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Elianny Domínguez-Tejo, Graciela Metternicht, Emma L Johnston, Luke Hedge
Sandy beaches are unique ecosystems increasingly exposed to human-induced pressures. Consistent with emerging frameworks promoting this holistic approach towards beach management, is the need to improve the integration of social data into management practices. This paper aims to increase understanding of links between demographics and community values and preferred beach activities, as key components of the social dimension of the beach environment. A mixed method approach was adopted to elucidate users' opinions on beach preferences and community values through a survey carried out in Manly Local Government Area in Sydney Harbour, Australia...
March 13, 2018: Journal of Environmental Management
Erika Obikane, Tomohiro Shinozaki, Daisuke Takagi, Norito Kawakami
BACKGROUND: Childhood abuse is associated with adult suicidal behaviors, partially mediated by mental disorders. However, the direct effect of childhood abuse not mediated by mental disorders is uncertain because the same risk factors serve as mediators and confounders of mental disorders and suicidal behaviors. The aim of the study was to estimate the direct effect of childhood abuse not mediated by mental disorders on suicidal behaviors using marginal structural models. METHODS: We used cross-sectional data of Japanese adults in Tokyo and neighboring prefectures (The Japanese Study on Stratification, Health, Income, and Neighborhood)...
February 22, 2018: Journal of Affective Disorders
Arthur M Lee, Rebecca J Scharf, Mark D DeBoer
OBJECTIVE: The aim of this study was to determine if food insecurity is an independent risk factor for obesity in U.S. children. METHODS: We analyzed data from a nationally representative sample of children participating in the Early Childhood Longitudinal Study-Kindergarten Cohort 2011. Statistical analyses were performed to evaluate longitudinal associations between food security and body mass index (BMI) z-score. All regression models included race/ethnicity, household income, and parental education...
February 5, 2018: Nutrition
Yongjian Xu, Jie Ma, Na Wu, Xiaojing Fan, Tao Zhang, Zhongliang Zhou, Jianmin Gao, Jianping Ren, Gang Chen
INTRODUCTION: In 2009, China officially launched the New Health Care Reform (NHCR). One important purpose of the reform was to reduce financial burden of health care through health insurance expansion and health care provider regulations. This study aimed to provide evidence on the effect of the NHCR reform on catastrophic health expenditure (CHE) by comparing the occurrence and inequality of CHE among households with chronic diseases patients before and after the reform. METHODS: This study used the subset of data from the 2008 and 2013 National Health Services Survey conducted in Shaanxi Province...
2018: PloS One
Waqas Hameed, Bilal Iqbal Avan
INTRODUCTION: Respectful and dignified healthcare is a fundamental right for every woman. However, many women seeking childbirth services, especially those in low-income countries such as Pakistan, are mistreated by their birth attendants. The aim of this epidemiological study was to estimate the prevalence of mistreatment and types of mistreatment among women giving birth in facility- and home-based settings in Pakistan in order to address the lack of empirical evidence on this topic...
2018: PloS One
Anatole Manzi, Jean Claude Mugunga, Hari S Iyer, Hema Magge, Fulgence Nkikabahizi, Lisa R Hirschhorn
BACKGROUND: Integrated management of childhood illness (IMCI) can reduce under-5 morbidity and mortality in low-income settings. A program to strengthen IMCI practices through Mentorship and Enhanced Supervision at Health centers (MESH) was implemented in two rural districts in eastern Rwanda in 2010. METHODS: We estimated cost per improvement in quality of care as measured by the difference in correct diagnosis and correct treatment at baseline and 12 months of MESH...
2018: PloS One
Víviam Vargas Barros, Emérita Sátiro Opaleye, Marcelo Demarzo, Sarah Bowen, Daniela Fernández Curado, Helena Hachul, Ana Regina Noto
INTRODUCTION: Dispositional mindfulness can be described as the mental ability to pay attention to the present moment, non-judgmentally. There is evidence of inverse relation between dispositional mindfulness and insomnia and substance use, but as of yet, no studies evaluating the specific association between dispositional mindfulness and the components of hypnotic use disorder. OBJECTIVE: To evaluate the association between dispositional mindfulness and the components of dependence among female chronic hypnotic users...
2018: PloS One
Biemba Maliti, Patience Mbozi
Cancer care is increasingly complicated worldwide by its management with concurrent acute and chronic illness states. In low- and middle-income countries, including those in sub-Saharan Africa, this results in lower overall survival rates and a higher burden of cancer deaths. A case study is presented to highlight the challenges patients with cancer in Zambia-many of whom are also positive for HIV or AIDS-face in relationship to access to care and comanagement of disease states.
