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Discover Social Science and Health
Number of Followers: 5  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2731-0469
Published by Springer-Verlag Homepage  [2467 journals]
  • Health related quality of life and factors relevant to return to work in
           cancer survivors after hospital discharge: a descriptive cross-sectional
           study

    • Abstract: Purpose The aim of this study was to examine the cross-sectional relationship between cancer survivors’ return-to-work (RTW) status and health-related quality of life (HR-QOL) following cancer diagnosis and treatment. Methods A questionnaire survey, which included three standardized HR-QOL instruments, was carried out among Japanese cancer survivors at their first follow-up appointment following hospital discharge. Participants were recruited by nurse investigators from 2016 to 2017 at their respective inpatient units. Statistical analyses were performed on the gathered data. Results Analysis of 94 returned questionnaires showed that symptom-related interference, physical function, mental function, and health and functioning, which were indicators of HR-QOL, and the factor “work category” were significantly associated with RTW status although symptoms, subjective well-being, and the other social background factors showed no statistically significant relationship with RTW status. Multinomial logistic regression analysis revealed that only the factor “work category,” which consisted of “physical” and “mental” work, had a significant effect on RTW status. Conclusions RTW status was associated with work category, symptom-related interference, physical function, mental function, and health and functioning; however, only the factor “work category” had significant influence. This study suggests that helping cancer survivors return to work considering the work category they are engaging is important. At that time interventions that are focused on the individual health functioning including physical and mental functions in preference to social background factors may get to be valuable.
      PubDate: 2022-11-24
       
  • Sexual and gender-based violence victims’ satisfaction of the support
           services through the holistic model of care in the Democratic Republic of
           Congo

    • Abstract: Background The quality-of-care assessment is an important indicator of the efficiency of a healthcare system. In the Democratic Republic of the Congo (DRC), despite the implementation of the holistic care model for the treatment of sexual and gender-based violence (SGBV) victims, little is known about the client’s perception of this model and its outcome. This study aimed to examine the expected and perceived satisfaction of service recipients through the One-Stop-Center model of health care in eastern DRC. Methodology This descriptive and analytical cross-sectional study was conducted at Panzi Hospital (PH), in eastern DRC. Data were collected by a mixed-methods approach, 64 Victims of Sexual Violence participated in individual (in-depth) interviews and 150 completed the Survey. The Kruskal–Wallis test was used to compare the mean item scores of sexual violence victims’ satisfaction. Results The findings from our qualitative analysis demonstrated that the victims admitted at PH had various expectations and needs on arrival depending on their social identity and residence locations. For instance, the VSVs coming from remote areas with ongoing armed conflicts mentioned concerns related to their security in the post-treatment period and the risks of re-victimization that this could incur. Conversely, those who came from the urban neighborhood, with relative security raised various concerns related to their legal reparation and ongoing access to other support services. With scores above 4, victims of sexual violence were extremely satisfied with the overall care provided and wished that PH could continue to support them mentally and financially for an effective reintegration into their communities. The Kruskal–Wallis analysis confirmed statistically significant differences (p < 0.1) in satisfaction with legal support based on the victims' residential locations, social support based on their age groups, occupational therapy based on their religious denominations, and accommodation based on their professional activity. Conclusions Results of this study suggest that victims’ satisfaction with support services is based on either the organizational frameworks of clinical or support services within the hospital and the victims’ social environment.
      PubDate: 2022-11-22
       
  • Using a realist approach in understanding youth offending service delivery
           requirements for young people who offend with speech, language and
           communication needs in England

