Lifestyle among Refugees Resettled in the United States” described community-based healthy lifestyle education classes for refugees resettled in the US and examined barriers and facilitators to the maintenance of a healthy lifestyle. Refugees resettled in the US often experience poor diet, and physical inactivity, and increased risks for chronic conditions such as cardiovascular disease.Community-based healthy lifestyle programs would be beneficial in order to improve lifestyles of individuals with refugee background. This article describes an innovative community approach to deliver healthy lifestyle education to individuals with refugee background.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.1000e26","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68044956","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 : 2018-01-01DOI: 10.21767/2049-5471.1000E17
B. Freshman
Racism is a health care issue, a disease of the mind and soul and should be treated as such. Cultural competency improvement initiatives should not only address the symptoms (what most training does now), but also address causes. This guest editorial suggests developing instructional methodologies with a holistic approach. Described in the paragraphs below are the need for, and characteristics of, an alternative paradigm to the Western European centric frame that most healthcare systems in developed nations currently use as a guiding heuristic. A broader more inclusive perspective is required to clarify foundational issues, expand understanding and intrinsically incentivize attitude and behavior change. While there are multitudes of noble efforts underway to address inequities in healthcare (in policy, resource allocation, and provider training to name a few) some of this work misses the mark. The primary reason, "No problem can be solved from the same level of consciousness that created it" as Albert Einstein (N.D.) so adeptly warns.
{"title":"Cultural Competency - Best Intentions are not goodenough","authors":"B. Freshman","doi":"10.21767/2049-5471.1000E17","DOIUrl":"https://doi.org/10.21767/2049-5471.1000E17","url":null,"abstract":"Racism is a health care issue, a disease of the mind and soul and should be treated as such. Cultural competency improvement initiatives should not only address the symptoms (what most training does now), but also address causes. This guest editorial suggests developing instructional methodologies with a holistic approach. Described in the paragraphs below are the need for, and characteristics of, an alternative paradigm to the Western European centric frame that most healthcare systems in developed nations currently use as a guiding heuristic. A broader more inclusive perspective is required to clarify foundational issues, expand understanding and intrinsically incentivize attitude and behavior change. While there are multitudes of noble efforts underway to address inequities in healthcare (in policy, resource allocation, and provider training to name a few) some of this work misses the mark. The primary reason, \"No problem can be solved from the same level of consciousness that created it\" as Albert Einstein (N.D.) so adeptly warns.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.1000E17","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68043931","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 : 2018-01-01DOI: 10.21767/2049-5471.1000e29
A. Kamimura, S. Panahi
The issue for July 2018 mainly focuses on health of underserved populations in the United States (US), except three articles - one from Vietnam, one from the United Kingdom (UK), and the other from Poland. Three of the articles from the US - “Physical Activity Education for Adults with Refugee Background in the United States” “Targeting Diet and Physical Activity: Reaching Homeless Adults through Customized Interventions,” and “Prevalence of Sarcopenia and Sarcopenic Obesity Vary with Race/Ethnicity and Advancing Age” studied lifestyle-related issues among diverse populations. Physical activity is very important to control weight and reduce the risk of developing chronic diseases such as cardiovascular disease and diabetes. One of the negative health consequences from physical inactivity is obesity.