April 1, 2018: Clinical Journal of Oncology Nursing
Kiran T Thakur, Alexandra Boubour, Deanna Saylor, Mitashee Das, David R Bearden, Gretchen L Birbeck
: Neurological conditions associated with HIV remain major contributors to morbidity and mortality and are increasingly recognized in the aging population on long-standing combination antiretroviral therapy (cART). Importantly, growing evidence shows that the CNS may serve as a reservoir for viral replication, which has major implications for HIV eradication strategies. Though there has been major progress in the last decade in our understanding of the pathogenesis, burden, and impact of neurological conditions associated with HIV infection, significant scientific gaps remain...
March 15, 2018: AIDS
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
Eugène Zoumenou, Martin Chobli, Bernard le Polain de Waroux, Philippe Louis Baele
Belgium has been collaborating for 20 years with Abomey-Calavi University in Cotonou, Republic of Benin, to train anesthesiologists for Sub-Saharan, French-speaking African countries. With 123 graduates from 15 countries and 46 residents still in training, this program has succeeded in reversing the trend of a decreasing anesthesiology workforce in those countries, thus improving the quality of anesthesia and patient safety. Belgian government sources, as well as hospitals and anesthesia teams, provided most of the financial resources...
April 2018: Anesthesia and Analgesia
Fauzia A Khan, Alan F Merry
The safety of anesthesia characteristic of high-income countries today is not matched in low-resource settings with poor infrastructure, shortages of anesthesia providers, essential drugs, equipment, and supplies. Health care is delivered through complex systems. Achieving sustainable widespread improvement globally will require an understanding of how to influence such systems. Health outcomes depend not only on a country's income, but also on how resources are allocated, and both vary substantially, between and within countries...
April 2018: Anesthesia and Analgesia
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
Søren Kudsk-Iversen, Naomi Shamambo, M Dylan Bould
The majority of the world's population lacks access to safe, timely, and affordable surgical care. Although there is a health workforce crisis across the board in the poorest countries in the world, anesthesia is disproportionally affected. This article explores some of the key issues that must be tackled to strengthen the anesthesia workforce in low- and lower-middle-income countries. First, we need to increase the overall number of safe anesthesia providers to match a huge burden of disease, particularly in the poorest countries in the world and in remote and rural areas...
April 2018: Anesthesia and Analgesia
C Roger Goucke, Pongparadee Chaudakshetrin
Approximately 80% of the world's population lives in countries with little or no access to pain management. These countries also have 74% of the world's deaths from cancer and human immunodeficiency virus. Appropriate use of oral opioids can control 80%-90% of cancer pain. However, only 6.7% of the world's medical opioids are available in these low-resource countries. With the Lancet Commission on Global Surgery calling for a significant expansion of surgical services, postoperative pain management will need to be an increasing focus of our attention...
April 2018: Anesthesia and Analgesia
Michael Schriver, Vincent Kalumire Cubaka, Peter Vedsted, Innocent Besigye, Per Kallestrup
BACKGROUND: External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. AIM: To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. METHODS: "External supervision: Provider Evaluation of Supervisor Support" (ExPRESS) was developed in 18 steps, primarily in Rwanda...
2018: Global Health Action
Patricio López-Jaramillo, Silvia González-Gómez, Diego Zarate-Bernal, Andrés Serrano, Leonor Atuesta, Christian Clausen, Claudia Castro-Valencia, Paul Camacho-Lopez, Johanna Otero
The simplification of fixed dose medications by using a single 'polypill' is an attractive strategy to improve adherence to medications which has shown benefit to cardiovascular risk factor control and cardiovascular disease prevention or delay in the progression of these diseases. We review the evidence obtained from a series of clinical trials demonstrating an improvement in adherence to the polypill compared to the use of each compound separately, and found similar or better control of the classical cardiovascular risk factors and a similar safety profile...
March 1, 2018: Therapeutic Advances in Cardiovascular Disease
Eric S Zhou, Karen Clark, Christopher J Recklitis, Richard Obenchain, Matthew Loscalzo
PURPOSE: Cancer patients are likely to experience sleep problems. Understanding their perception of sleep problems is important as subjective symptom experience is associated with treatment-seeking behavior. We explored the prevalence of sleep problems and its correlates in a large sample of cancer patients at an important but understudied stage of their cancer journey: prior to initiating treatment. METHODS: Cancer patients (5702) (67.5% female; 76.9% White; 23...
March 15, 2018: International Journal of Behavioral Medicine
Patrick Ip, Winnie Tso, Nirmala Rao, Frederick Ka Wing Ho, Ko Ling Chan, King Wa Fu, Sophia Ling Li, Winnie Goh, Wilfred Hing-Sang Wong, Chun Bong Chow
BACKGROUND: Proper parent-child interaction is crucial for child development, but an assessment tool in Chinese is currently lacking. This study aimed to develop and validate a parent-reported parent-child interaction scale for Chinese preschool children. METHODS: The Chinese parent-child interaction scale (CPCIS) was designed by an expert panel based on the literature and clinical observations in the Chinese context. The initial CPCIS had 14 parent-child interactive activity items...
March 15, 2018: World Journal of Pediatrics: WJP
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