    • Abstract: Abstract Research consistently demonstrates the over-representation of young people with speech, language and communication needs within the youth criminal justice system, with estimates suggesting this population accounts for up to 90% of young people who offend. Acknowledgement and understanding of these individual-based needs, along with identified service delivery adaptation(s) (where necessary) are required to ensure all young people, regardless of needs experienced, can effectively engage with, and have their voices heard, within the context of Youth Offending Services. By using a realist approach, qualitative interviews with stakeholders (n = 15) are used to explore service conditions required to incorporate speech, language and communication provision within a Youth Offending Service. Specifically, the research provides original and significant insights into the interconnections between understanding of speech, language and communication, service delivery models and engagement with young people. Seven themes pertaining to delivery requirements within youth offending settings were identified. From these themes, explanations in the form of programme theories are postulated detailing core service delivery conditions required in youth offending settings to address speech, language and communication need. These include, increased understanding of speech, language and communication; unpicking terminology and becoming communication friendly; staff cohesion prompting learning together; and co-construction approach to service delivery. The core approach underpinning these postulated programme theories was an increased awareness of speech, language and communication issues by youth offending staff. This increased awareness is evidenced to lead to an adaptation of behaviours and practices by staff which in turn increases engagement with young people.
      PubDate: 2022-11-01
       
  • Global COVID-19 case fatality rates influenced by inequalities in human
           development and vaccination rates

    • Abstract: Aim COVID-19 has exerted distress on virtually every aspect of human life with disproportionate mortality burdens on older individuals and those with underlying medical conditions. Variations in COVID-19 incidence and case fatality rates (CFRs) across countries have incited a growing research interest regarding the effect of social factors on COVID-19 case-loads and fatality rates. We investigated the effect of population median age, inequalities in human development, healthcare capacity, and pandemic mitigation indicators on country-specific COVID-19 CFRs across countries and regions. Subject and methods Using population secondary data from multiple sources, we conducted a cross-sectional study and used regional analysis to compare regional differences in COVID-19 CFRs as influenced by the selected indicators. Results The analysis revealed wide variations in COVID-19 CFRs and the selected indicators across countries and regions. Mean CFR was highest for South America at 1.973% (± 0.742) and lowest for Oceania at 0.264% (± 0.107), while the Africa sub-region recorded the lowest scores for pandemic preparedness, vaccination rate, and other indicators. Population Median Age [0.073 (0.033 0.113)], Vaccination Rate [−3.3389 (−5.570.033 −1.208)], and Inequality-Adjusted Human Development Index (IHDI) [−0.014 (−0.023 −0.004)] emerged as statistically significant predictors of COVID-19 CFR, with directions indicating increasing Population Median Age, higher inequalities in human development and low vaccination rate are predictive of higher fatalities from COVID-19. Conclusion Regional differences in COVID-19 CFR may be influenced by underlying differences in sociodemographic and pandemic mitigation indicators. Populations with wide social inequalities, increased population Median Age and low vaccination rates are more likely to suffer higher fatalities from COVID-19.
      PubDate: 2022-11-01
       
  • Income, education, and hospitalization in Canada: results from linked
           census and administrative data

    • Abstract: Background Addressing population health inequities begins with quantifying how social factors affect the health and health care utilization of individuals. Such quantification relies on the availability of detailed health and demographic data. Unfortunately, administrative health care data rarely includes detailed demographic information. Data linkage, which combines administrative health data with national-level census or survey data, enables researchers to examine socio-economic inequalities in health care utilization in greater detail. Data and methods With access to a unique Canadian dataset linking data from the Hospital Discharge Database (DAD) from 2006 to 2007 with detailed individual-level socio-demographic data from the 2006 Canadian Census, we are able to examine the patterning of hospitalization in Canada in the early 2000s across a variety of socio-demographic variables. We examine the association of education and income, controlling for immigration status, rural residence, marital status and ethnicity, with hospitalization rates for both ambulatory care sensitive conditions (ACSCs) and non-ambulatory care sensitive conditions (non-ACSCs) for children and youth, working-age adults, and older adults, in models stratified by sex. Results Age standardized hospitalization rates show that there is a clear socio-economic gradient in hospitalization in Canada in the 2000s. Education and income are independently, inversely associated with hospitalization for males and females across three broad age groups. These associations are stronger for ACSCs than non-ACSCs. The association of other socio-demographic variables, such as immigrant status, and rural residence is also stronger for hospitalization for ACSCs. The association of socio-economic status with hospitalization for ACSCs is strongest for working age women and men, and is somewhat attenuated for older adults. Conclusions Lower socio-economic status is associated with a higher likelihood of hospitalization for men and women in Canada across three broad age groups in the 2000s. These associations are stronger for ACSCs, suggesting that in addition to increased likelihood of disease, decreased access to preventative care may be driving up hospitalization rates for marginalized groups. We conclude with the recommendation that in order to track progress in reducing health inequities, health systems should either collect detailed individual-level socio-demographic data or link their administrative health data to existing demographic data sets.
      PubDate: 2022-11-01
       
