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May 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3834
Lagoe RonaldCorresponding author
Hospital Executive Council, Syracuse, New York, 13235, USA
This perspective outlines how community orthopedic services adapted to shifting demands and constraints. It discusses scheduling, triage, infection control, and telemedicine adoption, and proposes metrics to track access and outcomes during system changes.
Aug 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1105
J. Siembida ElizabethCorresponding author
Department of Human Development and Family Studies, University of Connecticut, USA
An often neglected factor in the examination of the mental quality of life of survivors of colorectal cancer is the role of family and community level resources and support. The aim of this study was to develop a deeper understanding of the influence of family and community level resources over and above previously examined mental health variables. A survey-based pilot study was conducted with 101 colorectal cancer survivors. Four multiple linear regression models were developed to examine the associations between demographic, health-related, individual psychosocial, family and community level factors, and specific dimensions of mental quality of life (measured using the mental health subscales of the SF-12). In addition to examining all of the correlates of mental quality of life, the unique role of family and community level factors over and above previously examined factors was examined. Analyses found that family and community level factors, as a whole, explained a significant portion of the variance in role emotional health, mental health, and social functioning over and above demographic, health-related, and individual psychosocial factors. Family cohesion was a significant, unique predictor of role limitations due to mental health, and family and community social support was a significant, unique predictor of role limitations due to mental health and overall mental health. These results suggest the potential importance of considering family and community level resources when conducting research and designing interventions to improve mental quality of life in colorectal cancer survivors.
Mar 2023 DOI 10.14302/issn.2379-7835.ijn-22-4116
Shuja SabaCorresponding author
Background In Low Middle-Income Countries (LIMCs), malnutrition, especially undernutrition is one of the leading causes of childhood mortality and morbidity. Poor complementary feeding practices are among the most notable contributors to poor nutritional indicators in children under five. This article provides an output of secondary data analysis of the Cost of Diet (CoD) and Optifood component of National Complementary Feeding Assessment conducted by UNICEF Pakistan along with Pakistan Demographic Health Survey (PDHS) 2018. Methods For correlation of Optifood data and CoD data with PDHS data of CF, GraphPad software, MS Excel was used along with manual quantifications. The analysis of DHS-2018 data was conducted using STATA software. Univariate analysis included comparison of categorical variables i.e. various individual, household and community level parameters with that of outcome variables of minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum dietary diversity (MAD) using chi-square test. Findings The overall rate of MMF was 56.6% among children of 6-23 months of age with MDD in 18.6% and MAD in 13.8% of children. Percentage of annual cost spent on nutritious diet for MDD, MMF and MAD varies from 27.86% to 43.08% across all the provinces. Children aged 6–8 months and 9–11 months often consumed infant milk and cereals, while children aged 12–23 months often consumed eggs and grain products. Consumption of dairy products was highest in Punjab, Sindh, AJK, and Islamabad, that of grains roots and tubers was highest in KPK, FATA and GB. Conclusion Considering CF practices in Pakistan are inadequate as indicated by poor MDD, MMF, and MAD, therefore it is imperative that a holistic approach using both communication and non-communication based interventions is to be employed through active stakeholder engagement.
Jan 2019 DOI 10.14302/issn.2643-6655.jcap-18-2541
S.O OyamakinCorresponding author
Department of Statistics, University of Ibadan, Nigeria
Many researchers have devoted considerable attention to the impact of individual-level factors on child mortality, but little is known about how family and community characteristics affect health of children. Trend in child mortality as well as its determinants, has long been the subject of academic and policy debates. In spite of this, the problem of child mortality remains as daunting as ever. In fact, advancement in medical sciences and the upsurge in information and telecommunication technology equipment have not significantly reduced child mortality in the country, unlike in the West. The Multilevel proportional hazards model for data that are hierarchically clustered at three levels was applied to the study of covariates of child mortality in Nigeria. This study merges two parallel developments of statistical tools for data analysis: statistical methods known as hazard models that are used for analyzing event-duration data and statistical methods for analyzing hierarchically clustered data known as multilevel models. These developments have rarely been integrated in research practice and the formalization and estimation of models for hierarchically clustered survival data remain largely uncharted. The model was estimated using the Newton-Raphsons numerical search approach. The model accounts for hierarchical clustering with three random effects or frailty effects. We assume that the random effects are independent and follow the Exponential and Weibull distribution. The results indicate that bio-demographic factors are more important in infancy while socioeconomic factors and household and environmental conditions have a greater effect in childhood. Furthermore, there is significant variation in child mortality risks even after controlling for measured determinants of mortality. Also, factors that fall under family and community level are more significant indicating that child survival is most controlled or determined by family and community factors and variables at the child level is not weighty. This suggests that there may exits unobserved or unobservable factors related to mortality.