{"title":"Improving Health of Diverse Populations","authors":"A. Kamimura, S. Panahi","doi":"10.21767/2049-5471.1000e29","DOIUrl":"https://doi.org/10.21767/2049-5471.1000e29","url":null,"abstract":"The issue for July 2018 mainly focuses on health of underserved populations in the United States (US), except three articles - one from Vietnam, one from the United Kingdom (UK), and the other from Poland. Three of the articles from the US - “Physical Activity Education for Adults with Refugee Background in the United States” “Targeting Diet and Physical Activity: Reaching Homeless Adults through Customized Interventions,” and “Prevalence of Sarcopenia and Sarcopenic Obesity Vary with Race/Ethnicity and Advancing Age” studied lifestyle-related issues among diverse populations. Physical activity is very important to control weight and reduce the risk of developing chronic diseases such as cardiovascular disease and diabetes. One of the negative health consequences from physical inactivity is obesity.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.1000e29","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68045775","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 : 2018-01-01DOI: 10.21767/2049-5471.1000156
Aless, Rachael A. Fusco, S. Colarusso, M. Piscopo, M. R. Improta, M. Corigliano
Aims: The aim of the study was to evaluate whether freshly available concentrated U-200 lispro insulin performed equally to previously marketed U-200 insulin lispro in terms of glycemic control and patient satisfaction. Methods: 360 outpatients with type 2 diabetes (T2DM) having self-injected U-100 lispro Kwikpen (KP) before meals for a long time were randomly selected to either going on with their usual treatment schedule (control group, n=180, CG) or switching to U-200 lispro KP for 12-weeks (treated group, n=180, TG) and filling in a treatment satisfaction questionnaire at the end of the observation period. They were all assessed for changes in body weight, blood pressure, BMI, fasting blood glucose, HbA1c, total cholesterol, HDL cholesterol, tryglicerides, uric acid, creatinine clearance rate with respect to baseline. Results: No significant changes were observed in the CG. Conversely, the TG displayed significantly decreased hypoglycemic episodes (p<0.001), as well as, fasting plasma glucose levels and glucose variability (p<0.01) compared to baseline. According to the questionnaire, 60 to 81% TG people were very satisfied with U-200 lispro KP and most of them preferred to stick to the new insulin preparation. Conclusions: hypoglycemic event rates, fasting blood glucose, glycemic variability and subjective ratings significantly improved in people treated with U-200 lispo. Diversity in both molecular insulin concentration and injection device engineering showed to provide better results in U-200 treated patients utilizing the same drug as controls.
{"title":"Despite being Apparently Equal, Concentrated Lispro-200 Performs Metabolically and Subjectively Better than Lispro-100","authors":"Aless, Rachael A. Fusco, S. Colarusso, M. Piscopo, M. R. Improta, M. Corigliano","doi":"10.21767/2049-5471.1000156","DOIUrl":"https://doi.org/10.21767/2049-5471.1000156","url":null,"abstract":"Aims: The aim of the study was to evaluate whether freshly available concentrated U-200 lispro insulin performed equally to previously marketed U-200 insulin lispro in terms of glycemic control and patient satisfaction. Methods: 360 outpatients with type 2 diabetes (T2DM) having self-injected U-100 lispro Kwikpen (KP) before meals for a long time were randomly selected to either going on with their usual treatment schedule (control group, n=180, CG) or switching to U-200 lispro KP for 12-weeks (treated group, n=180, TG) and filling in a treatment satisfaction questionnaire at the end of the observation period. They were all assessed for changes in body weight, blood pressure, BMI, fasting blood glucose, HbA1c, total cholesterol, HDL cholesterol, tryglicerides, uric acid, creatinine clearance rate with respect to baseline. Results: No significant changes were observed in the CG. Conversely, the TG displayed significantly decreased hypoglycemic episodes (p<0.001), as well as, fasting plasma glucose levels and glucose variability (p<0.01) compared to baseline. According to the questionnaire, 60 to 81% TG people were very satisfied with U-200 lispro KP and most of them preferred to stick to the new insulin preparation. Conclusions: hypoglycemic event rates, fasting blood glucose, glycemic variability and subjective ratings significantly improved in people treated with U-200 lispo. Diversity in both molecular insulin concentration and injection device engineering showed to provide better results in U-200 treated patients utilizing the same drug as controls.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.1000156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68029202","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 : 2018-01-01DOI: 10.21767/2049-5471.1000182
Temesgen Haile Anchebi, R. Fite, Bisrat Zeleke Shiferaw, S. G. Abeya
Menstruation is a physiological process that reproductive age group women will pass through. Due to myth and misconception about it, menstruation is considered as being unhealthy and impurity. Therefore, the study was aimed at assessing the level of knowledge and associated factors. A cross-sectional study design was used. Randomly selected 422 female students were involved. Binary and multivariable logistic regressions conducted using statistical Package for Social Sciences (SPSS) version 20. P-value less than 0.05 was taken as a significant association. The study revealed that 90.7% of the respondents scored high level of knowledge towards menstruation. Age of the respondents (AOR= 3.573, 95% CI= 1.440, 8.861), use of medication without consultation of the health personnel (AOR=3.081, CI: 1.385, 6.851) and being informed about menstruation before menarche (AOR= 0.326, 95% CI: 0.137, 0.778) were significantly associated with high level of knowledge towards menstruation. The study had shown that most of the respondents scored high level of knowledge about menstruation. Age of the respondents and those who used medication with consultation of health personnel and being informed about menstruation before menarche were associated with high level of knowledge towards menstruation.