  • Investigating change across time in prevalence or association: the
           challenges of cross-study comparative research and possible solutions

    • Abstract: Abstract Cross-study research initiatives to understand change across time are an increasingly prominent component of social and health sciences, yet they present considerable practical, analytical and conceptual challenges. First, we discuss the key challenges to comparative research as a basis for detecting societal change, as well as possible solutions. We focus on studies which investigate changes across time in outcome occurrence or the magnitude and/or direction of associations. We discuss the use and importance of such research, study inclusion, sources of bias and mitigation, and interpretation. Second, we propose a structured framework (a checklist) that is intended to provide guidance for future authors and reviewers. Third, we outline a new open-access teaching resource that offers detailed instruction and reusable analytical syntax to guide newcomers on techniques for conducting comparative analysis and data visualisation (in both R and Stata formats).
      PubDate: 2022-10-27
       
  • Factors associated with poor quality of life of transgender people

    • Abstract: Background The term transgender (TRANS) may be used for people whose gender identity differs from the one assigned at birth. A large part of this population segment faces social (lack of social support, discrimination, rejection, transphobia) and psychological (anxiety, depression) challenges. These factors, in turn, may negatively impact the quality of life (QoL) of these individuals. In this context, the aim of this study is to identify the factors associated with QoL of TRANS people. Methods Cross-sectional study with non-probability sample, conducted with TRANS and cisgender (CIS) adults living in a southeastern Brazilian state. The research questionnaire was accessed electronically and comprised sociodemographic, health, and QoL information. QoL was assessed through the Short-Form 6 dimensions (SF-6D) instrument. Multivariable linear regression analysis (forward method) was applied to determine the influence of independent variables on QoL (outcome variable). All variables that presented p < 0.10 in the bivariate analyses were included. The analyses were carried out in the Statistical Package for the Social Sciences (SPSS)® software, version 22.0, with a significance level of 5%. Results The sample included 65 TRANS individuals and 78 CIS individuals. The CIS group showed a predominance of people with higher education (p = 0.002) and higher income (p = 0.000) when compared with the TRANS sample. TRANS participants had worse QoL score (p = 0.014) and the same was observed when QoL was assessed by all dimensions (p ≤ 0.05). In addition, the place of residence and the report of recent prejudice remained associated with QoL even after adjusting for age, gender identity, occupation, and follow-up by a health professional (p < 0.05). Conclusion The TRANS population showed worse QoL when compared with the CIS population. Moreover, living in the state’s capital and having suffered episodes of prejudice were the factors remain statistically associated with the QoL among TRANS individuals.
      PubDate: 2022-10-03
       
  • Race, ethnicity and mortality in the United States during the first year
           of the COVID-19 pandemic: an assessment