Feb 2018 DOI 10.14302/issn.2379-7835.ijn-17-1872
Agaba EdgarCorresponding author
FTF Nutrition Innovation Lab, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
Objective: To elaborate on the procedures undertaken to establish blood draws and cold chain for nutrition assessments. Setting: A total of 5,044 birth cohort households were enrolled and assessed using household questionnaires, anthropometry, and blood sampling to assess nutritional issues and exposures to environmental contaminants. The challenge was to obtain, transport, process, store, and analyze tens of thousands of serum samples obtained in sites that were often difficult to reach. Approach: Before enrollment began, 24 healthcare facilities in the North and Southwest of Uganda were assessed for suitability as local nodes for processing and storage. Equipment needs included functional centrifuges, refrigeration, ice machines, and -20oC freezers. Other important physical infrastructure included the presence of backup power (generator or solar generated) in the event of electricity failure. Once samples were obtained, they were transported within 5 hours to the facility laboratories, where serum was separated and aliquoted into properly labelled storage tubes and then frozen. Relevant Changes: At community level, our team visited households or small group of household members close to their homes to reduce on travel time hence contributed to high retention rates. Our immediate testing for anemia and malaria results benefited enrollees and enhanced community acceptance. By using Village Health Teams (VHTs), we could accommodate household preferences for the timing of sample collection. Our engagement with phlebotomists transformed their role from a simple service into active team members. Lessons Learned: Our first lesson was that in our setting, the success of this nutrition biological sampling system required community engagement and acceptance. By combining an immediately actionable set of tests (for anemia and malaria), and visiting cohort households, we greatly enhanced the success of the system.
Nov 2014 DOI 10.14302/issn.2574-450X.jom-14-564
S. Aljabri KhalidCorresponding author
Department of Endocrinology, King Fahad Armed Forces Hospital. Jeddah, Kingdom of Saudi Arabia
Objective: Obesity is a major public health problem worldwide. We designed this study to determine the prevalence of obesity among Saudis in the department of primary care at King Fahad Armed Forces Hospital. Methods: Cross section study of Saudis of both sexes, aged more than or equal to 12 years at the department of primary care at King Fahad Armed Forces Hospital between January 2008 and June 2009. Results: A total of 5968 were attending the department of primary care were included in this study. There were 2269 (38.0%) male and 3699 (62.0%) female. With age, a gradual increase was seen in the Body mass index (BMI) in both males and females, up to the age of 59 years, with a decrease occurring thereafter. In the females below 20 years of age, the BMI was lower than in the male group. Above 30 years, the BMI in females was higher than in the males of corresponding ages. The prevalence of BMI≥25 was 70.0%.The prevalence of BMI≥25 was non significantly higher in the male compared to the female,71% and 69.3% respectively, p=0.2.The prevalence of overweight ( BMI=25-29.9) was higher in the males compared to the females, while the reverse was true for obesity(≥30),where 62.0% of the total female population was obese compared to 49.7% of the total male population. The magnitude of the difference in prevalence of obesity in the males and females was significantly high ( p<0.0001). Conclusion: The prevalence of obesity is high among Saudi population at the primary care setting and represents a major clinical and might represent a public health problem. A national prevention program at community level should be implemented.