{"title":"Predictors of Knowledge Towards Menstruation inEthiopia","authors":"Temesgen Haile Anchebi, R. Fite, Bisrat Zeleke Shiferaw, S. G. Abeya","doi":"10.21767/2049-5471.1000182","DOIUrl":"https://doi.org/10.21767/2049-5471.1000182","url":null,"abstract":"Menstruation is a physiological process that reproductive age group women will pass through. Due to myth and misconception about it, menstruation is considered as being unhealthy and impurity. Therefore, the study was aimed at assessing the level of knowledge and associated factors. A cross-sectional study design was used. Randomly selected 422 female students were involved. Binary and multivariable logistic regressions conducted using statistical Package for Social Sciences (SPSS) version 20. P-value less than 0.05 was taken as a significant association. The study revealed that 90.7% of the respondents scored high level of knowledge towards menstruation. Age of the respondents (AOR= 3.573, 95% CI= 1.440, 8.861), use of medication without consultation of the health personnel (AOR=3.081, CI: 1.385, 6.851) and being informed about menstruation before menarche (AOR= 0.326, 95% CI: 0.137, 0.778) were significantly associated with high level of knowledge towards menstruation. The study had shown that most of the respondents scored high level of knowledge about menstruation. Age of the respondents and those who used medication with consultation of health personnel and being informed about menstruation before menarche were associated with high level of knowledge towards menstruation.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.1000182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68031685","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 : 2018-01-01DOI: 10.21767/2049-5471.100055
I. I. Okafor
Background: Long Acting Reversible Contraceptive (LARC) methods provide very effective contraception for extended periods that do not depend on clients’ daily compliances or adherences. They are the ideal methods for the prevention of the harmful consequences of unintended pregnancies in most women including adolescents. Objectives: To determine the uptake rate of LARC in ESUTH Enugu, assess the characteristics of the acceptors, identify barriers, and make recommendations. Method: The new client register in ESUTH, Enugu was reviewed retrospectively from December 31, 2015 back to January 1, 2011. Data on clients’ characteristics, and uptakes of LARC and Non-LARC were extracted from the register, entered in Excel 2007 software, analyzed, and presented using percentages and graphs. Results: A total of 1737 clients accepted the available family planning methods during the five-year study period. One thousand five hundred and sixty seven (90.21%) accepted LARC while 170(9.79%) only accepted non-LARC. The LARC uptake rate was 90.21%. Majority of the clients were 30-39 years of age 1121(64.54%), 690 (39.72%) had secondary education, 821(47.27%) had tertiary education, and Christians were 1510 (86.93%). The acceptors increased as parity increased with a peak at Para 4 of 490(28.21%). Clients less than 20 years (0.06%), not educated (1.27%), and Para 0 (0.4%) rarely access the family planning clinic. The LARC acceptors opted for jadelle 526(30.28%) and implanon 465(26.77%) sub-dermal implants, depo-provera 276(15.89%), interval intrauterine contraceptive device 232(13.36%), noristerat 48(2.76%), and postpartum intrauterine contraceptive device 20(1.15%). Conclusion: There is a very high uptake of LARC in Enugu. Jadelle and implanon constitute over 50% of the LARC uptakes. Adolescents (< 20 years), less educated and low parity clients rarely access the family planning clinic.