    • Abstract: Abstract The fact that a disproportionate share of the disease burden from COVID-19, including mortality, has been borne by racial and ethnic minority communities is well documented. The purpose of this paper is to reassess the “race/ethnicity effect” in COVID-19 mortality in the United States. Using an ecological regression framework and county-level data, the study aims to make two contributions. First, it estimates the race/ethnicity effect for all major racial/ethnic groups at four important junctures during the first year of the pandemic. In doing so, it seeks to provide the fullest possible picture of the nature and evolution of the race/ethnicity effect. Second, it estimates the race/ethnicity effect net of basic socioeconomic factors (SEF). This helps to identify the likely mechanisms through which the race/ethnicity effect operates. Racial/ethnic composition is flexibly measured in two ways—by percentage contributions to county population and by indicators of group plurality. The ecological regressions revealed a positive association between the size of three racial/ethnic groups—non-Hispanic Blacks, non-Hispanic American Indian and Alaskan Natives (AIAN) and Hispanics—and county mortality, although the association was stronger and more consistent for Blacks and AIANs. Furthermore, accounting for basic SEF had different impacts on the race/ethnicity-mortality association for the three groups. For Hispanics, it was almost fully mediated. For Blacks, it decreased but remained statistically significant [62–6% higher mortality associated with a 1-standard deviation increase in Black share of county population; 2.3–1.1 times higher mortality in the average Black plurality county]. For AIANs, it was largely unaffected or even increased [44–10% higher mortality associated with a 1-standard deviation increase in AIAN share; 6.2–1.8 times higher mortality in AIAN plurality county). For all groups, the race/ethnicity effect generally decreased as the pandemic wore on during the first year.
      PubDate: 2022-09-26
       
  • Engaging caregivers to use an evidence-based intervention for medicaid
           beneficiaries with Alzheimer’s disease: a pilot study

    • Abstract: Background This pilot study aimed to adapt an intervention, engaging informal caregivers to help clinicians with providing care to improve (or maintain) physical function of individuals with Alzheimer’s Disease or other dementias. To the best of our knowledge, for the first time, we report on use of the intervention in those with Alzheimer’s Disease or other dementias. Methods This was a 5-month mixed methods cohort study in a convenience sample of clinicians, caregivers, and beneficiaries at 3-Medicaid Home and Community-based Service sites in Michigan. Two content experts and 5 caregivers modified the intervention. We trained 116 clinicians to engage caregivers and 50 caregivers to help clinicians provide the modified intervention to 52 beneficiaries with Alzheimer’s Disease or other dementias. Thematic analyses, descriptive statistics, counts, proportion comparisons, t-tests, and McNemar’s tests were used to examine socio-demographics, clinician knowledge uptake and satisfaction with training and use of the intervention; caregiver self-efficacy, feasibility, acceptability, usability, and satisfaction with intervention and beneficiary outcomes (pre-/post). Results Feasibility (enrolled/recruited = 78.5–86.7%), acceptability (7.55–8.35 [SD 1.50–2.06]), and usability (7.85–8.81 [SD 1.50–2.6]) of the modified intervention (1 = low;10 = high) were high. Pre-/post-intervention clinician knowledge (12.33–12.28, SD 1.80–2.84; -0.52, SD 1.95) was high. Caregiver self-efficacy increased (0.81 [SD 0.62] p < 0.01). Beneficiary outcomes did not improve nor decline (> 0.05). Conclusions Engaging informal caregivers to assist clinicians with providing an intervention adapted to the needs of those with Alzheimer’s Disease or other dementias was feasible, acceptable, and usable. Further testing in a broader sample of those with dementia in various settings is needed.
      PubDate: 2022-09-26
       
  • Political ideology and pandemic lifestyles: the indirect effects of
           empathy, authoritarianism, and threat

    • Abstract: Background In this paper, we integrate theory and research from sociology, psychology, and political science to develop and test a mediation model that helps to explain why political conservatism is often associated with pandemic behaviors and lifestyles that are inconsistent with public health recommendations for COVID-19. Methods Using national data from the 2021 Crime, Health, and Politics Survey (n = 1743), we formally test the indirect effects of political conservatism (an index of Republican party identification, conservative political orientation, right-wing news media consumption, and 2020 Trump vote) on pandemic lifestyles (an index of social distancing, hand sanitizing, mask usage, and vaccination) through the mechanisms of empathy (concern about the welfare of others), authoritarian beliefs (authoritarian aggressiveness and acquiescence to authority), and pandemic threat perceptions (threats to self and to the broader society). Result Our results confirm that political conservatism is associated with riskier pandemic lifestyles. We also find that this association is partially mediated by lower levels of empathy, higher levels of authoritarian beliefs, and lower levels of perceived pandemic threat. Conclusions Understanding why political conservatism is associated with riskier pandemic lifestyles may eventually lead us to ways of identifying and overcoming widespread cultural barriers to critical pandemic responses.
      PubDate: 2022-08-24
       
  • Knowledge, attitudes, and practices towards COVID-19 among undergraduates
           during emergency remote learning

    • Abstract: Background The coronavirus disease 2019 (COVID-19) pandemic paralyzes the education sector. To minimize the interruption of teaching and learning, most universities in Malaysia shifted to virtual mode during this unprecedented period of the pandemic. With an ever-increasing number of Malaysians fully vaccinated against COVID-19, the education system is expected to switch back to face-to-face mode this year. It is crucial to assess the knowledge, attitudes, and practices (KAP) of COVID-19 among emergency remote learning undergraduates before reverting to physical teaching and learning. Hence, a study was conducted with this aim in mind. Methods A total of 299 Malaysian undergraduates were recruited through a snowball sampling approach. The online questionnaire encompassed three main segments: informed consent, sociodemographic information, and KAP questions on COVID-19. Results The mean scores for knowledge, attitude, and practice were 4.05/6, 11.14/12, and 5.07/7, respectively. The results of the present study showed that year 1 respondents had significantly higher levels (p < 0.05) of KAP scores than year 4 respondents. In addition, the attitude score of science majors respondents was significantly greater (p < 0.05) than those of nonscience majors. The KAP scores showed no significant difference among groups with different sexes, ethnicities, and COVID-19 histories. Partial correlation analysis revealed that the overall knowledge score was positively correlated with attitude (r = 0.193, p = 0.001) and practice (r = 0.343, p < 0.001) scores whereas the total attitude score was positively correlated with the total practice score (r = 0.149, p = 0.010). Conclusion Our current results suggest that COVID-19 workshops, seminars, or training programs for year 4 students could be conducted to enhance their KAP levels.
      PubDate: 2022-08-01
       
  • Burden of care among primary caregivers’ of spinal cord injury patients
           attending a tertiary care center in Eastern Nepal

    • Abstract: Background Nepal is a resource-constrained country where primary caregivers of spinal cord injury (SCI) patients face increasing physical, social, emotional, and economic burdens. This study aimed to assess the level of primary caregiver burden and the association between caregiver burden and sociodemographic factors of SCI patients and their caregivers. Methods The burden of caregivers was evaluated in 71 primary caregivers through face-to-face interviews using the Zarit Burden Interview Scale (ZBI-22). Based on the total ZBI-22 score, caregiver burden was classified as little or no, mild to moderate, moderate to severe, and severe. Results The mean caregiver burden score was 46.28 ± 12.05. Moderate to severe burden was more common (63.4%), followed by severe (18.3%), mild to moderate (11.3%), and little or no burden (7.0%). Caregivers were more worried about “what the future holds for patients (3.07 ± 1.22) and what should do more for patients (3.04 ± 1.01)”. Several sociodemographic factors, such as marital status (P = 0.009), activities of daily living (P = 0.038), monthly family income (P = 0.023), and time spent caring for patients (P = 0.028), were statistically significantly associated with the burden on primary caregivers. Conclusions Our results showed that primary caregivers experienced a high burden of care, primarily related to fear and uncertainty about the patient’s future, patient’s dependency, caregiver exhaustion and finances. Several sociodemographic factors of patients and their caregivers were associated with the burden of the primary caregivers.
      PubDate: 2022-07-28
       
  • Prevalence and associated factors of alcohol intake in the first trimester
           of pregnancy in Dabat district, northwest Ethiopia