{"title":"Uptake of Long-Acting Reversible Contraceptive Methods in Enugu State University Teaching Hospital Enugu, South-East, Nigeria","authors":"I. I. Okafor","doi":"10.21767/2049-5471.100055","DOIUrl":"https://doi.org/10.21767/2049-5471.100055","url":null,"abstract":"Background: Long Acting Reversible Contraceptive (LARC) methods provide very effective contraception for extended periods that do not depend on clients’ daily compliances or adherences. They are the ideal methods for the prevention of the harmful consequences of unintended pregnancies in most women including adolescents. Objectives: To determine the uptake rate of LARC in ESUTH Enugu, assess the characteristics of the acceptors, identify barriers, and make recommendations. Method: The new client register in ESUTH, Enugu was reviewed retrospectively from December 31, 2015 back to January 1, 2011. Data on clients’ characteristics, and uptakes of LARC and Non-LARC were extracted from the register, entered in Excel 2007 software, analyzed, and presented using percentages and graphs. Results: A total of 1737 clients accepted the available family planning methods during the five-year study period. One thousand five hundred and sixty seven (90.21%) accepted LARC while 170(9.79%) only accepted non-LARC. The LARC uptake rate was 90.21%. Majority of the clients were 30-39 years of age 1121(64.54%), 690 (39.72%) had secondary education, 821(47.27%) had tertiary education, and Christians were 1510 (86.93%). The acceptors increased as parity increased with a peak at Para 4 of 490(28.21%). Clients less than 20 years (0.06%), not educated (1.27%), and Para 0 (0.4%) rarely access the family planning clinic. The LARC acceptors opted for jadelle 526(30.28%) and implanon 465(26.77%) sub-dermal implants, depo-provera 276(15.89%), interval intrauterine contraceptive device 232(13.36%), noristerat 48(2.76%), and postpartum intrauterine contraceptive device 20(1.15%). Conclusion: There is a very high uptake of LARC in Enugu. Jadelle and implanon constitute over 50% of the LARC uptakes. Adolescents (< 20 years), less educated and low parity clients rarely access the family planning clinic.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68038198","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 : 2018-01-01DOI: 10.21767/2049-5471.1000154
Ammar Alhosain
Premarital screening aims primarily to give couples (who are planning to get married soon) medical consultation on the odds of transmitting genetic diseases to their children. Given that consanguineous marriages are so common in the Middle East and children of consanguineous marriages are at increased risk for genetic diseases and congenital malformations, and due to its impacts on public health, it is important to provide health education on consanguinity at individual, family and community levels delivered mainly by the state’s primary health care staff. It is also important to provide pre-marriage and pre-pregnancy genetic diagnosis and counseling. The Availability, Accessibility, Acceptability and Quality (AAAQ framework) of specialized facilities/centers for pre-marriage and pre-pregnancy genetic counseling and testing services should be sufficient to implement the Right to Health in this regard. And human rights principles shall guide the whole aspects of premarital screening program to include planning, design, execution, monitoring and evaluation. Among those principles are also non-discrimination, participation, inclusion, and accountability. All parties should be involved in the premarital screening program- politicians (to enact laws), religious leaders (to reconsider abortion in case the fetus afflicted with grave congenital malformation), employees in primary health care, researchers, doctors, geneticists, disease prevention and control and social services, subject-matter experts, mother and child health care, media, and activists in NGOs and voluntary organizations.
{"title":"Premarital Screening Programs in the Middle East, from a Human Right's Perspective","authors":"Ammar Alhosain","doi":"10.21767/2049-5471.1000154","DOIUrl":"https://doi.org/10.21767/2049-5471.1000154","url":null,"abstract":"Premarital screening aims primarily to give couples (who are planning to get married soon) medical consultation on the odds of transmitting genetic diseases to their children. Given that consanguineous marriages are so common in the Middle East and children of consanguineous marriages are at increased risk for genetic diseases and congenital malformations, and due to its impacts on public health, it is important to provide health education on consanguinity at individual, family and community levels delivered mainly by the state’s primary health care staff. It is also important to provide pre-marriage and pre-pregnancy genetic diagnosis and counseling. The Availability, Accessibility, Acceptability and Quality (AAAQ framework) of specialized facilities/centers for pre-marriage and pre-pregnancy genetic counseling and testing services should be sufficient to implement the Right to Health in this regard. And human rights principles shall guide the whole aspects of premarital screening program to include planning, design, execution, monitoring and evaluation. Among those principles are also non-discrimination, participation, inclusion, and accountability. All parties should be involved in the premarital screening program- politicians (to enact laws), religious leaders (to reconsider abortion in case the fetus afflicted with grave congenital malformation), employees in primary health care, researchers, doctors, geneticists, disease prevention and control and social services, subject-matter experts, mother and child health care, media, and activists in NGOs and voluntary organizations.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.1000154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68028186","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 : 2018-01-01DOI: 10.21767/2049-5471.1000166
Luong Duong Huy, Khue Luong Ngoc, Phuong Do Hong, M. Le, A. Daly, Thuy Ha Thi Thu, Minh Hoang Nong
Since 1994, Vietnam has implemented the Baby Friendly Hospital Initiative (BFHI). Less than 1% of hospitals have been certified as BFHI in over 10 years. In 2013, the BFHI criteria (numbered E1.4) was successfully linked with the health system through its inclusion within the Ministry of Health (MOH) Hospital Quality Assessment Criteria. Through these criteria, the steps for successful breastfeeding became mandatory for all hospitals both public and private, which provide maternal and child care. This report was to examine the impact of these criteria on breastfeeding practices among mothers at hospital levels, focussing on challenges and good practices for lessons learned. Using a mixed methods approach, this assessment looked at the official data on Criteria E1.4, qualitative observation and discussion visits to 8 hospitals in 2 large cities in Vietnam. The findings showed improvements in implementation of Criteria E1.4 since 2013, with both cities reaching an average of Grade 3 (the average acceptable standard) as well as increasing breastfeeding rates in terms of early initiation of breastfeeding within the first hour after delivery. Challenges in reaching higher grade scores on these criteria related to difficulties with early initiation of breastfeeding following C-section deliveries, no mechanism for support between departments of the hospital and no mechanism for continued breastfeeding support at the community level when mothers are discharged from hospital. Many learnings from this report can help contribute to the revision of the Hospital Quality Assessment Criteria, to further strengthen the regulatory environment around breastfeeding protection, promotion and support.