    • Abstract: Background Now a day, the consumption of alcohol among pregnant women is increasing from time to time, and it has become one of the increasingly serious public health and socio-economic problems. In addition, cause miscarriages, stillbirths, and a range of physical, behavioural, and intellectual disabilities for the baby that can last a lifetime. There is also limited evidence. Therefore, the objective of this study was to prevalence and associated factors of alcohol intake in the first trimester of pregnancy in Dabat district, northwest Ethiopia. Methods A community-based cross-sectional survey was conducted to determine the magnitude of alcohol intake within the first three months of pregnancy at the Dabat Demographic and Health Survey Site. A census of pregnant women in Dabat demographic and health survey sites was employed. A total of 579 pregnant women were found and participated in this study. The Data were entered and analyzed using EPI INFO and STATA version 14, respectively. Multivariable logistic regression analysis was used to determine factors related to alcohol intake during the first trimester of pregnancy. The adjusted odds ratio (AOR) with 95% confidence interval was used to show the strength of the association, and P value < 0.05 was used to confirm the significance of the association. Results The prevalence of alcohol intake in the first trimester of pregnancy was 58% (95%CI (54.1, 61.8)). Rural residence (AOR = 6.83, 95% CI, 2.55, 18.32), being married (AOR = 2.37, 95% CI: 1.14, 4), being a housewife occupation (AOR = 2.24, 95% CI, 1.54, 3.26) and having a history of stillbirth ((AOR = 1.99, 95% CI: 1.2, 4.14) were significantly associated with alcohol intake in the first trimester. Conclusions The prevalence of alcohol consumption in the first trimester of pregnancy was high in the study area. Pregnant women’s’ sociodemogrphic characteristics and history of stillbirth are associated with alcohol consumption. Therefore, increasing maternal awareness of the negative effects of alcohol consumption among mothers living in rural areas is important to modify higher rates of alcohol intake in the first trimester. Mothers with a history of stillbirth should pay attention.
      PubDate: 2022-07-18
       
  • On societal response to pandemics: linking past experiences to present
           events

    • Abstract: Abstract There is a need for a factual understanding of the historical impact of pandemics in the world. Against this backdrop, this study provides a historical understanding of societal behaviour and responses to pandemics. Inferences are primarily drawn from a literature review from the past and present. The present analysis also reflects the ongoing COVID-19 pandemic in the world and India while providing a novel perspective to understand public health practices in a global context. It suggests the need for a more synchronised health response in pandemics while highlighting the uncertainties and challenges with historical evidence and comparisons to the ongoing pandemic. An emphasis is on learning from historical evidence and ascertaining how these retrospective diagnoses help make arguments about health and illness in our present moment.
      PubDate: 2022-07-01
       
  • COVID-19 testing in Delaware’s underserved communities: demographic and
           social determinants of testing inequality

    • Abstract: Background Health experts believe that frequent COVID-19 testing is one of the most important practices for stopping the spread of the COVID-19 virus. Demographic and social factors might play a role in whether a person gets tested for COVID. This present study aimed to investigate (1) the demographic and social factors affecting a person’s likelihood of getting tested for COVID-19, and (2) the demographic and social factors related to a positive serology test (i.e., indicating likely past infection). Methods Data were extracted from a survey conducted in Delaware’s underserved communities. Participants were asked to complete a questionnaire about their COVID-19 testing history, and nurses at the study site collected a serology sample from each participant. Results Our results indicated that Black or Hispanic individuals living in underserved communities had greater odds of having been tested previously for COVID compared to being non-Hispanic White. In addition, our study found that being female, educated, feeling safe in one’s neighborhood, being vaccinated against COVID, and being an essential worker increased one’s odds of having been previously tested for COVID-19. Regarding the results of the COVID-19 antibody serology tests, our findings revealed that Hispanic respondents were more likely to have a positive serology test compared to non-Hispanic White respondents, indicating that the Hispanic individuals were more likely to contract the virus. Educated individuals were less likely to have a positive serology test compared to the less-educated. Those who expressed hesitancy about getting vaccinated for COVID-19 and identified themselves as essential workers were more likely to have a positive serology test and to have previously contracted the virus. Conclusions Identifying key factors associated with COVID-19 testing may help establish novel strategies to increase testing rates among vulnerable population. Public health and policy implications are discussed in the article.
      PubDate: 2022-06-27
       
  • Compliance with wearing facemasks by university teaching staff during
           the second wave of COVID-19 pandemic: a cross sectional study

    • Abstract: Objective We aimed to explore compliance with and barriers to wearing facemasks at the workplace among university teaching staff in Egypt. Methods An online survey was shared with teaching staff members at 11 public and 12 private Egyptian universities and high institutes, and 218 responses were received. All participants were asked about beliefs related to wearing facemasks. For participants who taught in-person classes, compliance with and barriers to wearing facemasks at the workplace were assessed. Compliance level was classified into: Non-compliance, inadequate and adequate, based on the degree of adherence to having facemasks on and not taking them off at five main work settings. We compared demographic characteristics, beliefs, and barriers scores across compliance levels. Results Most participants (81.7%) believed that facemasks reduce infection risk to others and 74.3% believed facemasks can reduce risk to the wearer. Around 80% of the respondents who taught in-person classes wore facemasks, but only 37.8% met the criteria of adequate compliance. Difficulty breathing and impaired communication were cited as major barriers by 42.2% and 30.3% of in-person class tutors respectively. The risk of reporting COVID-19 like symptoms among non-compliant participants was double the risk among those with adequate compliance (45.9% vs 25.7% respectively). Adequate compliance was significantly associated with higher positive beliefs scores and lower barriers scores. Conclusion Adequate compliance with wearing facemasks at the workplace was low. Addressing negative beliefs may improve compliance. Difficulty breathing, and impaired communication were important barriers, therefore we recommend replacing in-person interactions with online classes whenever applicable.
      PubDate: 2022-06-20
       
  • Quality of life among out-patients with long-term indwelling urinary
           catheter attending Urology Clinic at a Tertiary Hospital in Northwestern
           Tanzania

    • Abstract: Background This study aimed to determine quality of life (QoL) among patients living with long-term indwelling urinary catheter (IUC) at home in the Northwestern Tanzania. To the best of our knowledge for the first time in Africa, we report on quality of life for patients living with a long-term IUC at home. Methods This was a descriptive cross‑sectional study conducted between December 2016 and September 2017. A total of 202 out-patients aged 18 years and above living with a long-term IUC were conveniently recruited. The QoL was determined using WHOQOL‑BREF tool. Quantitative data were entered into Microsoft Excel for cleaning and coding, then into STATA software version 13.0 for analysis. Descriptive statistics were used to compute means and standard deviations for numerical variables as well as frequencies for nominal and ordinal variables. Significance of association between various variables and QoL were tested using t test with equal variances. Inferential statistics applied included an independent sample’s t‑test for comparing numerical socio-demographic variables. A P-value < 0.05 was considered statistically significant. The mean score indicating good QoL according to our study is a mean score of 50 and above. The higher the score the higher the QoL. Results Median age of participants was 69 (IQR 61–77) years. Majority of participants were males (195, 96.5%), married (187, 92.6%), and having primary education (116, 57.3%). Generally, the QoL was poor in all the domains: mean score for physical health being 36.67 ± 0.89, psychological 29.54 ± 0.87, social relationship 49.59 ± 1.61, and environment 26.05 ± 0.63. Married participants were slightly better under social domain 51.1 ± 1.6 than singles 31.1 ± 5.4; P-value 0.001. Those with primary education & above were slightly better in environmental domain 26.1 ± 0.7 than those with no formal education 23.5 ± 1.5; P-value 0.039. Conclusion QoL of participants with a long-term IUC in Northwestern Tanzania is generally poor in all domains. Those with primary education & above and the married were slightly better in environmental and social domains respectively. We recommend on the needs of improved social economic status and the importance of close follow up at home for the married participants living with long-term IUC.
      PubDate: 2022-06-06
       