{"title":"The Status of Baby Friendly Hospital Initiative under Hospital Quality Assessment Criteria Implementation: A Report in Vietnam","authors":"Luong Duong Huy, Khue Luong Ngoc, Phuong Do Hong, M. Le, A. Daly, Thuy Ha Thi Thu, Minh Hoang Nong","doi":"10.21767/2049-5471.1000166","DOIUrl":"https://doi.org/10.21767/2049-5471.1000166","url":null,"abstract":"Since 1994, Vietnam has implemented the Baby Friendly Hospital Initiative (BFHI). Less than 1% of hospitals have been certified as BFHI in over 10 years. In 2013, the BFHI criteria (numbered E1.4) was successfully linked with the health system through its inclusion within the Ministry of Health (MOH) Hospital Quality Assessment Criteria. Through these criteria, the steps for successful breastfeeding became mandatory for all hospitals both public and private, which provide maternal and child care. This report was to examine the impact of these criteria on breastfeeding practices among mothers at hospital levels, focussing on challenges and good practices for lessons learned. Using a mixed methods approach, this assessment looked at the official data on Criteria E1.4, qualitative observation and discussion visits to 8 hospitals in 2 large cities in Vietnam. The findings showed improvements in implementation of Criteria E1.4 since 2013, with both cities reaching an average of Grade 3 (the average acceptable standard) as well as increasing breastfeeding rates in terms of early initiation of breastfeeding within the first hour after delivery. Challenges in reaching higher grade scores on these criteria related to difficulties with early initiation of breastfeeding following C-section deliveries, no mechanism for support between departments of the hospital and no mechanism for continued breastfeeding support at the community level when mothers are discharged from hospital. Many learnings from this report can help contribute to the revision of the Hospital Quality Assessment Criteria, to further strengthen the regulatory environment around breastfeeding protection, promotion and support.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.1000166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68029241","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 : 2018-01-01DOI: 10.21767/2049-5471.1000173
Kristy Du, S. Goates, M. Arensberg, S. Pereira, T. Gaillard
Sarcopenia is the natural age-associated loss of muscle mass/function, often occurring simultaneously with obesity, especially in older adults. Sarcopenia and obesity contribute to poor health outcomes and when occurring together as sarcopenic obesity (SO) can cause further health complications. Few studies have specifically considered these conditions across different racial/ethnic populations. This study examined the prevalence of sarcopenia and SO among U.S. adults by different age, sex, and racial/ethnic groups, using 1999-2004 data from the National Health and Nutrition Examination Survey (NHANES) and its racial/ethnic subpopulation groupings. Sarcopenia was defined as low appendicular lean mass (adjusted for Body Mass Index (BMI) of <0.789 kg/ m2 for males, <0.512 kg/m2 for females) and self-reported functional limitation. Obesity was defined as BMI ≥ 30 kg/m2 with SO defined as those meeting criteria for both sarcopenia and obesity. The analysis included 4367 adult subjects; for each race/ethnic subpopulation, sarcopenia prevalence increased with age. Sarcopenia prevalence varied by sex and race/ ethnic subpopulation: Hispanic (26.8% male, 27.2% female); Non-Hispanic (NH) White (15.5% male, 15.1% female); NH Black (8.6% male, 1.6% female); and Other (16.5% male, 23.2% female). Sarcopenic obesity also increased with age and varied by sex and race/ethnic subpopulation: Hispanic (8.57% male, 8.87% female); NH White (6.48% male, 8.06% female); NH Black (3.95% male, 1.12% female); and Other (4.46% male, 0.0% female). Increased awareness of variability in sarcopenia/SO may help develop effective screenings/ care management and interventions/public health policies to maintain functionality and reduce health disparities among an increasingly diverse U.S. older adult population.