  • An analysis of changes in wellbeing during the COVID-19 pandemic in the UK

    • Abstract: Purpose We investigated the trajectory of wellbeing over the course of the first wave and sought to determine whether the change in wellbeing is distributed equally across the population. Specifically we investigated pre-existing medical conditions, social isolation, financial stress and deprivation as a predictor for wellbeing and whether there were community level characteristics which protect against poorer wellbeing. Methods Using online survey responses from the COVID-19 modules of Understanding society, we linked 8379 English cases across five waves of data collection to location based deprivation statistics. We used ordinary least squares regression to estimate the association between deprivation, pre-existing conditions and socio-demographic factors and the change in well-being scores over time, as measured by the GHQ-12 questionnaire. Results A decline in wellbeing was observed at the beginning of the first lock down period at the beginning of March 2020. This was matched with a corresponding recovery between April and July as restrictions were gradually lifted. There was no association between the decline and deprivation, nor between deprivation and recovery. The strongest predictor of wellbeing during the lock down, was the baseline score, with the counterintuitive finding that for those will pre-existing poor wellbeing, the impact of pandemic restrictions on mental health were minimal, but for those who had previously felt well, the restrictions and the impact of the pandemic on well-being were much greater. Conclusions These data show no evidence of a social gradient in well-being related to the pandemic. In fact, well-being was shown to be highly elastic in this period indicating a national level of resilience which cut across the usually observed health inequalities.
      PubDate: 2022-04-25
       
  • Socioeconomic disparities in the uptake of substances of abuse: results
           from a household cross-sectional survey in Murang’ a County, Kenya

    • Abstract: Background Drug and substance abuse has adverse health effects and a substantial economic burden to the global economies and at the household level. There is, however, limited data on socio-economic disparities in the update of the substance of abuse in low-to-middle income countries such as Kenya. This study aimed to assess the socio-economic disparities among drugs and substances in Murang’a county of central Kenya. Method The study design was cross-sectional, and data collection was conducted between November and December 2017. A total of 449 households with at least one person who has experienced substance abuse were sampled from four purposively selected sub-locations of Murang’ a County. Household heads answered questions on house characteristics and as an abuser or on behalf of abusers in their households. Structured questionnaires were used to collect data on types of drugs used, economic burden, and gender roles at the household level. Household socio-economic status (SES) was established (low, middle, and high SES) using principal component analysis (PCA) from a set of household assets and characteristics. Bivariable logistic regression analysis was used to assess the association between SES, gender, and other factors on the uptake of drugs and substance abuse. Results Individuals in higher SES were more likely to use cigarettes (OR = 2.13; 95%CI = 1.25–3.61, p = 0.005) or piped tobacco (OR = 11.37; 95% CI, 2.55–50.8; p-value = 0.001) than those in low SES. The wealthier individuals were less likely to use legal alcohol (OR = 0.39; 95%CI = 0.21–0.71, p = 0.002) than the poorest individuals. The use of prescription drugs did not vary with SES. A comparison of the median amount of money spent on acquiring drugs showed that richer individuals spent a significantly lower amount than the poorest individuals (USD 9.71 vs. Ksh 14.56, p = 0.031). Deaths related to drugs and substance abuse were more likely to occur in middle SES than amongst the poorest households (OR = 2.96; 95%CI = 1.03–8.45, p = 0.042). Conclusion Socioeconomic disparities exist in the use of drugs and substance abuse. Low-income individuals are at a higher risk of abuse, expenditures and even death. Strategies to reduce drugs and substance abuse must address socio-economic disparities through targeted approaches to individuals in low-income groups.
      PubDate: 2022-04-06
       
  • From society to cells and back again: new opportunities for discovery at
           the biosocial interface

    • Abstract: Abstract A new generation of community- and population-based research is combining measures of social context, experience, and behavior with direct measures of physiology, gene sequence and function, and health. Studies drawing on models and methods from the social and biological sciences have the potential to illuminate the multilevel mechanisms through which experience becomes biology, and to move past decontextualized and reductionistic approaches to human development, behavior, and health. In this perspective we highlight challenges and opportunities at the biosocial interface, and briefly discuss COVID-19 as a case study demonstrating the importance of linking across levels of analysis.
      PubDate: 2022-03-09
       
 
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