{"title":"Prevalence of Sarcopenia and Sarcopenic Obesity Vary with Race/Ethnicity and Advancing Age","authors":"Kristy Du, S. Goates, M. Arensberg, S. Pereira, T. Gaillard","doi":"10.21767/2049-5471.1000173","DOIUrl":"https://doi.org/10.21767/2049-5471.1000173","url":null,"abstract":"Sarcopenia is the natural age-associated loss of muscle mass/function, often occurring simultaneously with obesity, especially in older adults. Sarcopenia and obesity contribute to poor health outcomes and when occurring together as sarcopenic obesity (SO) can cause further health complications. Few studies have specifically considered these conditions across different racial/ethnic populations. This study examined the prevalence of sarcopenia and SO among U.S. adults by different age, sex, and racial/ethnic groups, using 1999-2004 data from the National Health and Nutrition Examination Survey (NHANES) and its racial/ethnic subpopulation groupings. Sarcopenia was defined as low appendicular lean mass (adjusted for Body Mass Index (BMI) of <0.789 kg/ m2 for males, <0.512 kg/m2 for females) and self-reported functional limitation. Obesity was defined as BMI ≥ 30 kg/m2 with SO defined as those meeting criteria for both sarcopenia and obesity. The analysis included 4367 adult subjects; for each race/ethnic subpopulation, sarcopenia prevalence increased with age. Sarcopenia prevalence varied by sex and race/ ethnic subpopulation: Hispanic (26.8% male, 27.2% female); Non-Hispanic (NH) White (15.5% male, 15.1% female); NH Black (8.6% male, 1.6% female); and Other (16.5% male, 23.2% female). Sarcopenic obesity also increased with age and varied by sex and race/ethnic subpopulation: Hispanic (8.57% male, 8.87% female); NH White (6.48% male, 8.06% female); NH Black (3.95% male, 1.12% female); and Other (4.46% male, 0.0% female). Increased awareness of variability in sarcopenia/SO may help develop effective screenings/ care management and interventions/public health policies to maintain functionality and reduce health disparities among an increasingly diverse U.S. older adult population.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.1000173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68029416","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 : 2018-01-01DOI: 10.21767/2049-5471.100057
M. Cuadros
Osteoarthritis (OA) is one of the most disabling and incapacitating diseases on the autonomy of older people, affecting their quality of life. OA produces great impact on pain, function and use of resources, being considered as an important problem of Public Health. OA is a degenerative and progressive disease without treatment nowadays. The goals in OA treatment are to ameliorate symptoms and diminish articular damage. In knee OA, there is destruction of cartilage and subchondral bone, with the consequent narrowing of articular space. Knee OA is multifactorial. Besides the bio mechanic factors, trauma and obesity; it is believed that inflammation plays an important role. Future treatments should act on the regulation of inflammation to diminish progression of OA. There is evidence on several studies and years of experience that state that Ozone acts on the modulation of inflammation. The objective of this paper is to review the main pathophysiological mechanisms involved in knee OA, and to postulate ozone as a promising and ideal conservative treatment, since it could act on several therapeutic targets, besides inflammation.
{"title":"Could Ozone Be Used as a Feasible Future Treatment in Osteoarthritis of the Knee","authors":"M. Cuadros","doi":"10.21767/2049-5471.100057","DOIUrl":"https://doi.org/10.21767/2049-5471.100057","url":null,"abstract":"Osteoarthritis (OA) is one of the most disabling and incapacitating diseases on the autonomy of older people, affecting their quality of life. OA produces great impact on pain, function and use of resources, being considered as an important problem of Public Health. OA is a degenerative and progressive disease without treatment nowadays. The goals in OA treatment are to ameliorate symptoms and diminish articular damage. In knee OA, there is destruction of cartilage and subchondral bone, with the consequent narrowing of articular space. Knee OA is multifactorial. Besides the bio mechanic factors, trauma and obesity; it is believed that inflammation plays an important role. Future treatments should act on the regulation of inflammation to diminish progression of OA. There is evidence on several studies and years of experience that state that Ozone acts on the modulation of inflammation. The objective of this paper is to review the main pathophysiological mechanisms involved in knee OA, and to postulate ozone as a promising and ideal conservative treatment, since it could act on several therapeutic targets, besides inflammation.","PeriodicalId":90151,"journal":{"name":"Diversity and equality in health and care","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2049-5471.100057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68037878","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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